title: Late life depression and incident activity limitations: influence of gender and symptom severity.
abstract: BACKGROUND
  Mental disorders, especially depression, are one of the principal causes of disablement. Previous research has been limited partly due to the failure to take into account sub-syndromal states and the very large number of candidate mediating and confounding factors.
  
  
  METHODS
  Longitudinal associations between baseline depressive symptomatology and activity limitations were examined in a community-dwelling elderly cohort of 3191 participants. Mixed logistic models were used to determine associations between mild or severe depressive symptoms (Center for Epidemiologic Studies-Depression Scale, CES-D), and 7-year incident disability on four limitation scales assessing instrumental and basic activities of daily living, mobility using the Rosow and Breslau scale, and social restriction.
  
  
  RESULTS
  In men, mild depressive symptomatology was associated with increased incident limitations on instrumental activities of daily living (IADL) (odds ratio (OR) (95% CI)=5.07 (2.25-11.42)). In women, severe depressive symptomatology was related to social restriction (OR (95% CI)=2.36 (1.31-4.25)), IADL (OR (95% CI)=1.89 (1.13-3.15)) and activities of daily living (OR (95% CI)=11.15 (3.43-36.23)). Men and women with a 2-year increase in CES-D score were highly at risk for social restriction and limitations in mobility and IADL.
  
  
  CONCLUSIONS
  Depression is an independent predictor of disability in the elderly population; the relation is gender-dependent and varies with symptom load.
authors.affiliation: Inserm, U1061, Hopital La Colombière, Montpellier, F-34093, France. isabelle.carriere@inserm.fr
authors.forename: Isabelle
authors.initials: I
authors.lastname: Carrière
authors.forename: Laure Anne
authors.initials: LA
authors.lastname: Gutierrez
authors.forename: Karine
authors.initials: K
authors.lastname: Pérès
authors.forename: Claudine
authors.initials: C
authors.lastname: Berr
authors.forename: Pascale
authors.initials: P
authors.lastname: Barberger-Gateau
authors.forename: Karen
authors.initials: K
authors.lastname: Ritchie
authors.forename: Marie Laure
authors.initials: ML
authors.lastname: Ancelin
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003863:Depression; D003866:Depressive Disorder / Q000503:physiopathology*; D006233:Persons with Disabilities; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology; D012720:Severity of Illness Index; D012737:Sex Factors