title: Chronic diseases, depressive symptoms and functional limitation amongst older people in rural Malaysia, a middle income developing country.
abstract: OBJECTIVE
  To determine prevalence and prevalence ratio of functional limitation amongst older people with combined chronic diseases and co-morbid depressive symptoms compared with older people with either chronic disease or depressive symptoms alone.
  
  
  METHODS
  Data were analysed from a cross-sectional study of 765 people aged 60 years and over, conducted from 2007 to 2008 in Malaysia. Chronic diseases were self-reported, depressive symptoms were measured using the Geriatric Depression Scale and functional limitation was assessed using the Tinetti Performance Oriented Mobility Assessment Tool.
  
  
  RESULTS
  A higher proportion of older people with combined chronic diseases and depressive symptoms reported having functional limitation (44.7%) compared with older people with chronic diseases alone (12.5%) and depressive symptoms alone (18.1%). Adjusting for socio-demographic characteristics, cognitive status and living arrangements, chronic diseases were associated with functional limitation (PR 2.21, 95% CI 1.31, 3.72). Depressive symptoms were also associated with functional limitation (PR 2.07, 95% CI 1.56, 2.76). The prevalence ratio for functional limitation was much greater for combined chronic diseases and depressive symptoms (PR 4.09, 95% CI 2.23, 7.51).
  
  
  CONCLUSIONS
  Older people with combined chronic diseases and depressive symptoms are more likely to have functional limitation than those with chronic disease or depressive symptoms alone.
authors.affiliation: Department of Social and Preventive Medicine, University Malaya, Kuala Lumpur, Malaysia. noran@um.edu.my
authors.forename: Noran N
authors.initials: NN
authors.lastname: Hairi
authors.forename: Awang
authors.initials: A
authors.lastname: Bulgiba
authors.forename: Izzuna
authors.initials: I
authors.lastname: Mudla
authors.forename: Mas Ayu
authors.initials: MA
authors.lastname: Said
mesh_terms: D000368:Aged; D002908:Chronic Disease / Q000453:epidemiology*; D003071:Cognition; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology*; D003906:Developing Countries; D004185:Disability Evaluation; D005260:Female; D006306:Health Surveys; D006801:Humans; D008296:Malaysia / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012424:Rural Population; D012959:Socioeconomic Factors