HEALTH, HEALTH BEHAVIOR AND FUNCTIONAL ABILITY PREDICTING DEPRESSION IN OLD-AGE - A LONGITUDINAL-STUDY

The predictive value of health, health behaviour and functional abilit y for the occurrence of depression in elderly Finns is described using a longitudinal design. The persons determined as not being depressed (DSM-III. criteria) in an epidemiological study in 1984-85 were interv iewed and examined in a follow-up study in 1989-90 (N = 679). The risk factors were analysed by contrasting the persons depressed in 1989-90 with those not depressed. Of the symptoms, recurrent falling and a lo ss of appetite in men, and palpitation, dyspnoea at rest, tremor in th e hands, nausea, dizziness, recurrent falling, apathy and feebleness, fatigue and weakness, restlessness and sight disturbances in women pre dicted depression. Certain depressive symptoms, such as crying spells, psychomotor agitation, irritability, self-deprecation and suicidal th oughts in men, and sadness, tachycardia, a loss of concentration, psyc homotor retardation and indecisiveness in women, also predicted depres sion. Numerous somatic and psychosomatic symptoms and numerous depress ive symptoms were risk factors for women. Old age, poor self-perceived health, dependence on outside help in negotiating stairs and dependen ce on outside help in washing oneself were risk factors for men. A pre vious episode of depression was a predictor in both sexes. Sex was not related to the risk of depression. Both in men and women, an impairme nt of functional abilities during the follow-up was related to depress ion. A decline of self-perceived health, an occurrence of a serious di sease and a decrease in the amount of physical exercise among women an d moving into long-term institutional care and a decline of self-perce ived health during the follow-up among men were associated with a grea ter risk. The occurrence of genitourinary diseases in men and the occu rrence of vascular, cerebrovascular, thyroid or neurological disease i n women during the follow-up were related to a high risk. The results support the hypotheses of a multifactorial aetiology and a relapsing a nd episodic course of depression in old age.