Hierarchy levels, sum score, and worsening of disability are related to depressive symptoms in elderly men from three European countries

Objectives: The objectives were to investigate the predictive value of hierarchy levels and sum score of disability and change in disability on depressive symptoms. Method: Longitudinal data of 723 men age 70 and older from the Finland, Italy, and the Netherlands Elderly Study were collected in 1990 and 1995. Self-reported disability was based on three disability domains (instrumental activities, mobility, and basic activities) and depressive symptoms on the Zung questionnaire. Results: Severity levels of disability were positively associated with depressive symptoms. Men with no disability scored 5 to 17 points lower (p < .01) on depressive symptoms than did those with disability in all domains. Among men with mild disability, those who had worsening of disability status in the preceding 5 years scored 5 points higher (p = .004) on depressive symptoms than did men who improved. Discussion: Hierarchic severity levels, sum score of disability, and preceding changes in disability status are risk factors for depressive symptoms