Disability in geriatric depression

OBJECTIVE: The authors' purpose was to identify the relationship of disability to clinical measures that are part of a comprehensive psychiatric examination of depressed elderly patients. METHOD: The disability of 75 elderly inpatients and outpatients with major depression whose cognitive funct...

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Veröffentlicht in:The American journal of psychiatry 1996-07, Vol.153 (7), p.877-885
Hauptverfasser: ALEXOPOULOS, G. S, VRONTOU, C, KAKUMA, T, MEYERS, B. S, YOUNG, R. C, KLAUSNER, E, CLARKIN, J
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container_end_page 885
container_issue 7
container_start_page 877
container_title The American journal of psychiatry
container_volume 153
creator ALEXOPOULOS, G. S
VRONTOU, C
KAKUMA, T
MEYERS, B. S
YOUNG, R. C
KLAUSNER, E
CLARKIN, J
description OBJECTIVE: The authors' purpose was to identify the relationship of disability to clinical measures that are part of a comprehensive psychiatric examination of depressed elderly patients. METHOD: The disability of 75 elderly inpatients and outpatients with major depression whose cognitive function ranged from normality to mild dementia was assessed with the Philadelphia Multilevel Assessment Instrument. Age at onset of depression, chronicity of depression, severity of depression, cognitive impairment, medical burden, social support and living environment were assessed with standardized instruments. RESULTS: Impairment in instrumental activities of daily living was significantly associated with advanced age, severity of depression, and medical burden. The relationship of depressive symptoms to impairment in instrumental activities of daily living was not influenced by age or medical burden. Anxiety and depressive ideation as well as retardation and weight loss were significantly associated with impairment in instrumental activities of daily living. Interviewer- rated global disability was associated with advanced age at onset of depression, medical burden, and overall cognitive impairment. Specifically, a disturbance in initiation and perseveration was significantly related to global disability. CONCLUSIONS: Impairment in instrumental activities of daily living appears to be a relatively independent dimension of health status that is related to depressive symptoms, particularly anxiety and depressive ideation as well as retardation and weight loss. Global disability may be associated with impairment in initiation and perseveration and with late onset of depression. These findings provide a basis for studies investigating whether psychotherapy aimed at depressive ideation and rehabilitation efforts focused on instrumental activities of daily living can improve the outcome of geriatric depression.
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S ; VRONTOU, C ; KAKUMA, T ; MEYERS, B. S ; YOUNG, R. C ; KLAUSNER, E ; CLARKIN, J</creator><creatorcontrib>ALEXOPOULOS, G. S ; VRONTOU, C ; KAKUMA, T ; MEYERS, B. S ; YOUNG, R. C ; KLAUSNER, E ; CLARKIN, J</creatorcontrib><description>OBJECTIVE: The authors' purpose was to identify the relationship of disability to clinical measures that are part of a comprehensive psychiatric examination of depressed elderly patients. METHOD: The disability of 75 elderly inpatients and outpatients with major depression whose cognitive function ranged from normality to mild dementia was assessed with the Philadelphia Multilevel Assessment Instrument. Age at onset of depression, chronicity of depression, severity of depression, cognitive impairment, medical burden, social support and living environment were assessed with standardized instruments. RESULTS: Impairment in instrumental activities of daily living was significantly associated with advanced age, severity of depression, and medical burden. The relationship of depressive symptoms to impairment in instrumental activities of daily living was not influenced by age or medical burden. Anxiety and depressive ideation as well as retardation and weight loss were significantly associated with impairment in instrumental activities of daily living. Interviewer- rated global disability was associated with advanced age at onset of depression, medical burden, and overall cognitive impairment. Specifically, a disturbance in initiation and perseveration was significantly related to global disability. CONCLUSIONS: Impairment in instrumental activities of daily living appears to be a relatively independent dimension of health status that is related to depressive symptoms, particularly anxiety and depressive ideation as well as retardation and weight loss. Global disability may be associated with impairment in initiation and perseveration and with late onset of depression. These findings provide a basis for studies investigating whether psychotherapy aimed at depressive ideation and rehabilitation efforts focused on instrumental activities of daily living can improve the outcome of geriatric depression.