The Ottawa 3DY Predicts Mortality in a Prospective Cohort Study.

Background: The Ottawa 3DY (O3DY) is a simple measure of cognition. Objectives: 1) To determine if the O3DY predicts mortality; and 2) To compare the discrimination of the O3DY to the Mini-Mental State Examination (MMSE) and Modified MMSE (3MS). Methods: Analyses of a population based cohort study of 1,751 participants aged 65+; conducted in 1991/2 with follow-up over five years. The O3DY, age, sex, education, comorbid conditions, the MMSE, and the 3MS were measured: 4.5% of the participants had missing data for the O3DY; 42.8% were considered as positive (one or more errors), and 52.7% were considered as negative (no errors). Logistic regression models were constructed with the outcome of death at time 2. A Receiver Operator Curve (ROC) was constructed and the Area Under the ROC (AUROC) was calculated using a c-statistic. Results: The unadjusted odds ratio (OR) and 95% confidence interval (CI) for mortality was 1.96 (1.56, 2.47); and the adjusted OR was 1.33 (1.02, 1.72). The AUROC was 0.66 for the 3MS, 0.65 for the MMSE, and 0.60 for the O3DY. Conclusions: The O3DY predicts mortality over a long time frame, although the discrimination is less than that of longer measures of cognition.

Marital status, partner satisfaction, and depressive symptoms in older men and women.

OBJECTIVES: To determine if marital status is associated with depressive symptoms in men and women, and to determine if partner satisfaction is associated with depressive symptoms. METHODS: Community-dwelling adults (n = 1751) aged 65 years and older were sampled from a representative population-based registry. Age, sex, education, and marital status were self-reported. Satisfaction with living partner was assessed with an item from the terrible-delightful scale. The Center for Epidemiologic Studies-Depression was used to assess depressive symptoms, with a score of 15 or more indicating depressive symptoms. RESULTS: Only 3% of the sample were dissatisfied with their living partner, and those who were dissatisfied with their living partner had higher levels of depressive symptoms. Proportions of men with depressive symptoms were: 20.6% for never married; 19.2% for separated or divorced; 17.3% for widowed; 7.3% for married (satisfied); and 38.1% for married (dissatisfied) (chi square = 32.98, df = 4, P < 0.001). In women, the results were different: 11.8% for never married; 23.1% for separated or divorced; 15.4% for widowed; 14.4% for married (satisfied); and 41.9% for married (dissatisfied) (chi square = 18.33, df = 4, P < 0.001). In logistic regression models, a significant interaction term was seen for Marital status Sex. In stratified models, adjusting for age and education, an effect of marital status was seen in men, but not in women. CONCLUSIONS: The effects of marriage on depressive symptoms in men and women may be different, with lower levels of depressive symptoms in married men, compared with unmarried men, but similar rates in married women, compared with unmarried women. Dissatisfaction with their partner was uncommon, but highly associated with depressive symptoms.

Does a single-item measure of depression predict mortality?

OBJECTIVE: To determine if a single-item measure of depression predicts mortality over 5 years. DESIGN: Secondary analysis of a population-based cohort study. SETTING: Province of Manitoba. PARTICIPANTS: A total of 1751 community-dwelling adults aged 65 years or older. MAIN OUTCOME MEASURES: Self-reported depression; age, sex, education, functional status, and cognition; death over 5 years. Depression was measured with 1 item drawn from the Center for Epidemiologic Studies Depression (CES-D) scale: "I felt depressed." Bivariate and multivariate analyses were conducted. RESULTS: Those with self-reported depression had a 5-year mortality of 30.2% versus 19.7% in those without self-reported depression (P < .001, chi2). This association persisted after adjustment for age, sex, education, functional status, and cognition: adjusted odds ratio for mortality 1.35 (95% confidence interval 1.03 to 1.76). Among those with cognitive impairment, however, neither the CES-D scale nor the single-item measure predicted mortality. CONCLUSION: A simple measure of depression drawn from the CES-D predicts mortality among cognitively intact community-dwelling older adults, but not among cognitively impaired older adults. Further study is needed in order to determine the usefulness of this question in clinical practice.