Is a change in functional capacity or dependency in activities of daily living associated with a change in mental health among older people living in residential care facilities?

Abstract

Aim

Functional capacity and dependency in activities of daily living (ADL) could be important mediators for an association between physical exercise and mental health. The aim of this study was to investigate whether a change in functional capacity or dependency in ADL is associated with a change in depressive symptoms and psychological well-being among older people living in residential care facilities, and whether dementia can be a moderating factor for this association.

Methods

A prospective cohort study was undertaken. Participants were 206 older people, dependent in ADL, living in residential care facilities, 115 (56%) of whom had diagnosed dementia. Multivariate linear regression, with comprehensive adjustment for potential confounders, was used to investigate associations between differences over 3 months in Berg Balance Scale (BBS) and Geriatric Depression Scale (GDS-15) scores, and in BBS and Philadelphia Geriatric Center Morale Scale (PGCMS) scores. Associations were also investigated between differences in Barthel ADL Index and GDS-15 scores, and in Barthel ADL Index and PGCMS scores.

Results

There were no significant associations between changes in scores over 3 months; the unstandardized β for associations between BBS and GDS-15 was 0.026 (P=0.31), BBS and PGCMS 0.045 (P=0.14), Barthel ADL Index and GDS-15 0.123 (P=0.06), and Barthel ADL Index and PGCMS −0.013 (P=0.86). There were no interaction effects for dementia.

Conclusion

A change in functional capacity or dependency in ADL does not appear to be associated with a change in depressive symptoms or psychological well-being among older people living in residential care facilities. These results may offer one possible explanation as to why studies of physical exercise to influence these aspects of mental health have not shown effects in this group of older people.

Keywords:

• aged
• residential facilities
• dementia
• frail elderly
• activities of daily living
• physical fitness
• mental health
• depression
• quality of life

Acknowledgments

This work was supported by grants from the Swedish Research Council K2009-69P-21298-01-4, K2009-69X-21299-01-1, and K2009-69P-21298-04-4; the King Gustaf V’s and Queen Victoria’s Foundation of Freemasons; the County Council of Västerbotten (ALF); the Swedish Dementia Foundation; the Alzheimer Foundation; and Erik and Anne-Marie Detlof’s Foundation at Umeå University.

Disclosure

The authors report no conflicts of interest in this work.