Depressive symptoms in middle age and the development of later-life functional limitations: the long-term effect of depressive symptoms.

TitleDepressive symptoms in middle age and the development of later-life functional limitations: the long-term effect of depressive symptoms.
Publication TypeJournal Article
Year of Publication2010
AuthorsCovinsky, KE, Yaffe, K, Lindquist, K, Cherkasova, E, Yelin, E, Blazer, DG
JournalJ Am Geriatr Soc
Volume58
Issue3
Pagination551-6
Date Published2010 Mar
ISSN Number1532-5415
KeywordsActivities of Daily Living, depression, Female, Humans, Kaplan-Meier Estimate, Male, Middle Aged, Mobility Limitation, Proportional Hazards Models, Prospective Studies, Risk Factors, United States
Abstract

<p><b>OBJECTIVES: </b>To determine whether middle-aged persons with depressive symptoms are at higher risk for developing activity of daily living (ADL) and mobility limitations as they advance into older age than those without.</p><p><b>DESIGN: </b>Prospective cohort study.</p><p><b>SETTING: </b>The Health and Retirement Study (HRS), a nationally representative sample of people aged 50 to 61.</p><p><b>PARTICIPANTS: </b>Seven thousand two hundred seven community living participants in the 1992 wave of the HRS.</p><p><b>MEASUREMENTS: </b>Depressive symptoms were measured using the 11-item Center for Epidemiologic Studies Depression Scale (CES-D 11), with scores of 9 or more (out of 33) classified as significant depressive symptoms. Difficulty with five ADLs and basic mobility tasks (walking several blocks or up one flight of stairs) was measured every 2 years through 2006. The primary outcome was persistent difficulty with ADLs or mobility, defined as difficulty in two consecutive waves.</p><p><b>RESULTS: </b>Eight hundred eighty-seven (12%) subjects scored 9 or higher on the CES-D 11 and were classified as having significant depressive symptoms. Over 12 years of follow-up, subjects with depressive symptoms were more likely to reach the primary outcome measure of persistent difficulty with mobility or difficulty with ADL function (45% vs 23%, Cox hazard ratio (HR)=2.33, 95% confidence interval (CI)=2.06-2.63). After adjusting for age, sex, measures of socioeconomic status, comorbid conditions, high body mass index, smoking, exercise, difficulty jogging 1 mile, and difficulty climbing several flights of stairs, the risk was attenuated but still statistically significant (Cox HR=1.44, 95% CI=1.25-1.66).</p><p><b>CONCLUSION: </b>Depressive symptoms independently predict the development of persistent limitations in ADLs and mobility as middle-aged persons advance into later life. Middle-aged persons with depressive symptoms may be at greater risk for losing their functional independence as they age.</p>

DOI10.1111/j.1532-5415.2010.02723.x
User Guide Notes

http://www.ncbi.nlm.nih.gov/pubmed/20163486?dopt=Abstract

Endnote Keywords

Mobility/Older Adults/Middle Aged/Depression/Activities Of Daily Living/Geriatrics/Functional Assessment/Aging/FUNCTIONAL loss in older people/disability/disability/functional status/outcomes

Endnote ID

22810

Alternate JournalJ Am Geriatr Soc
Citation Key7468
PubMed ID20163486
PubMed Central IDPMC2904810
Grant ListP60 AR053308 / AR / NIAMS NIH HHS / United States
R01 AG028481-02S1 / AG / NIA NIH HHS / United States
R01 MH086498 / MH / NIMH NIH HHS / United States
R01 AG028481-03 / AG / NIA NIH HHS / United States
P60 AR053308-050003 / AR / NIAMS NIH HHS / United States
K24AG029812 / AG / NIA NIH HHS / United States
R01AG028481 / AG / NIA NIH HHS / United States
R01 AG028481-02 / AG / NIA NIH HHS / United States
K24 AG029812-03 / AG / NIA NIH HHS / United States
K24 AG029812 / AG / NIA NIH HHS / United States
R01 AG028481 / AG / NIA NIH HHS / United States