Functional limitations and somatic diseases are independent predictors for incident depressive disorders in seniors: Findings from a nationwide longitudinal study.
OBJECTIVE
Few nationwide comprehensive studies analyzed the factors leading to the onset of depression in correlation with medical disease and other related factors concerning geriatric depression. This study examined medical diseases with other factors which lead to depression among the elderly.


METHODS
This Taiwan-based longitudinal study examined a collection of 1467 seniors aged over 65. Subjects who fit this criteria were initially interviewed in 2003, and then four years later. Independent variables included baseline demographics, chronic medical illnesses, and the change of subjects' self-perceived health status, functional limitations including ADL, IADL and mobility limitation factors. The dependent variable was the symptoms of incident depression, as ascertained by the ten-item questionnaire during the later session. The logistic regression analyses were used to examine some of the predictors related to depressive disorders.


RESULTS
The findings showed that heart conditions (adjusted OR=1.55, 95% CI: 1.12-2.15, p=0.008) and joint disorders (adjusted OR=1.51, 95% CI: 1.09-2.09, p=0.013), as well as functional limitations, particularly IADL (adjusted OR=1.81, 95% CI: 1.24-2.65, p=0.002) and ADL (adjusted OR=1.77, 95% CI: 1.27-2.47, p=0.001) were independently associated with the onset of depression among the elderly population.


CONCLUSIONS
These findings indicated that when classifying symptoms of depression in geriatric patients with several underlying medical diseases, keen attention should be directed to the type of medical disorders and the functional deterioration in terms of daily activities and autonomic capabilities.
Institute of Health Policy and Management, National Taiwan University, Taipei, Taiwan, ROC; Golden Dream Think Tank and Research Center, Taipei, Taiwan, ROC; School of Health Care Administration, Taipei Medical University, Taipei, Taiwan, ROC.
Ya-Ting
YT
Yang
School of Health Care Administration, Taipei Medical University, Taipei, Taiwan, ROC; Department of Psychiatry, Buddhist Tzu-Chi General Hospital, Taipei Branch, New Taipei City, Taiwan, ROC.
Yao-Hsien
YH
Wang
Golden Dream Think Tank and Research Center, Taipei, Taiwan, ROC; Department of Public Health, China Medical University, 91 Hsueh-Shih Road, Taichung, Taiwan, ROC.
Hsien-Tsai
HT
Chiu
Golden Dream Think Tank and Research Center, Taipei, Taiwan, ROC; School of Health Care Administration, Taipei Medical University, Taipei, Taiwan, ROC.
Chia-Rong
CR
Wu
Southern TOHOKU Research Institute for Neuroscience, Southern Tohoku General Hospital, Fukushima, Japan.
Yujiro
Y
Handa
Southern TOHOKU Research Institute for Neuroscience, Southern Tohoku General Hospital, Fukushima, Japan.
Yin-Lin
YL
Liao
Golden Dream Think Tank and Research Center, Taipei, Taiwan, ROC; School of Health Care Administration, Taipei Medical University, Taipei, Taiwan, ROC. Electronic address: elsahsu@tmu.edu.tw.
Yi-Hsin Elsa
YH
Hsu
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D003863:Depression / Q000453:epidemiology*; D003866:Depressive Disorder / Q000453:epidemiology*; D005260:Female; D006304:Health Status; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D011795:Surveys and Questionnaires; D013624:Taiwan / Q000453:epidemiology
Depressive disorders; Functional limitations; Seniors