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Depressive Symptoms and Mortality in a Prospective Study of 2,558 Older Adults

Received October 5, 2000; revised January 8, 2001; accepted January 30, 2001. From the Center for Health Services Research, UCLA Neuropsychiatric Institute, Los Angeles, CA (JU,TM), the Department of Health Services, University of Washington. Seattle, WA (DLP), the Center for Health Studies, Group Health Cooperative of Puget Sound, Seattle, WA (GES), and the Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA (WJK). Address correspondence to Dr. Unützer, Center for Health Services Research, UCLA Neuropsychiatric Institute, 10920 Wilshire Blvd., Suite 300, Los Angeles, CA 90024. e-mail: unutzer{at}ucla.edu

OBJECTIVE: The authors report results from a 7-year prospective study of depression and mortality in 2,558 Medicare recipients age 65 and older. METHODS: This report is based on a secondary data analysis of a randomized controlled trial that evaluated the cost-effectiveness of preventive services for older enrollees in an HMO. RESULTS: Subjects with mild-to-moderate depression at baseline did not have an increased risk of mortality compared with those without significant depression. The 3% of older adults with the most severe depressive syndromes, however, had significant increases in mortality, even after adjusting for demographics, health risk behaviors, and chronic medical disorders. CONCLUSION: The increase in mortality in this group of older adults was comparable to that in participants with chronic medical disorders such as emphysema or heart disease.

Key Words: Depression • Mortality Predictors • Longitudinal Studies

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