Decreasing blood pressure over time is the strongest predictor of depressive symptoms in octogenarian men

The aim of this study was to examine the longitudinal impact of blood pressure variations and vascular risk factors on depressive symptoms in the elderly.

Longitudinal and cross-sectional cohort study.

Urban population of elderly men, city of Malmö, Sweden.

A total of 809 randomly included men took part in a prospective cohort study, "Men born in 1914", and 171 survivors reached the age of 81 years.

Depressive symptoms were estimated at the age of 81 using the Zung Self-Rating Depression Scale (ZSDS). Vascular risk factors were identified at both 68 and 81 years of age.

At the age of 68, diagnosis of hypertension and on-going antihypertensive therapy were more frequent in subjects with high than low ZSDS scores. In contrast, at age 81, the highest ZSDS scores correlated with low systolic blood pressure (SBP). Declining SBP between the ages of 68 and 81 was more frequent in high-scoring than in low-scoring groups. Subjects with high ZSDS scores took more drugs and had more clinical diagnoses at age 81. Those taking hypnotics and sedatives had higher ZSDS scores, lower SBP at 81, and showed more frequent decrease in SBP during the observation period.

Depressive symptoms in octogenarian men could be predicted by hypertension earlier in life, and were strongly associated with decreasing SBP during the last decade.