Depression and chronic medical illnesses in Asian older adults: the role of subjective health and functional status

Int J Geriatr Psychiatry. 2007 Nov;22(11):1087-94. doi: 10.1002/gps.1789.


Objective: Depression in elderly is reportedly associated with a number of specific chronic illnesses. Whether each of these co-morbid associations results uniquely from disease-specific psychobiological responses or is mediated by non-specific factors like subjective health and functional status is unclear.

Method: Analysis of data of 2,611 community-dwelling Chinese aged 55 and older, including depressive symptoms defined by Geriatric Depression Scale score >or= 5 and self-reports of specific chronic illnesses.

Results: The prevalence of depressive symptoms was 13.3%, lower in those without chronic illness (7.5%), and higher in those with illnesses (13.2-24.2%). Crude Odds Ratios (OR) were significantly elevated for hypertension, eye disorders, diabetes, arthritis, ischemic heart disease, asthma/COPD, stroke, osteoporosis, heart failure, thyroid problem, and gastric problem. In multivariable analyses, only asthma/COPD [OR:2.85, 95% Confidence Intervals (CI): 1.36, 5.98], gastric problem (OR:2.64, 95% CI: 1.11, 6.29), arthritis (OR:1.87, 95% CI: 1.02, 3.42) and heart failure (OR:2.11, 95% CI: 0.98, 4.58) remained independently associated with depressive symptoms, after adjusting for comorbidities, subjective health and functional status, cognitive functioning, smoking, alcohol, psychosocial and demographic variables.

Conclusion: Most comorbid associations of depressive symptoms with specific chronic illnesses are explained by accompanying poor self-reported health and functional status, but some illnesses probably have a direct psychobiological basis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Asian Continental Ancestry Group / psychology*
  • Asian Continental Ancestry Group / statistics & numerical data
  • Chronic Disease / ethnology
  • Chronic Disease / psychology*
  • Depression / ethnology
  • Depression / etiology*
  • Female
  • Geriatric Assessment
  • Health Status Indicators
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Singapore / epidemiology
  • Social Support
  • Socioeconomic Factors