Late life depression and incident activity limitations: Influence of gender and symptom severity

Background: Mental disorders, especially depression, are one of the principal causes of disablement. Previous research has been limited partly due to the failure to take into account sub-syndromal states and the very large number of candidate mediating and confounding factors.. Methods: Longitudinal associations between baseline depressive symptomatology and activity limitations were examined in a community-dwelling elderly cohort of 3191 participants. Mixed logistic models were used to determine associations between mild or severe depressive symptoms (Center for Epidemiologic Studies-Depression Scale, CES-D), and 7-year incident disability on four limitation scales assessing instrumental and basic activities of daily living, mobility using the Rosow and Breslau scale, and social restriction. Results: In men, mild depressive symptomatology was associated with increased incident limitations on instrumental activities of daily living (IADL) (odds ratio (OR) (95% CI) = 5.07 (2.25-11.42)). In women, severe depressive symptomatology was related to social restriction (OR (95% CI) = 2.36 (1.31-4.25)), IADL (OR (95% CI) = 1.89 (1.13-3.15)) and activities of daily living (OR (95% CI) = 11.15 (3.43-36.23)). Men and women with a 2-year increase in CES-D score were highly at risk for social restriction and limitations in mobility and IADL Conclusion: Depression is an independent predictor of disability in the elderly population: the relation is gender-dependent and varies with symptom load. (C) 2011 Elsevier B.V. All rights reserved.