The Effect of Gender, Age, and Symptom Severity in Late-Life Depression on the Risk of All-Cause Mortality: The Bambuí Cohort Study of Aging

Abstract

Background Increased mortality risk and its moderators is an important, but still under recognized, negative outcome of Late-Life Depression (LLD). Therefore, we aimed to evaluate whether LLD is a risk factor for all-cause mortality in a population-based study with over ten years of follow-up, and addressed the moderating effect of gender and symptom severity on mortality risk. Methods This analysis used data from the Bambuí Cohort Study of Aging. The study population comprised 1.508 (86.5%) of all eligible 1.742 elderly residents. Depressive symptoms were annually evaluated by the GHQ-12, with scores of 5 or higher indicating clinically significant depression. From 1997 to 2007, 441 participants died during 10,648 person-years of follow-up. We estimated the hazard ratio for mortality risk by Cox regression analyses. Results Depressive symptoms were a risk factor for all-cause mortality after adjusting for confounding lifestyle and clinical factors (adjusted HR=1.24 CI95% [1.00–1.55], p=0.05). Mortality risk was significantly elevated in men (adjusted HR=1.45 CI95% [1.01 – 2.07], p=0.04), but not in women (adjusted HR=1.13 CI95% [0.84 – 1.48], p=0.15). We observed a significant interaction between gender and depressive symptoms on mortality risk ((HR= 1.72 CI95% [1.18 – 2.49], p=0.004). Conclusion The present study provides evidence that LLD is a risk factor for all-cause mortality in the elderly, especially in men. The prevention and adequate treatment of LLD may help to reduce premature disability and death among elders with depressive symptoms.

Depression and excess mortality in the elderly living in low‐ and middle‐income countries: Systematic review and meta‐analysis

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Accuracy of three depression screening scales to diagnose major depressive episodes in older adults without neurocognitive disorders

“…1 LLMD has been associated with increased risk of dementia, medical comorbidities, mortality, and significant impact on quality of life. [2][3][4] Several scales are used to assess depressive symptoms in the elderly. The Geriatric Depression Scale (GDS), 5 developed in 1983, had its short version translated and validated for Brazilian Portuguese.…”

Predictors of incidence of clinically significant depressive symptoms in the elderly: 10-year follow-up study of the Bambui cohort study of aging

“…Late life depressive syndromes are one of the most common psychiatric disorders in older adults (Byers et al, 2010) and are associated with increased risks of functional disability, risk of dementia, mortality and use of health services (Cole and Dendukuri, 2003;Diniz et al, 2013;Diniz et al, 2014). Several factors are associated with prevalent depression in the elderly such as female gender, not married, less years of education, medical comorbidities, adverse life events and poor social support (Vorcaro et al, 2001;Han, 2002;Cole and Dendukuri, 2003;Castro-Costa et al, 2008).…”