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Disability in geriatric depression

G S Alexopoulos1, C Vrontou, T Kakuma

  • 1Cornell University Medical College, White Plains, N.Y. USA.

The American Journal of Psychiatry
|July 1, 1996
PubMed
Summary
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Disability in elderly patients with depression is linked to depressive symptoms like anxiety and weight loss, and cognitive issues. Addressing these may improve geriatric depression outcomes.

Area of Science:

  • Geriatric Psychiatry
  • Clinical Psychology
  • Health Services Research

Background:

  • Depression in the elderly is a significant health concern.
  • Understanding disability's relationship to clinical measures is crucial for effective treatment.
  • Cognitive function varies widely in depressed elderly populations.

Purpose of the Study:

  • To examine the connection between disability and clinical psychiatric measures in elderly patients with major depression.
  • To identify specific depressive symptoms and clinical factors associated with different types of disability.

Main Methods:

  • Assessed disability using the Philadelphia Multilevel Assessment Instrument in 75 elderly inpatients and outpatients with major depression.
  • Evaluated depression severity, age at onset, chronicity, cognitive impairment, medical burden, social support, and living environment using standardized instruments.

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Main Results:

  • Impairment in instrumental activities of daily living correlated with older age, depression severity, and medical burden.
  • Depressive symptoms such as anxiety, depressive ideation, retardation, and weight loss were significantly linked to instrumental activities of daily living impairment.
  • Global disability was associated with late age at depression onset, medical burden, and cognitive impairment, particularly disturbances in initiation and perseveration.

Conclusions:

  • Instrumental activities of daily living impairment is a distinct health status dimension related to specific depressive symptoms in the elderly.
  • Global disability in geriatric depression may be influenced by cognitive factors and late-onset depression.
  • Findings suggest psychotherapy for depressive ideation and rehabilitation for instrumental activities of daily living could enhance geriatric depression outcomes.