Impairment of Self-Maintenance Skills and Instrumental Activities of Daily Life in Geriatric Depression

ABSTRACT

OBJECTIVES: The purpose of this study is to evaluate the effect of geriatric depression in activities of daily living for self maintenance (ADL) and instrumental activities of daily living (IADL) under control for effect of cognitive impairment which can be originated by other reasons. METHODS: The author had interviews with 100 old peoples using various scales (KGDS, MMSE-K, Karnofsky Performance Status Scale, ADL, IADL, QOL questionnaire, HDRS). This study also attempts to compare three groups (depression group, recovered group, normal control group) in their functional status. RESULTS: 1) Self-maintenance skills are more affected by physical states than by depressive symptoms. But the effect of depression is more prominent in instrumental activities of daily living. 2) Korean Geriatric Depression Scale (KGDS) correlated well with activities of daily living for self maintenance (ADL) and instrumental activities of daily living (IADL), but Hamilton Depression Rating Scale (HDRS) did not show significant correlation. This reflects that KGDS is a more specific measure for geriatric depression patients. When the effect of physical illness state was eliminated, partial correlation between KGDS and ADL/IADL showed no significant association. This means that the patient's physical functioning status is very important in functional level of geriatric patient. 3) When the patient is recovered from geriatric depression through appropriate treatment, patient's functional level showed no significant differences with normal control. CONCLUSION: This article emphasizes the importance of appropriate treatment for geriatric depression. After the effect of cognitive function was controlled, geriatric depression itself showed significant functional impairment. This functional deficit can threaten the patient's independence and self-respect. So appropriate treatment for depression in geriatrics is indispensable for enhancing quality of life in old people.