title: Late-life depression and mortality: influence of gender and antidepressant use.
abstract: BACKGROUND
  Depression may increase the risk of mortality among certain subgroups of older people, but the part played by antidepressants in this association has not been thoroughly explored.
  
  
  OBJECTIVE
  To identify the characteristics of older populations who are most at risk of dying, as a function of depressive symptoms, gender and antidepressant use.
  
  
  METHODS
  Adjusted Cox proportional hazards models were used to determine the association between depression and/or antidepressant use and 4-year survival of 7,363 community-dwelling elderly people. Major depressive disorder was evaluated using a standardised psychiatric examination based on DSM-IV criteria and depressive symptoms were assessed using the Center for Epidemiological Studies-Depression scale.
  
  
  RESULTS
  Depressed men using antidepressants had the greatest risk of dying, with increasing depression severity corresponding to a higher hazard risk. Among women, only severe depression in the absence of treatment was significantly associated with mortality.
  
  
  CONCLUSIONS
  The association between depression and mortality is gender-dependent and varies according to symptom load and antidepressant use.
authors.affiliation: Institut National de la Santé et de la Recherche Médicale (INSERM) U888, University of Montpellier, France.
authors.forename: Joanne
authors.initials: J
authors.lastname: Ryan
authors.forename: Isabelle
authors.initials: I
authors.lastname: Carriere
authors.forename: Karen
authors.initials: K
authors.lastname: Ritchie
authors.forename: Robert
authors.initials: R
authors.lastname: Stewart
authors.forename: Gwladys
authors.initials: G
authors.lastname: Toulemonde
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Dartigues
authors.forename: Christophe
authors.initials: C
authors.lastname: Tzourio
authors.forename: Marie-Laure
authors.initials: ML
authors.lastname: Ancelin
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000627:therapeutic use*; D002423:Cause of Death; D003863:Depression / Q000401:mortality* / Q000523:psychology; D003866:Depressive Disorder / Q000188:drug therapy / Q000401:mortality* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D015995:Prevalence; D016016:Proportional Hazards Models; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D012737:Sex Factors
chemical_list: D000928:Antidepressive Agents