title: A multivariate score objectively assessed health of depressed elderly.
abstract: OBJECTIVE
  The self-report health measures commonly used may be biased in depressed persons. We introduce a method to assess physical health objectively in prospective studies of elderly persons.
  
  
  METHODS
  Longitudinal and cross-sectional analyses in the Rotterdam Study, a population-based cohort. Under the assumption that good health is related to survival, all baseline variables independently associated with mortality were included in a global health index. A multivariate score function for this index was derived from a Cox proportional hazard model.
  
  
  RESULTS
  Information on risk factors, disabilities, medical conditions, and physiologic measurements was combined into one score. This made it possible to compare the health of persons with depression to those with other diseases. Physical health of persons with depression and stroke was equally poor. Furthermore, in persons with established depression, worse health was related to more severe symptoms. Finally, we found that the association between an inflammation marker and depression is modified by health status as measured by our index.
  
  
  CONCLUSIONS
  Late-life depression is strongly associated with poor health as measured by an objective global health index. The index makes it possible to quantify health and to study potential etiological risk factors for depression in health strata.
authors.affiliation: Department of Epidemiology & Biostatistics, Erasmus Medical Center, Rotterdam, The Netherlands. h.tiemeier@erasmusmc.nl
authors.forename: Henning
authors.initials: H
authors.lastname: Tiemeier
authors.forename: Monique M B
authors.initials: MM
authors.lastname: Breteler
authors.forename: Albert
authors.initials: A
authors.lastname: Hofman
authors.forename: Theo
authors.initials: T
authors.lastname: Stijnen
mesh_terms: D000368:Aged; D003863:Depression / Q000150:complications / Q000523:psychology*; D004812:Epidemiologic Methods; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D008297:Male; D009426:Netherlands; D011788:Quality of Life