title: Depression trajectories and obesity among the elderly in Taiwan.
abstract: BACKGROUND
  The present study aimed to (a) characterize 10-year trajectory patterns of depressive symptoms and (b) investigate the association between depressive trajectory and subsequent obesity, metabolic function and cortisol level.
  
  
  METHODS
  In a prospective study of Taiwanese adults aged ≥60 years (n=3922) between 1989 and 1999, depression was assessed using a 10-item short-form of the Center for Epidemiologic Studies Depression Scale and information on body mass index (BMI) was collected by self-report. A subsample (n=445) of the original cohort in 1989 was drawn to assess metabolic variables and cortisol levels in a 2000 follow-up. After trajectory analyses were performed, multinomial logistic regression analyses were used to estimate the association estimates.
  
  
  RESULTS
  We identified four distinctive trajectories of depressive symptoms: class 1 (persistent low, 41.8%); class 2 (persistent mild, 46.8%); class 3 (late peak, 4.2%); and class 4 (high-chronic, 7.2%). The results from both complete cases and multiple imputation analyses indicated that the odds of obesity were lower in the class 2, 3 or 4 elderly, as compared with those in class 1, while the odds of underweight were higher. The classes of older adults with more and persistent depressive symptoms showed a trend toward having both a lower BMI (p=0.01) and a higher cortisol level (p=0.04) compared with those with low depressive symptoms.
  
  
  CONCLUSIONS
  Incremental increases in depressive symptoms over time were associated with reduced risk of obesity and higher cortisol levels.
authors.affiliation: Department of Nursing, Ching Kuo Institute of Management and Health, Keelung, Taiwan.
authors.forename: S-Y
authors.initials: SY
authors.lastname: Kuo
authors.forename: K-M
authors.initials: KM
authors.lastname: Lin
authors.forename: C-Y
authors.initials: CY
authors.lastname: Chen
authors.forename: Y-L
authors.initials: YL
authors.lastname: Chuang
authors.forename: W J
authors.initials: WJ
authors.lastname: Chen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D003863:Depression / Q000209:etiology / Q000523:psychology*; D018450:Disease Progression; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D013624:Taiwan
chemical_list: D006854:Hydrocortisone