title: Risk factors for late-life depression: A prospective cohort study among older women.
abstract: Depression prevention requires identifying key risk contributors. Prior studies have identified several factors related to late-life depression but have seldom addressed factors jointly or in dose-response fashion. This study aimed to examine a wide range of potential predisposing factors and to estimate individual and joint contributions to risk of late-life depression in women. A total of 21,728 women aged ≥65years, without prior depression, in the Nurses' Health Study conducted in the United States were followed from 2000 to 2010. Demographic, social, lifestyle/behavioral and health variables were selected a priori from the literature or previous findings in this cohort. Depression was defined as physician/clinician-diagnosed depression, regular antidepressant use, or the presence of severe depressive symptoms. During 10-year follow-up, 3945 incident cases were identified. After simultaneous multivariable-adjustment, multiple factors in the domains of social stress (lower self-rated societal position and high volume of caregiving to disabled/ill relatives), unfavorable lifestyle (smoking, physical inactivity, heavy or binge drinking), and poor physical health (multiple comorbidity burden, excessive sleep, difficulty falling/staying asleep, bodily pain, and physical/functional limitation or disability) were significantly associated with higher depression risk; many featured dose-response relationships. Sensitivity analyses that excluded outcomes within 2years yielded similar estimates. The total population attributable fraction for all factors was 55.5%. Physical/functional limitation accounted for one-quarter of population attributable fraction, followed by problematic sleep, inadequate exercise, and pain (combining for one-third of population attributable fraction). Efforts to remediate or prevent these factors may contribute to an efficient strategy for late-life depression prevention in women.
authors: Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States.
authors: Shun-Chiao
authors: SC
authors: Chang
authors: School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Hubei, China.
authors: An
authors: A
authors: Pan
authors: Harvard T. H. Chan School of Public Health, Boston, MA, United States.
authors: Ichiro
authors: I
authors: Kawachi
authors: Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States; Harvard T. H. Chan School of Public Health, Boston, MA, United States. Electronic address: ookereke@partners.org.
authors: Olivia I
authors: OI
authors: Okereke
mesh_terms: D000368:Aged; D000428:Alcohol Drinking; D000928:Antidepressive Agents / Q000627:therapeutic use; D015897:Comorbidity; D003866:Depressive Disorder / Q000188:drug therapy / Q000453:epidemiology*; D005260:Female; D006801:Humans; D010146:Pain; D011446:Prospective Studies; D012307:Risk Factors; D057185:Sedentary Behavior; D012893:Sleep Wake Disorders; D012907:Smoking; D014481:United States
chemical_list: D000928:Antidepressive Agents
keywords: Cohort; Depressive disorders; Epidemiology; Geriatrics; Prevention; Risk factors