September 09, 2019
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Depression linked to disability in older Chinese Americans

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Researchers found a significant relationship between depressive symptoms and onset of functional disability among U.S. Chinese older adults, according to a study published in Journal of the American Geriatrics Society.

“Understanding of disability trajectories and associated risk factors remain particularly limited among older Asian Americans,” Dexia Kong, PhD, from Rutgers University’s Institute for Health, Health Care Policy and Aging Research, and colleagues wrote. “However, developing targeted preventive interventions calls for an improved understanding of unique risk factors of disability in this vulnerable subgroup of U.S. older adults.”

In a prospective cohort study, researchers examined the link between depressive symptoms and onset of functional disability over 2 years using survey data from 2,713 U.S. Chinese older adults.

Kong and colleagues evaluated depressive symptoms at baseline (2011-2013) using the nine-item Patient Health Questionnaire and functional disability using three validated scales: the Katz Index of Independence in Activities of Daily Living (ADLs), Lawton Instrumental Activities of Daily Living (IADLs) scale and Rosow and Breslau mobility scale.

Overall, 5.2% of participants experienced ADL disability onset, 35.6% experienced IADL disability onset and 23.3% experienced mobility disability onset over the 2-year period.

After controlling for covariates, analysis revealed that baseline depressive symptoms predicted onset of disability across all three domains over 2 years. In U.S. Chinese older adults, those with higher compared to lower levels of depressive symptoms were at greater risk for:

  • ADL disability onset (OR = 1.06; 95% CI, 1.02-1.11);
  • IADL disability onset (OR = 1.05; 95% CI, 1.01-1.09); and
  • mobility disability onset (OR = 1.05; 95% CI, 1.01-1.09).

Other risk factors of disability were older age and more chronic physical conditions, according to the results. In addition, higher education and lower cognitive function predicted the development of ADL disability; lower income, lower levels of acculturation and obesity predicted IADL disability onset; and female sex predicted onset of both IADL and mobility disability.

“Study findings extend existing literature by demonstrating that depressive symptoms among a rapidly growing ethnic minority aging population are significant risk factors for development of functional disability over 2 years,” Kong and colleagues wrote. “Such findings suggest that culturally sensitive screening followed by developing culturally relevant intervention programs addressing depressive symptoms may have the potential to reduce functional disability in U.S. Chinese older adults.” – by Savannah Demko

Disclosure: The authors report no relevant financial disclosures.