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Are depressive symptoms a risk factor for mortality in elderly Japanese American men?: the Honolulu-Asia Aging Study
Junji Takeshita1, Kamal Masaki, Iqbal Ahmed
1The Honolulu-Asia Aging Study, Kuakini Medical Center, 4th Floor, 1356 Lusitana Street, Honolulu, HI 96813, USA. takeshita@dop.hawaii.edu
Insights
Depressive symptoms increase mortality risk in older adults. This risk is higher for those without chronic diseases, highlighting the importance of mental health in aging populations.
Area of Science:
- Gerontology
- Epidemiology
- Psychiatry
Background:
- The Honolulu Heart Program is a prospective cohort study of Japanese American men.
- Previous research suggests a link between mental health and physical health outcomes.
Purpose of the Study:
- To investigate the association between depressive symptoms and all-cause mortality in elderly Japanese American men.
- To determine if this association differs based on the presence of chronic diseases.
Main Methods:
- Utilized data from 3,196 Japanese American men (aged 71-93) from the Honolulu Heart Program.
- Assessed depressive symptoms using the Centers for Epidemiologic Studies Depression Scale.
- Followed participants for 6 years to collect all-cause mortality data, analyzing by chronic disease status.
Main Results:
- 9.9% of participants reported frequent depressive symptoms.
- Depressive symptoms were associated with a higher risk of all-cause mortality (3-year RR 1.53, 6-year RR 1.27) after adjustments.
- The association was stronger in physically healthy individuals (3-year RR 2.30, 6-year RR 1.57) compared to those with chronic diseases.
Conclusions:
- Depressive symptoms represent a significant risk factor for mortality in the elderly.
- Physically healthy older adults with depressive symptoms face a particularly elevated mortality risk.
Objective:
This study determined the influence of depressive symptoms on subsequent mortality of all causes.
Method:
The Honolulu Heart Program, established in 1965, is a prospective, community-based cohort of Japanese American men living in Hawaii. The analysis was based on 3,196 Japanese American men aged 71-93 at the time of the fourth examination in 1991-1993. Depressive symptoms were measured by use of an 11-question version of the Centers for Epidemiologic Studies Depression Scale questionnaire. All-cause mortality data were available for 6 years of follow up. Data were analyzed on the basis of presence or absence of chronic diseases.
Results:
The overall prevalence of frequent depressive symptoms was 9.9%. Age-adjusted mortality rates at 3 years were 48.0 and 30.3 per 1,000 person-years for the depressed and nondepressed groups, respectively. At 6 years, the rates were 54.1 (depressed) and 41.5 (nondepressed) per 1,000 person-years. After adjustment for age, marital status, and antidepressant use, the relative risk for all-cause mortality associated with depressive symptoms was 1.53 for 3-year and 1.27 for 6-year mortality. Among participants who were healthy (without cognitive impairment, coronary heart disease, stroke, diabetes, or cancer), the association between depressive symptoms and mortality was greater (relative risk of 2.30 and 1.57 for 3- and 6-year mortality, respectively). Among participants with chronic disease, there were no significant associations between depressive symptoms and mortality.
Conclusions:
Depressive symptoms are a risk factor for mortality in elderly people, particularly in physically healthy individuals.
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