Functional Limitations and Changes in Levels of Depression Among Older Adults: A Multiple-Hierarchy Stratification Perspective

Abstract

Objectives. This study examined the effects of functional limitations on changes in levels of depression over time. A multiple-hierarchy stratification perspective framed the analyses of potential stratification-based contingencies of race, gender, and socioeconomic status.Methods. We derived data from a longitudinal study of adults aged 65 and older in the Washington, DC, metropolitan area over a 3-year period (2001)(2002)(2003). We used ordinary least squares regression models in order to assess the focal associations across a set of social status interaction terms.Results. Changes in functional limitations were associated with changes in depression, but the patterns depended on interactions among race, gender, and socioeconomic status.Discussion. These observations contribute to research by blending ideas from double and triple jeopardy and differential vulnerability perspectives. Although analyses of multiple contingencies create analytical challenges, this complexity is needed to accurately specify the mental health effects of functional limitations.

Age, Aging, and Mental Health

“…Schieman and Plickert ( 2007 ) refer to this as the multiple-hierarchy strati fi cation perspective (i.e., multiple jeopardy). For the study of aging and mental health, this means that the mental health effects of stressors associated with aging may vary by race and other social statuses.…”

“…Of course, these differences may also be modi fi ed by the contingent factors noted above-age, SES, race and ethnicity, immigration, etc. (Schieman & Plickert, 2007 ) .…”

Modelling complex pathways between late-life depression and disability: evidence for mediating and moderating factors

“…Other potential mediators require further research ; in particular, physical rehabilitation was anticipated to change the course of both disability and depression (Bruce, 2001). With regard to effect modifiers and possible stratifications, time or age (Schnittker, 2005 ;Anstey et al 2007) and gender, race and socio-economic status (Schieman & Plickert, 2007) were found to be significant. However, most of the effect modifiers suggested above for the reverse association should be considered, providing that they precede activity limitation onset.…”

Dependencia funcional y su relación con la mortalidad general en adultos mayores. México: 2001-2015

“…En este caso, las personas con síntomas depresivos suelen tener mayor prevalencia de limitaciones en el desarrollo de las AVD; además, si bien la evidencia no es concluyente, se hipotetiza que la depresión disminuye la actividad física de las personas que la padecen, específicamente de la población adulta mayor (Schieman y Plickert, 2007;Yang y George, 2005). En el mismo sentido, otra condición que incrementa la probabilidad de presentar dependencia funcional entre personas adultas mayores es la artritis.…”

“…Por su parte, la percepción de la salud, como se mostró en el apartado anterior, es una de las variables asociadas con la dependencia funcional y con la mortalidad (Gama et al, 2000;Hu et al, 2008) (0= regular/mala/muy mala, 1= excelente/muy buena/buena). Por último, se incluyen cuatro EC que han mostrado asociación con el desarrollo de dependencia funcional, así como con el aumento de los riesgos de mortalidad: Artritis Veeranki et al, 2016), Depresión (Schieman y Plickert, 2007;Yang y George, 2005), Diabetes (Hung et al, 2012;Laditka y Laditka, 2006) y Enfermedades cardiovasculares (Jagger et al, 2007;Klijs et al, 2011); todas estas se evalúan individualmente mediante variables dicotómicas (1= si, 0= otro caso) 12 .…”