Does depression in old age increase only cardiovascular mortality? The Leiden 85-plus Study

✍ Scribed by David J. Vinkers; Max L. Stek; Jacobijn Gussekloo; Roos C. van der Mast; Rudi G. J. Westendorp

• Publisher: John Wiley and Sons
• Year: 2004
• Tongue: English
• Weight: 84 KB
• Volume: 19
• Category: Article
• ISSN: 0885-6230
• DOI: 10.1002/gps.1169

✦ Synopsis

Abstract

Background

Depression in old age is associated with an increased mortality risk of cardiovascular disease but the mortality risk from non‐cardiovascular causes is disputed.

Objective

To investigate the effect of depression on cardiovascular and non‐cardiovascular mortality in old age.

Methods

We prospectively followed 500 subjects from age 85 years onwards within the population‐based Leiden 85‐plus Study. Depressive symptoms were assessed annually with the 15‐item Geriatric Depression Scale (GDS‐15). Mortality risks were estimated in a Cox proportional‐hazards model with the annual assessment of depression (GDS‐15≥4 points) as a time‐dependent covariate.

Results

During 1654 person‐years of follow‐up (mean per person, 3.2 years), depression was associated with a two‐fold increase of all cause mortality [Relative Risk (RR), 1.83; 95% Confidence Interval (CI), 1.24–2.69] that was not explained by comorbid conditions. Both cardiovascular mortality and non‐cardiovascular mortality contributed equally to the excess mortality (RR 1.95 and 1.75 respectively).

Conclusion

Depression in old age contributes to an increase of both cardiovascular and non‐cardiovascular mortality. Motivational depletion may play an important role in the increased mortality in elderly with depression. Copyright © 2004 John Wiley & Sons, Ltd.