Are depressive symptoms a risk factor for mortality in elderly Japanese American men?: the Honolulu-Asia Aging Study.
OBJECTIVE
This study determined the influence of depressive symptoms on subsequent mortality of all causes.


METHODS
The Honolulu Heart Program, established in 1965, is a prospective, community-based cohort of Japanese American men living in Hawaii. The analysis was based on 3,196 Japanese American men aged 71-93 at the time of the fourth examination in 1991-1993. Depressive symptoms were measured by use of an 11-question version of the Centers for Epidemiologic Studies Depression Scale questionnaire. All-cause mortality data were available for 6 years of follow up. Data were analyzed on the basis of presence or absence of chronic diseases.


RESULTS
The overall prevalence of frequent depressive symptoms was 9.9%. Age-adjusted mortality rates at 3 years were 48.0 and 30.3 per 1,000 person-years for the depressed and nondepressed groups, respectively. At 6 years, the rates were 54.1 (depressed) and 41.5 (nondepressed) per 1,000 person-years. After adjustment for age, marital status, and antidepressant use, the relative risk for all-cause mortality associated with depressive symptoms was 1.53 for 3-year and 1.27 for 6-year mortality. Among participants who were healthy (without cognitive impairment, coronary heart disease, stroke, diabetes, or cancer), the association between depressive symptoms and mortality was greater (relative risk of 2.30 and 1.57 for 3- and 6-year mortality, respectively). Among participants with chronic disease, there were no significant associations between depressive symptoms and mortality.


CONCLUSIONS
Depressive symptoms are a risk factor for mortality in elderly people, particularly in physically healthy individuals.
Takeshita
Junji
J
The Honolulu-Asia Aging Study, Kuakini Medical Center, 4th Floor, 1356 Lusitana Street, Honolulu, HI 96813, USA. takeshita@dop.hawaii.edu
Masaki
Kamal
K
Ahmed
Iqbal
I
Foley
Daniel J
DJ
Li
Yuan Qing
YQ
Chen
Randi
R
Fujii
Daryl
D
Ross
G Webster
GW
Petrovitch
Helen
H
White
Lon
L
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001213:Asian / Q000706:statistics & numerical data*; D002423:Cause of Death; D015331:Cohort Studies; D015897:Comorbidity; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality*; D005500:Follow-Up Studies; D006254:Hawaii / Q000453:epidemiology; D006801:Humans; D008297:Male; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors