Prior depression history and deterioration of physical health in community-dwelling older adults--a prospective cohort study.

Cousins Center for Psychoneuroimmunology, University of California, Los Angeles, Semel Institute for Neuroscience, Los Angeles, CA, USA.
The American journal of geriatric psychiatry: official journal of the American Association for Geriatric Psychiatry (Impact Factor: 3.35). 05/2010; 18(5):442-51. DOI: 10.1097/JGP.0b013e3181ca3a2d
Source: PubMed

ABSTRACT Depression worsens outcomes of physical illness. However, it is unknown whether this negative effect persists after depressive symptoms remit in older adults. This study examined whether prior depression history predicts deterioration of physical health in community-dwelling older adults.
Prospective cohort study.
Three urban communities in the United States.
Three hundred fifty-one adults aged 60 years or older-145 with a history of major or nonmajor depression in full remission and 206 concurrent age- and gender-matched comparison subjects with no history of mental illness.
Participants were assessed at baseline, 6 weeks, 1 year, and 2 years for physical health functioning (the Physical Component Summary of the 36-Item Short-Form Health Survey) and chronic medical burden (the Chronic Disease Score). Given the repeated nature of measurements, linear mixed model regression was performed.
Both physical functioning and chronic medical burden deteriorated more rapidly over time in the group with prior depression history compared with comparison subjects, and these changes were independent of the measures of mental health functioning, depressive symptoms, and sleep quality. Similar results were observed when those who developed depressive episodes during follow-up were excluded.
A prior history of clinical depression is associated with a faster deterioration of physical health in community-dwelling older adults, which is not explained by current levels of depressive symptoms and mental health functioning or by recurrence of depressive episodes. Careful screening for a history of depression may identify those older adults at greatest risk for physical declines and chronic medical burden.

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    PLoS ONE 11/2014; 9(11):e113085. DOI:10.1371/journal.pone.0113085 · 3.53 Impact Factor
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    ABSTRACT: paciente con depresión. Rev Psiquiatr Salud Ment (Barc.).
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    ABSTRACT: Objective: Depression is the second most common mental disorder in older adults (OA) worldwide. The ways in which depression is influenced by the social determinants of health – specifically, by socioeconomic deprivation, income inequality and social capital - have been analyzed with only partially conclusive results thus far. The objective of our study was to estimate the association of income inequality and socioeconomic deprivation at the locality, municipal and state levels with the prevalence of depressive symptoms among OA in Mexico. Methods: Cross-sectional study based on a nationally representative sample of 8,874 OA aged 60 and over. We applied the brief seven-item version of the Center for Epidemiologic Studies Depression Scale (CES-D) to determine the presence of depressive symptoms. Additionally, to select the principal context variables, we used the Deprivation Index of the National Population Council of Mexico at the locality, municipal and state levels, and the Gini Index at the municipal and state levels. Finally, we estimated the association of income inequality and socioeconomic deprivation with the presence of depressive symptoms using a multilevel logistic regression model. Results: Socioeconomic deprivation at the locality (OR = 1.28; p<0.10) and municipal levels (OR = 1.16; p<0.01) correlated significantly with the presence of depressive symptoms, while income inequality did not. Conclusions: The results of our study confirm that the social determinants of health are relevant to the mental health of OA. Further research is required, however, to identify which are the specific socioeconomic deprivation components at the locality and municipal levels that correlate with depression in this population group.
    PLoS ONE 09/2014; 9(9):e108127. DOI:10.1371/journal.pone.0108127 · 3.53 Impact Factor

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