• Kumar B Rajan, Lisa L Barnes, Robert S Wilson, Denis A Evans, and Carlos F Mendes de Leon.
• 1645 West Jackson Boulevard, Suite 675, Chicago, IL 60612. kumar_rajan@rush.edu.
• J. Gerontol. A Biol. Sci. Med. Sci. 2014 Feb 1; 69 (2): 215-22.

BackgroundDepressive symptoms are predictive of multiple degenerative diseases in older age adults. However, the association of depressive symptoms with onset and progression of disability have not been studied.MethodsIn a cohort of community-dwelling, older black and white adults, 5,446 initially nondisabled subjects were followed annually for disability between 2000 and 2008. Depressive symptoms were assessed at baseline using a summary measure of 10-item version of the Center for Epidemiologic Survey-Depressive symptoms scale. The disability outcome was based on a summary measure of 13 basic and instrumental activities of daily living, and analyzed using a two-part regression model for onset and progression of disability.ResultsDuring follow-up, 44% of blacks and 35% of whites reported onset of disability. After adjusting for confounders, depressive symptoms were associated with increased odds of disability onset in blacks (odds ratio = 1.12, 95% confidence interval, 1.07-1.18) and whites (odds ratio = 1.21, 95% confidence interval, 1.08-1.36). The odds of disability onset associated with depressive symptoms also increased significantly over time in whites (odds ratio = 1.06, 95% confidence interval, 1.04-1.09), but not in blacks. In addition, depressive symptoms were associated with an increasing rate of progression of disability in whites (rate ratio = 1.08, 95% confidence interval, 1.06-1.09), but not in blacks.ConclusionsDepressive symptoms increased the risk of onset of disability in blacks and whites. This risk tended to increase over time only among whites. A similar race-specific pattern was observed for time-dependent changes due to depressive symptoms in the rate of progression in disability after onset.

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