Depressive Trajectories and Risk of Disability and Mortality in Older Adults

Longitudinal Findings from the Health, Aging, and Body Composition Study

Rachel A. Murphy, Ashley K. Hagaman, Ilse Reinders, Jeremy A. Steeves, Anne B. Newman, Susan M. Rubin, Suzanne Satterfield, Stephen B. Kritchevsky, Kristine Yaffe, Hilsa N. Ayonayon, Daniel S. Nagin, Eleanor Marie Simonsick, Brenda W J H Penninx, Tamara B. Harris

Research output: Contribution to journalArticle

Abstract

Background. Depression and disability are closely linked. Less is known regarding clinical and subclinical depressive symptoms over time and risk of disability and mortality. Methods. Responses to the Center for Epidemiologic Studies Short Depression scale (CES-D10) were assessed over a 4-year period in men (n = 1032) and women (n = 1070) aged 70-79 years initially free from disability. Depressive symptom trajectories were defined with group-based models. Disability (2 consecutive reports of severe difficulty walking one-quarter mile or climbing 10 steps) and mortality were determined for 9 subsequent years. Hazard ratios (HRs) were estimated using Cox proportional hazards adjusted for covariates. Results. Three trajectories were identified: persistently nondepressed (54% of men, 54% of women, mean baseline CES-D10: 1.16 and 1.46), mildly depressed and increasing (40% of men, 38% of women, mean baseline CES-D10: 3.60 and 4.35), and depressed and increasing (6% of men, 8% of women, mean baseline CES-D10: 7.44 and 9.61). Disability and mortality rates per 1,000 person years were 41.4 and 60.3 in men and 45.8 and 41.9 in women. Relative to nondepressed, men in the mildly depressed (HR = 1.45, 95% confidence interval [CI] 1.11-1.89) and depressed trajectories (HR = 2.12, 95% CI 1.33-3.38) had increased disability; women in the depressed trajectory had increased disability (HR = 2.02, 95% CI 1.37-2.96). Men in the mildly depressed (HR = 1.24, 95% CI 1.01-1.52) and depressed trajectories (HR = 1.63, 95% CI 1.10-2.41) had elevated mortality risk; women exhibited no mortality risk. Conclusions. Trajectories of depressive symptoms without recovery may predict disability and mortality in apparently healthy older populations, thus underscoring the importance of monitoring depressive symptoms in geriatric care.

Original languageEnglish (US)
Pages (from-to)228-235
Number of pages8
JournalJournals of Gerontology - Series A Biological Sciences and Medical Sciences
Volume71
Issue number2
DOIs
StatePublished - Feb 1 2016
Externally publishedYes

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Body Composition
Depression
Mortality
Health
Confidence Intervals
Mobility Limitation
Geriatrics
Epidemiologic Studies
Population

Keywords

  • Aging
  • Depression
  • Function
  • Geriatric
  • Mood

ASJC Scopus subject areas

  • Aging
  • Geriatrics and Gerontology

Cite this

Depressive Trajectories and Risk of Disability and Mortality in Older Adults : Longitudinal Findings from the Health, Aging, and Body Composition Study. / Murphy, Rachel A.; Hagaman, Ashley K.; Reinders, Ilse; Steeves, Jeremy A.; Newman, Anne B.; Rubin, Susan M.; Satterfield, Suzanne; Kritchevsky, Stephen B.; Yaffe, Kristine; Ayonayon, Hilsa N.; Nagin, Daniel S.; Simonsick, Eleanor Marie; Penninx, Brenda W J H; Harris, Tamara B.

In: Journals of Gerontology - Series A Biological Sciences and Medical Sciences, Vol. 71, No. 2, 01.02.2016, p. 228-235.

Research output: Contribution to journalArticle

Murphy, RA, Hagaman, AK, Reinders, I, Steeves, JA, Newman, AB, Rubin, SM, Satterfield, S, Kritchevsky, SB, Yaffe, K, Ayonayon, HN, Nagin, DS, Simonsick, EM, Penninx, BWJH & Harris, TB 2016, 'Depressive Trajectories and Risk of Disability and Mortality in Older Adults: Longitudinal Findings from the Health, Aging, and Body Composition Study', Journals of Gerontology - Series A Biological Sciences and Medical Sciences, vol. 71, no. 2, pp. 228-235. https://doi.org/10.1093/gerona/glv139
Murphy, Rachel A. ; Hagaman, Ashley K. ; Reinders, Ilse ; Steeves, Jeremy A. ; Newman, Anne B. ; Rubin, Susan M. ; Satterfield, Suzanne ; Kritchevsky, Stephen B. ; Yaffe, Kristine ; Ayonayon, Hilsa N. ; Nagin, Daniel S. ; Simonsick, Eleanor Marie ; Penninx, Brenda W J H ; Harris, Tamara B. / Depressive Trajectories and Risk of Disability and Mortality in Older Adults : Longitudinal Findings from the Health, Aging, and Body Composition Study. In: Journals of Gerontology - Series A Biological Sciences and Medical Sciences. 2016 ; Vol. 71, No. 2. pp. 228-235.
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T2 - Longitudinal Findings from the Health, Aging, and Body Composition Study

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AU - Hagaman, Ashley K.

