Trajectories and determinants of functional limitations in late-life depression: A 2-year prospective cohort study
European Psychiatry Oct 04, 2019
Wassink-Vossen S, et al. - In Netherlands Study of Depression in Older persons, researchers explored the course types of functional limitations in depressed older patients (≥ 60 years) and its relation with symptomatic remission. Inclusion of 378 depressed older patients (≥ 60 years) and 132 non-depressed persons was done. Depressive disorders were assessed at baseline and 2-year follow-up via Composite International Diagnostic Interview. Via the World Health Organization Disability Assessment II, assessment of functional limitations was done every 6 months. Two trajectories of functional limitations were identified via Growth Mixture Modeling among depressed patients, both starting at a high disability level. A course of high disability levels over time characterized the largest subgroup (81.2%). An improving course (functional recovery) characterized the smaller subgroup (18.8%). Findings thereby suggest a course with functional recovery in 1 in 5 depressed older patients. Integration of functional and symptomatic recovery led to the identification of a subgroup of older patients that might benefit from more rigorous psychiatric treatment targeted at psychiatric comorbidity and a group of frail depressed older patients that might benefit from integrated geriatric rehabilitation.
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