Postmenopausal estrogen therapy and depressive symptoms in older women.
BACKGROUND
Evidence regarding the effect of postmenopausal estrogen therapy on mood is limited.


METHODS
To determine whether postmenopausal estrogen therapy is associated with fewer depressive symptoms in elderly women, we conducted a cross-sectional study of 6, 602 white women ages 71 years or older who were recruited from population-based listings in Baltimore, Md; Minneapolis, Minn; Portland, Ore; and the Monongahela Valley, Pa. Use of estrogen and progestin was determined by interview. Participants completed the Geriatric Depression Scale short form (GDS) and were considered depressed if they reported 6 or more of 15 possible symptoms of depression.


RESULTS
A total of 6.3% (72/1,150) of current estrogen users, 7.2% (142/1,964) of past estrogen users, and 9.0% (313/3,488) of never users reported 6 or more symptoms of depression (P =.004). Current estrogen users had a decreased risk of reporting 6 or more depressive symptoms, compared with not current (past or never) users of estrogen (odds ratio [OR], 0.7; 95% CI, 0.5 to 0.9; P =.01], adjusted for living alone, bilateral oophorectomy, current smoking, physical activity, social network, self-perceived health, cognitive function, functional status, and antidepressant use. However, excluding women who use estrogen or progestin alone, we were unable to find an association between current use of combined estrogen plus progestin therapy and depressive symptoms (adjusted OR, 0.8; 95% CI, 0.5 to 1.4; P =.5).


CONCLUSIONS
This cross-sectional study found that current use of unopposed estrogen was associated with a decreased risk of depressive symptoms in older women. Additional studies are needed to understand the effect of combined estrogen and progestin therapy on the prevalence of depressive symptoms in older women.
Whooley
M A
MA
Section of General Internal Medicine, San Francisco Department of Veterans Affairs Medical Center, Departments of Medicine and Epidemiology and Biostatistics, University of California, San Francisco, California, USA. whooley@itsa.ucsf.edu
Grady
D
D
Cauley
J A
JA
D000368:Aged; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis / Q000517:prevention & control*; D015914:Estrogen Replacement Therapy; D004967:Estrogens / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D015999:Multivariate Analysis; D015995:Prevalence; D011372:Progestins / Q000627:therapeutic use; D011788:Quality of Life; D012307:Risk Factors; D012959:Socioeconomic Factors
D004967:Estrogens; D011372:Progestins