TitleSeverity of depressive symptoms as a predictor of mortality: the English longitudinal study of ageing.
Publication TypeJournal Article
Year of Publication2015
AuthorsWhite, J, Zaninotto, P, Walters, K, Kivimäki, M, Demakakos, P, Shankar, A, Kumari, M, Gallacher, J, Batty, GD
JournalPsychol Med
Volume45
Issue13
Pagination2771-9
Date Published10/2015
ISSN1469-8978
KeywordsAged, Aging, Cause of Death, Depression, Female, Humans, Kaplan-Meier Estimate, Longitudinal Studies, Male, Middle Aged, Proportional Hazards Models, Prospective Studies, Psychiatric Status Rating Scales, Risk Factors, Severity of Illness Index
Abstract
 

BACKGROUND: 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.

METHOD: 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.

RESULTS: During follow-up, one fifth of study members died (N = 2267). Depressive symptoms were associated with increased mortality across the full range of severity (p trend < 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 (p trend = 0.25).

CONCLUSIONS: 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.

DOI10.1017/S0033291715000732
Alternate JournalPsychol Med
PubMed ID25936473
Grant List / / British Heart Foundation / United Kingdom
RG/13/2/30098 / / British Heart Foundation / United Kingdom
K013351 / / Medical Research Council / United Kingdom
MR/K026992/1 / / Medical Research Council / United Kingdom
MR/K023233/1 / / Medical Research Council / United Kingdom
/ / Cancer Research UK / United Kingdom
MR/K013351/1 / / Medical Research Council / United Kingdom
R01AG034454 / AG / NIA NIH HHS / United States
R01HL036310 / HL / NHLBI NIH HHS / United States