The association between depression and mortality in older community-dwelling populations is still unresolved. This study determined the effect of both minor and major depression on mortality and examined the role of confounding and explanatory variables on this relationship.
A cohort of 3056 men and women from the Netherlands aged 55 to 85 years were followed up for 4 years. Major depression was defined according to DSM-III criteria by means of the Diagnostic Interview Schedule. Minor depression was defined as clinically relevant depression (defined by a Center for Epidemiologic Studies Depression score > or = 16) not fulfilling diagnostic criteria for major depression.
After adjustment for confounding variables (sociodemographics, health status), men with minor depression had a 1.80-fold higher risk of death (95% confidence interval, 1.35-2.39) during follow-up than nondepressed men. In women, minor depression did not significantly increase the mortality risk. Irrespective of sex, major depression was associated with a 1.83-fold higher mortality risk (95% confidence interval, 1.09-3.10) after adjustment for sociodemographics and health status. Health behaviors such as smoking and physical inactivity explained only a small part of the excess mortality risk associated with depression.
Even after adjustment for sociodemographics, health status, and health behaviors, minor depression in older men and major depression in both older men and women increase the risk of dying.
"However, not all studies support the hypothesis that depressive symptoms predict adverse cardiovascular health outcomes. Gender differences have been found to exist, with depression being associated with increased morbidity or mortality rates only in men, but not in women (Ferketich, Schwartzbaum, Frid, & Moeschberger, 2000; Penninx et al., 1998, 1999). Importantly, gender differences have also been found in the proposed mediator of these effects. "
"In fact, the risk for suicide among people with major depression is around 20 times higher than individuals without a diagnosis of depression (American Association of Suicidology, 2010). Other research has found that depression itself is a risk factor for dying among older persons (Penninx et al., 1999). However , like the majority of research on behavioral health, these rates were based on samples drawn from non- AI6 AN populations (Blazer, 2003; Chapleski et al., 2004). "
[Show abstract][Hide abstract] ABSTRACT: Objectives:
Despite efforts to promote health equity, many American Indian and Alaska Native (AI/AN) populations, including older adults, experience elevated levels of depression. Although adverse childhood experiences (ACE) and social support are well-documented risk and protective factors for depression in the general population, little is known about AI/AN populations, especially older adults. The purpose of this study was to examine factors related to depression among a sample of AI older adults in the midwest.
Data were collected using a self-administered survey completed by 233 AIs over the age of 50. The survey included standardized measures such as the Geriatric Depression Scale-Short Form, ACE Questionnaire, and the Multidimensional Scale of Perceived Social Support. Hierarchical multivariate regression analyses were conducted to evaluate the main hypotheses of the study.
Two dimensions of ACE (i.e., childhood neglect, household dysfunction) were positively associated with depressive symptoms; social support was negatively associated with depressive symptoms. Perceived health and living alone were also significant predictors.
ACE may play a significant role in depression among AI/AN across the life course and into old age. Social support offers a promising mechanism to bolster resilience among AI/AN older adults.
Aging and Mental Health 07/2014; 19(4):1-10. DOI:10.1080/13607863.2014.938603 · 1.75 Impact Factor
"Unfortunately, SI is not assessed in H-EPESE, but Pd was a unique predictor of self-rated QOL and health status. Self-rated health and QOL are potent predictors of mortality
[39,40] as is major depression
[41,42], subsyndromal depressive symptoms
[43,44] and depressive personality traits
. Pd could potentially mediate their associations with mortality in H-EPESE
[Show abstract][Hide abstract] ABSTRACT: Unobserved "latent" variables have the potential to minimize "measurement error" inherent to any single clinical assessment or categorical diagnosis.Objectives: To demonstrate the potential utility of latent variable constructs in pain's assessment.
We created two latent variables representing depressive symptom-related pain (Pd) and its residual, "somatic" pain (Ps), from survey questions.Setting: The Hispanic Established Population for Epidemiological Studies in the Elderly (H-EPESE) project, a longitudinal population-based cohort study.Participants: Community dwelling elderly Mexican-Americans in five Southwestern U.S. states. The data were collected in the 7th HEPESE wave in 2010 (N = 1,078).Measurements: Self-reported pain, Center for Epidemiological Studies Depression Scale (CES-D) scores, bedside cognitive performance measures, and informant-rated measures of basic and instrumental Activities of Daily Living.
The model showed excellent fit [chi2 = 20.37, DF =12; p = 0.06; Comparative fit index (CFI) = 0.998; Root mean statistical error assessment (RMSEA) = 0.025]. Ps was most strongly indicated by self-reported pain-related physician visits (r = 0.48, p <=0.001). Pd was most strongly indicated by self-reported pain-related sleep disturbances (r = 0.65, p <0.001). Both Pd and Ps were significantly independently associated with chronic pain (> one month), regional pain and pain summed across selected regions. Pd alone was significantly independently associated with self-rated health, life satisfaction, self-reported falls, Life-space, nursing home placement, the use of opiates, and a variety of sleep related disturbances. Ps was associated with the use of NSAIDS. Neither construct was associated with declaration of a resuscitation preference, mode of resuscitation preference declaration, or with opting for a "Do Not Resuscitate" (DNR) order.
This analysis illustrates the potential of latent variables to parse observed data into "unbiased" constructs with unique predictive profiles. The latent constructs, by definition, are devoid of measurement error that affects any subset of their indicators. Future studies could use such phenotypes as outcome measures in clinical pain management trials or associate them with potential biomarkers using powerful parametric statistical methods.
Health and Quality of Life Outcomes 01/2014; 12(1):13. DOI:10.1186/1477-7525-12-13 · 2.12 Impact Factor
Farah Daoud, Charbel El Bcheraoui, Marwa Tuffaha, Mohammad A AlMazroa, Mohammad Al Saeedi, Randa M Nooh, Zulfa Al Rayess, Rajaa Mohammad Al-Raddadi, Ziad A Memish, Mohammed Basulaiman, Abdullah A Al Rabeeah, Ali H Mokdad
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