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Severity of depressive symptoms as a predictor of mortality: the English longitudinal study of ageing

White, J and Zaninotto, P and Walters, K and Kivimäki, M and Demakakos, P and Shankar, A and Kumari, M and Gallacher, J and Batty, GD (2015) 'Severity of depressive symptoms as a predictor of mortality: the English longitudinal study of ageing.' Psychological Medicine, 45 (13). pp. 2771-2779. ISSN 0033-2917

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Abstract

<jats:sec id="S0033291715000732_sec_a1"><jats:title>Background</jats:title><jats:p>Major depressive disorder and subthreshold depression have been associated with premature mortality. We investigated the association between depressive symptoms and mortality across the full continuum of severity.</jats:p></jats:sec><jats:sec id="S0033291715000732_sec_a2" sec-type="methods"><jats:title>Method</jats:title><jats:p>We used Cox proportional hazards models to examine the association between depressive symptom severity, assessed using the eight-item Center for Epidemiological Studies Depression Scale (CES-D; range 0–8), and the risk of all-cause mortality over a 9-year follow-up, in 11 104 members of the English Longitudinal Study of Ageing.</jats:p></jats:sec><jats:sec id="S0033291715000732_sec_a3" sec-type="results"><jats:title>Results</jats:title><jats:p>During follow-up, one fifth of study members died (<jats:italic>N</jats:italic> = 2267). Depressive symptoms were associated with increased mortality across the full range of severity (<jats:italic>p</jats:italic><jats:sub>trend</jats:sub> &lt; 0.001). Relative to study members with no symptoms, an increased risk of mortality was found in people with depressive symptoms of a low [hazard ratio (HR) for a score of 2 was 1.59, 95% confidence interval (CI) 1.40–1.82], moderate (score of 4: HR 1.80, 95% CI 1.52–2.13) and high (score of 8: HR 2.27, 95% CI 1.69–3.04) severity, suggesting risk emerges at low levels but plateaus thereafter. A third of participants (36.4%, 95% CI 35.5–37.3) reported depressive symptoms associated with an increased mortality risk. Adjustment for physical activity, physical illnesses, and impairments in physical and cognitive functioning attenuated this association (<jats:italic>p</jats:italic><jats:sub>trend</jats:sub> = 0.25).</jats:p></jats:sec><jats:sec id="S0033291715000732_sec_a4" sec-type="conclusion"><jats:title>Conclusions</jats:title><jats:p>Depressive symptoms are associated with an increased mortality risk even at low levels of symptom severity. This association is explained by physical activity, physical illnesses, and impairments in physical and cognitive functioning.</jats:p></jats:sec>

Item Type: Article
Uncontrolled Keywords: Cohort study; depression; mortality
Subjects: H Social Sciences > H Social Sciences (General)
H Social Sciences > HA Statistics
R Medicine > R Medicine (General)
Divisions: Faculty of Social Sciences
Faculty of Social Sciences > Institute for Social and Economic Research
SWORD Depositor: Elements
Depositing User: Elements
Date Deposited: 15 Sep 2015 11:39
Last Modified: 15 Jan 2022 00:27
URI: http://repository.essex.ac.uk/id/eprint/14917

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