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.

Physical functioning in elderly Europeans: 10 year changes in the north and south: the HALE project.

OBJECTIVES: To examine age related changes in physical functioning in elderly men and women. DESIGN: Prospective, population based study. SETTING: Population of 15 rural and urban centres in 10 European countries. PARTICIPANTS: Altogether 3496 men and women born between 1900 and 1920 who participated in the baseline survey of the HALE project in 1988-1991. The study population was examined again about five (in 1993-1995) and 10 (in 1999-2001) years after the baseline examination. MAIN OUTCOME MEASURES: Physical functioning was measured by means of a self administered questionnaire of activities of daily living (ADL). Dichotomised prevalence of disability and need for help in self care and mobility ADL were used as dependent variables in the analyses. RESULTS: Prevalence of disability and need for help tended to be higher in women than in men and in mobility abilities than in self care activities. Disability and need for help increased with advancing age but ameliorated over time from one birth cohort to another. In longitudinal analyses this beneficial time trend was independent of the effect of age, study, and region in self care disability in men and women (OR 0.85, 95% CI 0.75 to 0.97 and OR 0.64, 95% CI 0.43 to 0.97, respectively) and self care need for help in men (OR 0.83, 95% CI 0.70 to 0.96). Mobility disability among men and self care disability among women decreased more in the south than in the north. CONCLUSION: While European populations are aging, the proportions of elderly people with disability are decreasing. These results suggest that dynamics of functioning may differ across cultures. Future studies are needed to clarify which potentially modifiable and culturally determined factors protect against functional decline.

Serum cholesterol and depressive symptoms in elderly Finnish men.

OBJECTIVE: Evidence from previous studies suggests that alterations in lipid levels may be associated with depression in old age. The objective of this study was to investigate the association between serum lipids and depressive symptoms in a population of elderly men. SUBJECTS AND METHODS: Altogether 470 men born between 1900 and 1919 were examined in the 30-year follow-up of the Seven Countries Study in 1989. Zung Self-Rating Depression Scale was used to determine the depressive status of the subjects. The depressive status was dichotomised and used as the dependent variable in the present study. RESULTS: The depressive status was available for 421 men aged 70 to 89 years in 1989. The prevalence of depression, defined as the Zung sum score equal to or greater than 48, was 15.2% (n = 64). A low serum total cholesterol (odds ratio (OR) 0.67, 95% confidence intervals (CI) 0.48-0.94, p = 0.022) and low low density lipoprotein cholesterol (OR 0.67, 95% CI: 0.46-0.98, p = 0.041) were independently associated with depression. No association with depression was found for high density lipoprotein (HDL) concentration or HDL/total cholesterol ratio after the adjustment for other putative correlates for depression. CONCLUSIONS: Our study of a well-documented population of elderly Finnish men confirms that low total serum cholesterol is associated with a high amount of depressive symptoms independently of weight change or chronic disease. Our study is the first to show an independent association of low LDL-cholesterol concentration with a high amount of depressive symptoms in the old-old.