title: Role of severity and gender in the association between late-life depression and all-cause mortality.
abstract: BACKGROUND
  Mortality associated with depression may be influenced by severity of depression and gender. We investigated the differential impacts on all-cause mortality of late-life depression by the type of depression (major depressive disorder, MDD; minor depressive disorder, MnDD; subsyndromal depression, SSD) and gender after adjusting comorbid conditions in the randomly sampled elderly.
  
  
  METHODS
  One thousand community-dwelling elderly individuals were enrolled. Standardized face-to-face clinical interviews, neurological examination, and physical examination were conducted to diagnose depressive disorders and comorbid cognitive disorders. Depressive disorders were diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) criteria and SSD to study-specific operational criteria. Five-year survivals were compared between groups using Cox proportional hazards models.
  
  
  RESULTS
  By the end of 2010, 174 subjects (17.4%) died. Depressive disorder (p = 0.001) and its interaction term with gender (p < 0.001) were significant in predicting five-year survival. MDD was an independent risk factor for mortality in men (hazard ratio = 3.65, 95% confidence interval = 1.67-7.96) whereas MnDD and SSD were not when other risk factors were adjusted.
  
  
  CONCLUSIONS
  MDD may directly confer the risk of mortality in elderly men whereas non-major depression may be just an indicator of increased mortality in both genders.
authors.affiliation: Department of Psychiatry, Korea University Guro Hospital, College of Medicine, Korea University, Seoul, Korea.
authors.forename: Hyun-Ghang
authors.initials: HG
authors.lastname: Jeong
authors.forename: Jung Jae
authors.initials: JJ
authors.lastname: Lee
authors.forename: Seok Bum
authors.initials: SB
authors.lastname: Lee
authors.forename: Joon Hyuk
authors.initials: JH
authors.lastname: Park
authors.forename: Yoonseok
authors.initials: Y
authors.lastname: Huh
authors.forename: Ji Won
authors.initials: JW
authors.lastname: Han
authors.forename: Tae Hui
authors.initials: TH
authors.lastname: Kim
authors.forename: Ho Jun
authors.initials: HJ
authors.lastname: Chin
authors.forename: Ki Woong
authors.initials: KW
authors.lastname: Kim
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003863:Depression / Q000175:diagnosis* / Q000401:mortality / Q000523:psychology; D003866:Depressive Disorder / Q000175:diagnosis* / Q000401:mortality; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D005500:Follow-Up Studies; D006306:Health Surveys; D006801:Humans; D007406:Interview, Psychological; D007407:Interviews as Topic; D007723:Korea / Q000453:epidemiology; D008297:Male; D009026:Mortality; D016016:Proportional Hazards Models; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D012720:Severity of Illness Index; D017678:Sex Distribution; D012737:Sex Factors; D011795:Surveys and Questionnaires; D015996:Survival Rate