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The impact of late-life depression on functional limitations.
Collard, R.M., Wassink-Vossen, S., Schene, A.H., Naarding, P., Verhaak, P., Oude Voshaar, R.C., Comijs, H. The impact of late-life depression on functional limitations. Journal of Advanced Nursing: 2016, 72(suppl. 1), p. 62. Abstract. 5th European Nursing Congress: 'Caring for older people: how can we do the right things right?' 4-7 oktober 2016, Rotterdam.
Background
Both depression and increasing age are associated with functional decline. Measures of functional decline can provide insight in the total impact of diseases, such as depression, on individuals.
Introduction
By older persons themselves, functional limitations are usually regarded as more important than reduction of disease symptoms. This is one of the reasons why functional decline is increasingly recognized as an important outcome measure in studies on (late-life) depression. However, research into the longitudinal association between late-life depression and functional decline is scarce.
Aim
This study aims to examine the course of functional decline in clinically depressed older persons. The following research questions will be answered: Does the course of functional decline differ between patients remitted from depression after 2 years and patients (still) depressed after 2 years of follow up? Does severity of depression predict functional decline (overall and in specific domains of functioning) in depressed older persons over 2 years?
Methods
A cohort study (N = 378) of depressed older persons aged = 60 years with depressive symptoms monitoring and functional limitations monitoring every 6 months, and a diagnostic follow-up at 2 years (n = 285). Functional limitations (outcome) were assessed with the WHODAS questionnaire. Total scores and domain scores were used. Depression (predictor) was classified according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria. Severity of depression (predictor) was assessed with the sum score as well as subscale scores of the Inventory of Depressive Symptomatology (IDS). Results: Linear mixed models showed that non-remission of depression (diagnosis) after 2 years predicted an adverse course of functional decline (P = .003). Severity of depression was associated with lower functioning over 2 years (P < .001). The following specific domains of functioning were at risk of a declining course when severity of depression increased: domain 4 (Getting along with people, P = .01) and domain 6 (Participation in society, P = .032). Zooming in on subscales of depressive symptoms, only motivational symptoms of depression predicted an adverse course of functional decline over 2 years (P = .004).
Conclusions
The negative impact of depression on functional limitations points to the potential importance of incorporating multifacetted, nurse-led interventions in the treatment of late-life depression. Further understanding of the mediating mechanisms underlying the association between depression and functional limitations may further guide the development of these interventions.
Both depression and increasing age are associated with functional decline. Measures of functional decline can provide insight in the total impact of diseases, such as depression, on individuals.
Introduction
By older persons themselves, functional limitations are usually regarded as more important than reduction of disease symptoms. This is one of the reasons why functional decline is increasingly recognized as an important outcome measure in studies on (late-life) depression. However, research into the longitudinal association between late-life depression and functional decline is scarce.
Aim
This study aims to examine the course of functional decline in clinically depressed older persons. The following research questions will be answered: Does the course of functional decline differ between patients remitted from depression after 2 years and patients (still) depressed after 2 years of follow up? Does severity of depression predict functional decline (overall and in specific domains of functioning) in depressed older persons over 2 years?
Methods
A cohort study (N = 378) of depressed older persons aged = 60 years with depressive symptoms monitoring and functional limitations monitoring every 6 months, and a diagnostic follow-up at 2 years (n = 285). Functional limitations (outcome) were assessed with the WHODAS questionnaire. Total scores and domain scores were used. Depression (predictor) was classified according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria. Severity of depression (predictor) was assessed with the sum score as well as subscale scores of the Inventory of Depressive Symptomatology (IDS). Results: Linear mixed models showed that non-remission of depression (diagnosis) after 2 years predicted an adverse course of functional decline (P = .003). Severity of depression was associated with lower functioning over 2 years (P < .001). The following specific domains of functioning were at risk of a declining course when severity of depression increased: domain 4 (Getting along with people, P = .01) and domain 6 (Participation in society, P = .032). Zooming in on subscales of depressive symptoms, only motivational symptoms of depression predicted an adverse course of functional decline over 2 years (P = .004).
