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Severity of depressive symptoms as a predictor of mortality: the English longitudinal study of ageing

White, James, Zaninotto, P., Walters, K., Kivimäki, M., Demakakos, P., Shankar, A., Kumari, M., Gallacher, John Edward and Batty, G. D. 2015. Severity of depressive symptoms as a predictor of mortality: the English longitudinal study of ageing. Psychological Medicine 45 (13) , pp. 2771-2779. 10.1017/S0033291715000732

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Abstract

Background Major depressive disorder and subthreshold depression have been associated with premature mortality. We investigated the association between depressive symptoms and mortality across the full continuum of severity. Method We used Cox proportional hazards models to examine the association between depressive symptom severity, assessed using the eight-item Center for Epidemiological Studies Depression Scale (CES-D; range 0–8), and the risk of all-cause mortality over a 9-year follow-up, in 11 104 members of the English Longitudinal Study of Ageing. Results During follow-up, one fifth of study members died (N = 2267). Depressive symptoms were associated with increased mortality across the full range of severity (ptrend < 0.001). Relative to study members with no symptoms, an increased risk of mortality was found in people with depressive symptoms of a low [hazard ratio (HR) for a score of 2 was 1.59, 95% confidence interval (CI) 1.40–1.82], moderate (score of 4: HR 1.80, 95% CI 1.52–2.13) and high (score of 8: HR 2.27, 95% CI 1.69–3.04) severity, suggesting risk emerges at low levels but plateaus thereafter. A third of participants (36.4%, 95% CI 35.5–37.3) reported depressive symptoms associated with an increased mortality risk. Adjustment for physical activity, physical illnesses, and impairments in physical and cognitive functioning attenuated this association (ptrend = 0.25). Conclusions Depressive symptoms are associated with an increased mortality risk even at low levels of symptom severity. This association is explained by physical activity, physical illnesses, and impairments in physical and cognitive functioning.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Biosciences
Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer)
Medicine
Systems Immunity Research Institute (SIURI)
Subjects: R Medicine > RA Public aspects of medicine
Uncontrolled Keywords: Cohort study; depression; mortality
Publisher: Cambridge University Press
ISSN: 0033-2917
Date of Acceptance: 7 April 2015
Last Modified: 14 Mar 2019 16:14
URI: http://orca-mwe.cf.ac.uk/id/eprint/75572

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