title: Duration of depressive symptoms and mortality risk: the English Longitudinal Study of Ageing (ELSA).
abstract: BACKGROUND
  The relationship between the duration of depressive symptoms and mortality remains poorly understood.
  
  
  OBJECTIVE
  To examine whether the duration of depressive symptoms is associated with mortality risk.
  
  
  METHODS
  Data (n= 9560) came from the English Longitudinal Study of Ageing (ELSA). We assessed depressive symptom duration as the sum of examinations with an eight-item Center for Epidemiologic Studies Depression Scale score of ⩾3; we ascertained mortality from linking our data to a national register.
  
  
  RESULTS
  Relative to those participants who never reported symptoms, the age- and gender-adjusted hazard ratios for elevated depressive symptoms over 1, 2, 3 and 4 examinations were 1.41 (95% CI 1.15-1.74), 1.80 (95% CI 1.44-2.26), 1.97 (95% CI 1.57-2.47) and 2.48 (95% CI 1.90-3.23), respectively (Pfor trend <0.001). This graded association can be explained largely by differences in physical activity, cognitive function, functional impairments and physical illness.
  
  
  CONCLUSIONS
  In this cohort of older adults, the duration of depressive symptoms was associated with mortality in a dose-response manner.
authors.affiliation: James White, PhD, School of Medicine, Cardiff University, Cardiff; Paola Zaninotto, PhD, Kate Walters, PhD, Mika Kivimäki, PhD, Panayotes Demakakos, PhD, Jane Biddulph, PhD, Meena Kumari, PhD, Cesar De Oliveira, PhD, Department of Epidemiology and Public Health, University College London, London; John Gallacher, PhD, Cochrane Institute of Primary Care and Public Health, School of Medicine, Cardiff University, Cardiff; G. David Batty, DSc, Department of Epidemiology and Public Health, University College London, London, Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, Alzheimer Scotland Dementia Research Centre, University of Edinburgh, Edinburgh, UK whitej11@cf.ac.uk.
authors.forename: James
authors.initials: J
authors.lastname: White
authors.affiliation: James White, PhD, School of Medicine, Cardiff University, Cardiff; Paola Zaninotto, PhD, Kate Walters, PhD, Mika Kivimäki, PhD, Panayotes Demakakos, PhD, Jane Biddulph, PhD, Meena Kumari, PhD, Cesar De Oliveira, PhD, Department of Epidemiology and Public Health, University College London, London; John Gallacher, PhD, Cochrane Institute of Primary Care and Public Health, School of Medicine, Cardiff University, Cardiff; G. David Batty, DSc, Department of Epidemiology and Public Health, University College London, London, Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, Alzheimer Scotland Dementia Research Centre, University of Edinburgh, Edinburgh, UK.
authors.forename: Paola
authors.initials: P
authors.lastname: Zaninotto
authors.affiliation: James White, PhD, School of Medicine, Cardiff University, Cardiff; Paola Zaninotto, PhD, Kate Walters, PhD, Mika Kivimäki, PhD, Panayotes Demakakos, PhD, Jane Biddulph, PhD, Meena Kumari, PhD, Cesar De Oliveira, PhD, Department of Epidemiology and Public Health, University College London, London; John Gallacher, PhD, Cochrane Institute of Primary Care and Public Health, School of Medicine, Cardiff University, Cardiff; G. David Batty, DSc, Department of Epidemiology and Public Health, University College London, London, Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, Alzheimer Scotland Dementia Research Centre, University of Edinburgh, Edinburgh, UK.
authors.forename: Kate
authors.initials: K
authors.lastname: Walters
authors.affiliation: James White, PhD, School of Medicine, Cardiff University, Cardiff; Paola Zaninotto, PhD, Kate Walters, PhD, Mika Kivimäki, PhD, Panayotes Demakakos, PhD, Jane Biddulph, PhD, Meena Kumari, PhD, Cesar De Oliveira, PhD, Department of Epidemiology and Public Health, University College London, London; John Gallacher, PhD, Cochrane Institute of Primary Care and Public Health, School of Medicine, Cardiff University, Cardiff; G. David Batty, DSc, Department of Epidemiology and Public Health, University College London, London, Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, Alzheimer Scotland Dementia Research Centre, University of Edinburgh, Edinburgh, UK.
authors.forename: Mika
authors.initials: M
authors.lastname: Kivimäki
