title: Major depression and disability in older primary care patients with heart failure.
abstract: The purpose of this study was to examine the association between dependence in activities of daily living (ADL) and instrumental ADL (IADL) and major depression among 415 community-dwelling primary care patients age 65+ with heart failure and significant ADL or IADL dependence. Main findings include (1) a progressive increase in depression prevalence from 0% for no IADL dependence to about 40% for 6 IADL dependencies (P < .001), (2) a steady rise in depression prevalence to 40% for 6 ADL dependencies following a "floor effect" at about 10% for 0 to 2 ADL dependencies (P < .001), and (3) the association in a logistic regression model of major depression with number of IADL dependencies (P = .016) but not with number of ADL dependencies (P = .602). Our principal conclusion is that the progressively greater likelihood of major depression as the number of IADL dependencies increases has important clinical, personal, social, and public health relevance.
authors.affiliation: Department of Community and Preventive Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York 14642, USA. Bruce_Friedman@urmc.rochester.edu
authors.forename: Bruce
authors.initials: B
authors.lastname: Friedman
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Lyness
authors.forename: Rachel L
authors.initials: RL
authors.lastname: Delavan
authors.lastname: Chunyu Li
authors.forename: William H
authors.initials: WH
authors.lastname: Barker
mesh_terms: D000203:Activities of Daily Living / Q000145:classification / Q000523:psychology*; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D004185:Disability Evaluation; D018450:Disease Progression; D005260:Female; D006333:Heart Failure / Q000453:epidemiology / Q000523:psychology*; D006801:Humans; D016013:Likelihood Functions; D008297:Male; D006278:Medicare; D011320:Primary Health Care; D013223:Statistics as Topic; D014481:United States