The associations of late-life depression with all-cause and cardiovascular mortality: The NHANES 2005–2014

Abstract

IntroductionLate-life depression has been linked to all-cause and cardiovascular mortality; however, results from previous studies showed heterogeneity. We aimed to examine the associations of late-life depression with all-cause and cardiovascular mortality in a representative sample of the US population. MethodsIn this prospective cohort study, participants aged 60 years or older in the National Health and Nutrition Examination Survey from 2005 to 2014 with measurement of depressive symptom and information of vital status were included for analysis. The Patient Health Questionnaire (PHQ-9) was used to measure depressive symptoms, and major depression was defined as PHQ-9 score ≥10. Multivariable proportional hazards models were used to examine the associations of depression and depressive symptoms with all-cause and cardiovascular mortality. ResultsAmong 8,082 participants included in the analysis, 603 (weighted prevalence: 6.1%) had major depression. There were 1,434 deaths from all causes, including 291 deaths from cardiovascular disease during an average follow-up of 63.2 months. After adjustment for covariates, depressive symptoms were associated with higher risk of all-cause and cardiovascular mortality; major depression was associated with increased risk of all-cause (HR=1.52, 95% CI: 1.18, 1.97) and cardiovascular mortality (HR=2.17, 95% CI: 1.36, 3.46). LimitationsThe assessment of depression with self-reported PHQ-9 scale, instead of a clinical diagnosis. Prevalent comorbidities were self-reported, which may raise concerns about misclassification. ConclusionsLate-life depression and its symptoms are associated with increased risk of all-cause and cardiovascular mortality. These findings may inform future studies of late-life depression treatment as a means of reducing mortality.