authors.affiliation: James White, PhD, School of Medicine, Cardiff University, Cardiff; Paola Zaninotto, PhD, Kate Walters, PhD, Mika Kivimäki, PhD, Panayotes Demakakos, PhD, Jane Biddulph, PhD, Meena Kumari, PhD, Cesar De Oliveira, PhD, Department of Epidemiology and Public Health, University College London, London; John Gallacher, PhD, Cochrane Institute of Primary Care and Public Health, School of Medicine, Cardiff University, Cardiff; G. David Batty, DSc, Department of Epidemiology and Public Health, University College London, London, Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, Alzheimer Scotland Dementia Research Centre, University of Edinburgh, Edinburgh, UK.
authors.forename: Panayotes
authors.initials: P
authors.lastname: Demakakos
authors.affiliation: James White, PhD, School of Medicine, Cardiff University, Cardiff; Paola Zaninotto, PhD, Kate Walters, PhD, Mika Kivimäki, PhD, Panayotes Demakakos, PhD, Jane Biddulph, PhD, Meena Kumari, PhD, Cesar De Oliveira, PhD, Department of Epidemiology and Public Health, University College London, London; John Gallacher, PhD, Cochrane Institute of Primary Care and Public Health, School of Medicine, Cardiff University, Cardiff; G. David Batty, DSc, Department of Epidemiology and Public Health, University College London, London, Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, Alzheimer Scotland Dementia Research Centre, University of Edinburgh, Edinburgh, UK.
authors.forename: Jane
authors.initials: J
authors.lastname: Biddulph
authors.affiliation: James White, PhD, School of Medicine, Cardiff University, Cardiff; Paola Zaninotto, PhD, Kate Walters, PhD, Mika Kivimäki, PhD, Panayotes Demakakos, PhD, Jane Biddulph, PhD, Meena Kumari, PhD, Cesar De Oliveira, PhD, Department of Epidemiology and Public Health, University College London, London; John Gallacher, PhD, Cochrane Institute of Primary Care and Public Health, School of Medicine, Cardiff University, Cardiff; G. David Batty, DSc, Department of Epidemiology and Public Health, University College London, London, Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, Alzheimer Scotland Dementia Research Centre, University of Edinburgh, Edinburgh, UK.
authors.forename: Meena
authors.initials: M
authors.lastname: Kumari
authors.affiliation: James White, PhD, School of Medicine, Cardiff University, Cardiff; Paola Zaninotto, PhD, Kate Walters, PhD, Mika Kivimäki, PhD, Panayotes Demakakos, PhD, Jane Biddulph, PhD, Meena Kumari, PhD, Cesar De Oliveira, PhD, Department of Epidemiology and Public Health, University College London, London; John Gallacher, PhD, Cochrane Institute of Primary Care and Public Health, School of Medicine, Cardiff University, Cardiff; G. David Batty, DSc, Department of Epidemiology and Public Health, University College London, London, Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, Alzheimer Scotland Dementia Research Centre, University of Edinburgh, Edinburgh, UK.
authors.forename: Cesar
authors.initials: C
authors.lastname: De Oliveira
authors.affiliation: James White, PhD, School of Medicine, Cardiff University, Cardiff; Paola Zaninotto, PhD, Kate Walters, PhD, Mika Kivimäki, PhD, Panayotes Demakakos, PhD, Jane Biddulph, PhD, Meena Kumari, PhD, Cesar De Oliveira, PhD, Department of Epidemiology and Public Health, University College London, London; John Gallacher, PhD, Cochrane Institute of Primary Care and Public Health, School of Medicine, Cardiff University, Cardiff; G. David Batty, DSc, Department of Epidemiology and Public Health, University College London, London, Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, Alzheimer Scotland Dementia Research Centre, University of Edinburgh, Edinburgh, UK.
authors.forename: John
authors.initials: J
authors.lastname: Gallacher
authors.affiliation: James White, PhD, School of Medicine, Cardiff University, Cardiff; Paola Zaninotto, PhD, Kate Walters, PhD, Mika Kivimäki, PhD, Panayotes Demakakos, PhD, Jane Biddulph, PhD, Meena Kumari, PhD, Cesar De Oliveira, PhD, Department of Epidemiology and Public Health, University College London, London; John Gallacher, PhD, Cochrane Institute of Primary Care and Public Health, School of Medicine, Cardiff University, Cardiff; G. David Batty, DSc, Department of Epidemiology and Public Health, University College London, London, Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, Alzheimer Scotland Dementia Research Centre, University of Edinburgh, Edinburgh, UK.
authors.forename: G David
authors.initials: GD
authors.lastname: Batty
mesh_terms: D000375:Aging; D016022:Case-Control Studies; D003863:Depression / Q000175:diagnosis* / Q000401:mortality*; D004739:England; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012042:Registries; D012307:Risk Factors; D013997:Time Factors