Improved mood despite worsening physical health in older adults: Findings from the International Mobility in Aging Study (IMIAS).

OBJECTIVES: Older adults experience increasing physical illness with age, but paradoxically, they frequently describe improvements in mood and self-rated health. The role of declining physical health as a risk for depression in elderly men and women remains unclear. We assessed whether declining physical health predicted changes in depression over time among seniors using data from the International Mobility in Aging Study (IMIAS).

METHODS: IMIAS is a longitudinal population-based study of older adults in Canada, Colombia, and Brazil. We assessed change in depression by comparing Center for Epidemiology-Depression (CES-D) scores for 1161 men and women between 2012 and 2016, and used multiple regression to identify whether changes in chronic health conditions, grip strength and self-rated health predicted change in depression over time.

RESULTS: Despite worsening physical health measured as chronic health conditions and grip strength, mean CES-D scores decreased from 8.15 (95% CI 7.70-8.60) in 2012 to 7.15 (95% CI 6.75 to 7.56) in 2016. Counterintuitively, women reported increased self-rated health despite having declining physical health, p = 0.004. Decreases in depressive symptoms were aligned with higher CES-D in 2012 and with increases in self-rated health among women and overall, and with high CES-D 2012 and increases in chronic health conditions in men, ps < 0.05.

CONCLUSIONS: Mental health appears to be a fundamentally different construct than physical health in older adults, allowing seniors to experience improved mood despite declining physical health. Clinicians should not consider depression in elderly populations as an inevitability of aging.