Depression and mortality in a high-risk population. 11-Year follow-up of the Medical Research Council Elderly Hypertension Trial.
BACKGROUND
It is not clear whether the increased mortality associated with depression can be explained by the effects of potential confounding variables.


OBJECTIVE
To measure the effect of depression on mortality after controlling for cognitive decline, cardiovascular risk factors and antidepressant use.


METHODS
A prospective cohort study derived from data from a multi-centre randomised controlled trial of moderate hypertension. A total of 2584 participants, aged 65-75 years at study entry, were followed up for 11 years.


RESULTS
Depression on the SelfCARE-D scale was associated with mortality after controlling for gender. After controlling for cardiovascular risk factors, cognitive decline and antidepressant use, depression continued to have a modest effect (hazard ratio=1.43; 95% C11.03-1.98). Depression in males and in people aged under 70 years significantly increased the risk of death.


CONCLUSIONS
Depression was associated with mortality only after controlling for gender. There was a modest but robust association between depression and mortality that was not explained by confounding by cardiovascular risk factors, cognitive decline or history of antidepressant use.
Abas
Melanie
M
Division of Psychiatry, University of Auckland, New Zealand. m.abas@auckland.ac.nz
Hotopf
Matthew
M
Prince
Martin
M
D000367:Age Factors; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000150:complications; D003072:Cognition Disorders / Q000209:etiology*; D015331:Cohort Studies; D003866:Depressive Disorder / Q000150:complications / Q000188:drug therapy / Q000401:mortality*; D004812:Epidemiologic Methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors
D000928:Antidepressive Agents