title: Depression, disability and somatic diseases among elderly.
abstract: OBJECTIVE
  Depression among older adults is associated with both disability and somatic disease. We aimed to further understand this complicated relationship and to study the possible modifying effect of increasing age.
  
  
  METHODS
  Cross sectional survey.
  
  
  METHODS
  Outpatient and inpatient clinics of regional facilities for mental health care and primary care.
  
  
  METHODS
  Elderly people, 60 years and older, 378 persons meeting DSM-IV criteria for a depressive disorder and 132 non-depressed comparisons.
  
  
  METHODS
  Depression diagnoses were assessed with the CIDI version 2.1. Disability was assessed with the WHO Disability Assessment Schedule (WHODAS). Social-demographic information and somatic diseases were assessed by self-report measurements.
  
  
  RESULTS
  Disability, in general and on all its subscales, was strongly related to depression. Presence of somatic disease did not contribute independently to variance in depression. The relationship was stronger for people of 60-69 years old than for those older than 70 years. Important aspects of disability that contributed to depression were disability in participation, self-care and social activities.
  
  
  CONCLUSIONS
  Results are based on cross sectional data. No inferences about causal relationships can be drawn.
  
  
  CONCLUSIONS
  Disability, especially disability regarding participation, self-care, or social activities is strongly related to late-life depression. Somatic diseases in itself are less of a risk for depression, except that somatic diseases are related to disability.
authors.affiliation: Groningen University, University Medical Center Groningen, Department of General Practice, Groningen, The Netherlands; Netherlands Institute of Health Services Research, PO Box 1568, 3500 BN Utrecht, The Netherlands. Electronic address: p.verhaak@nivel.nl.
authors.forename: P F M
authors.initials: PF
authors.lastname: Verhaak
authors.affiliation: Groningen University, University Medical Center Groningen, Department of General Practice, Groningen, The Netherlands.
authors.forename: J H
authors.initials: JH
authors.lastname: Dekker
authors.affiliation: Leiden University Medical Center, Department of Public Health and Primary Care, Leiden, The Netherlands.
authors.forename: M W M
authors.initials: MW
authors.lastname: de Waal
authors.affiliation: VU University Medical Center, Department of General Practice and EMGO Institute for Health Care Research, The Netherlands.
authors.forename: H W J
authors.initials: HW
authors.lastname: van Marwijk
authors.affiliation: VU University Medical Center/GGZinGeest, Department of Psychiatry and EMGO Institute for Health Care Research, The Netherlands.
authors.forename: H C
authors.initials: HC
authors.lastname: Comijs
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology*; D003866:Depressive Disorder / Q000453:epidemiology*; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care / Q000706:statistics & numerical data; D012648:Self Care
keywords: Aged; Chronic disease; Depression; Disability