title: Longitudinal and Reciprocal Relationships Between Depression and Disability in Older Women Caregivers and Noncaregivers.
abstract: Depressive symptoms and disability each increase the risk of the other, yet few studies have examined reciprocal associations between these conditions in a single study, or over periods longer than 3 years. These associations may differ in older caregivers due to chronic stress, health characteristics, or factors related to caregiving.
  
  
  
  Structural equation models were used to investigate relationships between depressive symptoms and disability over 3 interviews spanning 6 years among 956 older women (M = 81.5 years) from the Caregiver Study of Osteoporotic Fractures. Results were evaluated separately for 611 noncaregivers and 345 caregivers to a relative or friend.
  
  
  
  In noncaregivers, more depressive symptoms significantly predicted greater disability, whereas greater disability predicted increased depressive symptoms at the next interview in age-adjusted models. In contrast, there was not a significant relationship between depression and disability in either direction for caregivers. Further adjustment for body mass index and medical condition variables did not change these relationships.
  
  
  
  Caregivers did not exhibit longitudinal or reciprocal relationships between depressive symptoms and disability observed in noncaregivers. It is possible that older women caregivers are buffered by better physical condition or social interactions related to caregiving activities.
authors.affiliation: Department of Epidemiology, Boston University School of Public Health, Massachusetts.
authors.forename: Kathryn L
authors.initials: KL
authors.lastname: Bacon
authors.affiliation: Department of Biostatistics, Boston University School of Public Health, Massachusetts.
authors.forename: Timothy
authors.initials: T
authors.lastname: Heeren
authors.affiliation: Department of Physical Therapy, Boston University Sargent College, Massachusetts.
authors.forename: Julie J
authors.initials: JJ
authors.lastname: Keysor
authors.affiliation: Department of Epidemiology, Boston University School of Public Health, Massachusetts.
authors.forename: Sherri O
authors.initials: SO
authors.lastname: Stuver
authors.affiliation: Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pennsylvania.
authors.forename: Jane A
authors.initials: JA
authors.lastname: Cauley
authors.affiliation: Department of Epidemiology, Boston University School of Public Health, Massachusetts. lfredman@bu.edu.
authors.forename: Lisa
authors.initials: L
authors.lastname: Fredman
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology / Q000706:statistics & numerical data*; D003863:Depression / Q000453:epidemiology* / Q000523:psychology; D006233:Persons with Disabilities; D005260:Female; D006801:Humans; D008962:Models, Theoretical; D014930:Women
keywords: Activities of daily living; Caregiving; Depression; Disability