|
|
|
|
|
Dorothy Dunlop, PhD1, Larry Manheim, PhD1, Jing Song, MS1, John Lyons, PhD2, and Rowland W. Chang, MD, MPH3. (1) IHSRPS, Northwestern University, Wieboldt 7th Floor, 339 East Chicago Avenue, Chicago, IL 60611, 312-503-1622, ddunlop@northwestern.edu, (2) Institute for Health Services Research and Policy Studies, Northwestern University, 339 East Chicago Avenue, Suite 705, Chicago, IL 60611, (3) Northwestern University Medical School, 680 North Lake Shore Drive, Suite 1102, Chicago, IL 60611
Objectives. This study estimated the effect of depression on the development of functional limitation in a national sample and evaluated the risk by race. This study investigates factors amendable to clinical and public health intervention that may mediate the relationship between depression and incident functional limitation.
Methods. The two-year risk of incident functional limitation in activities of daily living (ADL) among people with and without depression is estimated from 6871 adults (aged 54-65) participating in the1996-1998 Health and Retirement Survey who reported no baseline (1996) ADL limitations. Depression is ascertained from standardized assessment using Composite International Diagnostic Interview short form.
Results. The odds of developing ADL limitations over two years were 4.3 times greater (95% confidence interval: 3.1, 6.0) for pre-retirement adults with depression than their non-depressed peers. Almost 1 in 5 depressed African Americans (18.7%) developed ADL limitations compared to only 5.0% of their non-depressed peers. Depression among Hispanics almost doubled the two-year rate of ADL onset (7.8% versus 4.2%) and increased the rate four times among Whites (8.0% versus 1.9%) compared to non-depressed peers. Chronic conditions and physical limitations are associated with increased rates of ADL limitation and mediate the risk associated with depression.
Conclusions. Depression substantially elevates the risk of developing ADL limitations among adults, a risk mediated by greater health burdens, factors amendable to public policy intervention. More effective treatment, and/or public health/policy programs that increase mental health and medical care access could reduce the development of function limitations among depressed adults.
Learning Objectives:
Keywords: Depression, Disability
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.