</description><identifier>ISSN: 0002-953X</identifier><identifier>EISSN: 1535-7228</identifier><identifier>DOI: 10.1176/ajp.153.7.877</identifier><identifier>PMID: 8659609</identifier><identifier>CODEN: AJPSAO</identifier><language>eng</language><publisher>Washington, DC: American Psychiatric Publishing</publisher><subject>Activities of Daily Living ; Age of Onset ; Aged ; Anxiety - psychology ; Biological and medical sciences ; Cognition Disorders - diagnosis ; Cognition Disorders - epidemiology ; Comorbidity ; Dementia - diagnosis ; Dementia - epidemiology ; Depression ; Depression - psychology ; Depressive Disorder - diagnosis ; Depressive Disorder - epidemiology ; Depressive Disorder - rehabilitation ; Disability ; Disability Evaluation ; Elderly people ; Female ; Geriatric Assessment - statistics &amp; numerical data ; Geriatric psychology ; Geriatrics ; Health Status Indicators ; Humans ; Male ; Medical sciences ; Mental depression ; Older people ; Psychiatric Status Rating Scales ; Psychiatry ; Psychology. Psychoanalysis. Psychiatry ; Psychomotor Performance ; Psychopathology. Psychiatry ; Regression Analysis ; Severity of Illness Index ; Social Support ; Weight Loss</subject><ispartof>The American journal of psychiatry, 1996-07, Vol.153 (7), p.877-885</ispartof><rights>1997 INIST-CNRS</rights><rights>Copyright American Psychiatric Association Jul 1996</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-a438t-20264cb35a6dc831dcbc42ce0fd7392e0e8776ff4c788c9e1438817a41652b443</citedby><cites>FETCH-LOGICAL-a438t-20264cb35a6dc831dcbc42ce0fd7392e0e8776ff4c788c9e1438817a41652b443</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://psychiatryonline.org/doi/epdf/10.1176/ajp.153.7.877$$EPDF$$P50$$Gappi$$H</linktopdf><linktohtml>$$Uhttps://psychiatryonline.org/doi/full/10.1176/ajp.153.7.877$$EHTML$$P50$$Gappi$$H</linktohtml><link.rule.ids>315,781,785,2860,21634,27874,27929,27930,31005,77796,77797</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&amp;idt=2749386$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/8659609$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>ALEXOPOULOS, G. S</creatorcontrib><creatorcontrib>VRONTOU, C</creatorcontrib><creatorcontrib>KAKUMA, T</creatorcontrib><creatorcontrib>MEYERS, B. S</creatorcontrib><creatorcontrib>YOUNG, R. C</creatorcontrib><creatorcontrib>KLAUSNER, E</creatorcontrib><creatorcontrib>CLARKIN, J</creatorcontrib><title>Disability in geriatric depression</title><title>The American journal of psychiatry</title><addtitle>Am J Psychiatry</addtitle><description>OBJECTIVE: The authors' purpose was to identify the relationship of disability to clinical measures that are part of a comprehensive psychiatric examination of depressed elderly patients. METHOD: The disability of 75 elderly inpatients and outpatients with major depression whose cognitive function ranged from normality to mild dementia was assessed with the Philadelphia Multilevel Assessment Instrument. Age at onset of depression, chronicity of depression, severity of depression, cognitive impairment, medical burden, social support and living environment were assessed with standardized instruments. RESULTS: Impairment in instrumental activities of daily living was significantly associated with advanced age, severity of depression, and medical burden. The relationship of depressive symptoms to impairment in instrumental activities of daily living was not influenced by age or medical burden. Anxiety and depressive ideation as well as retardation and weight loss were significantly associated with impairment in instrumental activities of daily living. Interviewer- rated global disability was associated with advanced age at onset of depression, medical burden, and overall cognitive impairment. Specifically, a disturbance in initiation and perseveration was significantly related to global disability. CONCLUSIONS: Impairment in instrumental activities of daily living appears to be a relatively independent dimension of health status that is related to depressive symptoms, particularly anxiety and depressive ideation as well as retardation and weight loss. Global disability may be associated with impairment in initiation and perseveration and with late onset of depression. These findings provide a basis for studies investigating whether psychotherapy aimed at depressive ideation and rehabilitation efforts focused on instrumental activities of daily living can improve the outcome of geriatric depression.