Depressive Symptoms and Functional Disability Among Older Adults in Nakhon Ratchasima Province, Thailand: A Cross-Sectional Population-Based Study

Background: Depressive symptoms have been associated with activities of daily living (ADL) disability; however, evidence among Thai older adults remains limited and inconsistent. This study investigates the association between depressive symptoms and ADL disability in older Thai adults. Methods: A cross-sectional analytic study was conducted among 312 older adults in Nakhon Ratchasima, Thailand, who were selected using a multistage sampling method. Data were collected between April and July 2023 using structured questionnaires covering demographic and environmental variables. Depressive symptoms were assessed using the 15-item Geriatric Depression Scale. ADL disability was measured using the Barthel and Chula ADL Indices. Multiple logistic regression was performed to estimate adjusted odds ratios (adjusted ORs) with 95% confidence intervals (CIs). Results: Among participants, 52.6% were female, with a mean age of 69.4 years (SD = 8.6). The prevalence of depressive symptoms was 17.3% (95% CI, 13.3–22.0). The prevalence of basic ADL disability and instrumental ADL (IADL) disability was 4.2% (95% CI, 2.2–7.0) and 21.5% (95% CI, 17.0–26.6), respectively. Depressive symptoms were significantly associated with IADL disability. Participants with depressive symptoms had approximately threefold higher odds of IADL disability than those without depressive symptoms (adjusted OR, 3.05; 95% CI, 1.35–6.87; p = 0.007). Conclusions: These findings highlight the importance of integrated community-based interventions targeting depression among older adults. Strengthening primary care and mental health services may reduce functional disability and support healthy aging.