Saira Saeed Mirza1,2,3, M Arfan Ikram1,4,5, Rosanne Freak-Poli1,6, Albert Hofman1, Dimitris Rizopoulos7, Henning Tiemeier1,8,9. 1. Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands. 2. Department of Medicine, Division of Neurology, University of Toronto, Toronto, Canada. 3. Department of Neurology, Sunnybrook Health Sciences Center, Toronto, Canada. 4. Department of Neurology, Erasmus Medical Center, Rotterdam, The Netherlands. 5. Department of Radiology, Erasmus Medical Center, Rotterdam, The Netherlands. 6. Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia. 7. Department of Biostatistics, Erasmus Medical Center, The Netherlands. 8. Department of Child and Adolescent Psychiatry, Erasmus Medical Center, The Netherlands. 9. Department of Psychiatry, Erasmus Medical Center, The Netherlands.
Abstract
Background: Populations of depressed persons are typically comprised of individuals with different courses of depression and thus might carry different risks of death. This study aimed to identify different trajectories of depressive symptoms in community-dwelling older adults and study the risk of death across these trajectories. Methods: In the population-based Rotterdam Study, depressive symptoms (Center for Epidemiological Studies-Depression scale) at three examination rounds (1993-2004) from 3,325 dementia-free participants (mean age 64.6 ± 6.1 years) were used to identify depression trajectories by latent-class trajectory modeling. Mortality rates by trajectory were calculated over a subsequent 13 year period (2002-2015), that is using 23 years of follow-up data. Results: Five trajectories of depressive symptoms characterized by low (73.4%), decreasing (11.1%), remitting (5.1%), increasing (7.7%), and high (2.7%) depressive symptoms were identified. Compared with persons in the low symptoms trajectory, persons with a trajectory of increasing depressive symptoms (hazard ratio [HR]: 1.21 [95% CI = 1.02, 1.44]) had a higher risk of death, but not those with remitting depressive symptoms, HR: 1.06 (95% CI = 0.85, 1.32). The estimates for the high symptoms trajectory were also suggestive of a higher risk of mortality, HR: 1.20 (95% CI = 0.91, 1.58). Conclusions: Repeated measures of depression can help predict long-term health outcomes in persons with depressive symptoms. Participants with increasing symptoms over time had a higher risk of death than those with low or no depressive symptoms. Transient high depressive symptoms that remitted were not associated with a higher risk compared with those with no symptoms. Our results open avenues for etiological and prognostic research to focus upon risk factors' key to a particular trajectory.
Background: Populations of depressed persons are typically comprised of individuals with different courses of depression and thus might carry different risks of death. This study aimed to identify different trajectories of depressive symptoms in community-dwelling older adults and study the risk of death across these trajectories. Methods: In the population-based Rotterdam Study, depressive symptoms (Center for Epidemiological Studies-Depression scale) at three examination rounds (1993-2004) from 3,325 dementia-freeparticipants (mean age 64.6 ± 6.1 years) were used to identify depression trajectories by latent-class trajectory modeling. Mortality rates by trajectory were calculated over a subsequent 13 year period (2002-2015), that is using 23 years of follow-up data. Results: Five trajectories of depressive symptoms characterized by low (73.4%), decreasing (11.1%), remitting (5.1%), increasing (7.7%), and high (2.7%) depressive symptoms were identified. Compared with persons in the low symptoms trajectory, persons with a trajectory of increasing depressive symptoms (hazard ratio [HR]: 1.21 [95% CI = 1.02, 1.44]) had a higher risk of death, but not those with remitting depressive symptoms, HR: 1.06 (95% CI = 0.85, 1.32). The estimates for the high symptoms trajectory were also suggestive of a higher risk of mortality, HR: 1.20 (95% CI = 0.91, 1.58). Conclusions: Repeated measures of depression can help predict long-term health outcomes in persons with depressive symptoms. Participants with increasing symptoms over time had a higher risk of death than those with low or no depressive symptoms. Transient high depressive symptoms that remitted were not associated with a higher risk compared with those with no symptoms. Our results open avenues for etiological and prognostic research to focus upon risk factors' key to a particular trajectory.
Authors: M Arfan Ikram; Guy Brusselle; Mohsen Ghanbari; André Goedegebure; M Kamran Ikram; Maryam Kavousi; Brenda C T Kieboom; Caroline C W Klaver; Robert J de Knegt; Annemarie I Luik; Tamar E C Nijsten; Robin P Peeters; Frank J A van Rooij; Bruno H Stricker; André G Uitterlinden; Meike W Vernooij; Trudy Voortman Journal: Eur J Epidemiol Date: 2020-05-04 Impact factor: 8.082
Authors: Tomáš Formánek; Zsófia Csajbók; Katrin Wolfová; Matěj Kučera; Sarah Tom; Dag Aarsland; Pavla Cermakova Journal: Sci Rep Date: 2020-11-30 Impact factor: 4.379