Effects of depression diagnosis and antidepressant treatment on mortality in medicare beneficiaries with chronic obstructive pulmonary disease

Jingjing Qian, Linda Simoni-Wastila, Patricia Langenberg, Gail B. Rattinger, Ilene H. Zuckerman, Susan Lehmann, Michael Terrin

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives To estimate the effects of depression diagnosis and antidepressant treatment on 2-year all-cause mortality in Medicare beneficiaries with chronic obstructive pulmonary disease (COPD) and determine whether Social Security Disability Insurance (SSDI) eligibility modifies these relationships. Design Retrospective cohort study. Setting A 5% random sample of Medicare beneficiaries aged 65 and older in stand-alone Part D plans in 2006 to 2008. Participants Beneficiaries diagnosed with COPD and continuously enrolled in Medicare Parts A, B, and D (N = 75,699). Measurements Depression diagnosis was assessed at baseline (2006). Evidence of antidepressant treatment was measured across time. Covariates included baseline characteristics, comorbidities, and disease severity. Survival analyses using Cox proportional hazards models estimated 2-year mortality associated with depression diagnosis or antidepressant treatment (in beneficiaries with depression). Interaction terms of SSDI eligibility with baseline depression and time-dependent antidepressant treatment were tested. Results More than one-fifth (21.6%) of beneficiaries with COPD had a depression diagnosis at baseline, and 82.1% of those received antidepressants. Nearly one-sixth (16.3%) of the sample were SSDI eligible. Baseline depression heightened risk of death (hazard ratio = 1.13, 95% confidence interval = 1.09-1.18) in beneficiaries who were not eligible for SSDI. In beneficiaries with depression, the association between antidepressant treatment and lower mortality was different according to SSDI eligibility status. Conclusion Social Security Disability Insurance eligibility modifies the effects of depression and antidepressant treatment on mortality in Medicare beneficiaries with COPD. These data suggest that clinicians should identify and treat depression in individuals with COPD, but further studies are needed to determine the effect of these interventions.

Original languageEnglish (US)
Pages (from-to)754-761
Number of pages8
JournalJournal of the American Geriatrics Society
Volume61
Issue number5
DOIs
StatePublished - 2013

Keywords

  • Medicare beneficiaries
  • SSDI eligibility
  • antidepressant treatment
  • chronic obstructive pulmonary disease
  • depression

ASJC Scopus subject areas

  • Geriatrics and Gerontology

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