THE ASSOCIATION BETWEEN CHRONIC DISEASES AND DEPRESSIVE SYMPTOMATOLOGY IN OLDER MEXICAN-AMERICANS

Background. Among the elderly population, the risk for psychological d istress increases with the number of chronic diseases and accompanying functional disability. The prevalence of chronic medical conditions a nd functional disability varies substantially across ethnocultural gro ups, however. Using data from the Hispanic EPESE, we previously report ed that among older Mexican Americans, the total number of chronic med ical conditions and the presence of functional impairment are strong p redictors of depressive symptoms. Methods. Using multiple regression, we examined the association between specific chronic diseases, individ ual functional disabilities, and depressive symptoms in this group of ethnic elders. Results. Multiple regression models indicated that diab etes (OR = 1.25, 95% CI = 1.03-1.56), arthritis (OR = 1.42, 95% CI = 1 .17-1.72), urinary incontinence (OR = 1.94, 95% CI = 1.46-2.59), bowel incontinence (OR = 2.28, 95% CI = 1.15-4.55), kidney disease (OR = 3. 11, 95% CI = 1.13-8.58), and ulcers (OR = 2.56, 95% CI = 1.23-5.29) we re predictive of high levels of depressive symptoms. Hip fracture, alt hough recognized as having a substantial impact on functional status, was not found to be associated with depressive symptoms. History of st roke was not significantly associated with depressive symptoms in biva riate or multivariate analyses, but history of stroke with residual sp eech problems was predictive (OR = 2.16, 95% CI = 1.01-4.79). Among sp ecific activities of daily living, only impaired ability to walk acros s a room (OR = 1.65, 95% CI = 1.04-2.73) or to baths oneself (OR = 1.8 7, 95% CI = 1.12-3.12) proved to be predictive in multivariate analyse s. Conclusions. This constellation of chronic medical conditions and f unctional disabilities is very different from those reported to be ass ociated with depressive symptoms in older non-Hispanic White and Afric an Americans, and appears to comprise those conditions most associated with substantial physical impairment, pain, and discomfort.