HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Cited by other online articles Google Scholar Articles by Blazer, D. G. Articles by Pieper, C. F. Articles citing this Article PubMed PubMed Citation Articles by Blazer, D. G. Articles by Pieper, C. F.

The Association of Depression and Mortality in Elderly Persons

A Case for Multiple, Independent Pathways

^a Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina
^b Center for the Study of Aging, Duke University Medical Center, Durham, North Carolina

Dan G. Blazer, Department of Psychiatry and Behavioral Sciences, Center for the Study of Aging, Box 3003, Duke University Medical Center, Durham, NC 27710 E-mail: blaze0001{at}mc.duke.edu.

Decision Editor: John E. Morley, MB, BCh

Background. The evidence for an association between depression and mortality among community-dwelling elderly persons remains inconclusive, although it is well established for younger individuals. Extant studies suggest that this association weakens when adjusted for potential confounding factors, especially functional impairment. A cohort of elderly subjects followed for 3 years was analyzed to determine the association of depression and 3-year mortality, controlling for the major known risk factors for mortality in the elderly population.

Methods. Information on depression (CES-D scores), mortality, demographics, body mass index, chronic disease, smoking history, cognitive impairment, functional impairment, self-rated health, and social support was obtained from a stratified probability-based sample of community-dwelling elderly persons, with equal distribution between African Americans and whites in the Piedmont of North Carolina. Descriptive statistics were calculated, and logistic regression was used for a series of models with progressively more control variables.

Results. The unadjusted relative odds of mortality among depressed subjects at baseline was 1.98 over 3 years of follow-up. Inclusion of age, gender, and race into the model did not reduce the relative odds. When chronic disease and health habits, cognitive impairment, functional impairment, and social support were added to the model, the odds ratios for mortality with depression were 1.74, 1.69, 1.29, and 1.21, respectively. This decrease in odds ratios was not observed for other variables in the model when additional variables were added.

Conclusions. The estimated odds of dying if depressed moved toward unity as other risk factors for mortality were controlled. Unlike other known risk factors for mortality in the elderly population, depression appears to be associated with mortality through a number of independent mechanisms, perhaps through complex feedback loops.

This article has been cited by other articles: (Search Google Scholar for Other Citing Articles)

				J. McCusker, M. Cole, A. Ciampi, E. Latimer, S. Windholz, and E. Belzile Does Depression in Older Medical Inpatients Predict Mortality? J. Gerontol. A Biol. Sci. Med. Sci., September 1, 2006; 61(9): 975 - 981. [Abstract] [Full Text] [PDF]

				C. F. Hybels, D. G. Blazer, C. F. Pieper, B. M. Burchett, J. C. Hays, G. G. Fillenbaum, L. D. Kubzansky, and L. F. Berkman Sociodemographic Characteristics of the Neighborhood and Depressive Symptoms in Older Adults: Using Multilevel Modeling in Geriatric Psychiatry Am J Geriatr Psychiatry, June 1, 2006; 14(6): 498 - 506. [Abstract] [Full Text] [PDF]

				C. L. van den Brink, G. A. M. van den Bos, M. Tijhuis, S. Aijanseppa, A. Nissinen, S. Giampaoli, and D. Kromhout Hierarchy Levels, Sum Score, and Worsening of Disability Are Related to Depressive Symptoms in Elderly Men From Three European Countries J Aging Health, February 1, 2006; 18(1): 125 - 141. [PDF]

				E. E. Freeman, B. L. Egleston, S. K. West, K. Bandeen-Roche, and G. Rubin Visual Acuity Change and Mortality in Older Adults Invest. Ophthalmol. Vis. Sci., November 1, 2005; 46(11): 4040 - 4045. [Abstract] [Full Text] [PDF]

				G. Onder, B. W. J. H. Penninx, M. Cesari, S. Bandinelli, F. Lauretani, B. Bartali, A. M. Gori, M. Pahor, and L. Ferrucci Anemia Is Associated With Depression in Older Adults: Results From the InCHIANTI Study J. Gerontol. A Biol. Sci. Med. Sci., September 1, 2005; 60(9): 1168 - 1172. [Abstract] [Full Text] [PDF]

