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Disentangling the complex relation of disability and depressive symptoms in old age – findings of a multicenter prospective cohort study in Germany

Published online by Cambridge University Press:  30 January 2017

André Hajek Open the ORCID record for André Hajek [Opens in a new window] ,
Christian Brettschneider ,
Marion Eisele ,
Dagmar Lühmann ,
Silke Mamone ,
Birgitt Wiese ,
Siegfried Weyerer ,
Jochen Werle ,
Angela Fuchs  and
Michael Pentzek
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André Hajek*
Affiliation:
Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Germany
Christian Brettschneider
Affiliation:
Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Germany
Marion Eisele
Affiliation:
Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Germany
Dagmar Lühmann
Affiliation:
Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Germany
Silke Mamone
Affiliation:
Institute of General Practice, Hannover Medical School, Germany
Birgitt Wiese
Affiliation:
Institute of General Practice, Hannover Medical School, Germany
Siegfried Weyerer
Affiliation:
Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Germany
Jochen Werle
Affiliation:
Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Germany
Angela Fuchs
Affiliation:
Institute of General Practice, Medical Faculty, Heinrich-Heine-University Düsseldorf, Germany
Michael Pentzek
Affiliation:
Institute of General Practice, Medical Faculty, Heinrich-Heine-University Düsseldorf, Germany
Janine Stein
Affiliation:
Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Germany
Tobias Luck
Affiliation:
Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Germany
Horst Bickel
Affiliation:
Department of Psychiatry, Technical University of Munich, Germany
Edelgard Mösch
Affiliation:
Department of Psychiatry, Technical University of Munich, Germany
Kathrin Heser
Affiliation:
Department of Psychiatry, University of Bonn, Germany
Michael Wagner
Affiliation:
Department of Psychiatry, University of Bonn, Germany German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
Wolfgang Maier
Affiliation:
Department of Psychiatry, University of Bonn, Germany German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
Martin Scherer
Affiliation:
Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Germany
Steffi G. Riedel-Heller
Affiliation:
Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Germany
Hans-Helmut König
Affiliation:
Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Germany
*
Correspondence should be addressed to: Dr. André Hajek, University Medical Center, Hamburg-Eppendorf, Department of Health Economics and Health Services Research, Hamburg Center for Health Economics. Phone +49 40 7410 52877; Fax +49 40 7410 40261. Email: a.hajek@uke.de.
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Abstract

Background:

Most of the previous studies attempted to disentangle the relationship between disability and depressive symptoms were limited to observation periods of only few years. Moreover, evidence is missing regarding the complex co-occurrence of disability and depressive symptoms in old age in Germany. In order to close the research gap, we aimed at disentangling the complex co-occurrence of disability and depressive symptoms in old age in Germany over a longer time frame.

Methods:

Based on data from a representative survey of the German general population aged 75 years and older, the course of disability as well as depressive symptoms was observed every 1.5 years over six waves. While disability was quantified by the Lawton and Brody Instrumental Activities of Daily Living scale, the Geriatric Depression Scale was used to measure depressive symptoms. Taking into account the complex co-occurrence of depressive symptoms and disability, a panel vector autoregressive model was used. By taking the first differences, unobserved heterogeneity was taken into account.

Results:

In the total sample and in both sexes, we revealed a robust positive association between an initial change in depressive symptoms and subsequent changes in disability. No robust association between an initial change in disability and a subsequent change in depressive symptoms was detected.

Conclusion:

Our findings highlight the importance of changes in depressive symptoms for future changes in disability in old age.

Keywords

depressionlongitudinal studiesactivities of daily living (ADLs)
Type
Paper of the Month
Information
International Psychogeriatrics , Volume 29 , Issue 6 , June 2017 , pp. 885 - 895
Copyright
Copyright © International Psychogeriatric Association 2017 

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Footnotes

*

These authors contributed equally to this work

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