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A longitudinal study of depression in old age II: depression and physical disability

Published online by Cambridge University Press:  13 June 2014

Aideen Freyne ,
Fiona Keogh ,
Maria Kelly  and
Margo Wrigley
Aideen Freyne
Affiliation:
St Vincents University Hospital, Elm Park, Dublin 4, Ireland
Maria Kelly
Affiliation:
Wellington Rd, Dublin 4, Ireland
Margo Wrigley
Affiliation:
Dept of Old Age Psychiatry, Mater Hospital, 61 Eccles St, Dublin 7, Ireland
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Abstract

Objectives: As part of an outcome study of depression in older people, the relationship between physical disability and depression was explored at baseline and longitudinally. The aims were to identify whether illness in specific body systems or physical disability was associated with a poorer outcome of depression.

Method: Subjects over 65 with depression referred to an old age psychiatry service were recruited. Depression was diagnosed according to ICD-10 criteria. An in-depth initial assessment obtained data concerning depression severity and illness in specific body systems as well as disability levels. Objective and subjective ratings of health status were also made. Subjects were followed up at three, six, 12, 18, and 24 months. Ongoing assessments were made of depressive symptomatology and of physical status.

Results: Subjects with higher disability levels had more severe depression at baseline. There was no relationship between illness in specific body systems and depression severity. At follow up assessments, those with higher disability scores had poorer outcomes as recorded by depression rating scales and by reviewing the longitudinal course of depression in terms of proportions remaining well, suffering relapses or remaining depressed.

Conclusions: There is an ongoing relationship between depression and disability. Older people with greater physical disability have a poorer outcome of depression. Service providers should be aware of this relationship and respond rapidly and assertively to depression in older people with disability. There should be a lower threshold for initiating treatment in this population.

Keywords

DepressionOld agePhysical disabilityOutcome
Type
Original Papers
Information
Irish Journal of Psychological Medicine , Volume 22 , Issue 3 , September 2005 , pp. 94 - 100
Copyright
Copyright © Cambridge University Press 2005

