Problem-Solving Therapy and Supportive Therapy in Older Adults With Major Depression and Executive Dysfunction

Abstract

Disability is a primary concern of patients, families, clinicians, and policy makers.¹ The World Health Organization Global Burden of Disease Initiative identified unipolar depression as the leading cause of disability worldwide.² Depression accounts for 10.7% of the variance in disability and is responsible for more than 1 in 10 years lived with disability.² Longitudinal studies of community-residing adults show a strong relationship between depression and new-onset disability,^3-7 with the likelihood of becoming disabled increasing with each additional symptom of depression.⁴ Moreover, as the number of depressive symptoms increases, the likelihood of recovering from a physical disability decreases.⁴ Even subsyndromal depressive symptoms are associated with disability in older persons.⁸ Similar relationships between depression and disability have been observed in psychiatric and primary care patients.^9-13