Population impact of depression on functional disability in elderly: results from “São Paulo Ageing & Health Study” (SPAH)

  • Simone Almeida da Silva
  • Marcia Scazufca
  • Paulo R. Menezes
Original Paper


With the fast population aging, functional disability among the elderly is becoming a major public health issue. Depression is highly prevalent in this phase of life and may be associated with a significant proportion of the disability among elderly populations. We investigated the association of depressive symptoms and ICD-10 depression with functional disability in older adults and estimated the corresponding population attributable fractions (PAF). A cross-sectional one-phase population-based study was carried out with 2,072 individuals aged 65 years or over living in a low-income area of São Paulo, Brazil. Depressive symptoms and ICD-10 depression were assessed with the Geriatric Mental State and the Neuropsychiatric Inventory. We assessed functional disability with the WHO Disability Assessment Schedule Instrument. Prevalence Ratios and PAF were calculated using Poisson regression. The prevalence of depressive symptoms and ICD-10 depression was 21.4 and 4.8 %, respectively. Depression and depressive symptoms were strongly associated with high functional disability, even after adjustment for demographic factors, socioeconomic conditions, physical morbidities, and dementia. The PAFs for depressive symptoms and ICD-10 depression were 12.0 % for each of the psychiatric morbidity. Depressive symptoms contributed as much as ICD-10 depression to the population burden of functional disability in the elderly. Effective management of clinically significant depressive symptoms, delivered mainly at the primary care level, may reduce the total population disability.


Functional disability Depressive symptoms Elderly Population attributable fraction Epidemiology Brazil 


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Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Simone Almeida da Silva
    • 1
  • Marcia Scazufca
    • 2
  • Paulo R. Menezes
    • 1
  1. 1.Department of Preventive Medicine, Faculty of MedicineUniversity of São PauloSão PauloBrazil
  2. 2.Institute of Psychiatry and LIM-23, Clinics HospitalUniversity of São PauloSão PauloBrazil

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