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

Abstract

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.