Abstract
BackgroundInstrumental Activities of Daily Living (IADL) is an indicator of whether a community-dwelling elderly can live independently. IADL decline was reported to be associated with aging and depression. The present study aimed to investigate whether the association between IADL decline and depressive symptoms differs with aging, using two age groups of community-dwelling Japanese elderly in their 70s and 80s.MethodsWe conducted longitudinal analysis among participants in their 70s and 80s at the baseline from Septuagenarians, Octogenarians, Nonagenarians Investigation with Centenarians (SONIC) study. IADL was assessed by The Tokyo Metropolitan Institute of Gerontology (TMIG) index of competence. As a main predictor, depressive symptoms were measured by the five-item version of the Geriatrics Depression Scale (GDS-5). As possible confounders, we considered cognitive function, body mass index, solitary living, education, economic status, medical history of stroke and heart disease, hypertension, dyslipidemia, diabetes, and sex. We obtained odds ratios (ORs) of IADL decline for having depressive symptoms in each age group (70s/80s) and tested interactions between depressive symptoms and age groups in relation to IADL decline in 3 years by logistic regression. Additionally, to confirm age group differences, we conducted multiple group analysis.ResultsThere were 559 participants in their 70s and 519 in their 80s. Compared to participants without depressive symptoms, those with depressive symptoms had higher OR of IADL decline in 70s (OR [95% CI] = 2.33 [1.13, 4.78]), but not in 80s (OR [95% CI] = 0.85 [0.46, 1.53]). There were significant interactions between depressive symptoms and age groups in relation to IADL decline (p-value = 0.03). Multiple group analyses showed differences between the age groups by Akaike information criterion (AIC), and ORs (95%CI) decline for depressive symptoms was 2.33 (1.14, 4.77) in 70s and 0.85 (0.47, 1.54) in 80s.ConclusionThe association of depressive symptoms and IADL decline during the 3 years was significantly different between the 70s and 80s age groups, and significant association was found only in people in their 70s. Detecting depressive symptoms may be a key for preventing IADL decline in people in their 70s and not for those in their 80s.
Highlights
Instrumental Activities of Daily Living (IADL) is an indicator of whether a community-dwelling elderly can live independently
To investigate whether the association of the baseline depressive symptoms with IADL decline in 3 years was different between the two age groups of 70s and 80s, we investigated interactions between depressive symptoms and age groups in relation to IADL decline in 3 years by logistic regression analyses and conducted multiple group analysis
We investigated the association of depressive symptoms with IADL decline in 3 years for the 70s age group and the 80s age group (Table 2)
Summary
Instrumental Activities of Daily Living (IADL) is an indicator of whether a community-dwelling elderly can live independently. The present study aimed to investigate whether the association between IADL decline and depressive symptoms differs with aging, using two age groups of community-dwelling Japanese elderly in their 70s and 80s. A previous epidemiological study has reported that depressive symptoms increased the risk of difficulties in ADL and IADL [3] among community-dwelling Japanese elderly people aged 75 years and older (n = 581). Another previous study using a prospective cohort design has shown that depressive symptoms predicted IADL decline in 3–4 years [4] among people aged 65 years and older in the United States of America (n = 3052). Few studies have investigated whether the association of depressive symptoms with IADL decline was different between age groups
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