Bridging Disciplinary Boundaries (January 11 - 14, 2007)

Purpose: There is a growing body of evidence documenting the high prevalence of subthreshold depression among older adults with disabilities, as well as the negative consequences of subthreshold depression for life quality, which are often equal to those of major depression. However, little is known about the extent to which subthreshold depression persists over time and the factors that predict its natural course among disabled elders. Methods: This presentation reports on six-month follow-up data from a longitudinal study of older adults (n=584) with age-related vision impairment, one of the most common and disabling conditions of later life. In-depth interviews included the Structured Clinical Interview for DSM (SCID) to establish DSM-IV diagnoses of depression. At baseline, 27% (n=157) met criteria for subthreshold depression (minor depression, major depression in partial remission, dysthymia, or CES-D score of 16+). Results: One hundred nine (69.4%) participated in the 6-month follow-up; 60 (55%) had persistent subthreshold (54) or major depression (6), and 49 (45%) were in remission. Logistic regression analyses were conducted which tested the significance of demographic, vision, health, rehabilitation and mental health service use, and social support variables in differentiating the two groups. While the equation was significant, results indicated that only higher concurrent perceived availability of social support was a significant predictor of remission. Findings provide further evidence for the importance of social support in addressing the effects of disability on mental health, but also raise questions about the lack of significance of health and vision status and service variables. Implications: Implications for future research and mental health interventions for older disabled adults in community rehabilitation settings are discussed.