Functional capacity and dependency in transfer and dressing are associated with depressive symptoms in older people

Figures & data

Figure 1 Flow chart of the inclusion process for this study.

Note: ^aIf a person participated in more than one study, results from the first study were used.
Abbreviations: ADL, activities of daily living; FOPANU, Frail Older People–Activity and Nutrition; GDS-15, 15-item Geriatric Depression Scale; GERDA, Gerontological Regional Database; MMSE, mini mental state examination; REMANU, Residential Care Facilities–Mobility, Activity and Nutrition.

Table 1 Participant characteristics and their association with 15-item Geriatric Depression Scalea

Characteristic	Total (n=392)	Unstandardized b (95% CI)	P
Age (years)	86.2±6.0 (65–103)	0.03 (−0.02, 0.08)	0.20
Female sex	282 (72)	0.27 (−0.35, 0.88)	0.39
Living in residential care facility	264 (67)	0.67 (0.09, 1.26)	0.024
Diagnoses and medical conditions
Depression	166 (42)	2.27 (1.76, 2.78)	<0.001
Dementia	153 (39)	−0.49 (−1.06, 0.07)	0.088
Previous stroke	94 (24)	0.66 (0.01, 1.30)	0.045
Urinary tract infection, current	44 (11)	0.75 (−0.12, 1.62)	0.091
Diabetes mellitus	59 (15)	0.54 (−0.23, 1.31)	0.17
Heart failure	96 (25)	0.21 (−0.43, 0.85)	0.52
Angina pectoris	127 (32)	0.44 (−0.15, 1.03)	0.14
Malignancy, in the last 5 years	47 (12)	−0.76 (−1.61, 0.09)	0.078
Constipation	173 (44)	1.37 (0.83, 1.91)	<0.001
Osteoporosis	125 (32)	0.37 (−0.23, 0.95)	0.23
Rheumatic disease	45 (12)	1.67 (0.82, 2.52)	<0.001
Regular use of drugs
Diuretics	200 (51)	0.52 (−0.03, 1.07)	0.065
Analgesics (not ASA)	213 (54)	0.61 (0.06, 1.16)	0.03
Benzodiazepines	132 (34)	0.96 (0.38, 1.54)	0.001
Antidepressants	132 (34)	1.05 (0.48, 1.63)	<0.001
Neuroleptics	72 (18)	0.20 (−0.51, 0.92)	0.58
Acetylcholinesterase inhibitors	37 (9)	−1.08 (−2.01, −0.14)	0.025
Number of drugs used regularly	7.9±4.4 (0–24)	0.17 (0.11, 0.23)	<0.001
Assessments
Visual impairment	82 (21) (n=391)	0.71 (0.04, 1.39) (n=391)	0.039
Hearing impairment	65 (17)	0.45 (−0.29, 1.19)	0.23
Mini mental state examination (0–30)	20.5±6.0 (8–30) (n=391)	−0.06 (−0.10, −0.01)	0.015
Body mass index (kg/m^2)	25.0±4.4 (12.6–41.4) (n=386)	−0.02 (−0.08, 0.04)	0.53

Notes: Data are presented as mean ± standard deviation (range) or n (%).

a Associations are tested with linear regression using 15-item Geriatric Depression Scale as the dependent variable.

Abbreviations: ASA, acetylsalicylic acid; CI, confidence interval.

Table 2 GDS-15 scores of participants independent and dependent in individual tasks of Barthel ADL Index (n=392)

Tasks of Barthel ADL Index	Participants dependent, n (%)	GDS-15, mean ± SD		P
		Independent	Dependent
Bowel continence	52 (13)	3.91 ±2.63	4.19±3.63	0.59
Bladder continence	122 (31)	3.79±2.61	4.29±3.10	0.13
Grooming	99 (25)	3.75±2.58	4.54±3.24	0.03
Toilet use	88 (22)	3.71 ±2.52	4.75±3.42	0.009
Feeding	58 (15)	3.80±2.73	4.78±2.92	0.01
Transfer	73 (19)	3.62±2.49	5.36±3.47	<0.001
Mobility	90 (23)	3.69±2.53	4.81 ±3.37	0.004
Dressing	166 (42)	3.54±2.43	4.50±3.12	0.001
Stairs	246 (63)	3.44±2.27	4.25±3.00	0.003
Bathing	274 (70)	3.64±2.36	4.08±2.94	0.12

Notes: Between-group differences were analyzed using independent samples t-test. For GDS-15, higher scores indicate more depressive symptoms.

Abbreviations: ADL, activities of daily living; GDS-15, 15-item Geriatric Depression Scale; SD, standard deviation.

Table 3 Univariate and multivariate linear regression analyses for associations between GDS-15 and Berg Balance Scale, GDS-15 and Barthel ADL Index, and GDS-15 and each individual ADL task of Barthel ADL Index, separatelya

Characteristic	Univariate linear regression analyses n=392		Multivariate linear regression analyses n=391		R^2
	Unstandardized b (95% CI)	P	Unstandardized b (95% CI)	P
Berg Balance Scale	−0.04 (−0.06, −0.03)	<0.001	−0.03 (−0.05, −0.01)	0.008	0.174
Barthel ADL Index	−0.12 (−0.18, −0.06)	<0.001	−0.07 (−0.14, 0.004)	0.068	0.166
Dependency in individual tasks of Barthel ADL Index
Bowel continence	−0.39 (−0.88, 0.11)	0.12	−0.02 (−0.83, 0.79)	0.96	0.158
Bladder continence	−0.27 (−0.62, 0.08)	0.13	0.09 (−0.54, 0.71)	0.79	0.158
Grooming	−0.79 (−1.42, −0.16)	0.015	−0.41 (−1.06, 0.25)	0.22	0.161
Toilet use	−0.66 (−1.05, −0.28)	<0.001	−0.47 (−1.17, 0.24)	0.19	0.162
Feeding	−1.01 (−1.69, −0.33)	0.004	−0.36 (−1.14, 0.42)	0.36	0.160
Transfer	−0.95 (−1.36, −0.54)	<0.001	−1.03 (−1.77, −0.29)	0.007	0.175
Mobility	−0.55 (−0.87, −0.23)	<0.001	−0.57 (−1.26, 0.13)	0.11	0.164
Dressing	−0.79 (−1.15, −0.44)	<0.001	−0.70 (−1.35, −0.05)	0.035	0.168
Stairs	−0.50 (−0.79, −0.20)	<0.001	0.05 (−0.76, 0.86)	0.90	0.158
Bathing	−0.43 (−1.03, 0.17)	0.16	0.03 (−0.67, 0.74)	0.93	0.156

Notes: Each multivariate linear regression analysis was adjusted for age, sex, and baseline characteristics associated (P≤0.15) with GDS-15 in univariate analysis; dementia, previous stroke, current urinary tract infection, angina pectoris, malignancy in the last 5 years, constipation, rheumatic disease, diuretics, analgesics, acetylcholinesterase inhibitors, number of drugs used regularly, and visual impairment. Living in residential care facility was adjusted for in all multivariate analyses except for that of the ADL item bathing.

a GDS-15 was used as dependent variable.

Abbreviations: ADL, activities of daily living; CI, confidence interval; GDS-15, 15-item Geriatric Depression Scale.