Obrizan, Maksym (2011): Unobserved Factors Linking Functional Decline and Depression Among the Oldest Americans.
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This study considers the dependence between functional decline and depression in a nationally representative sample of older Americans from the Survey on Assets and Health Dynamics among the Oldest Old (AHEAD) covering the years from 1993 to 2002. Previous research has shown that depression is a significant predictor of functional decline and, conversely, functional limitations lead to more depressive symptoms. While this cross-dependence is an established fact in the literature, relatively few prior papers formally modeled the association between functional decline and depression.
In this paper, functional decline is defined as 2 or more limitations in 5 Activities of Daily Living (ADL) and 2 or more limitations in 5 Instrumental Activities of Daily Living (IADL) from the baseline to the last available follow-up interview. Depression is defined as 3 or more points on the 8-item Center for Epidemiological Studies Depression (CES-D) Scale over the same range of time. In the analytic sample of 5,470 oldest Americans, each of the three measures is initially estimated in the univariate probit model controlling for a rich set of available risk factors identified in the previous studies.
Then it is argued that univariate probit models are incapable of capturing individual differences (for example, predisposition to both physical and emotional ill health) that may link functional decline and depression in the oldest Americans. Thus, a more advanced multivariate probit model is employed, and three discrete equations are estimated jointly. In this way, unmeasured factors specific to the individual will become part of the error terms, and statistically significant correlations in the variance matrix will indicate dependence between functional decline and depression. Estimation of multivariate probit model reveals substantial unobserved heterogeneity in the dynamics of ADLs, IADLs, and CES-D score over time. Thus, previous results based on univariate methods should be interpreted with caution.
|Item Type:||MPRA Paper|
|Original Title:||Unobserved Factors Linking Functional Decline and Depression Among the Oldest Americans|
|Keywords:||Multivariate probit, Activities of Daily Living, Depression, Older Adults|
|Subjects:||I - Health, Education, and Welfare > I1 - Health > I18 - Government Policy ; Regulation ; Public Health
C - Mathematical and Quantitative Methods > C3 - Multiple or Simultaneous Equation Models ; Multiple Variables > C35 - Discrete Regression and Qualitative Choice Models ; Discrete Regressors ; Proportions
|Depositing User:||Maksym Obrizan|
|Date Deposited:||01. Jul 2011 08:02|
|Last Modified:||17. Jan 2015 12:32|
Ashford, J. and R. Sowden. (1970). Multi-variate probit analysis. Biometrics (26):535-546.
Balia S., and A.M. Jones. (2008). Mortality, lifestyle and socio-economic status. Journal of Health Economics 27:1–26.
Boyd C.M., Q.L. Xue, J.M. Guralnik, and L.P. Fried. (2005). Hospitalization and development of dependence in Activities of Daily Living in a cohort of disabled older women: The Women’s Health and Aging Study I. Journal of Gerontology: Medical Sciences 60A(7):888–893.
Bruce M.L. (2001). Depression and disability in late life: Directions for future research. Am J Geriatr Psychiatry 9:102–112.
Cappellari L., and S.P. Jenkins. (2003). Multivariate probit regression using simulated maximum likelihood. The Stata Journal 3(3): 278–294.
Chib, S. and E. Greenberg. (1998). Analysis of multivariate probit models. Biometrika 85(2):347-361.
Cole, M.G., and N. Dendukuri. (2003). Risk factors for depression among elderly community subjects: A systematic review and meta-analysis. American Journal of Psychiatry, 50, 1147-1156.
Covinsky K.E., Yaffe K., Lindquist K., Cherkasova E., Yelin E., and D.G. Blazer. (2010). Depressive symptoms in middle age and the development of later-life functional limitations: the long-term effect of depressive symptoms.” J Am Geriatr Soc: 58(3), 551- 556.
Choi, N.G., and F.S. Kim. (2007). Age group differences in depressive symptoms among older adults with functional impairments. Health & Social Work: 3(3), 177-188.
Fonda, S.J., and A.R. Herzog. (2001). Patterns and risk factors of change in somatic and mood symptoms among older adults. Annals of Epidemiology, 11, 361-368.
Gill T.M., H.G. Allore, T.R. Holford, and Z. Gui. (2004). Hospitalization, restricted activity, and the development of disability among older persons. JAMA 292(17):2115-2124.
van Gool C.H., G.I.J.M. Kempen, B.W.J.H. Penninx, D.J.H. Deeg, A.T.F. Beekman, J.Th.M. van Eijk. (2005). Impact of depression on disablement in late middle aged and older persons: results from the Longitudinal Aging Study Amsterdam. Social Science & Medicine 60 (1): 25-36.
Greene, W. (2003). Econometric Analysis. 5th ed. Upper Saddle River, NJ: Prentice Hall.
Health and Retirement Study, AHEAD Core 1993 public use dataset. (1998). Produced and distributed by the University of Michigan with funding from the National Institute on Aging (grant number NIA U01AG009740), Ann Arbor, MI.
Jones A.M., N. Rice, T. Bago d’Uva, and S. Balia. (2007). Applied Health Economics. 1st ed. NY: New York. Routledge.
Juster, F.T., and R.M. Suzman. (1995). An overview of the Health and Retirement Study. J Hum Resources 30: S7-S56.
Kohout, F., Berkman, L., Evans, D, and Cornoni-Huntley. (1993). Two shorter forms of the CES-D depression symptoms index. Journal of Aging and Health, 5, 179-193.
Lamb V.L. (1996). A cross-national study of quality of life factors associated with patterns of elderly disablement. Social Science & Medicine 42(3): 363-377.
Myers, G.C., F.T. Juster, and R. M. Suzman. (1997). Assets and Health Dynamics among the Oldest Old (AHEAD): Initial results from the longitudinal study. J Gerontol Psychol Sci Soc Sci 52B: Special Issue.
Ormel J., F.V. Rijsdijk, M. Sullivan, E. van Sonderen, and G. I. J. M. Kempen. (2002). Temporal and reciprocal relationship between IADL/ADL disability and depressive symptoms in late life. J Gerontol B Psychol Sci Soc Sci 57B:338–347.
Steffick, D.E. (2000). HRS/AHEAD documentation report: Documentation of affective functioning measures in the Health and Retirement Study. Ann Arbor: University of Michigan, Survey Research Center.
Stuck A.E., J.M. Walthert, T. Nikolau, C.J. Bula, C. Hohmann, and J.C. Beck. (1999). Risk factors for functional status decline in community-living elderly people: a systematic literature review. Social Science & Medicine 48:445-469.
Wolinsky F.D., S.E. Bentler, L. Liu, M. Obrizan, E.A. Cook, K.B. Wright, J.F. Geweke, E.A. Chrischilles, C.E. Pavlik, R.L. Ohsfeldt, M.P. Jones, K.K. Richardson, G.E. Rosenthal, and R.B. Wallace. (2009). Recent hospitalization and the risk of hip fracture among older Americans. J Gerontol A Biol Sci Med Sci, Feb, 64(2): 249-55.