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Does depression in old age increase only cardiovascular mortality? The Leiden 85‐plus Study
Author(s) -
Vinkers David J.,
Stek Max L.,
Gussekloo Jacobijn,
van der Mast Roos C.,
Westendorp Rudi G. J.
Publication year - 2004
Publication title -
international journal of geriatric psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.28
H-Index - 129
eISSN - 1099-1166
pISSN - 0885-6230
DOI - 10.1002/gps.1169
Subject(s) - depression (economics) , medicine , geriatric depression scale , proportional hazards model , confidence interval , relative risk , late life depression , population , demography , risk of mortality , gerontology , depressive symptoms , psychiatry , anxiety , environmental health , hippocampal formation , sociology , economics , macroeconomics
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.