Depressive Symptoms and Risk of Mortality in Frail, Community-Living Elderly Persons

Abstract

Objective Depression and depressive symptoms have been associated with increased rates of mortality in a variety of populations, but have not been studied in frail, community-living elderly persons. The authors determined whether depressive symptoms were associated with mortality in a frail, multi-ethnic cohort. Methods Authors conducted a prospective study of 250 participants enrolled in a program for patients in the community eligible for nursing home placement, determining the occurrence of depressive symptoms at enrollment and survival after 18 months of follow-up, using Cox proportional-hazards models to determine whether depressive symptoms were independently associated with mortality. Results At enrollment, 73 of the participants (29%) were judged to have depression. Among depressed participants, 26% died, versus 17% of those with fewer depressive symptoms. After they adjusted for various demographic factors, 18-month mortality was almost 70% higher in those with depressive symptoms than in those with fewer symptoms. Women with more depressive symptoms showed nearly a 2.5-fold increase in risk of mortality than women with fewer symptoms, whereas more depressed men were not at increased risk of mortality compared with less depressed men. Conclusion Depressive symptoms constitute a risk factor for mortality in frail elderly persons. Depression and depressive symptoms have been associated with increased rates of mortality in a variety of populations, but have not been studied in frail, community-living elderly persons. The authors determined whether depressive symptoms were associated with mortality in a frail, multi-ethnic cohort. Authors conducted a prospective study of 250 participants enrolled in a program for patients in the community eligible for nursing home placement, determining the occurrence of depressive symptoms at enrollment and survival after 18 months of follow-up, using Cox proportional-hazards models to determine whether depressive symptoms were independently associated with mortality. At enrollment, 73 of the participants (29%) were judged to have depression. Among depressed participants, 26% died, versus 17% of those with fewer depressive symptoms. After they adjusted for various demographic factors, 18-month mortality was almost 70% higher in those with depressive symptoms than in those with fewer symptoms. Women with more depressive symptoms showed nearly a 2.5-fold increase in risk of mortality than women with fewer symptoms, whereas more depressed men were not at increased risk of mortality compared with less depressed men. Depressive symptoms constitute a risk factor for mortality in frail elderly persons.