title: Depression, non-fatal stroke and all-cause mortality in old age: a prospective cohort study of primary care patients.
abstract: BACKGROUND
  Depression is a risk factor for stroke and mortality but whether this also holds into old age is uncertain. We therefore studied the association of depression with the risk for non-fatal stroke and all-cause mortality in very old age.
  
  
  METHODS
  A representative sample of 3085 primary care patients aged ≥ 75 years were serially assessed during a 6-year follow-up. The relation between depression (Geriatric Depression Scale >6, n=261) and relevant covariates including vascular risk factors and disease, functional and mild cognitive impairment and ApoE genotype on primary care givers information of incident stroke (n=209) and mortality (n=647) were assessed by Cox regression and by competing risk regressions.
  
  
  RESULTS
  Depression was not independently associated with incident stroke in fully adjusted models that treated death as the competing event (subdistribution hazard ratio=0.80, 95% confidence interval=0.47 to 1.36). The risk associated with depression was similar for men and women, and for age groups 75-79, 80-84 and ≥ 85 years. In contrast, depression increased all-cause mortality rates, even after adjusting for a range of confounders (hazard ratio=1.31, 95% confidence interval=1.03 to 1.67).
  
  
  CONCLUSIONS
  We have no information on past depressive episodes and cause of death.
  
  
  CONCLUSIONS
  In contrast to reports in younger populations, depression does not appear to increase stroke risk among the old and very old, but continuous to be a risk factor for all-cause mortality.
authors.affiliation: Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University Medical Centre+, Maastricht, The Netherlands. s.koehler@maastrichtuniversity.nl
authors.forename: Sebastian
authors.initials: S
authors.lastname: Köhler
authors.forename: Frans
authors.initials: F
authors.lastname: Verhey
authors.forename: Siegfried
authors.initials: S
authors.lastname: Weyerer
authors.forename: Birgitt
authors.initials: B
authors.lastname: Wiese
authors.forename: Kathrin
authors.initials: K
authors.lastname: Heser
authors.forename: Michael
authors.initials: M
authors.lastname: Wagner
authors.forename: Michael
authors.initials: M
authors.lastname: Pentzek
authors.forename: Angela
authors.initials: A
authors.lastname: Fuchs
authors.forename: Mirjam
authors.initials: M
authors.lastname: Köhler
authors.forename: Cadja
authors.initials: C
authors.lastname: Bachmann
authors.forename: Steffi G
authors.initials: SG
authors.lastname: Riedel Heller
authors.forename: Melanie
authors.initials: M
authors.lastname: Luppa
authors.forename: Sandra
authors.initials: S
authors.lastname: Eifflaender-Gorfer
authors.forename: Jochen
authors.initials: J
authors.lastname: Werle
authors.forename: Horst
authors.initials: H
authors.lastname: Bickel
authors.forename: Edelgard
authors.initials: E
authors.lastname: Mösch
authors.forename: Hans-Helmut
authors.initials: HH
authors.lastname: König
authors.forename: Christian
authors.initials: C
authors.lastname: Brettschneider
authors.forename: Martin
authors.initials: M
authors.lastname: Scherer
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Maier
mesh_terms: D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D003863:Depression / Q000453:epidemiology* / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D015233:Models, Statistical; D011320:Primary Health Care / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D020521:Stroke / Q000453:epidemiology*
keywords: Cerebrovascular accident; Depression; Epidemiology; Mortality; Prevention; Risk factors