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Disabilty in Older Adults with Depression

Chisholm, Denise (2005) Disabilty in Older Adults with Depression. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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Depression is a leading cause of disability among older adults which can change the scope of daily life for older adults and threaten their ability to live independently in the community. This dissertation explored task disability in older adults with depression in three studies. A unique aspect of the studies was the assessment of disability through performance-testing. The first study examined task disability patterns in a sample of older adults with depression being treated as inpatients (n = 60) or outpatients (n = 59). Rasch analysis revealed that the degree of disability for task domains (functional mobility [FM], basic activities of daily living [BADL], instrumental activities of daily living [IADL] with a greater physical component [IADL-physical], and IADL with a greater cognitive component [IADL-cognitive]), and task items, was different for older women whose depression resulted in inpatient versus outpatient treatment. With the same sample, the second study examined the impact of information processing speed on task disability. The patients were separated into groups by speed of processing (slower patients, n = 76; faster patients, n = 23) based on their performance on the Trail Making Test - B. Speed of processing was associated with severity of depression and both depression and slower speed of processing interfered more with effortful processing tasks (i.e., IADL-cognitive and IADL-physical) and less with tasks requiring automatic processing (i.e. FM). The third study compared physician rated disability on the Global Assessment of Function (GAF) Scale with performance-disability observed on the Performance Assessment of Self-Care Skills (PASS) in a hospitalized community-based sample separated into subgroups by readmission status (readmit patients, n = 15; non-readmit patients, n = 43). There was a lack of concordance between the measures with only the GAF Scale showing significant reduction in disability at discharge. Findings from these studies suggest that for older adults with depression, there may be sentinel tasks which are disability indicators and those tasks may differ based on speed of processing. The lack of concordance between the disability measures suggests the need for consideration of performance-based testing of daily life tasks as a component of usual care.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Chisholm, Denisedchishol@pitt.eduDCHISHOL
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairHolm, Margo Bmbholm@pitt.eduMBHOLM
Committee MemberReynolds, Charles F
Committee Member Irrgang, James J
Committee MemberRogers, Joan C
Date: 17 November 2005
Date Type: Completion
Defense Date: 7 November 2005
Approval Date: 17 November 2005
Submission Date: 17 November 2005
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Institution: University of Pittsburgh
Schools and Programs: School of Health and Rehabilitation Sciences > Rehabilitation Science
Degree: PhD - Doctor of Philosophy
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: Activities of Daily Living; Depression; Disability; Geriatrics; Instrumental Activities of Daily Living
Other ID:, etd-11172005-084722
Date Deposited: 10 Nov 2011 20:05
Last Modified: 15 Nov 2016 13:51


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