title: Depressive symptoms as an independent risk factor for mortality in elderly persons: results of a national longitudinal study.
abstract: OBJECTIVE
  Depressive symptoms have been associated with increased mortality risk in previous cohort studies, but there is a paucity of research on Asian elderly in recent years. The authors investigated the depression-mortality link using data from a representative national cohort.
  
  
  METHODS
  Data came from the Survey of Health and Living Status of the Elderly in Taiwan. A cohort of 2416 men and women in Taiwan aged 65 or older were followed up for eight years from 1999 to 2007. Depressive symptoms were assessed by the 10-item Center for Epidemiologic Studies Depression Scale. The mortality risk of depression was computed after adjustment for a variety of covariates. Data on the presence or absence of chronic diseases were further analyzed.
  
  
  RESULTS
  Overall, depressive symptoms were associated with all-cause mortality (hazard ratio (HR), 1.21; 95% confidence interval (CI), 1.03-1.42) after eight years follow-up, but this mortality risk was detected in men only (HR, 1.27; 95% CI, 1.03-1.56), not in women (HR, 1.1; 95% CI, 0.86-1.4). Further analyses showed that in the group without chronic diseases (without diabetes mellitus, stroke, lung disease, cancer, or cognitive impairment), depressive symptoms were associated with mortality (HR, 1.40; 95% CI, 1.12-1.76) after eight years follow-up; however, there was no association between depressive symptoms and mortality in participants with chronic diseases (HR, 1.02; 95% CI, 0.82-1.26).
  
  
  CONCLUSIONS
  Depressive symptoms are an independent risk factor for mortality in the elderly. Elderly depressive men and elderly without chronic diseases seemed to have a greater mortality risk.
authors.affiliation: Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.
authors.forename: Po-Ren
authors.initials: PR
authors.lastname: Teng
authors.forename: Chih-Jung
authors.initials: CJ
authors.lastname: Yeh
authors.forename: Meng-Chih
authors.initials: MC
authors.lastname: Lee
authors.forename: Hui-Sheng
authors.initials: HS
authors.lastname: Lin
authors.forename: Te-Jen
authors.initials: TJ
authors.lastname: Lai
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People / Q000523:psychology* / Q000706:statistics & numerical data*; D002908:Chronic Disease / Q000453:epidemiology; D003863:Depression / Q000401:mortality*; D005260:Female; D006304:Health Status; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D009026:Mortality; D011159:Population Surveillance; D016016:Proportional Hazards Models; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D017678:Sex Distribution; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013624:Taiwan / Q000453:epidemiology