Do depressive symptoms predict mortality in older people?
BACKGROUND
Depressive symptoms are common in older persons, and may predict mortality.


OBJECTIVE
To determine: (1) If depressive symptoms predict mortality; (2) If there is a gradient in this effect; and (3) Which depressive factors predict mortality.


METHODS
In 1991-1992, 1751 community-dwelling older persons, sampled from a population-based registry, were interviewed.


METHODS
The Center for Epidemiologic Studies - Depression (CES-D), age, gender, the Modified Mini-Mental State Examination, self-rated health, and functional status.


METHODS
Time to death.


METHODS
Those scoring 16+ on the CES-D were considered depressed. To determine if a gradient was present, the CES-D was treated as a continuous variable. Four depressive factors from the CES-D (depressed affect, positive affect, somatic, and interpersonal) were analyzed. Cox regression models were constructed.


RESULTS
The mortality in those with depressive symptoms was higher in those without depressive symptoms (Hazard Ratio of 1.71, p < 0.001, Log rank test). In multivariable models, this association was no longer significant after accounting for self-rated health and functional status. There was a gradient in risk of mortality across the range of the CES-D. Somatic factors, depressed affect, and positive affect were all associated with mortality in bivariate analyses, but not in multivariable models adjusting for functional status. Interpersonal factors were not associated with mortality.


CONCLUSIONS
Depressive symptoms predict mortality in older persons.
St John
Philip D
PD
Section of Geriatrics, Health Sciences Centre, University of Manitoba, Winnipeg, MB R3A 1R9, Canada. pstjohn@hsc.mb.ca
Montgomery
Patrick R
PR
D000339:Affect; D000368:Aged; D000375:Aging / Q000523:psychology; D003072:Cognition Disorders / Q000453:epidemiology / Q000523:psychology; D003866:Depressive Disorder / Q000401:mortality* / Q000523:psychology; D005260:Female; D015577:Geriatric Assessment / Q000379:methods / Q000706:statistics & numerical data; D006801:Humans; D007398:Interpersonal Relations; D053208:Kaplan-Meier Estimate; D008297:Male; D008350:Manitoba / Q000453:epidemiology; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D012307:Risk Factors; D015996:Survival Rate