title: Twenty-year depressive trajectories among older women.
abstract: BACKGROUND
  Despite the frequent occurrence of depressive symptoms among older adults, especially women, little is known about the long-term course of late-life depressive symptoms.
  
  
  OBJECTIVE
  To characterize the natural course of depressive symptoms among older women (from the young old to the oldest old) followed up for almost 20 years.
  
  
  METHODS
  Using latent-class growth-curve analysis, we analyzed women enrolled in an ongoing prospective cohort study (1988 through 2009).
  
  
  METHODS
  Clinic sites in Baltimore, Maryland; Minneapolis, Minnesota; the Monongahela Valley near Pittsburgh, Pennsylvania; and Portland, Oregon.
  
  
  METHODS
  We studied 7240 community-dwelling women 65 years or older.
  
  
  METHODS
  The Geriatric Depression Scale short form (score range, 0-15) was used to routinely assess depressive symptoms during the follow-up period.
  
  
  RESULTS
  Among older women, we identified 4 latent classes during 20 years, with the predicted probabilities of group membership totaling 27.8% with minimal depressive symptoms, 54.0% with persistently low depressive symptoms, 14.8% with increasing depressive symptoms, and 3.4% with persistently high depressive symptoms. In an adjusted model for latent class membership, odds ratios (ORs) for belonging in the increasing depressive symptoms and persistently high depressive symptoms classes, respectively, compared with a group having minimal depressive symptoms were substantially and significantly (P < .05) elevated for the following variables: baseline smoking (ORs, 4.69 and 7.97), physical inactivity (ORs, 2.11 and 2.78), small social network (ORs, 3.24 and 6.75), physical impairment (ORs, 8.11 and 16.43), myocardial infarction (ORs, 2.09 and 2.41), diabetes mellitus (ORs, 2.98 and 3.03), and obesity (ORs, 1.86 and 2.90).
  
  
  CONCLUSIONS
  During 20 years, almost 20% of older women experienced persistently high depressive symptoms or increasing depressive symptoms. In addition, these women had more comorbidities, physical impairment, and negative lifestyle factors at baseline. These associations support the need for intervention and prevention strategies to reduce depressive symptoms into the oldest-old years.
authors.affiliation: Department of Psychiatry, University of California, San Francisco, CA 94121, USA. Amy.Byers@ucsf.edu
authors.forename: Amy L
authors.initials: AL
authors.lastname: Byers
authors.forename: Eric
authors.initials: E
authors.lastname: Vittinghoff
authors.forename: Li-Yung
authors.initials: LY
authors.lastname: Lui
authors.forename: Tina
authors.initials: T
authors.lastname: Hoang
authors.forename: Dan G
authors.initials: DG
authors.lastname: Blazer
authors.forename: Kenneth E
authors.initials: KE
authors.lastname: Covinsky
authors.forename: Kristine E
authors.initials: KE
authors.lastname: Ensrud
authors.forename: Jane A
authors.initials: JA
authors.lastname: Cauley
authors.forename: Teresa A
authors.initials: TA
authors.lastname: Hillier
authors.forename: Lisa
authors.initials: L
authors.lastname: Fredman
authors.forename: Kristine
authors.initials: K
authors.lastname: Yaffe
mesh_terms: D000368:Aged; D000375:Aging / Q000523:psychology*; D015142:Baltimore / Q000453:epidemiology; D003866:Depressive Disorder / Q000145:classification / Q000453:epidemiology*; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008910:Minnesota / Q000453:epidemiology; D009922:Oregon / Q000453:epidemiology; D010414:Pennsylvania / Q000453:epidemiology; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D013997:Time Factors