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Mild depressive symptoms, self-reported disability, and slowing across multiple functional domains

Published online by Cambridge University Press:  01 August 2011

Steven M. Albert ,
Jane Bear-Lehman  and
Ann Burkhardt
Steven M. Albert*
Affiliation:
Department of Behavioral and Community Health Sciences, University of Pittsburgh, Pittsburgh, USA
Jane Bear-Lehman
Affiliation:
Department of Occupational Therapy, New York University, New York, USA
Ann Burkhardt
Affiliation:
Department of Occupational Therapy, Quinnipiac University, Hamden, Connecticut, USA
*
Correspondence should be addressed to: Steven Albert, PhD, MSPH, Department of Behavioral & Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, Crabtree A211, 130 DeSoto St., Pittsburgh, PA 15261, USA. Phone: +1 412-383-8693; Fax: +1 412-383-5846. Email: smalbert@pitt.edu.
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Abstract

Background: Subthreshold depressive symptoms are common in older adults. The threshold for the clinical significance of such symptoms is unclear. Mechanisms linking depressed mood to increased risk of disability need further investigation.

Methods: Among older adults who did not meet criteria for depression, respondents reporting no anhedonia and dysphoria over the past two weeks were compared to respondents reporting occasional symptoms with respect to self-reported disability and cognitive, psychomotor, and physical performance tests.

Results: Of 312 community-resident participants without dementia, 35.3% (n = 110) reported one or both of the two depressive symptoms at mild severity (no more than “several days” in the past two weeks). Older adults with mild depressive symptoms reported more physician-diagnosed medical conditions (2.2 vs. 1.8, p < 0.01) and mobility problems (3.0 vs. 1.8, 0–7 scale, p < 0.001), and were slower in gait (0.80 vs. 0.73 m/sec, p < 0.01) and speed of cognitive processing (Trail B, 166.1 vs. 184.7 sec, p < 0.001). In regression models that adjusted for sociodemographic and medical status, subthreshold symptoms were not a significant correlate of slowing in gait speed or cognitive performance. However, subthreshold depressive symptoms were associated with self-reported mobility limitation in models that adjusted for observed performance.

Conclusions: Mild depressive symptoms in this sample were not an independent correlate of slowed performance. However, the presence of mild depressive symptoms was associated with poorer appraisal of mobility after adjustment for objective measures of mobility.

Keywords

depressionslowingphysical functioncognitionsubsyndromal
Type
Research Article
Information
International Psychogeriatrics , Volume 24 , Issue 2 , February 2012 , pp. 253 - 260
Copyright
Copyright © International Psychogeriatric Association 2011

