Symptomatic and functional recovery in depression in later life

Collard, Rose M.; Wassink-Vossen, Sanne; Schene, Aart H.; Naarding, Paul; Verhaak, Peter; Voshaar, Richard C. Oude; Comijs, Hannie C.

doi:10.1007/s00127-018-1540-z

Cited by 15 publications

(13 citation statements)

References 49 publications

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“…Despite this, most subjects lived within their communities rather than in institutions; this corroborates with current global trends in deinstitutionalization of people with disabilities. The overall functioning of people with depression improved within two years, which is consistent with results of other studies [ 6 , 13 , 19 ]. Their functioning is poorer than that of people without depression [ 6 , 13 ], but, after a period of time, people gradually recover from depression.…”

Section: Discussionsupporting

confidence: 91%

“…According to the 11th revision of the International Classification of Diseases (ICD-11; [ 3 ]), depression symptoms are mainly depressive mood or depressive mood accompanied by a loss of pleasure, which adversely impacts individual social functioning. These symptoms cause more severe functional limitations in life situations such as interpersonal relationships [ 4 ], and reduced cognitive [ 5 ], psychosocial [ 6 ], and physical functioning [ 7 ], and a diminished ability to complete the activities of daily living [ 8 ]. Such changes affect people’s interactions with their environment, which is termed participation [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

“…Functioning, including social participation, in people with depression may decrease, remain unchanged, or improve over time [ 6 , 13 ]. Such changes depend on various factors and situations.…”

Section: Introductionmentioning

confidence: 99%

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Exploring Factors Associated with Functional Change and Predictors of Participation Improvement—A Two Years Follow-Up on People with Depression

Chou

Yen

Liou

et al. 2021

IJERPH

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The purpose of this study is to understand the functional status distribution and to explore the factors associated with changes in functional status and social participation in people with depression using two-year follow-up data. Subjects were selected from the Taiwan Databank of Persons with Disabilities (TDPD) if they had an evaluation date between July 2012 and 31 December 2017. We used data for 1138 individuals with multiple evaluation records and who were diagnosed with depression. The WHO Disability Assessment Schedule 2.0 (WHODAS 2.0) was the primary functional status measure. Other factors selected from the TDPD included social demographic data, living situation, employment status, economic status, and educational level. The results show scores in all dimensions of the WHODAS 2.0 declined over two years, especially in the domains of cognition, household activities, social participation, and total WHODAS 2.0 score. Aging groups showed poor recovery in cognition, getting along with others, and household activities. People living in suburban areas showed poorer recovery than people living in rural and urban areas in cognition, self-care, and general function (total score of WHODAS 2.0). Employment was also strongly associated with functional recovery in household activities, social participation, and general function. The original scores for cognition and getting along with others showed a significant negative relationship with social participation improvement. Our results can be used by policy makers to provide resources and conduct investigations, and by clinicians when making rehabilitation plans.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

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Exploring Factors Associated with Functional Change and Predictors of Participation Improvement—A Two Years Follow-Up on People with Depression

Chou

Yen

Liou

et al. 2021

IJERPH

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“…Previous studies on functional outcome in depressed patients show that a substantial part of the patients with symptomatic improvement also significantly improve in their functioning [11,12]. However, many remitted patients do not reach the level of functioning of non-depressed controls [13], even when controlled for comorbid chronic somatic diseases and cognitive decline [14,15]. More knowledge on course of functional recovery and its determinants in late-life depression may provide new insights in what is needed in the treatment and care for older persons with depression [16].…”

Section: Introductionmentioning

confidence: 98%

Trajectories and determinants of functional limitations in late-life depression: A 2-year prospective cohort study

et al. 2019

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Background: In mental health research, functional recovery is increasingly valued as an important outcome in addition to symptomatic remission. Methods: Course types of functional limitations among depressed older patients and its relation with symptomatic remission were explored in a naturalistic cohort study (Netherlands Study of Depression in Older persons). 378 depressed older patients (≥60 years) and 132 non-depressed persons were included. Depressive disorders were assessed with Composite International Diagnostic Interview at baseline and two-year follow-up. Functional limitations were assessed every 6 months with the World Health Organization Disability Assessment II. Results: Depressed patients had more functional limitations compared to their non-depressed counterparts. Growth Mixture Modeling among depressed patients identified two trajectories of functional limitations, both starting at a high disability level. The largest subgroup (81.2%) was characterized by a course of high disability levels over time. The smaller subgroup (18.8%) had an improving course (functional recovery). After two years, the main predictor of functional recovery was the remission of depression. Among symptomatic remitted patients, female sex, higher level of education, higher gait speed, and less severe depression were associated with no functional recovery. Non-remitted patients without functional recovery were characterized by the presence of more chronic somatic diseases, a lower sense of mastery, and a higher level of anxiety. Conclusions: 1 in 5 depressed older patients have a course with functional recovery. Combining functional and symptomatic recovery points to a subgroup of older patients that might profit from more rigorous psychiatric treatment targeted at psychiatric comorbidity and a group of frail depressed older patients that might profit from integrated geriatric rehabilitation.

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“…Many prospective epidemiological studies have examined the association between depression with functional impairment. Findings indicate that depression (ie, depressive disorders and symptoms) places older adults at an increased risk for developing, having persistent, or having worsening functional impairment or disability . Evidence also suggests that functional impairment affects mental health, with disability increasing the risk for subsequent depression …”

Section: Introductionmentioning

confidence: 99%

Association of the cumulative burden of late‐life anxiety and depressive symptoms with functional impairment

Simning

Seplaki

2019

Int J Geriat Psychiatry

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Objectives: This study investigates the association of the cumulative burden of anxiety-only, depression-only, and comorbid anxiety and depression symptoms with (a) incident self-care or household activities impairment among those with no baseline self-care or household activities impairment, respectively, or (b) change in status of self-care or household activities impairment among those with baseline impairment. Methods: This study consists of participants (N = 4619) from the National Health and Aging Trends Study, a longitudinal study that examines a nationally representative sample of US adults aged 65 years and older. Outcomes included incident or change in self-care or household activity impairment. Primary independent variables were yearly counts of screening positive for clinically significant symptoms for anxietyonly, depression-only, or co-occurring anxiety and depression. Multivariable logistic regression models examined incident impairment and change in impairment status.Results: Yearly counts of anxiety-only symptoms were associated with incident impairment in self-care and household activities and less improvement in self-care functioning. Yearly counts of depression-only symptoms were associated with incident impairment in self-care and household activities. Yearly counts of co-occurring symptoms of anxiety and depression were associated with incident impairment in self-care and household activities, less improvement in self-care activities, and worsening impairment in household activities. Conclusions:This study finds that the cumulative burden of co-occurring anxiety and depression symptoms is associated with incident impairment in functioning, persistent self-care impairment, and deterioration in household activity impairment.These findings emphasize the importance of managing late-life anxiety and depressive symptoms, which are treatable, frequently co-occur, and contribute to disability.

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Symptomatic and functional recovery in depression in later life

Cited by 15 publications

References 49 publications

Exploring Factors Associated with Functional Change and Predictors of Participation Improvement—A Two Years Follow-Up on People with Depression

Exploring Factors Associated with Functional Change and Predictors of Participation Improvement—A Two Years Follow-Up on People with Depression

Trajectories and determinants of functional limitations in late-life depression: A 2-year prospective cohort study

Association of the cumulative burden of late‐life anxiety and depressive symptoms with functional impairment

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