Mixed cognitive and affective disorders in the elderly:: A longitudinal study of related disability

Cognitive disorder is a primary cause of disability in the elderly. In some cases, the problem is exacerbated by co-existing affective disorders which may make community care more difficult and, through its effect on self-control and motivation, also increase disability levels. The present study examines the evolution of disabilities as defined by the International Classification of Impairments, Disabilities and Handicaps, in a cohort of 397 elderly persons with sub-clinical cognitive deficits. Over the three years of the study, 11 % of this cohort developed dementia without depression and 5 % dementia with depression. Dementia alone was found to produce an increased prevalence in the final year of the study of difficulties in dressing, sleeping, walking, continence. bathing and dental care. Rates were higher for all functions except sleeping in cases of dementia with depression. Significant 'decrements over time were found in dressing, putting on shoes, use of telephone and continence. Additionally, elderly persons with dementia and depression showed decline in ability to wash. These preliminary results suggest that dementia-related disability may be reduced, if an associated affective illness is treated.