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Cited by 41Aging, Health, and DisabilityMental Health Treatment and AccessTreatment of Major Depression

Predictors of mortality in people with late-life depression: A retrospective cohort study

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Cai, Wa, Mueller, Christoph, Shetty, Hitesh, Perera, Gayan, Stewart, Robert·2020·Journal of Affective Disorders
DOI 10.1016/j.jad.2020.01.021
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Abstract

Objectives Late-life depression (LLD) is associated with an increased mortality risk in the general older population. It remains however unclear which signs or symptoms are predictive of mortality in those suffering from LLD.Setting and participants Patients aged 65 years or older with depressive disorder diagnosed in Southeast London between January 2008 and December 2017.Methods We assembled patients diagnosed with late-life depression from the Maudsley Biomedical Research Centre Case Register, which is linked to national mortality data. Using depression diagnosis as index date, we followed patients until death or censoring point. Sociodemographic data, scores of Health of the Nation Outcome Scales (HoNOS65+), which include a physical illness scale, profiles of depressive symptoms, and psychotropic medications were extracted and modeled in multivariable survival analyses to determine predictors of mortality.Results Of 4,243 patients with LLD (mean age 77.0 years; 61.2% female), 2,327 (54.8%) died over a median follow-up time of 3.5 years. In multivariable Cox regression models, an increased risk of all-cause mortality was associated with older age, cognitive problems, physical illness/disability, impaired activities of daily living, apathy, lack of appetite and mirtazapine prescription; conversely, female gender, non-white ethnicity, guilt feelings, tearfulness, impaired concentration, disturbed sleep and delusions were associated with lower mortality risk.Conclusions Besides demographic factors, physical health, functioning and cognition, different depressive symptoms were significantly associated with the prognosis of LLD. Elderly patients presenting with depressive symptoms predicting higher mortality risk should be examined and followed more closely.

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Authors
Cai, W., Mueller, C., Shetty, H., Perera, G., & Stewart, R.
Affiliations
  • Shanghai University of Traditional Chinese Medicine (CN)
  • King's College London (GB)
  • South London and Maudsley NHS Foundation Trust (GB)
Corresponding author
Cai, Wa
ORCID
Venue
Journal of Affective Disorders
Publisher
Elsevier BV
Published
2020-04
Volume
266
Pages
695-701
ISSN
0165-0327 (ISSN-L)
DOI
10.1016/j.jad.2020.01.021
OpenAlex
W2999752059
Cited by
41
References
53
Citations by year
2026: 3 · 2025: 7 · 2024: 2 · 2023: 6 · 2022: 16 · 2021: 2 · 2020: 5
FWCI
5.44
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Affective Disorders (publishedVersion)
  • PubMed (publishedVersion)
  • Research Portal (King's College London) (submittedVersion, cc-by-nc-nd)
Funders
National Institute for Health and Care Research (CL-2016-17-003)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Aging, Health, and Disability
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
Keywords
geriatric depression, mortality risk, all-cause mortality, prognostic factors, depressive symptoms, cognitive impairment, physical illness, activities of daily living, apathy, appetite loss, mirtazapine, older adults, gender differences, ethnicity, sleep disorders
MeSH terms
Activities of Daily Living, Aged, Depression, Female, Humans, London, Male, Retrospective Studies, Apathy

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