Hierarchy Levels, Sum Score, and Worsening of Disability Are Related to Depressive Symptoms in Elderly Men From Three European Countries

Abstract

The objectives were to investigate the predictive value of hierarchy levels and sum score of disability and change in disability on depressive symptoms. Longitudinal data of 723 men age 70 and older from the Finland, Italy, and the Netherlands Elderly Study were collected in 1990 and 1995. Self-reported disability was based on three disability domains (instrumental activities, mobility, and basic activities) and depressive symptoms on the Zung questionnaire. Severity levels of disability were positively associated with depressive symptoms. Men with no disability scored 5 to 17 points lower (p < .01) on depressive symptoms than did those with disability in all domains. Among men with mild disability, those who had worsening of disability status in the preceding 5 years scored 5 points higher (p = .004) on depressive symptoms than did men who improved. Hierarchic severity levels, sum score of disability, and preceding changes in disability status are risk factors for depressive symptoms.