title: The association of depression and multimorbidity in the elderly: implications for the assessment of depression.
abstract: BACKGROUND
  Depression and multimorbidity are common in the elderly. Assessing depression might be difficult because of the overlap of depressive and somatic symptoms, possibly leading to confounded results.
  
  
  METHODS
  This study investigates the frequency of depression, multimorbidity and their association, the potential impact of multimorbidity on the assessment of depression by the Patient Health Questionnaire, and whether using a cut point might cause misleading results in the elderly German population (60-85 years, n= 1659).
  
  
  RESULTS
  Depressive syndromes are significantly more frequent in multimorbid respondents. Multimorbidity is associated with higher item scores, especially in the somatic items, and multimorbid respondents show higher depression severity levels in comparison to non-multimorbid persons.
  
  
  CONCLUSIONS
  There are associations between multimorbidity and depressive symptoms, therefore potentially confounding prevalence rates. As such, causal pathways of these associations should be studied under a longitudinal perspective in future studies.
authors.affiliation: Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany. lena.spangenberg@medizin.uni-leipzig.de
authors.forename: Lena
authors.initials: L
authors.lastname: Spangenberg
authors.forename: Thomas
authors.initials: T
authors.lastname: Forkmann
authors.forename: Elmar
authors.initials: E
authors.lastname: Brähler
authors.forename: Heide
authors.initials: H
authors.lastname: Glaesmer
mesh_terms: D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000175:diagnosis* / Q000453:epidemiology*; D003937:Diagnosis, Differential; D005260:Female; D015577:Geriatric Assessment / Q000379:methods* / Q000706:statistics & numerical data; D005858:Germany / Q000453:epidemiology; D006304:Health Status; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011602:Psychophysiologic Disorders / Q000175:diagnosis* / Q000453:epidemiology*; D011788:Quality of Life; D012720:Severity of Illness Index; D017678:Sex Distribution; D011795:Surveys and Questionnaires