Depressive Symptoms and Physical Decline in Community-Dwelling Older Persons

Abstract

Context.-Significant symptoms of depression are common in the older community-dwelling population. Although depressive symptoms and disability may commonly occur in the same person, whether depressive symptoms contribute to subsequent functional decline has not been elucidated.Objective.-To determine whether depressive symptoms in older persons increase the risk of subsequent decline in physical function as measured by objective performance-based tests.Design.-A 4-year prospective cohort study. Setting.-The communities of Iowa and Washington counties, Iowa. Participants.-A total of 1286 persons aged 71 years and older who completed a short battery of physical performance tests in 1988 and again 4 years later. Main Outcome Measures.-Baseline depressive symptoms were assessed by the Center for Epidemiological Studies Depression Scale. Physical performance tests included an assessment of standing balance, a timed 2.4-m (8-ft) walk, and a timed test of 5 repetitions of rising from a chair and sitting down.Results.-After adjustment for baseline performance score, health status, and sociodemographic factors, increasing levels of depressive symptoms were predictive of greater decline in physical performance over 4 years (odds ratio for decline in those with depressed mood vs those without, 1.55; 95% confidence interval [CI], 1.02-2.34). Even among those at the high end of the functional spectrum, who reported no disability, the severity of depressive symptoms predicted subsequent decline in physical performance (odds ratio for decline, 1.03; 95% CI, 1.00-1.08).Conclusions.-This study provides evidence that older persons who report depressive symptoms are at higher risk of subsequent physical decline. These results suggest that prevention or reduction of depressed mood could play a role in reducing functional decline in older persons.

The impact of chronic low back pain on older adults: A comparative study of patients and controls

“…This is an important finding, given that psychosocial function can cause progressive physical decline and have a devastating impact on older adults (Pennix et al, 1998;Hebert et al, 1999;Sarkisian et al, 2000). Scores on the Geriatric Depression Screen (GDS) uniquely maximized the separation between our two study groups.…”

Hypercortisolemic depression is associated with the metabolic syndrome in late-life

“…Analyses were performed with both the continuous CES-D score (referred to as depressive symptoms) as well as a dichotomous indicator for clinically relevant depressed mood (CES-D≥20; referred to as depressed mood). Normally, a cutoff score of 16 on the CES-D is considered to represent clinically relevant depression; however, previous studies have demonstrated that a cutoff of 20 on the CES-D avoids overestimation in older adult populations (Penninx et al, 1998a;Penninx et al, 1998b;Penninx et al, 1998c).…”

Workers' perceptions of how jobs affect health: A social ecological perspective.

“…Thus, it seems likely that self-reported effects of job on health are measuring a slightly different construct than job satisfaction. relationship between physical and mental health (Cohen & Rodriguez, 1995;Patrick & Erickson, 1993;Ryff & Singer, 1998;Salovey, Rothman, Detweiler, & Steward, 2000), with longitudinal studies finding that mental health predicts subsequent physical health outcomes (Fiscella & Franks, 1997;Levanthal, Hansell, Diefenbach, Leventhal, & Glass, 1996;Penninx et al, 1998) and physical illness predicts psychological well-being (Berkman et al, 1986;Wickrama, Lorenz, Conger, Matthews, & Elder, 1997). Thus, the effects of work on mental and physical health are also likely to be inextricably linked.…”