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To the Editor: We welcome the contribution by Drs. St. John and Montgomery. Their findings are consistent with ours. 1 However, contrary to our findings, when they adjusted for physical function, the association lost significance. In our analyses, we adjusted for activity of daily living (ADL) limitations, which were found to be a significant predictor even while the effect of depressive symptoms remained highly significant. Drs. St. John and Montgomery also used ADLs and included an additional measurement for instrumental activities of daily living (IADLs). It appears that they added both variables into their model concurrently rather than determining the individual effect of each. It is possible that the IADL scale undermined the effect of physical impairment as measured using the ADLs.

We adjusted for considerably more variables than Drs. St. John and Montgomery, which also may explain the different results. For …