title: The effect of gender and age at onset of depression on mortality.
abstract: BACKGROUND
  Depression has a marked negative impact on geriatric patient mortality and morbidity. The risk factors and exact reasons for these effects are not well understood.
  
  
  METHODS
  Seeking to better define the factors, we retrospectively analyzed the effects of gender and age at onset of affective disorder in a naturalistic study of 192 geriatric patients consecutively admitted to a large midwestern tertiary care center between 1980 and 1987 for the treatment of unipolar depression.
  
  
  RESULTS
  After controlling for age at index admission, patients with an onset of depression before age 40 suffered significantly (p < .05) less mortality in follow-up than those with onset after age 40. When effects of gender are examined, the effects of age at onset are most profound in women, with a threefold increase in the rate of death in the cohort with age at onset of depression after 70 years when compared to those with onset before age 40.
  
  
  CONCLUSIONS
  These results and those of others suggest that depressed elderly women with no previous history of affective disorder are at a markedly increased risk compared with elderly women with a history of affective illness for morbidity and mortality and that a significant proportion of elderly depressed patients are admitted to a psychiatric hospital for a depression that is secondary to serious medical illness.
authors.affiliation: Clinical Neuroscience Branch, National Institute of Mental Health, Bethesda, Md 20892-4405, USA.
authors.forename: R A
authors.initials: RA
authors.lastname: Philibert
authors.forename: L
authors.initials: L
authors.lastname: Richards
authors.forename: C F
authors.initials: CF
authors.lastname: Lynch
authors.forename: G
authors.initials: G
authors.lastname: Winokur
mesh_terms: D000367:Age Factors; D017668:Age of Onset; D015897:Comorbidity; D019992:Databases as Topic / Q000706:statistics & numerical data; D003866:Depressive Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment; D006333:Heart Failure / Q000175:diagnosis / Q000453:epidemiology; D006760:Hospitalization; D006778:Hospitals, Psychiatric; D006801:Humans; D008173:Lung Diseases, Obstructive / Q000175:diagnosis / Q000453:epidemiology; D008297:Male; D017063:Outcome Assessment, Health Care; D012307:Risk Factors; D012737:Sex Factors; D016019:Survival Analysis