Mid-life predictors of late-life depressive symptoms; determining risk factors spanning two decades in the Women's Heathy Ageing Project.

BACKGROUND: Data available from longitudinal studies of adequate duration to explore midlife risk factors for late life higher depressive symptom scores in women is lacking. This study examines midlife (mean ages 50 years and 60 years) predictors of late life (mean age 70 years) depressive symptom scores to enrich our understanding of the role of changing risk factors across the lifespan. METHODS: This investigation was an assessment of the long-term impact of lifestyle and health variables on depressive symptoms. Data were drawn from an epidemiological prospective study of women's healthy ageing spanning two decades. Variables included assessment of mood, demographics, physical health, smoking status, attitudes towards ageing and menopause, alcohol consumption and employment. Analysis was conducted to determine the set of strongest predictors assessed in 1992 (mean age 50 years) and in 2002 (mean age 60 years) in relation to higher CESD-SF scores measured in 2012 (mean aged 70 years (n = 249)). A cross-sectional analysis determining concurrent associations at mean age 70 years was also conducted. RESULTS: An increase in positive mood at 50 and 60 years was associated with a 0.3 (95% CI 0.1-0.5) and 0.4 (95%CI 0.1-0.8) point reduction in CESD score at 70 years respectively. An increase in Hassles score at age 50 was associated with a 0.18-point increase in CESD (95% CI 0.01-0.05) 20 years later. However, no relationship was observed between Hassles score at 60 and CESD 10 years later. Analysis of concurrent risk factors demonstrated that bothersome symptom frequency and higher anxiety were associated with higher depressive symptom scores when women were 70 years. CONCLUSION: Low levels of positive mood were consistently associated with depressive symptoms scores 10 and 20 years later, suggesting clinical interventions aimed at improving positive affect may be particularly useful across the midlife.

Impact of menopausal status on negative mood and depressive symptoms in a longitudinal sample spanning 20 years.

OBJECTIVE: Studies examining depressive symptoms and negative mood across the postmenopause are lacking, particularly those that examine prevalence in early and late postmenopause. This study examines negative mood and depressive occurrence in the menopausal stages to provide a better understanding of prevalence of mood disturbance during this period. METHODS: This study was a longitudinal assessment of variables drawn from an epidemiological prospective study of women's healthy aging. Scores were analyzed using general linear mixed models to determine whether there were reductions in negative mood across the stages of the menopausal transition, including the substages of the early and late postmenopause, as defined by Stages of Reproductive Ageing Workshop+10 criteria. Negative mood scores, derived from the Affectometer 2, were obtained at 11 time points between 1992 and 2012 in a group of 438 Melbourne-based, community-dwelling women aged between 45 and 55 years at baseline (n = 234; 53% retention in 2012). Depressive symptoms were assessed using the Centre for Epidemiological Studies Depression Scale administered at three time points for 10 years. RESULTS: Women's experience of negative mood and depressive symptoms was highest during the menopausal transition and lowest in the late postmenopause. Increasing age was associated with a reduction in depressive symptoms F(1,559) = 14.83, P < 0.001 and negative mood F(1,935) = 14.97, P < 0.001. When controlling for age, there was no difference found between the early and late postmenopause stage mean scores. CONCLUSIONS: Although there were differences found between negative mood and depressive symptom scores in relation to categories of reproductive aging, age was found to be the driving influence to their association.

The trajectory of negative mood and depressive symptoms over two decades.

OBJECTIVE: Research aimed at understanding the temporal characteristics of depressive symptoms and negative mood in an older female population is lacking, despite the relationship between the two factors being well established. The aim of this study was to examine the characteristics of negative mood scores and depressive symptom scores in a longitudinal sample of women transitioning from mid-life to late life. STUDY DESIGN: This study was a longitudinal assessment of variables drawn from an epidemiological prospective study of women's healthy ageing. Scores were analysed using General Linear Mixed Models. MAIN OUTCOME MEASURES: Negative mood scores derived from the Affectometer 2 were assessed at 11 time points spanning 20 years. Depressive symptom scores were assessed using the Centre for Epidemiological Studies Depression Scale (CESD), administered in 2002, 2004 and 2012. RESULTS: Mean negative mood scores reduced significantly between 1992 and 2012, as did mean CESD scores between 2002 and 2012. Mean negative mood scores reduced by 0.007 for each year of increasing age. For depressive symptoms, a reduction in mean score of 0.15 was found for each year of increase in age. CONCLUSION: Depressive symptom scores and negative mood scores decreased significantly over time.

The course of depressive symptoms during the postmenopause: a review.

As the Australian population ages, significantly more women are entering the postmenopausal stage of the climacteric, yet research focusing on the prevalence of depressive symptoms in this stage of ovarian ageing is scarce. This review will examine the information provided by studies that have a cohort with data of adequate duration to explore depressive symptom prevalence in the early and late postmenopause. Longitudinal epidemiological studies of women transitioning through the postmenopause that included measures of mood and/or depressive symptoms were identified through searches of MEDLINE (1980-2014) and PsycINFO (1980-2014) databases. Population based studies with at least two time points of assessment were included. Longitudinal studies of ageing that did not categorise women as postmenopausal were not included, as this was outside the scope of this review. Prevalence estimates of depressive symptoms varied between studies and ranged from 8.5 % to 25.7 % with percentages between 22 and 25 % being most consistently reported. Surgical postmenopause groups reported higher ratings of depressive symptoms at 18-42 % and higher incidence of major depressive disorder in all but one study. The prevalence of Major Depressive Disorder also varied with ranges from <1 % to 42 % reported. Wide ranges in prevalence were reported in the literature. Differences in definitions, inconsistent sample sizes and varying measures make it difficult to compare results across studies. The specific inclusions and exclusions of sub-samples of larger cohorts are at times inconsistent with epidemiological acquisition and, as such, impact upon generalizability of results to a healthy population.