title: Risk of depressive symptoms in the oldest old subjects with chronic obstructive pulmonary disease: the Leiden 85-plus study.
abstract: OBJECTIVE
  Chronic obstructive pulmonary disease (COPD) has been associated with depression in middle-aged and younger old adults. However, it remains unknown whether COPD contributes to the occurrence of depressive symptoms in the oldest old subjects. The authors aimed to determine whether oldest old persons with COPD are at increased risk of developing depressive symptoms.
  
  
  METHODS
  The authors prospectively followed up 333 subjects from age 85 years onward within the population-based Leiden 85-plus Study. COPD, along with other chronic diseases, was assessed using structured questionnaires and confirmed with the diagnosis of the treating physician. Depressive symptoms were assessed annually using the 15-item version of the Geriatric Depression Scale (GDS-15). Nondepressed subjects with and without COPD at baseline were compared for the occurrence of depressive symptoms during 5 years of follow-up using multilevel analysis.
  
  
  RESULTS
  At baseline, COPD was present in 40 subjects (12%) and associated with male gender, lower education, and smoking. During 5 years of follow-up, an additional annual increase of 0.29 points (standard error [SE] = 0.14) in the GDS-score was observed in subjects with COPD, when compared with those without COPD (F[1, 212] = 4.1, p = 0.04). This difference persisted after adjustment for demographics, baseline GDS score, functional limitations, and presence of chronic diseases (F[1, 451] = 4.6, p = 0.03).
  
  
  CONCLUSIONS
  In the oldest old subjects, COPD independently contributes to an increased risk of developing depressive symptoms. Clinicians should be aware of the association of COPD with depressive symptoms in the oldest old to offer them optimal treatment in an early stage.
authors.affiliation: Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands. N.Rius_Ottenheim@lumc.nl
authors.forename: Nathaly Rius
authors.initials: NR
authors.lastname: Ottenheim
authors.forename: Erik J
authors.initials: EJ
authors.lastname: Giltay
authors.forename: Frans G
authors.initials: FG
authors.lastname: Zitman
authors.forename: Roos C
authors.initials: RC
authors.lastname: van der Mast
authors.forename: Anton J M
authors.initials: AJ
authors.lastname: de Craen
mesh_terms: D000367:Age Factors; D000369:Aged, 80 and over; D003863:Depression / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D009426:Netherlands; D011569:Psychiatric Status Rating Scales; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications* / Q000453:epidemiology; D011788:Quality of Life; D012307:Risk Factors; D012737:Sex Factors