Philip Donald St John1, Patrick Montgomery. 1. Section of Geriatrics, University of Manitoba, GG 441 Health Sciences Centre, 820 Sherbrook St, Winnipeg, MB R3A 1R9, Canada. pstjohn@hsc.mb.ca
Abstract
OBJECTIVE: To determine if a single-item measure of depression predicts mortality over 5 years. DESIGN: Secondary analysis of a population-based cohort study. SETTING: Province of Manitoba. PARTICIPANTS: A total of 1751 community-dwelling adults aged 65 years or older. MAIN OUTCOME MEASURES: Self-reported depression; age, sex, education, functional status, and cognition; death over 5 years. Depression was measured with 1 item drawn from the Center for Epidemiologic Studies Depression (CES-D) scale: "I felt depressed." Bivariate and multivariate analyses were conducted. RESULTS: Those with self-reported depression had a 5-year mortality of 30.2% versus 19.7% in those without self-reported depression (P < .001, chi2). This association persisted after adjustment for age, sex, education, functional status, and cognition: adjusted odds ratio for mortality 1.35 (95% confidence interval 1.03 to 1.76). Among those with cognitive impairment, however, neither the CES-D scale nor the single-item measure predicted mortality. CONCLUSION: A simple measure of depression drawn from the CES-D predicts mortality among cognitively intact community-dwelling older adults, but not among cognitively impaired older adults. Further study is needed in order to determine the usefulness of this question in clinical practice.
OBJECTIVE: To determine if a single-item measure of depression predicts mortality over 5 years. DESIGN: Secondary analysis of a population-based cohort study. SETTING: Province of Manitoba. PARTICIPANTS: A total of 1751 community-dwelling adults aged 65 years or older. MAIN OUTCOME MEASURES: Self-reported depression; age, sex, education, functional status, and cognition; death over 5 years. Depression was measured with 1 item drawn from the Center for Epidemiologic Studies Depression (CES-D) scale: "I felt depressed." Bivariate and multivariate analyses were conducted. RESULTS: Those with self-reported depression had a 5-year mortality of 30.2% versus 19.7% in those without self-reported depression (P < .001, chi2). This association persisted after adjustment for age, sex, education, functional status, and cognition: adjusted odds ratio for mortality 1.35 (95% confidence interval 1.03 to 1.76). Among those with cognitive impairment, however, neither the CES-D scale nor the single-item measure predicted mortality. CONCLUSION: A simple measure of depression drawn from the CES-D predicts mortality among cognitively intact community-dwelling older adults, but not among cognitively impaired older adults. Further study is needed in order to determine the usefulness of this question in clinical practice.
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