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Cognitive Status, Depressive Symptoms, and Health Status as Predictors of Functional Disability Among Elderly Persons With Low-to-Moderate Education

The Faenza Community Aging Study

Received November 13, 2003; revised July 20, 2004, and January 13, 2005; accepted January 18, 2005. From the Institute of Psychiatry, Univ. of Bologna, Bologna, Italy (DDR, FB, DB, BF); the Dept. of Psychiatry, Vita-Salute Univ., San Raffaele Institute, Milan, Italy (AS); the Dept. of Geriatric Medicine, Azienda SL Ravenna, Faenza, Italy (ED). Send correspondence and reprint requests to Diana De Ronchi, M.D., Institute of Psychiatry, Univ. of Bologna, Viale Carlo Pepoli 5, 40123 Bologna, Italy. e-mail: deronchi{at}alma.unibo.it
© 2005 American Association for Geriatric Psychiatry

Objective: The authors examined the impact of very early dementia and symptoms of depression on functional disability in a community-based group of 216 elderly people with low-to-moderate education level. Methods: The combined effect of very early dementia and symptoms of depression on functional disability was assessed with a logistic-regression model in which functional disability was the dependent variable. The same model was repeated with each item on the Instrumental Activities of Daily Living scale as the dependent variable. Results: Very early dementia alone was strongly associated with functional disability, and this association tripled in subjects with both very early dementia and symptoms of depression. In fact, whereas subjects with very early dementia had an 11-fold higher risk than normal persons for disability, subjects with both very early dementia and symptoms of depression showed a 37-fold higher risk for functional dependence. Conclusions: Elderly people who suffer from very early dementia and who also have symptoms of depression are at very high risk for functional disability and have a great need for accurate diagnostic assessment. If confirmed, the results are relevant for prevention because people who suffer from very early dementia and have symptoms of depression may be a suitable target group for intervention before the development of severe disability.

Key Words: Health Status • Cognitive Status • Depression

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