title: Use of the late-life function and disability instrument to assess disability in major depression.
abstract: OBJECTIVE
  To determine whether there was greater disability in subjects with depression than in those without, the correlation between disability and depression severity and quality of life, and whether improvement in disability after antidepressant pharmacotherapy was greater in those who responded to antidepressant treatment.
  
  
  METHODS
  Disability in subjects with and without depression from two different studies was compared for 22 weeks. Correlations were performed for the subjects with depression between disability and depression, anxiety, health-related quality of life (HRQOL), and medical comorbidity. T-tests were used to compare disability between subjects who did and did not respond to antidepressant treatment and change in disability after pharmacotherapy.
  
  
  METHODS
  Late-life depression research clinic.
  
  
  METHODS
  The 313 subjects were recruited from primary care and the community and were aged 60 and older; 244 subjects were participants in a depression treatment protocol, and 69 subjects without depression participated in a separate longitudinal observational study of the mental and cognitive health of depression-free older adults.
  
  
  METHODS
  The Late-Life Function and Disability Instrument (LL-FDI), a measure of instrumental activity of daily living, personal role, and social role functioning.
  
  
  RESULTS
  Subjects with depression scored lower than controls for domains measuring limitation (can do) and frequency (does do) of activities. Both disability domains correlated with depression severity, anxiety, HRQOL, and cognition. Disability improved with antidepressant treatment; for partial responders who continued to receive higher-dose antidepressant treatment out to 22 weeks, there was continued improvement, although not to the level of comparison subjects without depression.
  
  
  CONCLUSIONS
  The LL-FDI appears to discriminate subjects with depression from those without, correlates with depression severity, and demonstrates sensitivity to antidepressant treatment response. We recommend further investigation of the LL-FDI and similar disability instruments for assessing depression-related disability.
authors.affiliation: Advanced Center for Intervention and Services Research for Late Life Mood Disorders, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, 3811 O'Hara Street, Courier/Office: 100 North Bellefield Avenue, Room 766, Pittsburgh, PA 15213, USA. karpjf@upmc.edu
authors.forename: Jordan F
authors.initials: JF
authors.lastname: Karp
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Skidmore
authors.forename: Meredith
authors.initials: M
authors.lastname: Lotz
authors.forename: Eric
authors.initials: E
authors.lastname: Lenze
authors.forename: Mary Amanda
authors.initials: MA
authors.lastname: Dew
authors.forename: Charles F
authors.initials: CF
authors.lastname: Reynolds
mesh_terms: D000203:Activities of Daily Living / Q000145:classification / Q000523:psychology; D000368:Aged; D000369:Aged, 80 and over; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use*; D001008:Anxiety Disorders / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology; D015283:Citalopram / Q000627:therapeutic use*; D003072:Cognition Disorders / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology; D003131:Combined Modality Therapy; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008609:Mental Status Schedule; D010353:Patient Education as Topic; D010555:Personality Inventory; D011613:Psychotherapy; D011788:Quality of Life / Q000523:psychology; D013223:Statistics as Topic
chemical_list: D018687:Antidepressive Agents, Second-Generation; D015283:Citalopram
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