Increased Depressive and Anxiety Symptoms Predict Increased Severity of Functional Impairment After Five Years: A Nationally Representative Retrospective Cohort Study

Purpose: Performing self-care and domestic life tasks are key aspects of functional independence for older adults. While both depression and anxiety symptoms are correlated with increased functional limitation, these disorders are often studied separately, despite frequent co-occurrence and plausibl...

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Main Authors: Elisabeth C. DeMarco, Samantha Zocher, Blake Miyamoto, Leslie Hinyard, Divya S. Subramaniam
Format: Article
Language:English
Published: Advocate Aurora Health 2025-01-01
Series:Journal of Patient-Centered Research and Reviews
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Online Access:https://institutionalrepository.aah.org/cgi/viewcontent.cgi?article=2097&context=jpcrr
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author Elisabeth C. DeMarco
Samantha Zocher
Blake Miyamoto
Leslie Hinyard
Divya S. Subramaniam
author_facet Elisabeth C. DeMarco
Samantha Zocher
Blake Miyamoto
Leslie Hinyard
Divya S. Subramaniam
author_sort Elisabeth C. DeMarco
collection DOAJ
description Purpose: Performing self-care and domestic life tasks are key aspects of functional independence for older adults. While both depression and anxiety symptoms are correlated with increased functional limitation, these disorders are often studied separately, despite frequent co-occurrence and plausible interaction, and without the consideration of social health. This study examined the impact of comorbid depressive and anxiety symptoms, controlling for social participation and loneliness, on severity of functional limitation in a nationally representative sample of older adults to improve patient-centered care. Methods: The National Social Life, Health, and Aging Project (NSHAP) Rounds 2 and 3 data were utilized. Primary outcomes were self-reported difficulty with activities of daily living and instrumental activities of daily living. All analyses were weighted for Round 2 to account for NSHAP sampling design. Results: Approximately one-quarter of respondents documented either depressive or anxiety symptoms, with 9.4% documenting both. Those with both depressive and anxiety symptoms reported the greatest number of functional limitations and greatest difficulty with tasks when assessed after 5 years. Using multivariate linear regression, poorer mental health status and increased comorbidity burden significantly predicted severity of functional limitation. While loneliness was associated with slightly worse function, increased social participation appeared to be a protective factor. Conclusions: These results build on existing literature calling for a more holistic assessment of health – physical, mental, and social – and further emphasize the need for mental health interventions as an avenue to increase functional independence in older adults to improve patient experience and patient-centered care.
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spelling doaj-art-747422fdde234e9db741e761456e886c2025-01-29T20:14:51ZengAdvocate Aurora HealthJournal of Patient-Centered Research and Reviews2330-06982025-01-01121213110.17294/2330-0698.2097Increased Depressive and Anxiety Symptoms Predict Increased Severity of Functional Impairment After Five Years: A Nationally Representative Retrospective Cohort StudyElisabeth C. DeMarco0https://orcid.org/0000-0003-4488-9772Samantha Zocher1https://orcid.org/0009-0007-1766-2018Blake Miyamoto2https://orcid.org/0009-0001-5800-6419Leslie Hinyard3https://orcid.org/0000-0002-9481-7737Divya S. Subramaniam4https://orcid.org/0009-0006-4897-2409Saint Louis University School of MedicineSaint Louis University School of MedicineSaint Louis University School of MedicineSaint Louis University School of MedicineSaint Louis University School of MedicinePurpose: Performing self-care and domestic life tasks are key aspects of functional independence for older adults. While both depression and anxiety symptoms are correlated with increased functional limitation, these disorders are often studied separately, despite frequent co-occurrence and plausible interaction, and without the consideration of social health. This study examined the impact of comorbid depressive and anxiety symptoms, controlling for social participation and loneliness, on severity of functional limitation in a nationally representative sample of older adults to improve patient-centered care. Methods: The National Social Life, Health, and Aging Project (NSHAP) Rounds 2 and 3 data were utilized. Primary outcomes were self-reported difficulty with activities of daily living and instrumental activities of daily living. All analyses were weighted for Round 2 to account for NSHAP sampling design. Results: Approximately one-quarter of respondents documented either depressive or anxiety symptoms, with 9.4% documenting both. Those with both depressive and anxiety symptoms reported the greatest number of functional limitations and greatest difficulty with tasks when assessed after 5 years. Using multivariate linear regression, poorer mental health status and increased comorbidity burden significantly predicted severity of functional limitation. While loneliness was associated with slightly worse function, increased social participation appeared to be a protective factor. Conclusions: These results build on existing literature calling for a more holistic assessment of health – physical, mental, and social – and further emphasize the need for mental health interventions as an avenue to increase functional independence in older adults to improve patient experience and patient-centered care.https://institutionalrepository.aah.org/cgi/viewcontent.cgi?article=2097&context=jpcrrmental healthactivity levelsepidemiologydepressionanxiety
spellingShingle Elisabeth C. DeMarco
Samantha Zocher
Blake Miyamoto
Leslie Hinyard
Divya S. Subramaniam
Increased Depressive and Anxiety Symptoms Predict Increased Severity of Functional Impairment After Five Years: A Nationally Representative Retrospective Cohort Study
Journal of Patient-Centered Research and Reviews
mental health
activity levels
epidemiology
depression
anxiety
title Increased Depressive and Anxiety Symptoms Predict Increased Severity of Functional Impairment After Five Years: A Nationally Representative Retrospective Cohort Study
title_full Increased Depressive and Anxiety Symptoms Predict Increased Severity of Functional Impairment After Five Years: A Nationally Representative Retrospective Cohort Study
title_fullStr Increased Depressive and Anxiety Symptoms Predict Increased Severity of Functional Impairment After Five Years: A Nationally Representative Retrospective Cohort Study
title_full_unstemmed Increased Depressive and Anxiety Symptoms Predict Increased Severity of Functional Impairment After Five Years: A Nationally Representative Retrospective Cohort Study
title_short Increased Depressive and Anxiety Symptoms Predict Increased Severity of Functional Impairment After Five Years: A Nationally Representative Retrospective Cohort Study
title_sort increased depressive and anxiety symptoms predict increased severity of functional impairment after five years a nationally representative retrospective cohort study
topic mental health
activity levels
epidemiology
depression
anxiety
url https://institutionalrepository.aah.org/cgi/viewcontent.cgi?article=2097&context=jpcrr
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AT samanthazocher increaseddepressiveandanxietysymptomspredictincreasedseverityoffunctionalimpairmentafterfiveyearsanationallyrepresentativeretrospectivecohortstudy
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