				S. C. Matthews, R. A. Nelesen, and J. E. Dimsdale Depressive Symptoms Are Associated With Increased Systemic Vascular Resistance to Stress Psychosom Med, July 1, 2005; 67(4): 509 - 513. [Abstract] [Full Text] [PDF]

				J. L. Gatz, S. L. Tyas, P. St. John, and P. Montgomery Do Depressive Symptoms Predict Alzheimer's Disease and Dementia? J. Gerontol. A Biol. Sci. Med. Sci., June 1, 2005; 60(6): 744 - 747. [Abstract] [Full Text] [PDF]

				S. A. Everson-Rose, J. S. House, and R. P. Mero Depressive Symptoms and Mortality Risk in a National Sample: Confounding Effects of Health Status Psychosom Med, November 1, 2004; 66(6): 823 - 830. [Abstract] [Full Text] [PDF]

				R. S. Wilson, J. L. Bienias, C. F. Mendes de Leon, D. A. Evans, and D. A. Bennett Negative Affect and Mortality in Older Persons Am. J. Epidemiol., November 1, 2003; 158(9): 827 - 835. [Abstract] [Full Text] [PDF]

				J. E. Morley, J. H. Flaherty, and D. R. Thomas Editorial: Geriatricians, Continuous Quality Improvement, and Improved Care for Older Persons J. Gerontol. A Biol. Sci. Med. Sci., September 1, 2003; 58(9): M809 - 812. [Full Text] [PDF]

				D. S. Charney, C. F. Reynolds III, L. Lewis, B. D. Lebowitz, T. Sunderland, G. S. Alexopoulos, D. G. Blazer, I. R. Katz, B. S. Meyers, P. A. Arean, S. Borson, C. Brown, M. L. Bruce, C. M. Callahan, M. E. Charlson, Y. Conwell, B. N. Cuthbert, D. P. Devanand, M. J. Gibson, G. L. Gottlieb, K. R. Krishnan, S. K. Laden, C. G. Lyketsos, B. H. Mulsant, G. Niederehe, J. T. Olin, D. W. Oslin, J. Pearson, T. Persky, B. G. Pollock, S. Raetzman, M. Reynolds, C. Salzman, R. Schulz, T. L. Schwenk, E. Scolnick, J. Unutzer, M. M. Weissman, and R. C. Young Depression and Bipolar Support Alliance Consensus Statement on the Unmet Needs in Diagnosis and Treatment of Mood Disorders in Late Life Arch Gen Psychiatry, July 1, 2003; 60(7): 664 - 672. [Abstract] [Full Text] [PDF]

				D. G. Blazer Depression in Late Life: Review and Commentary J. Gerontol. A Biol. Sci. Med. Sci., March 1, 2003; 58(3): M249 - 265. [Abstract] [Full Text] [PDF]

				J. E. Morley Editorial: Hot Topics in Geriatrics J. Gerontol. A Biol. Sci. Med. Sci., January 1, 2003; 58(1): M30 - 36. [Full Text] [PDF]

				J. E. Morley Editorial: Citations, Impact Factor, and the Journal J. Gerontol. A Biol. Sci. Med. Sci., December 1, 2002; 57(12): M765 - 769. [Full Text] [PDF]

				J. E. Morley, H. M. Perry III, and D. K. Miller Editorial: Something About Frailty J. Gerontol. A Biol. Sci. Med. Sci., November 1, 2002; 57(11): M698 - 704. [Full Text] [PDF]

				J. E. Morley and J. H. Flaherty Editorial It's Never Too Late: Health Promotion and Illness Prevention in Older Persons J. Gerontol. A Biol. Sci. Med. Sci., June 1, 2002; 57(6): M338 - 342. [Full Text]

				N. Minicuci, S. Maggi, M. Pavan, G. Enzi, and G. Crepaldi Prevalence Rate and Correlates of Depressive Symptoms in Older Individuals: The Veneto Study J. Gerontol. A Biol. Sci. Med. Sci., March 1, 2002; 57(3): M155 - 161. [Abstract] [Full Text] [PDF]

				J. E. Morley Editorial: Drugs, Aging, and the Future J. Gerontol. A Biol. Sci. Med. Sci., January 1, 2002; 57(1): M2 - 6. [Full Text] [PDF]