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Patterns of Association between Depressive Symptoms and Chronic Medical Morbidities in Older Adults
Author(s) -
Agustini Bruno,
Lotfaliany Mojtaba,
Woods Robyn L.,
McNeil John J.,
Nelson Mark R.,
Shah Raj C.,
Murray Anne M.,
Ernst Michael E.,
Reid Christopher M.,
Tonkin Andrew,
Lockery Jessica E.,
Williams Lana J.,
Berk Michael,
Mohebbi Mohammadreza
Publication year - 2020
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/jgs.16468
Subject(s) - medicine , odds ratio , comorbidity , depression (economics) , polypharmacy , diabetes mellitus , population , dyslipidemia , confidence interval , confounding , physical therapy , obesity , economics , macroeconomics , environmental health , endocrinology
OBJECTIVES To investigate the association between depressive symptoms and several medical morbidities, and their combination, in a large older population. DESIGN Cross‐sectional study of baseline data from the ASPirin in Reducing Events in the Elderly (ASPREE) trial. SETTING Multicentric study conducted in Australia and the United States. PARTICIPANTS A total of 19,110 older adults (mean age = 75 years [standard deviation = ±4.5]). MEASUREMENTS Depressive symptoms were measured using the Center for Epidemiological Studies Depression (CES‐D 10) scale. Medical morbidities were defined according to condition‐specific methods. Logistic regression was used to calculate odds ratios (ORs) with 95% confidence intervals (CIs) to test associations before and after accounting for possible confounders. RESULTS Depressive symptoms were significantly associated with obesity (OR = 1.19; 95% CI = 1.07‐1.32), diabetes (OR = 1.22; 95% CI = 1.05‐1.42), gastroesophageal reflux disease (GERD) (OR = 1.41; 95% CI = 1.28‐1.57), metabolic syndrome (OR = 1.16; 95% CI = 1.03‐1.29), osteoarthritis (OR = 1.41; 95% CI = 1.27‐1.57), respiratory conditions (OR = 1.25; 95% CI = 1.10‐1.42), history of cancer (OR = 1.19; 95% CI = 1.05‐1.34), Parkinson’s disease (OR = 2.56; 95% CI = 1.83‐3.56), polypharmacy (OR = 1.60; 95% CI = 1.44‐1.79), and multimorbidity (OR = 1.29; 95% CI = 1.12‐1.49). No significant association was observed between depressive symptoms and hypertension, chronic kidney disease, dyslipidemia, and gout ( P > .05). A significant dose‐response relationship was evident between the number of medical comorbidities and the prevalence of depression (OR = 1.18; 95% CI = 1.13‐1.22). CONCLUSION Late‐life depressive symptoms are significantly associated with several medical morbidities, and there appears to be a cumulative effect of the number of somatic diseases on the prevalence of depression. These findings augment the evidence for a complex relationship between mental and physical health in an otherwise healthy older population and might guide clinicians toward early recognition of high‐risk individuals. J Am Geriatr Soc 68:1834‐1841, 2020.