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Am J Psychiatry 1994; 151:1600-1604
Copyright © 1994 by American Psychiatric Association
Association of age, sex, cognitive dysfunction, and disability with major depressive symptoms in an elderly sample
Y Forsell, AF Jorm and B Winblad
Stockholm Gerontology Research Centre, Canberra, Australia.
OBJECTIVE: Previous studies have yielded conflicting results regarding the
association of age, sex, and cognitive deficit with depression in the
elderly. However, there is agreement about a relationship between
depressive symptoms and disability. The authors previously conducted a
factor analysis of the symptoms of major depression in elderly subjects and
found that the symptoms clustered into factors of mood disturbance and
motivation disturbance. The aim of the present study was to replicate these
findings in a larger population sample and relate some of the variables
possibly associated with depression to these two factors. METHOD: A
population sample of 1,304 persons aged 75 years or older registered in a
parish of Stockholm were examined by physicians to determine DSM-III-R
depressive symptoms and disability in activities of daily living. The
Mini-Mental State examination was also performed. RESULTS: Factor analysis
showed factors of mood and motivation symptoms, and these were related
differently to the associated variables. When the other associated
variables were controlled for, age was unrelated to both types of symptoms.
Women had more mood disturbance, but men had slightly more motivation
disturbance. As cognitive function declined, mood disturbance first
increased, then decreased. Motivation symptoms increased sharply with
decreasing cognitive function. A relationship was found between increasing
disability and both the mood and motivation symptoms. CONCLUSIONS: In the
elderly, symptoms of depression involve either mood or motivation
disturbance and the two types of symptoms are associated with different
variables.
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