AU - Reinders, Ilse

AU - Steeves, Jeremy A.

AU - Newman, Anne B.

AU - Rubin, Susan M.

AU - Satterfield, Suzanne

AU - Kritchevsky, Stephen B.

AU - Yaffe, Kristine

AU - Ayonayon, Hilsa N.

AU - Nagin, Daniel S.

AU - Simonsick, Eleanor Marie

AU - Penninx, Brenda W J H

AU - Harris, Tamara B.

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N2 - Background. Depression and disability are closely linked. Less is known regarding clinical and subclinical depressive symptoms over time and risk of disability and mortality. Methods. Responses to the Center for Epidemiologic Studies Short Depression scale (CES-D10) were assessed over a 4-year period in men (n = 1032) and women (n = 1070) aged 70-79 years initially free from disability. Depressive symptom trajectories were defined with group-based models. Disability (2 consecutive reports of severe difficulty walking one-quarter mile or climbing 10 steps) and mortality were determined for 9 subsequent years. Hazard ratios (HRs) were estimated using Cox proportional hazards adjusted for covariates. Results. Three trajectories were identified: persistently nondepressed (54% of men, 54% of women, mean baseline CES-D10: 1.16 and 1.46), mildly depressed and increasing (40% of men, 38% of women, mean baseline CES-D10: 3.60 and 4.35), and depressed and increasing (6% of men, 8% of women, mean baseline CES-D10: 7.44 and 9.61). Disability and mortality rates per 1,000 person years were 41.4 and 60.3 in men and 45.8 and 41.9 in women. Relative to nondepressed, men in the mildly depressed (HR = 1.45, 95% confidence interval [CI] 1.11-1.89) and depressed trajectories (HR = 2.12, 95% CI 1.33-3.38) had increased disability; women in the depressed trajectory had increased disability (HR = 2.02, 95% CI 1.37-2.96). Men in the mildly depressed (HR = 1.24, 95% CI 1.01-1.52) and depressed trajectories (HR = 1.63, 95% CI 1.10-2.41) had elevated mortality risk; women exhibited no mortality risk. Conclusions. Trajectories of depressive symptoms without recovery may predict disability and mortality in apparently healthy older populations, thus underscoring the importance of monitoring depressive symptoms in geriatric care.

AB - Background. Depression and disability are closely linked. Less is known regarding clinical and subclinical depressive symptoms over time and risk of disability and mortality. Methods. Responses to the Center for Epidemiologic Studies Short Depression scale (CES-D10) were assessed over a 4-year period in men (n = 1032) and women (n = 1070) aged 70-79 years initially free from disability. Depressive symptom trajectories were defined with group-based models. Disability (2 consecutive reports of severe difficulty walking one-quarter mile or climbing 10 steps) and mortality were determined for 9 subsequent years. Hazard ratios (HRs) were estimated using Cox proportional hazards adjusted for covariates. Results. Three trajectories were identified: persistently nondepressed (54% of men, 54% of women, mean baseline CES-D10: 1.16 and 1.46), mildly depressed and increasing (40% of men, 38% of women, mean baseline CES-D10: 3.60 and 4.35), and depressed and increasing (6% of men, 8% of women, mean baseline CES-D10: 7.44 and 9.61). Disability and mortality rates per 1,000 person years were 41.4 and 60.3 in men and 45.8 and 41.9 in women. Relative to nondepressed, men in the mildly depressed (HR = 1.45, 95% confidence interval [CI] 1.11-1.89) and depressed trajectories (HR = 2.12, 95% CI 1.33-3.38) had increased disability; women in the depressed trajectory had increased disability (HR = 2.02, 95% CI 1.37-2.96). Men in the mildly depressed (HR = 1.24, 95% CI 1.01-1.52) and depressed trajectories (HR = 1.63, 95% CI 1.10-2.41) had elevated mortality risk; women exhibited no mortality risk. Conclusions. Trajectories of depressive symptoms without recovery may predict disability and mortality in apparently healthy older populations, thus underscoring the importance of monitoring depressive symptoms in geriatric care.

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