Disability in geriatric depression

The authors examined impairment in self-maintenance skills and in instrumen tal activities of daily living (IADL) among 211 older patients with unipola r major depression. In regression models, self-maintenance impairment was a ssociated with older age, less reported depressed mood, psychomotor retarda tion, and severe chronic medical illness. IADL deficit was associated with older age, greater severity of depression, less guilt, more apathy, weight loss, greater cognitive impairment, more severe chronic medical illness, le ss social interaction, lower subjective social support, and greater instrum ental support. The authors conclude that efforts to remediate basic skills deficits in depressed older adults should focus on treating comorbid medica l conditions; impaired IADL skills in geriatric depressed patients should i mprove with treatment of depression and medical illness. Clinicians should be aware that substantial IADL impairment may accompany mild cognitive impa irment associated with depression in older patients.