Differential effects of premorbid physical and emotional health on recovery from acute events

Glenn V. Ostir, James Goodwin, Kyriakos Markides, Kenneth Ottenbacher, Jennifer Balfour, Jack M. Guralnik

Research output: Contribution to journalArticle

60 Citations (Scopus)

Abstract

OBJECTIVES: Emotional health may have an important effect on disease onset, but there has been little work evaluating premorbid emotional health on recovery from disability that results from acute medical events. The aim of this study is to determine whether premorbid emotional health is predictive of recovery in functional ability 1 year after reporting a stroke, heart attack, or hip fracture (event). DESIGN: A prospective cohort study of an older population-based sample from 1986 to 1992. SETTING: Data are from baseline and six annual follow-ups of the North Carolina Established Population for Epidemiological Study of the Elderly. PARTICIPANTS: Two hundred forty whites and blacks aged 65 and older who reported a stroke, heart attack, or hip fracture during one of the first five follow-up interviews and had an increased level of disability at that follow-up. MEASUREMENT: Improvement in disability in activities of daily living (ADLs) 1 year postevent. RESULTS: High depressive symptoms at baseline showed a significant association with poorer recovery in functional ability 1-year postevent after adjustments were made for sociodemographic characteristics, smoking status, ADLs at time of event, cognitive status, and prior history of disease. Compared with nondepressed subjects, depressed subjects had an odds ratio (OR) of 0.38 (95% confidence interval (CI) = 0.16-0.94) for recovery 1 year after reporting a stroke, heart attack, or hip fracture. Additionally, among subjects who reported low depressive symptoms, high positive affect was significantly associated with increased odds of recovery (OR = 2.70, 95% CI = 1.10-6.68), adjusting for the same variables. CONCLUSIONS: Emotional health, independent of other baseline measures, is associated with recovery in functional ability 1 year after a major health event. Our findings suggest that reducing premorbid levels of depressive symptoms or increasing positive affect may help the recovery process.

Original languageEnglish (US)
Pages (from-to)713-718
Number of pages6
JournalJournal of the American Geriatrics Society
Volume50
Issue number4
DOIs
StatePublished - 2002

Fingerprint

Aptitude
Hip Fractures
Health
Stroke
Myocardial Infarction
Depression
Activities of Daily Living
Odds Ratio
Confidence Intervals
Social Adjustment
Population
Epidemiologic Studies
Cohort Studies
Smoking
Prospective Studies
Interviews

Keywords

  • Depression
  • Heart attack
  • Hip fracture
  • Older
  • Positive affect
  • Stroke

ASJC Scopus subject areas

  • Geriatrics and Gerontology

Cite this

Differential effects of premorbid physical and emotional health on recovery from acute events. / Ostir, Glenn V.; Goodwin, James; Markides, Kyriakos; Ottenbacher, Kenneth; Balfour, Jennifer; Guralnik, Jack M.

In: Journal of the American Geriatrics Society, Vol. 50, No. 4, 2002, p. 713-718.

Research output: Contribution to journalArticle

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abstract = "OBJECTIVES: Emotional health may have an important effect on disease onset, but there has been little work evaluating premorbid emotional health on recovery from disability that results from acute medical events. The aim of this study is to determine whether premorbid emotional health is predictive of recovery in functional ability 1 year after reporting a stroke, heart attack, or hip fracture (event). DESIGN: A prospective cohort study of an older population-based sample from 1986 to 1992. SETTING: Data are from baseline and six annual follow-ups of the North Carolina Established Population for Epidemiological Study of the Elderly. PARTICIPANTS: Two hundred forty whites and blacks aged 65 and older who reported a stroke, heart attack, or hip fracture during one of the first five follow-up interviews and had an increased level of disability at that follow-up. MEASUREMENT: Improvement in disability in activities of daily living (ADLs) 1 year postevent. RESULTS: High depressive symptoms at baseline showed a significant association with poorer recovery in functional ability 1-year postevent after adjustments were made for sociodemographic characteristics, smoking status, ADLs at time of event, cognitive status, and prior history of disease. Compared with nondepressed subjects, depressed subjects had an odds ratio (OR) of 0.38 (95{\%} confidence interval (CI) = 0.16-0.94) for recovery 1 year after reporting a stroke, heart attack, or hip fracture. Additionally, among subjects who reported low depressive symptoms, high positive affect was significantly associated with increased odds of recovery (OR = 2.70, 95{\%} CI = 1.10-6.68), adjusting for the same variables. CONCLUSIONS: Emotional health, independent of other baseline measures, is associated with recovery in functional ability 1 year after a major health event. Our findings suggest that reducing premorbid levels of depressive symptoms or increasing positive affect may help the recovery process.",
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AU - Guralnik, Jack M.

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