Clock-drawing potentially mediates the effect of depression on mortality: replication in three cohorts

✍ Scribed by Donald R. Royall; Raymond F. Palmer; Laura K. Chiodo; Marsha J. Polk; Kyriakos S. Markides; Helen Hazuda

• Publisher: John Wiley and Sons
• Year: 2008
• Tongue: English
• Weight: 145 KB
• Volume: 23
• Category: Article
• ISSN: 0885-6230
• DOI: 10.1002/gps.1990

✦ Synopsis

Abstract

Objective

Previously studies have associated visuospatial tasks, particularly ‘clock‐drawing’, with mortality. We sought to determine whether clock‐drawing also mediates the association between depressive symptoms and mortality.

Participants

Non‐institutionalized Hispanic and non‐Hispanic White elderly volunteers.

Measurements

Survival curves were generated as a function of baseline depressive symptom ratings. Significant models were adjusted for CLOX performance. CLOX is divided into CLOX1, a measure of executive control, and CLOX2, a measure of visuospatial skills.

Design

Retrospective analysis of three longitudinal cohorts.

Results

CLOX2 and depressive symptoms were both associated with mortality in unadjusted models. CLOX2 predicted survival independently of CLOX1 in all three cohorts. CLOX2 also attenuated, and/or mediated the association between depressive symptoms and mortality. These results withstood adjustment for age and education in all three cohorts.

Conclusion

Regardless of the sample examined, or the measure of depressive symptoms applied, the association between depressive symptoms and mortality appears to be at least partially mediated by visuospatial skills. This finding supports our hypothesis that right hemisphere structural brain disease, particularly that involving the insula, may mediate depression's effects on mortality. Copyright © 2008 John Wiley & Sons, Ltd.