Depression, disability and intermediate pathways: A review of longitudinal studies in elders

Jason E. Schillerstrom, Donald R. Royall, Raymond F. Palmer

Research output: Contribution to journalArticlepeer-review

76 Scopus citations


Cross-sectional studies demonstrate depression is associated with disability in elders. These studies also report that disability in depressed elders is associated with greater medical illness burden, cognitive impairment, and behavioral changes. Only longitudinal studies, however, can determine the impact of depression and its comorbidities on functional decline. This review summarizes the findings of 20 longitudinal studies examining the relationship between baseline or incident depression and functional decline. However, the mediational effects of potential risk factors identified by cross-sectional studies cannot be derived from the current literature. We propose a mediational effects model for future longitudinal studies, incorporating measures sensitive to both mood symptoms and the medical, cognitive, and behavioral comorbidities of depression to better understand the impact of each on functional decline and to focus future clinical interventions.

Original languageEnglish (US)
Pages (from-to)183-197
Number of pages15
JournalJournal of Geriatric Psychiatry and Neurology
Issue number3
StatePublished - Sep 2008


  • Cohort
  • Depression
  • Disability
  • Functional status
  • Longitudinal study

ASJC Scopus subject areas

  • Clinical Neurology
  • Geriatrics and Gerontology
  • Psychiatry and Mental health


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