The majority of older adults with depression have high levels of disability over time, according to results published in European Psychiatry. The study included older participants aged at least 60 years with and without depression (n=378 and n=132, respectively). The researchers used The World Health Organization World Mental Health Composite International Diagnostic Interview to assess depressive disorders at baseline and follow-up. Using the World Health Organization Disability Assessment 2.0, they assessed participants’ functional limitations every 6 months. The researchers analyzed course types of functional limitations in relation with symptomatic remission. Compared with participants without depression, participants with depression had more functional limitations.
Using Growth Mixture Modeling, the researchers identified 2 trajectories of functional limitations for participants with depression, both starting at a high disability level. The larger trajectory group (81.2%) had a course of high disability levels over time, whereas a smaller subgroup (18.8%) had functional recovery. After 2 years of follow-up, the results indicated that depression remission was the main predictor of functional recovery.
For symptomatic remitted participants, female sex, higher level of education, higher gait speed, and less severe depression were associated with no functional recovery. Nonremitted participants with no functional recovery were more likely to have chronic somatic diseases, a low sense of mastery, and a higher level of anxiety.
The study had several limitations. The researchers noted that by including a depressed sample at baseline, there are no data on their premorbid levels of functioning.
“[M]ental health nursing interventions should be incorporated in future treatment studies as these interventions specifically focus on functional recovery,” the researchers wrote.
Wassink-Vossen S, Collard RM, Wardenaar KJ, et al. Trajectories and determinants of functional limitations in late-life depression: a 2-year prospective cohort study. Eur Psychiatr. 2019;62:90-96.