TY - JOUR
T1 - Depressive Multimorbidity and Trajectories of Functional Status among Older Americans
T2 - Differences by Racial/Ethnic Group
AU - Botoseneanu, Anda
AU - Elman, Miriam R.
AU - Allore, Heather G.
AU - Dorr, David A.
AU - Newsom, Jason T.
AU - Nagel, Corey L.
AU - Quiñones, Ana R.
N1 - Publisher Copyright:
© 2022 AMDA – The Society for Post-Acute and Long-Term Care Medicine
PY - 2023/2
Y1 - 2023/2
N2 - Objective: This study aims to evaluate the impact of depressive multimorbidity (ie, including depressive symptoms) on the long-term development of activities of daily living (ADL) and instrumental activities of daily living (IADL) limitations according to racial/ethnic group in a representative sample of US older adults. Design: Prospective, observational, population-based 16-year follow-up study of nationally representative sample. Setting and Participants: Sample of older non-Hispanic Black, Hispanic, and nonHispanic White Americans from the Health and Retirement Study (2000‒2016, N = 16,364, community-dwelling adults ≥65 years of age). Methods: Data from 9 biennial assessments were used to evaluate the accumulation of ADL-IADL limitations (range 0‒11) among participants with depressive (8-item Center for Epidemiologic Studies Depression score≥4) vs somatic (ie, physical conditions only) multimorbidity vs those without multimorbidity (no or 1 condition). Generalized estimating equations included race/ethnicity (non-Hispanic Black, Hispanic, non-Hispanic White), baseline age, sex, body mass index, education, partnered, and net worth. Results: Depressive and somatic multimorbidity were associated with 5.18 and 2.95 times greater accumulation of functional limitations, respectively, relative to no disease [incidence rate ratio (IRR) = 5.18, 95% confidence interval, CI (4.38,6.13), IRR = 2.95, 95% CI (2.51,3.48)]. Hispanic and Black respondents experienced greater accumulation of ADL-IADL limitations than White respondents [IRR = 1.27, 95% CI (1.14, 1.41), IRR = 1.31, 95% CI (1.20, 1.43), respectively]. Conclusions and Implications: Combinations of somatic diseases and high depressive symptoms are associated with greatest accumulation of functional limitations over time in adults ages 65 and older. There is a more rapid growth in functional limitations among individuals from racial/ethnic minority groups.
AB - Objective: This study aims to evaluate the impact of depressive multimorbidity (ie, including depressive symptoms) on the long-term development of activities of daily living (ADL) and instrumental activities of daily living (IADL) limitations according to racial/ethnic group in a representative sample of US older adults. Design: Prospective, observational, population-based 16-year follow-up study of nationally representative sample. Setting and Participants: Sample of older non-Hispanic Black, Hispanic, and nonHispanic White Americans from the Health and Retirement Study (2000‒2016, N = 16,364, community-dwelling adults ≥65 years of age). Methods: Data from 9 biennial assessments were used to evaluate the accumulation of ADL-IADL limitations (range 0‒11) among participants with depressive (8-item Center for Epidemiologic Studies Depression score≥4) vs somatic (ie, physical conditions only) multimorbidity vs those without multimorbidity (no or 1 condition). Generalized estimating equations included race/ethnicity (non-Hispanic Black, Hispanic, non-Hispanic White), baseline age, sex, body mass index, education, partnered, and net worth. Results: Depressive and somatic multimorbidity were associated with 5.18 and 2.95 times greater accumulation of functional limitations, respectively, relative to no disease [incidence rate ratio (IRR) = 5.18, 95% confidence interval, CI (4.38,6.13), IRR = 2.95, 95% CI (2.51,3.48)]. Hispanic and Black respondents experienced greater accumulation of ADL-IADL limitations than White respondents [IRR = 1.27, 95% CI (1.14, 1.41), IRR = 1.31, 95% CI (1.20, 1.43), respectively]. Conclusions and Implications: Combinations of somatic diseases and high depressive symptoms are associated with greatest accumulation of functional limitations over time in adults ages 65 and older. There is a more rapid growth in functional limitations among individuals from racial/ethnic minority groups.
KW - Multimorbidity
KW - depressive symptoms
KW - functional limitations
KW - health disparities
KW - race/ethnicity
UR - http://www.scopus.com/inward/record.url?scp=85146025628&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85146025628&partnerID=8YFLogxK
U2 - 10.1016/j.jamda.2022.11.015
DO - 10.1016/j.jamda.2022.11.015
M3 - Article
C2 - 36535384
AN - SCOPUS:85146025628
SN - 1525-8610
VL - 24
SP - 250-257.e3
JO - Journal of the American Medical Directors Association
JF - Journal of the American Medical Directors Association
IS - 2
ER -