Changes in activities of daily living during treatment of late-life depression

Background: Patients with late-life depression often exhibit cognitive deficits or disability. The relationship between late-life depression and disability is an area of significance for geriatric psychiatry. The purpose of the present study was to investigate the association between changes in the severity of depression and activities of daily living (ADL) during treatment of late-life depression. Methods: We examined the severity of depression, cognitive function and ADL among 70 subjects aged 65 years or older with a history or a current episode of major depression. Examination with the Hamilton Depression Rating Scale (Ham-D), the Mini-Mental State Examination (MMSE), the Barthel Index (BI) and the Hyogo Activities of Daily Living Scale (HADLS) were performed twice at an interval of approximately 1 month. All patients were receiving drug therapy for their depression. Results: Participants presented with varied depressive severity on the Ham-D and a slight cognitive deficit on the MMSE; approximately 60% had at least one problem on the HADLS. Between baseline and the follow-up examination, significant improvements were noted in Ham-D, MMSE and HADLS; scores, but not the BI score. The correlations between the Ham-D and ADL scores were significant at baseline and at the follow up examinations. In a multiple regression analysis, the difference in follow-up and baseline scores on the Ham-D contributed significantly to that of HADLS. Conclusions: The present study demonstrates that many patients with late-life depression have some problems with ADL and that a substantial improvement in ADL occurs in association with temporal improvement of depressive severity among subjects with late-life depression.