Conclusions
The negative impact of depression on functional limitations points to the potential importance of incorporating multifacetted, nurse-led interventions in the treatment of late-life depression. Further understanding of the mediating mechanisms underlying the association between depression and functional limitations may further guide the development of these interventions.
Background
Both depression and increasing age are associated with functional decline. Measures of functional decline can provide insight in the total impact of diseases, such as depression, on individuals.
Introduction
By older persons themselves, functional limitations are usually regarded as more important than reduction of disease symptoms. This is one of the reasons why functional decline is increasingly recognized as an important outcome measure in studies on (late-life) depression. However, research into the longitudinal association between late-life depression and functional decline is scarce.
Aim
This study aims to examine the course of functional decline in clinically depressed older persons. The following research questions will be answered: Does the course of functional decline differ between patients remitted from depression after 2 years and patients (still) depressed after 2 years of follow up? Does severity of depression predict functional decline (overall and in specific domains of functioning) in depressed older persons over 2 years?
Methods
A cohort study (N = 378) of depressed older persons aged = 60 years with depressive symptoms monitoring and functional limitations monitoring every 6 months, and a diagnostic follow-up at 2 years (n = 285). Functional limitations (outcome) were assessed with the WHODAS questionnaire. Total scores and domain scores were used. Depression (predictor) was classified according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria. Severity of depression (predictor) was assessed with the sum score as well as subscale scores of the Inventory of Depressive Symptomatology (IDS). Results: Linear mixed models showed that non-remission of depression (diagnosis) after 2 years predicted an adverse course of functional decline (P = .003). Severity of depression was associated with lower functioning over 2 years (P < .001). The following specific domains of functioning were at risk of a declining course when severity of depression increased: domain 4 (Getting along with people, P = .01) and domain 6 (Participation in society, P = .032). Zooming in on subscales of depressive symptoms, only motivational symptoms of depression predicted an adverse course of functional decline over 2 years (P = .004).
Conclusions
The negative impact of depression on functional limitations points to the potential importance of incorporating multifacetted, nurse-led interventions in the treatment of late-life depression. Further understanding of the mediating mechanisms underlying the association between depression and functional limitations may further guide the development of these interventions.
Both depression and increasing age are associated with functional decline. Measures of functional decline can provide insight in the total impact of diseases, such as depression, on individuals.
Introduction
By older persons themselves, functional limitations are usually regarded as more important than reduction of disease symptoms. This is one of the reasons why functional decline is increasingly recognized as an important outcome measure in studies on (late-life) depression. However, research into the longitudinal association between late-life depression and functional decline is scarce.
Aim
This study aims to examine the course of functional decline in clinically depressed older persons. The following research questions will be answered: Does the course of functional decline differ between patients remitted from depression after 2 years and patients (still) depressed after 2 years of follow up? Does severity of depression predict functional decline (overall and in specific domains of functioning) in depressed older persons over 2 years?
Methods
A cohort study (N = 378) of depressed older persons aged = 60 years with depressive symptoms monitoring and functional limitations monitoring every 6 months, and a diagnostic follow-up at 2 years (n = 285). Functional limitations (outcome) were assessed with the WHODAS questionnaire. Total scores and domain scores were used. Depression (predictor) was classified according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria. Severity of depression (predictor) was assessed with the sum score as well as subscale scores of the Inventory of Depressive Symptomatology (IDS). Results: Linear mixed models showed that non-remission of depression (diagnosis) after 2 years predicted an adverse course of functional decline (P = .003). Severity of depression was associated with lower functioning over 2 years (P < .001). The following specific domains of functioning were at risk of a declining course when severity of depression increased: domain 4 (Getting along with people, P = .01) and domain 6 (Participation in society, P = .032). Zooming in on subscales of depressive symptoms, only motivational symptoms of depression predicted an adverse course of functional decline over 2 years (P = .004).
Conclusions
The negative impact of depression on functional limitations points to the potential importance of incorporating multifacetted, nurse-led interventions in the treatment of late-life depression. Further understanding of the mediating mechanisms underlying the association between depression and functional limitations may further guide the development of these interventions.