</description><subject>Activities of Daily Living</subject><subject>Age of Onset</subject><subject>Aged</subject><subject>Anxiety - psychology</subject><subject>Biological and medical sciences</subject><subject>Cognition Disorders - diagnosis</subject><subject>Cognition Disorders - epidemiology</subject><subject>Comorbidity</subject><subject>Dementia - diagnosis</subject><subject>Dementia - epidemiology</subject><subject>Depression</subject><subject>Depression - psychology</subject><subject>Depressive Disorder - diagnosis</subject><subject>Depressive Disorder - epidemiology</subject><subject>Depressive Disorder - rehabilitation</subject><subject>Disability</subject><subject>Disability Evaluation</subject><subject>Elderly people</subject><subject>Female</subject><subject>Geriatric Assessment - statistics &amp; numerical data</subject><subject>Geriatric psychology</subject><subject>Geriatrics</subject><subject>Health Status Indicators</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Mental depression</subject><subject>Older people</subject><subject>Psychiatric Status Rating Scales</subject><subject>Psychiatry</subject><subject>Psychology. 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S</au><au>VRONTOU, C</au><au>KAKUMA, T</au><au>MEYERS, B. S</au><au>YOUNG, R. C</au><au>KLAUSNER, E</au><au>CLARKIN, J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Disability in geriatric depression</atitle><jtitle>The American journal of psychiatry</jtitle><addtitle>Am J Psychiatry</addtitle><date>1996-07-01</date><risdate>1996</risdate><volume>153</volume><issue>7</issue><spage>877</spage><epage>885</epage><pages>877-885</pages><issn>0002-953X</issn><eissn>1535-7228</eissn><coden>AJPSAO</coden><abstract>OBJECTIVE: The authors' purpose was to identify the relationship of disability to clinical measures that are part of a comprehensive psychiatric examination of depressed elderly patients. METHOD: The disability of 75 elderly inpatients and outpatients with major depression whose cognitive function ranged from normality to mild dementia was assessed with the Philadelphia Multilevel Assessment Instrument. Age at onset of depression, chronicity of depression, severity of depression, cognitive impairment, medical burden, social support and living environment were assessed with standardized instruments. RESULTS: Impairment in instrumental activities of daily living was significantly associated with advanced age, severity of depression, and medical burden. The relationship of depressive symptoms to impairment in instrumental activities of daily living was not influenced by age or medical burden. Anxiety and depressive ideation as well as retardation and weight loss were significantly associated with impairment in instrumental activities of daily living. Interviewer- rated global disability was associated with advanced age at onset of depression, medical burden, and overall cognitive impairment. Specifically, a disturbance in initiation and perseveration was significantly related to global disability. CONCLUSIONS: Impairment in instrumental activities of daily living appears to be a relatively independent dimension of health status that is related to depressive symptoms, particularly anxiety and depressive ideation as well as retardation and weight loss. Global disability may be associated with impairment in initiation and perseveration and with late onset of depression. These findings provide a basis for studies investigating whether psychotherapy aimed at depressive ideation and rehabilitation efforts focused on instrumental activities of daily living can improve the outcome of geriatric depression.</abstract><cop>Washington, DC</cop><pub>American Psychiatric Publishing</pub><pmid>8659609</pmid><doi>10.1176/ajp.153.7.877</doi><tpages>9</tpages></addata></record>
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subjects Activities of Daily Living
Age of Onset
Aged
Anxiety - psychology
Biological and medical sciences
Cognition Disorders - diagnosis
Cognition Disorders - epidemiology
Comorbidity
Dementia - diagnosis
Dementia - epidemiology
Depression
Depression - psychology
Depressive Disorder - diagnosis
Depressive Disorder - epidemiology
Depressive Disorder - rehabilitation
Disability
Disability Evaluation
Elderly people
Female
Geriatric Assessment - statistics & numerical data
Geriatric psychology
Geriatrics
Health Status Indicators
Humans
Male
Medical sciences
Mental depression
Older people
Psychiatric Status Rating Scales
Psychiatry
Psychology. Psychoanalysis. Psychiatry
Psychomotor Performance
Psychopathology. Psychiatry
Regression Analysis
Severity of Illness Index
Social Support
Weight Loss
title Disability in geriatric depression
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