CONTEXT: : Depression is a treatable illness that disproportionately places older adults at increased risk for mortality. OBJECTIVE: : We sought to examine whether there are patterns of course of depression severity among older primary care patients that are associated with increased risk for mortality. DESIGN AND SETTING: : Our study was a secondary analysis of data from a practice-based randomized controlled trial within 20 primary care practices located in greater New York City, Philadelphia, and Pittsburgh. PARTICIPANTS: : The study sample consisted of 599 adults aged 60 years and older recruited from primary care settings. Participants were identified though a two-stage, age-stratified (60-74 years; older than 75 years) depression screening of randomly sampled patients. Severity of depression was assessed using the 24-item Hamilton Depression Rating Scale (HDRS). MEASUREMENTS: : Longitudinal analysis via growth curve mixture modeling was carried out to classify patterns of course of depression severity across 12 months. Vital status at 5 years was ascertained via the National Death Index Plus. RESULTS: : Three patterns of change in course of depression severity over 12 months were identified: 1) persistent depressive symptoms, 2) high but declining depressive symptoms, 3) low and declining depressive symptoms. After a median follow-up of 52.0 months, 114 patients had died. Patients with persistent depressive symptoms were more likely to have died compared with patients with a course of high but declining depressive symptoms (adjusted hazard ratio 2.32, 95% confidence interval [1.15-4.69]). CONCLUSIONS: : Persistent depressive symptoms signaled increased risk of dying in older primary care patients, even after adjustment for potentially influential characteristics such as age, smoking status, and medical comorbidity.
RCT Entities:
CONTEXT: : Depression is a treatable illness that disproportionately places older adults at increased risk for mortality. OBJECTIVE: : We sought to examine whether there are patterns of course of depression severity among older primary care patients that are associated with increased risk for mortality. DESIGN AND SETTING: : Our study was a secondary analysis of data from a practice-based randomized controlled trial within 20 primary care practices located in greater New York City, Philadelphia, and Pittsburgh. PARTICIPANTS: : The study sample consisted of 599 adults aged 60 years and older recruited from primary care settings. Participants were identified though a two-stage, age-stratified (60-74 years; older than 75 years) depression screening of randomly sampled patients. Severity of depression was assessed using the 24-item Hamilton Depression Rating Scale (HDRS). MEASUREMENTS: : Longitudinal analysis via growth curve mixture modeling was carried out to classify patterns of course of depression severity across 12 months. Vital status at 5 years was ascertained via the National Death Index Plus. RESULTS: : Three patterns of change in course of depression severity over 12 months were identified: 1) persistent depressive symptoms, 2) high but declining depressive symptoms, 3) low and declining depressive symptoms. After a median follow-up of 52.0 months, 114 patients had died. Patients with persistent depressive symptoms were more likely to have died compared with patients with a course of high but declining depressive symptoms (adjusted hazard ratio 2.32, 95% confidence interval [1.15-4.69]). CONCLUSIONS: : Persistent depressive symptoms signaled increased risk of dying in older primary care patients, even after adjustment for potentially influential characteristics such as age, smoking status, and medical comorbidity.
Authors: B W Penninx; J M Guralnik; C F Mendes de Leon; M Pahor; M Visser; M C Corti; R B Wallace Journal: Am J Cardiol Date: 1998-04-15 Impact factor: 2.778
Authors: Patrick J Brown; Bret R Rutherford; Kristine Yaffe; Jane M Tandler; Justina Laurence Ray; Emily Pott; Sarah Chung; Steven P Roose Journal: Am J Geriatr Psychiatry Date: 2016-06-23 Impact factor: 4.105
Authors: Chima C Igbokwe; Veronica J Ejeh; Olaoluwa S Agbaje; Prince Ifeanachor Christian Umoke; Cylia N Iweama; Eyuche L Ozoemena Journal: BMC Geriatr Date: 2020-04-23 Impact factor: 3.921
Authors: Marianna Virtanen; Jane E Ferrie; G David Batty; Marko Elovainio; Markus Jokela; Jussi Vahtera; Archana Singh-Manoux; Mika Kivimäki Journal: Am J Geriatr Psychiatry Date: 2014-04-12 Impact factor: 4.105