Depression and excess mortality: evidence for a dose response relation in community living elderly
- 21 July 2008
- journal article
- research article
- Published by Wiley in International Journal of Geriatric Psychiatry
- Vol. 24 (2), 169-176
- https://doi.org/10.1002/gps.2088
Abstract
Context Depression is associated with an increased mortality risk. It is not known to what extent depression characteristics such as severity and length of exposure to depression contribute to the association with excess mortality. Objectives To investigate the association between depression severity and duration with mortality in community-living elderly. Design Two-wave prospective cohort study with 10-year follow-up of vital status. Assessment of depression at baseline and at three year follow-up (GMS-AGECAT). Cox proportional hazards analyses of mortality with depression according to severity and length of exposure, adjusted for demographic variables, physical illnesses, cognitive decline and functional disabilities. Setting and participants Randomly selected cohort of 3 746 non-demented older community-living persons in the city of Amsterdam. Main outcome measures Excess mortality of both the baseline cohort, and of non-demented subjects participating in both assessments (n = 1989). Results Both moderate (MHR 1.29, 95% CI 1.03–1.61) and severe depression (MHR 1.34, 95% CI 1.07–1.68) predicted 10-year mortality after multivariate adjustment. Chronic depression was associated with a 41% higher mortality risk in 6-year follow-up compared to subjects without depression. Conclusions Severity and chronicity of depression are associated with a higher mortality risk. In combination with other findings this is suggestive of a causal relationship and may have implications for both preventive and treatment strategies of late-life depression. Copyright © 2008 John Wiley & Sons, Ltd.Keywords
This publication has 50 references indexed in Scilit:
- Differences in heart rate variability between depressed and non-depressed elderlyInternational Journal of Geriatric Psychiatry, 2006
- The natural history of late-life depression: results from the Amsterdam Study of the Elderly (AMSTEL)Journal of Affective Disorders, 2003
- SuicideThe Lancet, 2002
- The Corticosteroid Receptor Hypothesis of DepressionNeuropsychopharmacology, 2000
- Late-Life Consequences of Affective Spectrum DisorderInternational Psychogeriatrics, 1996
- A standardized interview for the elderly (GMS): Reliability studies comparing the Dutch language version with the originalInternational Journal of Geriatric Psychiatry, 1991
- Dementia and depression in elderly persons: Agecat compared with dsm III and pervasive illnessInternational Journal of Geriatric Psychiatry, 1990
- A computerized psychiatric diagnostic system and case nomenclature for elderly subjects: GMS and AGECATPsychological Medicine, 1986
- Assessment of Older People: Self-Maintaining and Instrumental Activities of Daily LivingThe Gerontologist, 1969
- Studies of Illness in the AgedJAMA, 1963