Association between depressive symptoms and twelve-year mortality among elderly in a rural community in Taiwan

The association between depression and mortality for adults has been established, but the results for older adults remain inconsistent. This study investigated whether depressive symptoms at baseline identify a group of community-residing Taiwanese elderly with a greater mortality over a 12-year period.

A cohort of 281 adults aged 65 years and over living in the Shin-Woo district of Taoyuan were interviewed to screen for depressive symptoms using the Center for Epidemiological Studies-Depression Scale (CES-D) in 1986. During follow-up, one subject had relocated, therefore, 280 subjects were included in the subsequent mortality analysis. The variables selected for analyses were age, gender, physical health, educational level, marital status, religious beliefs, income, type of household, Family APGAR Index, and depressive symptoms. The primary outcome measure was 12-year mortality. Mortality data were collected through 1998. Cox proportional hazard regression model was used to determine the association between CES-D score and mortality.

Of the 280 study participants, 94 died within the 12-year study period. Univariate analysis revealed the following significant predictors of mortality: advanced age, type of household, marital status, and CES-D score. The multivariate age-adjusted hazard ratio for depressive symptoms (CES-D score >/= 15 vs < 15) was 1.55 (95% confidence interval, 0.99 to 2.44).

Depression among community-residing elderly increased the risk of dying during the 12-year period of follow-up.