Depression as a risk factor for non-suicide mortality in the elderly

Schulz, Richard; Drayer, Rebecca A.; Rollman, Bruce L.

doi:10.1016/s0006-3223(02)01423-3

Cited by 315 publications

(209 citation statements)

References 86 publications

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“…Indeed, three systematic reviews in the general population (Wulsin et al 1999;Cuijpers et al 2014) and in older people (Schulz et al 2002) cover almost all the available literature on the issue, with compelling evidence of an increased risk of dying linked to depression. In addition, depressive symptoms have also been associated with mortality in community-dwelling elderly (Sun et al 2011;White et al 2015).…”

Section: Introductionmentioning

confidence: 99%

Association of detected depression and undetected depressive symptoms with long-term mortality in a cohort of institutionalised older people

Damián

Pastor-Barriuso

Valderrama-Gama

et al. 2016

Epidemiol Psychiatr Sci

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Background. Studies on depression and mortality in nursing homes have shown inconclusive findings, and none has studied the role of detection. We sought to measure the association of depression with long-term all-cause mortality in institutionalised older people and evaluate a potential modification in the association by its detection status.Methods. We selected a stratified cluster sample of 591 residents aged 75 years or older (mean age 84.5 years) living in residential and nursing homes of Madrid, Spain, who were free of severe cognitive impairment at the 1998-1999 baseline interview. Mortality was ascertained until age 105 years or September 2013 (median/maximum follow-up 4.8/15.2 years) through linkage to the Spanish National Death Index. Detected depression was defined at baseline as a physician's diagnosis or antidepressant use, undetected depression as significant depressive symptoms (score of 4 or higher on the ten-item version of the Geriatric Depression Scale) without documented diagnosis or treatment, and no depression as the absence of diagnosis, treatment, and symptoms. Constant and age-dependent hazard ratios for mortality comparing detected and undetected depression with no depression were estimated using Cox models, and absolute years of life gained and lost using Weibull models.Results. The baseline prevalences of detected and undetected depression were 25.9 and 18.8%, respectively. A total of 499 participants died during 3575 person-years of follow-up. In models adjusted for age, sex, type of facility, number of chronic conditions, and functional dependency, overall depression was not associated with long-term all-cause mortality (hazard ratio 0.87, 95% confidence interval (CI): 0.70-1.08). However, compared with no depression, detected depression showed lower mortality (hazard ratio 0.63, 95% CI: 0.46-0.86), while undetected depression registered higher, not statistically significant, mortality (hazard ratio 1.35, 95% CI: 0.98-1.86). The median life expectancy increased by 1.8 years (95% CI: −3.1 to 6.7 years) in residents with detected depression and decreased by 6.3 years (95% CI: 2.6-10.1 years) in those undetected. Results were more marked in women than men and they were robust to the exclusion of antidepressants from the definition of depression and also to the use of a stricter cut-off for the presence of depressive symptoms.Conclusions. The long-term mortality risk associated with depression in nursing homes depends on its detection status, with better prognosis in residents with detected depression and worse in those undetected. The absolute impact of undetected depressive symptoms in terms of life expectancy can be prominent.

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Section: Introductionmentioning

confidence: 99%

Association of detected depression and undetected depressive symptoms with long-term mortality in a cohort of institutionalised older people

Damián

Pastor-Barriuso

Valderrama-Gama

et al. 2016

Epidemiol Psychiatr Sci

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“…This higher rate of depression reported in the younger groups may reflect a combination of factors. Depressed older individuals are subject to survivor effects since depressed individuals die at an earlier age than non-depressed individuals (Schulz et al, 2002). In addition, it is possible that our elderly participants were a select sample (with a relatively low rate of depression) because of their propensity to volunteer for a four-day research study.…”

Section: Discussionmentioning

confidence: 99%

Older adults make less advantageous decisions than younger adults: Cognitive and psychological correlates

Fein

McGillivray

Finn

2007

J. Inter. Neuropsych. Soc.

141

114

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This study tested the hypotheses that older adults make less advantageous decisions than younger adults on the Iowa gambling task (IGT). Less advantageous decisions, as measured by the IGT, are characterized by choices that favor larger versus smaller immediate rewards, even though such choices may result in long-term negative consequences. The IGT, and measures of neuropsychological function, personality, and psychopathology were administered to 164 healthy adults 18-85 years of age. Older adults performed less advantageously on the IGT compared with younger adults. Additionally, a greater number of older adult's IGT performances were classified as 'impaired' when compared to younger adults. Less advantageous decisions were associated with obsessive symptoms in older adults and with antisocial symptoms in younger adults. Performance on the IGT was positively associated with auditory working memory and psychomotor function in young adults, and in immediate memory in older adults.

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“…Depression and hopelessness have been studied as independent predictors of increased deaths in observational studies, which have also drawn attention to the link among depression, cardiovascular disease, and death (1,2). Intervention trials, such as the Enhancing Recovery in Coronary Heart Disease Patients (ENRICHD) trial (9,10) and the Sertraline Anti-Depressant Heart Attack Randomized Trial (SADHART) (11), have focused on depression treatment for persons with advanced cardiovascular disease (7).…”

Section: Discussionmentioning

confidence: 99%

“…P rospective, observational studies from many settings have shown that depression is independently associated with an increased risk for death (1)(2)(3)(4)(5). However, few studies have evaluated whether an intervention focused on depression can modify this risk.…”

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confidence: 99%

The Effect of a Primary Care Practice–Based Depression Intervention on Mortality in Older Adults

et al. 2007

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Depression as a risk factor for non-suicide mortality in the elderly

Cited by 315 publications

References 86 publications

Association of detected depression and undetected depressive symptoms with long-term mortality in a cohort of institutionalised older people

Association of detected depression and undetected depressive symptoms with long-term mortality in a cohort of institutionalised older people

Older adults make less advantageous decisions than younger adults: Cognitive and psychological correlates

The Effect of a Primary Care Practice–Based Depression Intervention on Mortality in Older Adults

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