Depressive symptoms predicting six-year mortality in depressed elderly finns.

The specific symptoms of depression associated with increased mortality in the depressed elderly are poorly known. The aim of this paper is to analyse the individual depressive symptoms measured by the Zung Self Rated Depression Scale (ZSDS) and the Hamilton Rating Scale for Depression (HRSD) in association with mortality among depressed elderly subjects. The population consisted of 169 depressed (DSM-III criteria) aged (65+ years) persons from a Finnish epidemiological research project. The follow-up for deaths continued for about 6 years. When age, sex, smoking, physical health and functional abilities were taken into account, dissatisfaction, weight loss and gastrointestinal symptoms (anorexia and constipation) predicted mortality together with high age and poor physical health. Weight loss was related to an increased risk of death, specifically in the depressed. Dissatisfaction and gastrointestinal symptoms were more general markers of increased mortality.

Survival of elderly Finns suffering from dysthymic disorder: a community study.

The survival of aged Finns suffering from dysthymic disorder (DSM-III criteria) was assessed in two cohorts (60+ yrs and 65+ yrs) in a longitudinal epidemiological study conducted in Ahtäri in western Central Finland from 1984 onwards. The mortality of dysthymic persons (N = 214 and N = 115) was compared to that of the non-depressed population living in the same municipality (N = 982 and N = 853). Two follow-up periods (6 yrs and 11.5 yrs) were used for the first cohort, and one (6 yrs) for the second cohort. The Kaplan-Meier procedure and Mantel-Cox statistics followed by Cox proportional hazards models were used in the analyses. The occurrence of dysthymic disorder in men was related to higher mortality in both cohorts during all follow-up periods. In women, the occurrence of dysthymic disorder was related to higher mortality in the first cohort during the follow-up of 11.5 years, and in the second during the follow-up of 6 years. When age, sex, marital status, education, smoking, physical health and functional abilities were taken into account in the Cox proportional hazards models, high age, male sex, smoking, low educational level, the use of more than two medicines and lowered functional abilities emerged as predictors of mortality in the first cohort during both follow-up periods. In the second cohort, high age male sex, smoking, poor physical health and lowered functional abilities emerged as predictors. The results suggest that the higher mortality of the aged suffering from dysthymic disorder is explained by the high occurrence of somatic diseases and disabilities in dysthymic persons. They do not suggest that there might exist biochemical factors in the aetiology of dysthymic disorders that would increase mortality. Nor do they give any evidence to suggest that dysthymic disorders might be precursors of somatic diseases increasing mortality.

Major depression as a predictor of premature deaths in elderly people in Finland: a community study.

In order to analyse the survival of elderly Finnish people with major depression, a total of 29 elderly (> or =65 years) subjects suffering from major depression (DSM-III criteria) and 853 non-depressed elderly subjects were followed up for 6 years. The Kaplan-Meier survival curves showed the survival of patients suffering from major depression to be poorer than that of non-depressed subjects. When age, sex, marital status, level of education, smoking habits, physical health, functional abilities and major depression were introduced into the Cox model, advanced age, male sex, smoking, poor physical health, reduced functional abilities and the occurrence of major depression were found to be related to higher levels of mortality. The results suggest that major depression in the elderly predicts higher mortality which is not explained by their poor baseline level of physical health alone.

Six-year survival of depressed elderly Finns: a community study.

BACKGROUND: The 6-year survival of depressed elderly (N = 290) Finns was assessed and compared to that of a non-depressed population (N = 982), and the factors related to high mortality were analysed. METHOD: Depression was determined according to the DSM-III criteria, and a majority of the depressed population suffered from dysthymic disorder. Survival distributions were represented as Kaplan-Meier survival curves. The Cox proportional hazards model was used to analyse the simultaneous relationships between mortality and certain variables. RESULTS: The survival curves showed an increased mortality of the depressed elderly in both men and women. However, when the simultaneous relationships of age, marital status, education, smoking, functional abilities, somatic illnesses and depression were taken into account, depression did not predict mortality. The predictors of mortality were high age, a high number of medicines, smoking, disability, male sex and occurrence of somatic illnesses. CONCLUSIONS: Evidence of once measured depression is not predictive of increased mortality in an unselected elderly population (60+) when the other factors known to influence survival probability are taken into account.