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References

1.Gurland, BJ, Wilder, DE, Berkman, C. Depression and disability in the elderly: reciprocal relations and changes with age. Int J Ger Psychiatry 1988; 3: 163–179.CrossRefGoogle Scholar
2.Ormel, J. Synchrony of change in depression and disability, what next? Arch Gen Psychiatry 2000; 48: 700–706.CrossRefGoogle Scholar
3.Berkman, LF, Berkman, CS, Kasl, SVet al.Depressive symptoms in relation to physical health and functioning in the elderly. Am J Epidemiology 1986; 124: 372–388.CrossRefGoogle ScholarPubMed
4.Bowling, A, Farquhar, M. Associations with social networks, social support, health status and psychiatric morbidity in three samples of elderly people. Soc Psych Psych Epidemiology 1991; 26: 115–126.CrossRefGoogle ScholarPubMed
5.Anenshal, CS, Frerichs, RR, Huba, GJ. Depression and physical illness: a multiwave, nonrecursive causal model. J Health Soc Behaviour 1984; 25: 350–371.CrossRefGoogle Scholar
6.Kennedy, GJ, Kelman, HR, Thomas, C. The emergence of depressive symptoms in late life: the importance of declining health and increasing disability. J Community Health. 1990; 15; 93–104.CrossRefGoogle ScholarPubMed
7.Kennedy, GJ, Kelman, HR, Thomas, C. Persistence and remission of depressive symptoms in late life. Am J Psychiatry 1991; 148; 174–178.Google ScholarPubMed
8.Beekman, ATF, Kriegsman, DMW, Deeg, DJHet al.The association of physical health and depressive symptoms in the older population: age and sex differences. Soc Psych Psychiatr Epidemiol 1995; 30, 32–38.CrossRefGoogle ScholarPubMed
9.Prince, MJ, Harwood, RH, Thomas, A, Mann, AH. A prospective population-based cohort study of the effects of disablement and social milieu on the onset and maintenance of late-life depression. The Gospel Oak Project VII. Psychol Med. 1998; 28; 337–350.CrossRefGoogle ScholarPubMed
10.Geerlings, SW, Beekman, ATF, Deeg, et al.Physical health and the onset and persistence of depression in older adults: an eight wave prospective community – based study. Psychol Med 2000; 30; 369–380.CrossRefGoogle ScholarPubMed
11.Murrell, SA, Meeks, S, Walker, J. Protective functions of health and self-esteem against depression in older adults facing illness or bereavement. Psychology and Aging 1991; 6: 352–360.CrossRefGoogle ScholarPubMed
12.Murray, CJL, Lopez, AD. The global burden of disease: a comprehensive assessment of mortality and disability from diseases, injuries and risk factors in 1990 and projected to 2020. Cambridge MA, Harvard University Press, 1996.Google Scholar
13.Gurland, BJ. The impact of depression on quality of life of the elderly. Clin Ger Med 1992; 8: 377–386.Google ScholarPubMed
14.Ormel, J, Oldehinkel, T, Brilman, Eet al.Outcome of depression and anxiety in primary care. A three-wave 31/2-year study of psychopathology and disability. Arch Gen Psychiatry 1993; 50: 759–766.CrossRefGoogle Scholar
15.Ormel, J, Von Korff, M, Ustun, TBet al.Common mental disorders and disability across cultures. JAMA 1994; 272: 1741–1748.CrossRefGoogle ScholarPubMed
16.Ormel, J, Kempen, Gl, Deeg, DJet al.Functioning, well-being and health perception in late middle-aged and older people: comparing the effects of depressive symptoms and chronic conditions. JAGS 1998; 46: 39–48.CrossRefGoogle Scholar
17.Hays, RD, Wells, KB, Sherbourne, et al.Functioning and well-being outcomes of patients with depression compared with chronic general medical illnesses. Arch Gen Psychiatry 1995; 52: 11–19.CrossRefGoogle ScholarPubMed
18.Wells, KB, Stewart, A, Hays, RDet al.The functioning and well-being of depressed patients. Results from the Medical Outcomes Study. JAMA 1989; 262: 914–919.CrossRefGoogle ScholarPubMed
19.Geerlings, SW, Beekman, AT, Deeg, DJ, Twisk, JW, Van Tilburg, W. The longitudinal effect of depression on functional limitations and disability in older adults: and eight wave prospective community based study. Psychol Med 2001; 31, 1361–71.CrossRefGoogle ScholarPubMed
20.Kivela, SL, Pakhala, K. Depressive disorder as a predictor of physical disability in old age. J Am Geriatr Soc 2001; 49, 290–6.CrossRefGoogle ScholarPubMed
21.Penninx, BWJH, Geerlings, SW, Dorly, JHet al.Minor and major depression and the risk of death in older persons. Arch Gen Psychiatry 1999; 56; 889–895.CrossRefGoogle ScholarPubMed
22.Von Korff, M, Ormel, J, Katon, Wet al.Disability and depression among high utilisers of health care. A longitudinal analysis. Arch Gen Psychiatry 1992; 49, 91–100.CrossRefGoogle Scholar
23.Simon, GE, Katon, W, Rutter, Cet al.Impact of improved depression treatment in primary care on daily functioning and disability. Psychol Med 1998; 28: 693–701.CrossRefGoogle ScholarPubMed
24.Oslin, D, Strein, J, Katz, Iet al.Change in disability follows inpatient treatment for late life depression J Am Geriatr Soc 2000; 48: 357–362.CrossRefGoogle ScholarPubMed
25.Lenze, EI, Rogers, JC, Martire, LMet al.The association of late-life depression and anxiety with physical disability. Am J Ger Psychiatry 2001; 9; 113–135.CrossRefGoogle ScholarPubMed
26.Ormel, J, Kempen, GIJM, Penninx, BWJHet al.Chronic medical conditions and mental health in older people: disability and psychosocial resources mediate specific mental health effects. Psychol Med 1997; 27: 1065–1077.CrossRefGoogle ScholarPubMed
