Cognitive impairment and syndromal depression in estimates of active life expectancy: the 13-year follow-up of the Baltimore Epidemiologic Catchment Area sample

Objective: Our hypothesis was that including cognitive status and syndromal depression in specifying functional impairment would result in significant differences in estimates of active life expectancy from specifications tha t included only standard functional measures (such as activities of daily l iving). Method: The subjects were the 3481 continuing participants of the Baltimore Epidemiologic Catchment Area Program. Interviews included criterion-based diagnosis of depression, assessment of cognitive status and standard survey questions on function. Results: Estimates of active life expectancy decreased from 9.8 years to 8. 9 years at age 65 years for men, and from 10 years to 8.4 years at age 65 y ears for women, when the definition of active-life expectancy included meas ures of cognitive impairment and syndromal depression. Conclusion: Measurements of active life expectancy tend to ignore dependenc ies related to psychological causes, and should move beyond mere enumeratio n of activities of daily living and instrumental activities of daily living .