title: Gender differences in the trajectories of late-life depressive symptomology and probable depression in the years prior to death.
abstract: BACKGROUND
  Gender differences in depression are well established. Whether these differences persist into late life and in the years preceding death is less clear. There is a suggestion that there is no increased likelihood of depression in late life, but that there is an increase in depressive symptomology, particularly with proximity to death. We compared trajectories of probable depression and depressive symptomology between men and women over age and distance-to-death metrics to determine whether reports of depressive symptoms are more strongly related to age or mortality.
  
  
  METHODS
  Participants (N = 2,852) from the Dynamic Analyses to Optimise Ageing (DYNOPTA) project had a mean age of 75 years (SD = 5.68 years) at baseline and were observed for up to 16 years prior to death. Multi-level regression models estimated change in depressive symptomology and probable depression over two time metrics, increasing age, and distance-to-death.
  
  
  RESULTS
  Increases in depressive symptomology were reported over increasing age and in the years approaching death. Only male participants reported increased probable depression in the years preceding death. Models that utilized distance-to-death metrics better represented changes in late-life depression, although any changes in depression appear to be accounted for by co-varying physical health status.
  
  
  CONCLUSIONS
  As death approaches, there are increases in the levels of depressive symptomology even after controlling for socio-demographic and health covariates. In line with increases in suicide rates in late life, male participants were at greater risk of reporting increases in depressive symptomology.
authors.affiliation: Centre for Research on Ageing, Health and Wellbeing, The Australian National University, Canberra, Australian Capital Territory, Australia.
authors.forename: R A
authors.initials: RA
authors.lastname: Burns
authors.forename: M A
authors.initials: MA
authors.lastname: Luszcz
authors.forename: K M
authors.initials: KM
authors.lastname: Kiely
authors.forename: P
authors.initials: P
authors.lastname: Butterworth
authors.forename: C
authors.initials: C
authors.lastname: Browning
authors.forename: P
authors.initials: P
authors.lastname: Mitchell
authors.forename: K J
authors.initials: KJ
authors.lastname: Anstey
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003643:Death; D003863:Depression / Q000523:psychology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D012737:Sex Factors