An association between incident disability and depressive symptoms over 3 years of follow-up among older women: The Women's Health and Aging Study

Background and aims: To examine the impact of new disability on the incidence of depressive symptoms, with 3-year biannual data from The Woman's Health and Aging Study. Methods: Subjects (n=671) were selected if they were independent at baseline in 5 basic activities of daily living (ADLs) and were not depressed [scored <14 on the Geriatric Depression Scale (GDS; range 0 to 30)]. During the follow-ups, worsening of ADL disability (needed help on an increased number of ADLs) and onset of depressive symptoms (GDS score >= 14) were defined. For each pair of consecutive interviews in which depressive symptoms were not present in the first interview in the pair, we assessed incidence of worsening disability and depressive symptoms in the second interview of the pair. We also summarized the incidence of depressive symptoms 6 months later among the people who did not develop depressive symptoms at the time they reported a new disability. Results: Compared with those not developing disability, after adjusting for demographic characteristics, number of diseases, and ADL difficulty level at the moment of onset of the disability, the odds ratio (OR) for developing depressive symptoms at disability onset was 2.2 (95% Confidence Interval (CI) 1.1-4.3). For those developing new disability without depressive symptoms, the adjusted OR for developing depressive symptoms 6 months later was 1.7 (CI 0.6-4.8). Conclusion: Onset of new disability in basic ADLs had a significant impact on the development of depressive symptoms at the moment of onset. Our results demonstrate that clinicians should carefully evaluate depressive symptoms in patients with new onset of disability. (Aging Clin Exp Res 2009; 21: 191-197) (C) 2009, Editrice Kurtis