Prevalence and Association of Depressive Symptoms with Physical Disability and Long-Term Care Use among Older American Indians

Health officials have recently been sounding the alarm that depression will soon surpass many of the major medical conditions in causing disability among adults. Recent demographic and health trends are generating public health concern about depression. First, the prevalence of chronic conditions has dramatically increased over the last several generations. Second, depression often accompanies chronic conditions and can exacerbate physical health outcomes. Third, the recent entry of the baby-boomers into the older age bracket is spawning an substantive expansion of the older adult population in this country, an age group that disproportionately experiences greater number of chronic conditions, physical disabilities, and associated long-term care needs. These health trends are even greater among older American Indians. However, despite greater prevalence of morbidity, depression, and physical disability among older American Indians, very little is known about the relative impact of morbidity and depression on physical disability. Therefore, the first manuscript examines 1) the prevalence and correlates of depressive symptoms and 2) the relationship of depressive symptoms with chronic conditions and physical disability among older American Indians, using the Native Elder Care Study data.;The presence of depressive symptoms in older adults have been implicated in the need for and use of greater medical care, greater number of caregiving hours received, and increased medical expenditures above and beyond the severity of chronic conditions or physical disability. No published studies have examined the difference in amount of long-term informal and formal care receipt between older American Indians with different levels of depressive symptoms. Therefore, the second manuscript examines the difference in amount of informal and formal long-term care receipt between older American Indians with different levels of depressive symptoms.;Examining the contribution of depressive symptoms to physical disability and long-term care use among older adults is important because it is a preventable and treatable condition afflicting a substantive proportion of this population. As the number of older adults increases, long-term care will be in greater demand. However, it is unclear whether our long-term care system will be able to meet the growing demand. Thus, this research contributes to our understanding of the factors leading to greater physical disability and long-term care use.