Association Between Depression Symptoms and Disability Outcomes in Older Adults at Risk of Mobility Decline

Abstract

ObjectiveTo assess the association between depression symptoms and physical functioning and participation in daily life over 2 years in older adults at risk of mobility decline. DesignA secondary analysis of 2-year observational data from the Boston Rehabilitative Impairment Study of the Elderly. SettingNine primary care clinics within a single health care system. ParticipantsParticipants (N=432; mean age ± SD, 76.6±7.0y; range, 65-96y; 67.7% women) were community-dwelling adults (>65y) at risk of mobility decline. InterventionsNot applicable. Main Outcome MeasuresSecondary data analyses of the Late Life Function and Disability Instrument (primary outcome), Short Physical Performance Battery (secondary outcome), and Patient Health Questionnaire-9 (PHQ-9) (predictor). Measures were administered at baseline, 12 months, and 24 months. Participants completed a self-report survey asking about 16 medical comorbidities, and demographic information was collected at baseline. ResultsParticipants had an average ± SD PHQ-9 score of 1.3±3.1, ranging from 0 to 24 at baseline. Twenty-nine percent of participants reported a history of depression. Greater depression symptoms were associated with lower physical functioning (unstandardized beta [B]=−0.14, SE=0.05, P=.011) and restricted participation (frequency subscale: B=−0.21, SE=0.11, P=.001; limitation subscale: B=−0.45, SE=0.04, P<.001) cross-sectionally over 2 years. PHQ-9 was not significantly associated with the rate of change in Late Life Function and Disability Instrument score over 2 years. ConclusionsTreating depression in primary care may be an important strategy for reducing the burden of functional limitations and participation restrictions at any 1 time. Further research is needed on treatment models to cotarget depression and physical functioning among at-risk older adults.