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References

Albert, S. M., Bear-Lehman, J., Burkhardt, A., Merete-Roa, B. and Noboa-Lemonier, R. (2006). Variation in sources of clinician- and self-rated IADL disability. Journal of Gerontology: Medical Sciences, 61A, 826–831.Google Scholar
Babyak, M. A. (2004). What you see may not be what you get: a brief, nontechnical introduction to overfitting in regression-type models. Psychosomatic Medicine, 66, 411–421.Google Scholar
Barry, L. C., Allore, H. G., Bruce, M. L. and Gill, T. M. (2009). Longitudinal association between depressive symptoms and disability burden among older persons. Journal of Gerontology: Medical Sciences, 64A, 1325–1332.Google Scholar
Benton, A. L. (1955). The Benton Visual Retention Test. New York: The Psychological Corporation.Google Scholar
Benton, A. L. and Hamsher, K. D. (1976). Multilingual Aphasia Examination. Iowa City, IA: University of Iowa.Google Scholar
Bhalla, R. K. et al. (2009). Patterns of mild cognitive impairment after treatment of depression in the elderly. American Journal of Geriatric Psychiatry, 17, 308–316.Google Scholar
Bushke, H. and Fuld, P. A. (1974). Evaluating storage, retention, and retrieval in disordered memory and learning. Neurology, 24, 1019–1025.CrossRefGoogle Scholar
Castro-Costa, R. et al. (2007). Prevalence of depressive symptoms and syndromes in later life in 10 European countries. British Journal of Psychiatry, 191, 393–401.CrossRefGoogle Scholar
Cronin-Stubbs, D., de Leon, C. F., Beckett, L. A., Field, T. S., Glynn, R. J. and Evans, D. A. (2000). Six-year effect of depressive symptoms on the course of physical disability in community-living older adults. Archives of Internal Medicine, 160, 3074–3080.Google Scholar
Gallo, J. J., Rabins, P. V., Lyketos, C. G., Tien, A. Y. and Anthony, J. C. (1997). Depression without sadness: functional outcomes of nondysphoric depression in later life. Journal of the American Geriatrics Society, 45, 570–578.CrossRefGoogle ScholarPubMed
Goodglass, H. and Kaplan, E. (1983). The Assessment of Aphasia and Related Disorders. Philadephia: Lea & Febiger.Google Scholar
Guralnik, J. M. et al. (1994). A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. Journal of Gerontology, 49, M85–M94.CrossRefGoogle Scholar
Guralnik, J. M., Fried, L. P., Simonsick, E. M., Kasper, J. D. and Lafferty, M. E. (1995). The Women's Health and Aging Study: Health and Social Characteristics of Older Women with Disability. Bethesda, MD: National Institute on Aging, NIH Publ. No. 95-4009.Google Scholar
Hybels, C.-F., Pieper, C. F. and Blazer, D. G. (2009). The complex relationship between depressive symptoms and functional limitations in community-dwelling older adults: the impact of subthreshold depression. Psychological Medicine, 39, 1677–1688.CrossRefGoogle ScholarPubMed
Judd, L. L. and Akiskal, H. S. (2002). The clinical and public health relevance of current research on subthreshold depressive symptoms to elderly patients. American Journal of Geriatric Psychiatry, 10, 233–238.CrossRefGoogle Scholar
Kaplan, E., Goodglass, H. and Weintraub, S. (1983). Boston Naming Test. Philadelphia: Lea & Febiger.Google Scholar
Katon, W. J. et al. (2005). Cost-effectiveness of improving primary care treatment of late life depression. Archives of General Psychiatry, 62, 1313–1320.CrossRefGoogle ScholarPubMed
Kroenke, K., Spitzer, R. L. and Williams, J. B. W. (2003). The Patient Health Questionnaire-2: validity of a two-item depression screener. Medical Care, 41, 1284–1292.Google Scholar
Lyness, J. M. et al. (2006). Outcomes of minor and subsyndromal depression among elderly patients in primary care settings. Annals of Internal Medicine, 44, 496–504.CrossRefGoogle Scholar
Lyness, J. M. et al. (2007). The clinical significance of subsyndromal depression in older primary care patients. American Journal of Geriatric Psychiatry, 15, 214–223.Google Scholar
Manly, J. J., Bell-McGinty, S., Tang, M.-X., Schupf, N., Stern, Y. and Mayeux, R. (2005). Implementing diagnostic criteria and estimating frequency of mild cognitive impairment in an urban community. Archives of Neurology, 62, 1739–1746.CrossRefGoogle Scholar
McKhann, G., Drachman, D., Folstein, M., Katzman, R., Price, D. and Stadlan, E. M. (1984). Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer's Disease. Neurology, 34, 939–944.Google Scholar
Meeks, T. W., Vahia, I. V., Lavretsky, H., Kulkarni, G. and Jeste, D. V. (2011). A tune in “a minor” can “b major”: a review of the epidemiology, illness course, and public health implications of subthreshold depression in older adults. Journal of Affective Disorders, 129, 126–142.CrossRefGoogle Scholar
Moberg, E. (1958). Objective methods for determining the functional value of sensibility in the hand. Journal of Bone and Joint Surgery, 40B, 454–476.Google Scholar
Penninx, B. W. J. H., Guralnik, J. M., Ferrucci, L., Simonsick, E. M., Deeg, D. J. H. and Wallace, R. B. (1998). Depressive symptoms and physical decline in community-dwelling older persons. JAMA, 279, 1720–1726.CrossRefGoogle ScholarPubMed
Reitan, R. M. (1958). Validity of the Trail Making test as an indicator of organic brain damage. Perceptual and Motor Skills, 8, 271–276.CrossRefGoogle Scholar
Rogers, J. C. et al. (2010). Disability in late-life major depression: patterns of self-reported task abilities, task habits, and observed task performance. Psychiatry Research, 178, 475–479.CrossRefGoogle ScholarPubMed
Royston, P., Altman, D. G. and Sauerbrei, W. (2006). Dichotomizing continuous predictors in multiple regression: a bad idea. Statistics in Medicine, 25, 127–141.Google Scholar
Spitzer, R. L., Kroenke, K. and Williams, J. B. W. (1999). Validation and utility of a self-report version of PRIME-MD: the PHQ primary care study. JAMA, 282, 1737–1744.CrossRefGoogle ScholarPubMed
Tinetti, M. E., Richman, D. and Powell, L. (1990). Falls efficacy as a measure of fear of falling. Journal of Gerontology, 45, P239–43.Google Scholar
van't Veer-Tazelaar, P. J. et al. (2009). Stepped-care prevention of anxiety and depression in late life. Archives of General Psychiatry, 66: 297–304.CrossRefGoogle ScholarPubMed
Yen, Y. H., Rebok, G. W., Gallo, J. J., Jones, R. N. and Tennstadt, S. L. (2011). Depressive symptoms impair everyday problem-solving ability through cognitive abilities in late life. American Journal of Geriatric Psychiatry, 19, 142–150.CrossRefGoogle ScholarPubMed