title: Depression, functional status, treatment for psychiatric problems, and the health-related practices of elderly HMO members.
abstract: OBJECTIVE
  To study relationships between depression, functional limitations, psychiatric treatment, and the health-related practices of elderly individuals.
  
  
  METHODS
  Cross-sectional, observational study based on survey data (response rate = 90%) analyzed using multiple linear and logistic regression models.
  
  
  METHODS
  Kaiser Permanente Northwest, a large nonprofit HMO.
  
  
  METHODS
  Medicare members (4615) aged 65-103 years who responded to a health status survey.
  
  
  METHODS
  Depression, health and functional status, frequency of alcohol consumption, smoking status, advance medical directive completion, influenza or pneumonia vaccinations, mammograms, recent psychiatric treatment, and attempts to lose weight or increase exercise.
  
  
  RESULTS
  Self-reported depression was related to a greater risk of smoking (odds ratio [OR] = 1.54). Health-related functional limitations were related to fewer attempts to change health behaviors and less preventive service use (significant ORs ranged from 0.84 to 0.94). Minority group membership and Supplemental Security Income were negatively associated with better health practices and with completing advance medical directives (ORs 0.41 and 0.79, respectively). Falls in the prior year, more prescription medications, and psychiatric treatment were positively associated with better health practices (significant ORs ranged from 1.12 to 1.88).
  
  
  CONCLUSIONS
  Depression and smoking are associated among elderly individuals, as are psychiatric treatment and attempts to lose weight. Those with functional limitations, minority status, or Supplemental Security Income use fewer preventive services; the latter two groups are less likely to complete advance medical directives. Older adults with these characteristics might need assistance in improving health-related practices.
authors.affiliation: Oregon Health & Science University, Portland, Oregon, USA. carla.a.green@kpchr.org
authors.forename: Carla A
authors.initials: CA
authors.lastname: Green
authors.forename: Michael R
authors.initials: MR
authors.lastname: Polen
authors.forename: Kathleen K
authors.initials: KK
authors.lastname: Brody
mesh_terms: D000223:Adaptation, Psychological; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D003863:Depression; D005260:Female; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006279:Health Maintenance Organizations; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008603:Mental Health; D015999:Multivariate Analysis; D016017:Odds Ratio; D011594:Psychometrics; D012309:Risk-Taking; D011795:Surveys and Questionnaires