Key result
Depression in subjects aged 85 years and older was associated with an increased risk of all-cause mortality (RR 1.83; 95% CI 1.24-2.69), driven by cardiovascular and non-cardiovascular causes.
Why the study?
Does depression increase cardiovascular and non-cardiovascular mortality in adults aged 85 years and older?
Cohort (n=500)
No
Does depression increase cardiovascular and non-cardiovascular mortality in adults aged 85 years and older?
In adults aged 85 and older, depression is associated with a nearly two-fold increased risk of both cardiovascular and non-cardiovascular mortality.
Depression warrants attention as a mortality risk marker in adults ≥85; leaves open whether treatment modifies cardiovascular or all-cause risk.
BACKGROUND: Depression in old age is associated with an increased mortality risk of cardiovascular disease but the mortality risk from non-cardiovascular causes is disputed. OBJECTIVE: To investigate the effect of depression on cardiovascular and non-cardiovascular mortality in old age. METHODS: We prospectively followed 500 subjects from age 85 years onwards within the population-based Leiden 85-plus Study. Depressive symptoms were assessed annually with the 15-item Geriatric Depression Scale (GDS-15). Mortality risks were estimated in a Cox proportional-hazards model with the annual assessment of depression (GDS-15> or =4 points) as a time-dependent covariate. RESULTS: During 1654 person-years of follow-up (mean per person, 3.2 years), depression was associated with a two-fold increase of all cause mortality [Relative Risk (RR), 1.83; 95% Confidence Interval (CI), 1.24-2.69] that was not explained by comorbid conditions. Both cardiovascular mortality and non-cardiovascular mortality contributed equally to the excess mortality (RR 1.95 and 1.75 respectively). CONCLUSION: Depression in old age contributes to an increase of both cardiovascular and non-cardiovascular mortality. Motivational depletion may play an important role in the increased mortality in elderly with depression.
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Vinkers et al. (2004) conducted a cohort in Depression (n=500). Depression (GDS-15 ≥ 4 points) vs. No depression was evaluated on All-cause mortality (RR 1.83, 95% CI 1.24-2.69). Depression in subjects aged 85 years and older was associated with an increased risk of all-cause mortality (RR 1.83; 95% CI 1.24-2.69), driven by cardiovascular and non-cardiovascular causes.
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