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Research Article

Does depression in old age increase only cardiovascular mortality? The Leiden 85-plus Study

  1. David J. Vinkers1,*,
  2. Max L. Stek1,2,
  3. Jacobijn Gussekloo1,
  4. Roos C. van der Mast3,
  5. Rudi G. J. Westendorp1

Article first published online: 28 JUL 2004

DOI: 10.1002/gps.1169

Issue

International Journal of Geriatric Psychiatry

International Journal of Geriatric Psychiatry

Volume 19, Issue 9, pages 852–857, September 2004

Additional Information

How to Cite

Vinkers, D. J., Stek, M. L., Gussekloo, J., van der Mast, R. C. and Westendorp, R. G. J. (2004), Does depression in old age increase only cardiovascular mortality? The Leiden 85-plus Study. Int. J. Geriat. Psychiatry, 19: 852–857. doi: 10.1002/gps.1169

Author Information

  1. 1

    Department of General Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands

  2. 2

    Department of Old Age Psychiatry, Valeriuskliniek Amsterdam, Amsterdam, The Netherlands

  3. 3

    Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands

*Leiden University Medical Center (LUMC), Section of Gerontology and Geriatrics, C2-R, PO Box 9600, 2300 RC Leiden, The Netherlands.

Publication History

  1. Issue published online: 28 JUL 2004
  2. Article first published online: 28 JUL 2004
  3. Manuscript Accepted: 18 MAY 2004
  4. Manuscript Received: 11 FEB 2004

Funded by

  • Netherlands Organisation of Scientific Research (ZonMw)
  • Ministry of Health, Welfare and Sports

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Keywords:

  • depression;
  • mortality;
  • cardiovascular mortality;
  • non-cardiovascular mortality;
  • motivational depletion

Abstract

Background

Depression in old age is associated with an increased mortality risk of cardiovascular disease but the mortality risk from non-cardiovascular causes is disputed.

Objective

To investigate the effect of depression on cardiovascular and non-cardiovascular mortality in old age.

Methods

We prospectively followed 500 subjects from age 85 years onwards within the population-based Leiden 85-plus Study. Depressive symptoms were assessed annually with the 15-item Geriatric Depression Scale (GDS-15). Mortality risks were estimated in a Cox proportional-hazards model with the annual assessment of depression (GDS-15≥4 points) as a time-dependent covariate.

Results

During 1654 person-years of follow-up (mean per person, 3.2 years), depression was associated with a two-fold increase of all cause mortality [Relative Risk (RR), 1.83; 95% Confidence Interval (CI), 1.24–2.69] that was not explained by comorbid conditions. Both cardiovascular mortality and non-cardiovascular mortality contributed equally to the excess mortality (RR 1.95 and 1.75 respectively).

Conclusion

Depression in old age contributes to an increase of both cardiovascular and non-cardiovascular mortality. Motivational depletion may play an important role in the increased mortality in elderly with depression. Copyright © 2004 John Wiley & Sons, Ltd.

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