Depression and Physical Function: Results From the Aging and Longevity Study in the Sirente Geographic Area (ilSIRENTE Study)

Abstract

Depression in older persons represents a major issue because of its relevant prevalence and the associated higher risk of adverse health-related events. The aim of this study was to evaluate the relationship of depressive symptoms with measures of physical performance, muscle strength, and functional status. Data are from baseline evaluation of the ilSIRENTE Study (n = 364). Physical performance was assessed using the Short Physical Performance Battery and the 4-meter walking test. Muscle strength was measured by hand-grip strength. Functional performance was assessed using Basic and Instrumental Activities of Daily Living. Depression was defined by analyzing the different depressive manifestations included in the Minimum Data Set for Home Care Form: verbal expression of sad and/or anxious mood and demonstrated signs of mental distress. Analyses of covariance and linear regressions were performed to evaluate the relationship between depression and physical function. Participants with depression showed significantly worse results in all of the physical function tests. Subjects with depression presented significantly lower adjusted mean results for the 4-meter walking test (0.41 m/s; SE, 0.03) and the Short Physical Performance Battery score (5.68; SE, 0.38) compared with those without depression (0.50 m/s; SE, 0.01 and 6.93; SE, 0.21; all P < .01, respectively). Participants with depressed mood also presented a higher number of impaired instrumental activities of daily living (3.69; SE, 0.25) compared with participants with less than 3 depressive symptoms (2.85; SE, 0.14; P = .005). No significant difference was reported for the hand-grip strength and the Basic Activities of Daily Living scale. In conclusion, physical performance and functional status measures are significantly and negatively influenced by the presence of depression in community-dwelling older persons aged 80 years and older. (J Geriatr Psychiatry Neurol 2007;20:131-137)

Keywords

geriatrics functional status depression clinical epidemiology

Get full access to this article

View all access options for this article.

References

Kessler RC , Berglund P. , Demler O. , et al. The epidemiology of major depressive disorder: results from the National Comorbidity Survey Replication (NCS-R). JAMA 2003;289:3095-3105.

Blazer DG Depression in late life: review and commentary. J Gerontol A Biol Sci Med Sci 2003;58:249-265.

Onder G. , Penninx BW , Landi F. , et al. Depression and adverse drug reactions among hospitalized older adults. Arch Intern Med 2003;163:301-305.

Landi F. , Onder G. , Cesari M. , Russo A. , Barillaro C. , Bernabei R. Pain and its relation to depressive symptoms in frail older people living in the community: an observational study. J Pain Symptom Manage 2005;29:255-262.

Onder G. , Penninx BW , Cesari M. , et al. Anemia is associated with depression in older adults: results from the InCHIANTI study. J Gerontol A Biol Sci Med Sci 2005;60:1168-1172.

Unutzer J. , Patrick DL , Simon G. , et al. Depressive symptoms and the cost of health services in HMO patients aged 65 years and older: a 4-year prospective study. JAMA 1997;277:1618-1623.

Guralnik JM , Simonsick EM , Ferrucci L. , et al. A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. J Gerontol A Biol Sci Med Sci 1994;49:M85-M94.

Guralnik JM , Branch LG , Cummings SR , Curb JD Physical performance measures in aging research. J Gerontol 1989;44:M141-M146.

Guralnik JM , Ferrucci L. , Simonsick EM , Salive ME , Wallace RB Lower-extremity function in persons over the age of 70 years as a predictor of subsequent disability. N Engl J Med 1995 ; 332:556-561.

10.

Applegate WB , Blass JP , Williams TF Instruments for the functional assessment of older patients. N Engl J Med 1990;322:1207-1214.

11.

Bruce ML , Seeman TE , Merrill SS , Blazer DG The impact of depressive symptomatology on physical disability: MacArthur Studies of Successful Aging. Am J Public Health 1994;84: 1796-1799.

12.

Landi F. , Russo A. , Cesari M. , et al. The ilSIRENTE study: a prospective cohort study on persons aged 80 years and older living in a mountain community of Central Italy. Aging Clin Exp Res 2005;17:486-493.

13.

Landi F. , Sgadari A. , Cipriani L. , et al. A simple program to train case managers in community elderly care. Aging Clin Exp Res 1996; 8:211-218.

14.

Morris JN , Fries BE , Bernabei R. , et al. RAI-Home Care Assessment Manual. Washington, DC: InterRAI Corp, 1996.

15.

Morris JN , Fries BE , Steel K. , et al. Comprehensive clinical assessment in community setting: applicability of the MDS-HC. J Am Geriatr Soc 1997;45:1017-1024.

16.

Hawes C. , Morris JN , Phillips CD , Mor V. , Fries BE , Nonemaker S. Reliability estimates for the Minimum Data Set for nursing home resident assessment and care screening (MDS). Gerontologist 1995 ; 35:172-178.

17.

Landi F. , Tua E. , Onder G. , et al. Minimum data set for home care: a valid instrument to assess frail older people living in the community. Med Care 2000;38:1184-1190.

18.

Ferrucci L. , Bandinelli S. , Benvenuti E. , et al. Subsystems contributing to the decline in ability to walk: bridging the gap between epidemiology and geriatric practice in the InCHIANTI study. J Am Geriatr Soc 2000 ;48:1618-1625.

19.

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington, DC: American Psychiatric Association, 1994.

20.

Onder G. , Landi F. , Gambassi G. , et al. Association between pain and depression among older adults in Europe: results from the Aged in Home Care (AdHOC) project: a cross-sectional study. J Clin Psychiatry 2005;66:982-988.

21.

Guralnik JM , Ferrucci L. , Pieper CF , et al. Lower extremity function and subsequent disability: consistency across studies, predictive models, and value of gait speed alone compared with the Short Physical Performance Battery. J Gerontol A Biol Sci Med Sci 2000;55A:M221-M231.

22.

Cesari M. , Onder G. , Russo A. , et al. Comorbidity and physical function: results from the aging and longevity study in the Sirente geographic area (ilSIRENTE study). Gerontology 2006;52:24-32.

23.

Rantanen T. , Guralnik JM , Foley D. , et al. Midlife hand grip strength as a predictor of old age disability. JAMA 1999;281:558-560.

24.

Brach JS , VanSwearingen JM , Newman AB , Kriska AM Identifying early decline of physical function in communitydwelling older women: performance-based and self-report measures. Phys Ther 2002;82:320-328.

25.

Penninx BW , Guralnik JM , Ferrucci L. , Simonsick EM , Deeg DJ , Wallace RB Depressive symptoms and physical decline in community-dwelling older persons . JAMA 1998;279:1720-1726.

26.

Penninx BW , Leveille S. , Ferrucci L. , van Eijk JT , Guralnik JM Exploring the effect of depression on physical disability: longitudinal evidence from the established populations for epidemiologic studies of the elderly . Am J Public Health 1999;89:1346-1352.

27.

Von Korff M. , Ormel J. , Katon W. , Lin EH Disability and depression among high utilizers of health care: a longitudinal analysis. Arch Gen Psychiatry 1992;49:91-100.

28.

Penninx BW , Deeg DJ , van Eijk JT , Beekman AT , Guralnik JM Changes in depression and physical decline in older adults: a longitudinal perspective. J Affect Disord 2000;61:1-12.

29.

Russo A. , Onder G. , Cesari M. , et al. Lifetime occupation and physical function: a prospective cohort study on persons aged 80 years and older living in a community. Occup Environ Med 2006;63:438-442.

30.