TY - JOUR
T1 - Depression, non-fatal stroke and all-cause mortality in old age: A prospective cohort study of primary care patients
AU - Kohler, Sebastian
AU - Verhey, Frans
AU - Weyerer, Siegfried
AU - Wiese, Birgitt
AU - Heser, Kathrin
AU - Wagner, Michael
AU - Pentzek, Michael
AU - Fuchs, Angela
AU - Kohler, Mirjam
AU - Bachmann, Cadja
AU - Heller, Steffi G. Riedel
AU - Luppa, Melanie
AU - Eifflaender-Gorfer, Sandra
AU - Werle, Jochen
AU - Bickel, Horst
AU - Mosh, Edelgard
AU - Konig, Hans-Helmut
AU - Brettschneider, Christian
AU - Scherer, Martin
AU - Maier, Wolfgang
PY - 2013/8/15
Y1 - 2013/8/15
N2 - Background: Depression is a risk factor for stroke and mortality but whether this also holds into old age is uncertain. We therefore studied the association of depression with the risk for non-fatal stroke and all-cause mortality in very old age. Methods: A representative sample of 3085 primary care patients aged >= 75 years were serially assessed during a 6-year follow-up. The relation between depression (Geriatric Depression Scale >6, n=261) and relevant covariates including vascular risk factors and disease, functional and mild cognitive impairment and ApoE genotype on primary care givers information of incident stroke (n=209) and mortality (n=647) were assessed by Cox regression and by competing risk regressions. Results: Depression was not independently associated with incident stroke in fully adjusted models that treated death as the competing event (subdistribution hazard ratio=0.80, 95% confidence interval =0.47 to 1.36). The risk associated with depression was similar for men and women, and for age groups 75-79, 80-84 and >= 85 years. In contrast, depression increased all-cause mortality rates, even after adjusting for a range of confounders (hazard ratio =1.31, 95% confidence interval =1.03 to 1.67). Limitations: We have no information on past depressive episodes and cause of death. Conclusions: In contrast to reports in younger populations, depression does not appear to increase stroke risk among the old and very old, but continuous to be a risk factor for all-cause mortality.
AB - Background: Depression is a risk factor for stroke and mortality but whether this also holds into old age is uncertain. We therefore studied the association of depression with the risk for non-fatal stroke and all-cause mortality in very old age. Methods: A representative sample of 3085 primary care patients aged >= 75 years were serially assessed during a 6-year follow-up. The relation between depression (Geriatric Depression Scale >6, n=261) and relevant covariates including vascular risk factors and disease, functional and mild cognitive impairment and ApoE genotype on primary care givers information of incident stroke (n=209) and mortality (n=647) were assessed by Cox regression and by competing risk regressions. Results: Depression was not independently associated with incident stroke in fully adjusted models that treated death as the competing event (subdistribution hazard ratio=0.80, 95% confidence interval =0.47 to 1.36). The risk associated with depression was similar for men and women, and for age groups 75-79, 80-84 and >= 85 years. In contrast, depression increased all-cause mortality rates, even after adjusting for a range of confounders (hazard ratio =1.31, 95% confidence interval =1.03 to 1.67). Limitations: We have no information on past depressive episodes and cause of death. Conclusions: In contrast to reports in younger populations, depression does not appear to increase stroke risk among the old and very old, but continuous to be a risk factor for all-cause mortality.
KW - Cerebrovascular accident
KW - Depression
KW - Epidemiology
KW - Prevention
KW - Risk factors
KW - Mortality
U2 - 10.1016/j.jad.2013.02.020
DO - 10.1016/j.jad.2013.02.020
M3 - Article
C2 - 23474092
SN - 0165-0327
VL - 150
SP - 63
EP - 69
JO - Journal of Affective Disorders
JF - Journal of Affective Disorders
IS - 1
ER -