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Association of depression and gender with mortality in old age

Results from the Amsterdam Study of the Elderly (AMSTEL)

Department of Psychiatry, Vrije Universiteit Amsterdam, The Netherlands

D. J. H. DEEG, PhD and C. JONKER, MD

Department of Psychiatry and Institute for Research in Extramural Medicine, Vrije Universiteit Amsterdam, The Netherlands

M. I. GEERLINGS, PhD

Department of Epidemiology and Biostatistics, Erasmus University, Rotterdam, The Netherlands

B. W. J. H. PENNINX, PhD

Sticht Center on Aging, Wake Forest University School of Medicine, Winston-Salem, NC, USA

Correspondence: R. A. Schoevers, Department of Psychiatry, Vrije Universiteit Amsterdam, Valeriusplein 9, 1075 BG Amsterdam, The Netherlands. Tel: 00-31-20-4446770; Fax: 00-31-4446775; e-mail: RA.Schoevers.emgo{at}med.vu.nl

Declaration of interest Grants from the Netherlands Health Research Programme and the Netherlands Fund of Mental Health (see Acknowledgements).

Background The association between depression and increased mortality risk in older persons may depend on the severity of the depressive disorder and gender.

Aims To investigate the association between major and mild depressive syndromes and excess mortality in community-living elderly men and women.

Method Depression (Geriatric Mental State AGECAT) was assessed in 4051 older persons, with a 6-year follow-up of community death registers. The mortality risk of neurotic and psychotic depression was calculated after adjustment for demographic variables, physical illness, cognitive decline and functional disabilities.

Results A total of 75% of men and 41% of women with psychotic depression had died at follow-up. Psychotic depression was associated with significant excess mortality in both men and women. Neurotic depression was associated with a 1.67-fold higher mortality risk in men only.

Conclusions In the elderly, major depressive syndromes increase the risk of death in both men and women, but mild depression increases the risk of death only in men.

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