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Change in disability follows inpatient treatment for late life depression
D W Oslin1, J Streim, I R Katz
1Section of Geriatric Psychiatry and the Center for the Study of Addictions, University of Pennsylvania, Philadelphia VA Medical Center, 19104, USA.
Objectives:
The objective of this study was to examine the relationship between functional disability and improvement in late life depression after acute inpatient treatment.
Design:
The study was a longitudinal assessment of depression and disability. Patients were assessed during an initial inpatient hospitalization and then 3 months postdischarge.
Setting:
All patients were evaluated initially after admission to one of 71 inpatient psychiatric treatment facilities.
Participants:
The study comprised of 2572 patients older than age 60 who were relatively cognitively intact and experiencing significant depressive symptoms.
Measurements:
Depressive symptoms were measured using the Geriatric Depression Scale. Disability was measured using the Instrumental Activities of Daily Living Scale and the Medical Outcomes SF-36.
Results:
Depressive symptoms improved in the majority of patients. Moreover, improvement in depressive symptomatology was significantly related to improvement in instrumental activities of daily living (IADLs) and to health-related quality of life as measured by the SF-36. This relationship was strongest among those who initially presented with some disability in IADLs.
Conclusions:
This work underscores further the disabling nature of depression. Moreover, findings from this study suggest that treatment focused on depression can lead to significant improvements in both depressive symptoms and functional abilities. However, the results also suggest that the relationship between depression and disability is complex and that the effect of treating depression is not the only factor in the reversal of disability.