Depressive Symptoms and Physical Decline in Community-Dwelling Older Persons

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Abstract
MAJOR DEPRESSION is relatively rare among older community-dwelling persons, affecting only about 1% to 2% of that population.1-3 However, a high proportion of community-dwelling elderly persons (12%-20%)1-3 suffer from significant symptoms of depression below the severity threshold of major depression as defined by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). These subsyndromal depressive symptoms, often referred to as "depressed mood," are associated with high societal costs due to increased morbidity and high utilization of health services.1-5 From the perspective of older persons themselves, depressed mood significantly affects their well-being and ability to function.6,7 Physical disability among depressed persons not only is significantly higher than among nondepressed persons, but also is similar or even greater than the disability found among patients with chronic medical illnesses.8