title: Is depression in old age fatal only when people feel lonely?
abstract: OBJECTIVE
  The impact of depression and perceived loneliness in the oldest old is largely unknown. The authors studied the relationship between the presence of depressive symptoms and all-cause mortality in old age, especially the potential distorting effect of perceived loneliness.
  
  
  METHODS
  Within a prospective population-based study of 85-year-olds, the 15-item Geriatric Depression Scale and the Loneliness Scale were annually applied in all 476 participants with a Mini-Mental State Examination score of 18 points or more.
  
  
  RESULTS
  Depression was present in 23% and associated with marital state, institutionalization, and perceived loneliness. When depression and perceived loneliness were assessed during follow-up, neither depression nor perceived loneliness had a significant effect on mortality. However, those who suffered from both depression and feelings of loneliness had a 2.1 times higher mortality risk.
  
  
  CONCLUSIONS
  The data suggest that the increased mortality risk attributable to depression in the presence of perceived loneliness may result from motivational depletion.
authors.affiliation: Section of Gerontology and Geriatrics, Department of General Internal Medicine, Leiden University Medical Center, The Netherlands. m.l.stek@ggzba.nl
authors.forename: Max L
authors.initials: ML
authors.lastname: Stek
authors.forename: David J
authors.initials: DJ
authors.lastname: Vinkers
authors.forename: Jacobijn
authors.initials: J
authors.lastname: Gussekloo
authors.forename: Aartjan T F
authors.initials: AT
authors.lastname: Beekman
authors.forename: Roos C
authors.initials: RC
authors.lastname: van der Mast
authors.forename: Rudi G J
authors.initials: RG
authors.lastname: Westendorp
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D015331:Cohort Studies; D003865:Major Depressive Disorder / Q000401:mortality* / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D008132:Loneliness / Q000523:psychology*; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires