title: Are older people dying of depression? Findings from the Medical Research Council trial of the assessment and management of older people in the community.
abstract: OBJECTIVE
  To examine the relationship between symptoms of depression and mortality in older people.
  
  
  METHODS
  Prospective longitudinal study.
  
  
  METHODS
  Fifty-three general practices in the United Kingdom.
  
  
  METHODS
  Thirteen thousand ninety-seven people aged 75 and older participating in the Medical Research Council Trial of the Assessment and Management of Older People in the Community.
  
  
  METHODS
  Depression was measured using the 15-item Geriatric Depression Scale (GDS-15); the main outcome was all-cause mortality.
  
  
  RESULTS
  Morbidity, disability, and lifestyle factors can explain most of the observed relationship between symptoms of depression and mortality (hazard ratio=1.75, 95% confidence interval (CI)=1.53-1.99), but after mutual adjustment for these factors, subjects who reported six or more symptoms of depression on the GDS-15 were still 27% more likely to have died by the end of the follow-up period than those below the threshold for depression (95% CI=1.11-1.45).
  
  
  CONCLUSIONS
  The findings from this study suggest that depression confers a small risk for mortality in older people, not explained solely by poor health. The results support the encouragement of effective diagnosis, treatment, and support for individuals with depression as highlighted by the World Health Organization and the UK National Service Framework for older people.
authors.affiliation: Centre for Aging and Public Health, London School of Hygiene and Tropical Medicine, London, United Kingdom.
authors.forename: Joy A
authors.initials: JA
authors.lastname: Adamson
authors.forename: Gill M
authors.initials: GM
authors.lastname: Price
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Breeze
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Bulpitt
authors.forename: Astrid E
authors.initials: AE
authors.lastname: Fletcher
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D003863:Depression / Q000401:mortality*; D006233:Persons with Disabilities; D005260:Female; D006801:Humans; D008019:Life Style; D008137:Longitudinal Studies; D008297:Male; D009026:Mortality; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D006113:United Kingdom / Q000453:epidemiology