title: Depression and Unmet Needs for Assistance With Daily Activities Among Community-Dwelling Older Adults.
abstract: This study aims to investigate the impact of depressive symptoms on adverse consequences of unmet needs for assistance with daily activities among community-dwelling older adults.
  
  
  
  Data came from round 1 to 5 of the National Health and Aging Trends Study. Study sample consisted of 3,400 Medicare beneficiaries needing assistance with activities of daily living (ADL), instrumental activities of daily living (IADL), or mobility for any two consecutive years between 2011 and 2015. Study outcome was the number of self-reported adverse consequences of unmet needs for assistance with daily activities (e.g., went without eating, wet or soiled clothes). Mixed-effects negative binomial regression was used to estimate the association of lagged depressive symptoms and covariates in period t-1 and the number of adverse consequences of unmet needs in period t.
  
  
  
  The prevalence rates of adverse consequences of unmet needs were twice as high among older adults with elevated depressive symptoms as those without depression. After adjusting for covariates, prior wave depressive symptoms were associated with 1.24 times the rate of adverse consequences of unmet needs for assistance with ADL (Incidence Rate Ratio [IRR] = 1.24, 95% confidence interval [CI] = 1.09-1.41, p < .01) and IADL (IRR = 1.24, 95% CI = 1.06-1.44, p < .01), and 1.14 times the rate of adverse consequences of unmet needs for assistance with mobility (IRR = 1.14, 95% CI = 1.03-1.27, p < .05).
  
  
  
  Caring for older adults with mental health and long-term care needs calls for an integrated social and health services system.
authors.affiliation: Northwestern University Feinberg School of Medicine, University of Illinois at Urbana-Champaign.
authors.forename: Xiaoling
authors.initials: X
authors.lastname: Xiang
authors.affiliation: Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign.
authors.forename: Ruopeng
authors.initials: R
authors.lastname: An
authors.affiliation: Northwestern University Feinberg School of Medicine, Director, Center for Rehabilitation Outcomes Research, Rehabilitation Institute of Chicago.
authors.forename: Allen
authors.initials: A
authors.lastname: Heinemann
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D003863:Depression / Q000453:epidemiology*; D003866:Depressive Disorder / Q000453:epidemiology*; D005260:Female; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data*; D006801:Humans; D057187:Independent Living; D008297:Male; D006278:Medicare; D000073222:Patient Health Questionnaire; D015995:Prevalence; D014481:United States / Q000453:epidemiology