27.Bruce, MLThe association between depression and disability Am J Geriatr Psychiatry 1999; 7: 8–11.CrossRefGoogle ScholarPubMed
28.Penninx, BWJH, Beekman, ATF, Ormel, Jet alPsychological status among elderly people with chronic diseases: does type of disease play a part? J Psychosomatic Res 1996; 40: 521–534.CrossRefGoogle ScholarPubMed
29.Oslin, D, Datto, CJ, Kalian, MJet al.Association between medical co morbidity and treatment outcomes in late-life depression. J Am Geriatr Society 2002; 50: 823–828.CrossRefGoogle ScholarPubMed
30.Kinzie, JD, Lewinsohn, P, Maricle, Ret alThe relationship of depression to medical illness in an older community population. Compr Psychiatry 1986; 27: 241–246.CrossRefGoogle Scholar
31.Kennedy, GJ, Kelman, HR, Wisniewsky, et al.Hierarchy of characteristics associated with depressive symptoms in an urban elderly sample. Am J Psychiatry 1989; 46, 220–225.Google Scholar
32.Beekman, ATF, Deeg, DJH, van Tilburg, et al.Major and minor depression in later life: a study of prevalence and risk factors. J Affect Disord 1995; 36, 65–75.CrossRefGoogle ScholarPubMed
33.Beekman, ATF, Deeg, DJH, Braam, AWet al.Consequences of major and minor depression in later life: a study of disability, well being and service utilization. Psychol Med 1997 27; 1065–7CrossRefGoogle ScholarPubMed
34.Hamilton, M. A rating scale for depression. J Neurol Neurosurg Psychiatry 1960; 23: 56–62.CrossRefGoogle ScholarPubMed
35.Yesavage, JA, Brink, TL, Rose, TLet alDevelopment and validation of a geriatric depression scale, J Psychiat Res 1983; 17: 31–49.Google Scholar
36.Folstein, MF, Folstein, SE, McHugh, PR. Mini-mental state: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975; 12: 189–198.CrossRefGoogle Scholar
37.Morgan, K, Dallosso, MM, Ibrahim, SBJ. A brief self-report scale for assessing personal engagement in the elderly: reliability and validity. In: Ageing: Recent advances and creative responses (Butler, A, Ed) Croom Helm, 1985.Google Scholar
38.Burvill, PW, Mowry, B, Hall, W. Quantification of physical illness in psychiatric research in the elderly. Int J Ger Psychiatry 1990; 5; 161–170.CrossRefGoogle Scholar
39.Saunders, PA, Copeland, JRM, Dewey, Met al.The prevalence of dementia, depression and neurosis in later life: the Liverpool MRC-ALPHA study. Int J Epidemiology 1993; 22: 838–847.CrossRefGoogle ScholarPubMed
40.Pattie, AH, Gilleard, CJ. A survey version of the Clifton Assessment Procedure for the Elderly (CAPE). Br J Clin Psychol 1981; 20: 1173–8.CrossRefGoogle ScholarPubMed
41.Freyne, A, Wrigley, M. Prognosis of depression in the elderly. Ir J Psychol Med 1995; 12: 6–11.CrossRefGoogle Scholar
42.Gueorguieva, R, Crystal, J. Move over ANOVA. Progress in analysing repeated-measures data and its reflection in papers published in the Archives of General Psychiatry. Arch Gen Psychiatry 2004; 61: 310–317.CrossRefGoogle Scholar
43.Bush, TL, Miller, SR, Golden, Aet al.Self-report and medical record report agreement of selected medical conditions in the elderly. Am J Public Health 1989; 79: 1554–1556.CrossRefGoogle ScholarPubMed
44.Smith, LA, Branch, LG, Scherr, PAet al.Short-term measures of physical function in older people. J Am Geriatr Soc 1990; 83, 1154–1203.Google Scholar
45.Elam, JT, Graney, MJ, Beaver, Tet al.Comparison of subjective ratings of function with observed functional ability of frail older persons. Am J Public Health 1991; 81, 1127–1130.CrossRefGoogle ScholarPubMed
46.Cole, M. The prognosis of depression in the elderly. Can Med Assoc J 1990; 43; 633–639.Google Scholar
47.Kriegsman, DMW, Penninx, BWJH, van Eijik, JTMet al.Self-reports and general practitioner information on the prevalence of chronic diseases in community dwelling elderly. J Clin Epidemiol 1996; 49: 1407–1417.CrossRefGoogle ScholarPubMed
48.Sinclair, PALyness, JMKing, DAet alDepression and self-reported functional status in older primary care patients. Am J Psychiatry 2001; 158: 416–419.CrossRefGoogle ScholarPubMed
49.Thomas, C, Kelman, H, Kennedy, GCet alDepressive symptoms and mortality in older persons. J Gerontology. 1992; 47: S80–87.CrossRefGoogle Scholar
50.Williamson, GM, Schulz, RPhysical illness and symptoms of depression among elderly outpatients. Psychology and Aging 1992; 7: 343–351.CrossRefGoogle ScholarPubMed
51.Verbrugge, LM, Jette, AMThe disablement process. Soc Sci Med 1994; 38: 1–14.CrossRefGoogle ScholarPubMed
52.Prince, MJ, Harwood, RH, Blizard, RAet alSocial support deficits, loneliness and life events as risk factors for depression in old age. The Gospel Oak Project VI. Psychol Med 1997; 27: 323–332.CrossRefGoogle ScholarPubMed
53.Beekman, ATF, Penninx, BWJH, Deeg, DHGet al.Depression and physical health in later life: results from the Longitudinal Aging Study Amsterdam (LASA). J Affective Disorders 1997; 46; 219–231.CrossRefGoogle ScholarPubMed
54.Kivela, S-L, Kongas-Savario, P, Kimmo, Pet al.Health, health behaviour and functional ability predicting depression in old age: a longitudinal study. Int J Ger Psychiatry 1996; 11; 871–877.3.0.CO;2-6>CrossRefGoogle Scholar