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Mental and psychological conditions, medical comorbidity and functional limitation: differential associations in older adults with cognitive impairment, depressive symptoms and co-existence of both.
Int J Geriatr Psychiatry 2011; 26(10):1071-9IJ

Abstract

OBJECTIVE

Cognitive impairment and depressive symptoms are common among the geriatric population but the co-occurrence of both is rarely studied. The purpose of this study was to identify and compare the factors associated with three groups of elderly people: those assessed with cognitive impairment alone (COG), depressive symptoms alone (DEP) or co-existence of both (COG-DEP).

METHODS

The cross-sectional study included 600 community-dwellers ages 65 and older. All participants underwent a comprehensive evaluation. Global cognition was measured by the Mini-Mental State Examination (MMSE) and depressive symptoms were defined by the Geriatric Depression Scale (GDS). Specific chronic illnesses relevant to the Charlson comorbidity index (CCI) were self-reported. Functional status was evaluated by the Katz' basic (ADL) and Lawton's instrumental (IADL) activities of daily living scales.

RESULTS

COG-DEP was explained by IADL dependence (OR: 11.9, 95% CI: 4.59-30.78), ADL dependence (OR: 11.5, 95% CI: 5.59-23.69), cerebrovascular disease (OR: 3.6, 95% CI: 1.48-8.68), congestive heart failure (OR: 3.4, 95% CI: 1.77-6.59) and diabetes (OR: 2.6, 95% CI: 1.30-5.18), but it was best predicted by functional limitations in the adjusted model. Being functionally dependent and medically ill with shorter life expectancy was shown to significantly increase the odds of being DEP. Functional limitation in IADL was without distinction associated to COG, DEP and COG-DEP.

CONCLUSION

The present results on COG, DEP and COG-DEP show the particular relevance of certain medical comorbidities and functional limitations to those three distinct groups of elderly people.

Authors+Show Affiliations

Gerontology Research Group, Faculty of Health Sciences, University of A Coruña, Spain. jcmillan@udc.esNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

21905101

Citation

Millán-Calenti, José C., et al. "Mental and Psychological Conditions, Medical Comorbidity and Functional Limitation: Differential Associations in Older Adults With Cognitive Impairment, Depressive Symptoms and Co-existence of Both." International Journal of Geriatric Psychiatry, vol. 26, no. 10, 2011, pp. 1071-9.
Millán-Calenti JC, Maseda A, Rochette S, et al. Mental and psychological conditions, medical comorbidity and functional limitation: differential associations in older adults with cognitive impairment, depressive symptoms and co-existence of both. Int J Geriatr Psychiatry. 2011;26(10):1071-9.
Millán-Calenti, J. C., Maseda, A., Rochette, S., Vázquez, G. A., Sánchez, A., & Lorenzo, T. (2011). Mental and psychological conditions, medical comorbidity and functional limitation: differential associations in older adults with cognitive impairment, depressive symptoms and co-existence of both. International Journal of Geriatric Psychiatry, 26(10), pp. 1071-9. doi:10.1002/gps.2646.
Millán-Calenti JC, et al. Mental and Psychological Conditions, Medical Comorbidity and Functional Limitation: Differential Associations in Older Adults With Cognitive Impairment, Depressive Symptoms and Co-existence of Both. Int J Geriatr Psychiatry. 2011;26(10):1071-9. PubMed PMID: 21905101.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Mental and psychological conditions, medical comorbidity and functional limitation: differential associations in older adults with cognitive impairment, depressive symptoms and co-existence of both. AU - Millán-Calenti,José C, AU - Maseda,Ana, AU - Rochette,Sophie, AU - Vázquez,Gustavo A, AU - Sánchez,Alba, AU - Lorenzo,Trinidad, Y1 - 2010/12/09/ PY - 2010/04/09/received PY - 2010/09/09/accepted PY - 2011/9/10/entrez PY - 2011/9/10/pubmed PY - 2011/12/22/medline SP - 1071 EP - 9 JF - International journal of geriatric psychiatry JO - Int J Geriatr Psychiatry VL - 26 IS - 10 N2 - OBJECTIVE: Cognitive impairment and depressive symptoms are common among the geriatric population but the co-occurrence of both is rarely studied. The purpose of this study was to identify and compare the factors associated with three groups of elderly people: those assessed with cognitive impairment alone (COG), depressive symptoms alone (DEP) or co-existence of both (COG-DEP). METHODS: The cross-sectional study included 600 community-dwellers ages 65 and older. All participants underwent a comprehensive evaluation. Global cognition was measured by the Mini-Mental State Examination (MMSE) and depressive symptoms were defined by the Geriatric Depression Scale (GDS). Specific chronic illnesses relevant to the Charlson comorbidity index (CCI) were self-reported. Functional status was evaluated by the Katz' basic (ADL) and Lawton's instrumental (IADL) activities of daily living scales. RESULTS: COG-DEP was explained by IADL dependence (OR: 11.9, 95% CI: 4.59-30.78), ADL dependence (OR: 11.5, 95% CI: 5.59-23.69), cerebrovascular disease (OR: 3.6, 95% CI: 1.48-8.68), congestive heart failure (OR: 3.4, 95% CI: 1.77-6.59) and diabetes (OR: 2.6, 95% CI: 1.30-5.18), but it was best predicted by functional limitations in the adjusted model. Being functionally dependent and medically ill with shorter life expectancy was shown to significantly increase the odds of being DEP. Functional limitation in IADL was without distinction associated to COG, DEP and COG-DEP. CONCLUSION: The present results on COG, DEP and COG-DEP show the particular relevance of certain medical comorbidities and functional limitations to those three distinct groups of elderly people. SN - 1099-1166 UR - https://www.unboundmedicine.com/medline/citation/21905101/Mental_and_psychological_conditions_medical_comorbidity_and_functional_limitation:_differential_associations_in_older_adults_with_cognitive_impairment_depressive_symptoms_and_co_existence_of_both_ L2 - https://doi.org/10.1002/gps.2646 DB - PRIME DP - Unbound Medicine ER -