title: Late-life depressive symptoms: prediction models of change.
abstract: BACKGROUND
  Depression is a well-recognised problem in the elderly. The aim of this study was to determine the factors associated with predictors of change in depressive symptoms, both in subjects with and without baseline significant depressive symptoms.
  
  
  METHODS
  Longitudinal study of community-dwelling elderly people (>60 years or older), baseline evaluations, and two additional evaluations were reported. Depressive symptoms were measured using a 30-item geriatric depression scale, and a score of 11 was used as cut-off point for significant depressive symptoms in order to stratify the analyses in two groups: with significant depressive symptoms and without significant depressive symptoms. Sociodemographic data, social support, anxiety, cognition, positive affect, control locus, activities of daily living, recent traumatic life events, physical activity, comorbidities, and quality of life were evaluated. Multi-level generalised estimating equation model was used to assess the impact on the trajectory of depressive symptoms.
  
  
  RESULTS
  A number of 7882 subjects were assessed, with 29.42% attrition. At baseline assessment, mean age was 70.96 years, 61.15% were women. Trajectories of depressive symptoms had a decreasing trend. Stronger associations in those with significant depressive symptoms, were social support (OR.971, p<.001), chronic pain (OR 2.277, p<.001) and higher locus of control (OR.581, p<.001). In contrast for those without baseline significant depressive symptoms anxiety and a higher locus of control were the strongest associations.
  
  
  CONCLUSIONS
  New insights into late-life depression are provided, with special emphasis in differentiated factors influencing the trajectory when stratifying regarding basal status of significant depressive symptoms.
  
  
  CONCLUSIONS
  The study has not included clinical evaluations and nutritional assessments.
authors.affiliation: Epidemiological and Health Research Unit, Ageing Area, Centro Médico Nacional XXI, Instituto Mexicano del Seguro Social, Mexico, DF, Mexico. carmen.garcia@imss.gob.mx
authors.forename: Carmen
authors.initials: C
authors.lastname: García-Peña
authors.forename: Fernando A
authors.initials: FA
authors.lastname: Wagner
authors.forename: Sergio
authors.initials: S
authors.lastname: Sánchez-García
authors.forename: Claudia
authors.initials: C
authors.lastname: Espinel-Bermúdez
authors.forename: Teresa
authors.initials: T
authors.lastname: Juárez-Cedillo
authors.forename: Mario
authors.initials: M
authors.lastname: Pérez-Zepeda
authors.forename: Victoria
authors.initials: V
authors.lastname: Arango-Lopera
authors.forename: Francisco
authors.initials: F
authors.lastname: Franco-Marina
authors.forename: Ricardo
authors.initials: R
authors.lastname: Ramírez-Aldana
authors.forename: Joseph J
authors.initials: JJ
authors.lastname: Gallo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003866:Depressive Disorder / Q000175:diagnosis*; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D007389:Internal-External Control; D008137:Longitudinal Studies; D008297:Male; D015233:Models, Statistical; D011379:Prognosis; D011569:Psychiatric Status Rating Scales; D012944:Social Support
keywords: Depression trajectories; Depressive symptoms; Geriatric depression scale; Geriatric syndromes; Late-life depression