Trajectories of Depression and Their Associations with Mortality in Older People in Korea over 12 Years

다국어 초록 (Multilingual Abstract)

Background: As the course of depression and depressive symptoms over a lifetime varies between individuals, we used trajectory models based on the Korean Longitudinal Study of Aging to repeatedly measure symptoms over a follow-up period of 12 years to reveal the association with mortality.
Methods: Three thousand five hundred sixty-one (1,483 men and 2,078 women) subjects aged over 65 years were included. Using the 10-item Center for Epidemiological Studies Depression Scale (CES-D 10), a trajectory model was classified into different depressive symptom groups by gender. Cox proportional hazards models were used to investigate the association between depression trajectory and all-cause mortality.
Results: We identified four trajectories of depressive symptoms in both men and women characterized by low CES-D 10 scores throughout the study: Low trajectory (LT), Moderate high trajectory (MHT), High, but increasing trajectory (HIT), and High, but decreasing trajectory (HDT). The adjusted hazard ratios of the HIT, HDT, and MHT compared with LT in men were 2.12 (95% confidence interval [CI], 1.43-3.16), 1.52 (95% CI, 0.96-2.40), and 1.58 (95% CI, 1.10-2.26), respectively. In women, ratios of each group were 1.62 (95% CI, 1.25-2.10), 0.84 (95% CI, 0.61-1.16), and 1.20 (95% CI, 0.99-1.46).
Conclusions: Highly depressive symptoms that increased over the 12 years period were associated with the highest risk of mortality in the Korean elderly population. The trajectory group with remitting depressive symptoms (HDT), despite having a similar baseline level of mood symptoms as the high increasing group (HIT) experienced a lower mortality risk in both men and women.

참고문헌 (Reference)

1 Aziz R, "What are the causes of late-life depression" 36 (36): 497-516, 2013

2 Shin S, "Validity study of short forms of the Korean version center for epidemiologic studies depression scale (CESD)" Seoul National University 2011

3 Byers AL, "Twenty-year depressive trajectories among older women" 69 (69): 1073-1079, 2012

4 Andreescu C, "Twelve-year depressive symptom trajectories and their predictors in a com-munity sample of older adults" 20 (20): 221-236, 2008

5 Huang JF, "Trajectory of depression symptoms and related fac-tors in later life--a population based study" 133 (133): 499-508, 2011

6 Jong Won Kong, "Trajectories of Body Mass Index and Their Associations with Mortality among Older Adults in Korea: Analysis of the Korean Longitudinal Study of Aging" The Korean Geriatrics Society 24 (24): 195-203, 2020

7 Beekman AT, "The natural history of late-life depression : a 6-year prospective study in the community" 59 (59): 605-611, 2002

8 Won CW, "The development of Korean activities of daily living(K-ADL)and korean instrumental activities of daily living scale" 6 (6): 107-120, 2002

9 Blazer DG, "The association of depres-sion and mortality in elderly persons : a case for multiple, in-dependent pathways" 56 (56): M505-M509, 2001

10 Chen R, "Severity of depression and risk for subsequent dementia : cohort studies in China and the UK" 193 (193): 373-377, 2008

11 Schoenfeld DE, "Self-rated health and mortality in the high-functioning eld-erly--a closer look at healthy individuals : MacArthur field study of successful aging" 49 (49): M109-15, 1994

12 Ganguli M, "Rates and predictors of mortality in an aging, rural, community-based cohort : the role of depression" 59 (59): 1046-1052, 2002

13 Barry LC, "Race-related differences in depression on-set and recovery in older persons over time : the health, aging, and body composition study" 22 (22): 682-691, 2014

14 Zheng H, "Obesity and mortality risk : new findings from body mass index trajectories" 178 (178): 1591-1599, 2013

15 Roeder K, "Modeling uncertainty in latent class membership : a case study in criminology" 94 (94): 766-776, 1999

16 Mojtabai R, "Major depression in community-dwell-ing middle-aged and older adults : prevalence and 2-and 4-year follow-up symptoms" 34 (34): 623-634, 2004

17 Penninx BW, "Inflammatory markers and depressed mood in older persons : results from the health, aging and body com-position study" 54 (54): 566-572, 2003

18 Nagin DS, "Group-based modeling of development" Harvard University Press 2005

19 Oquendo MA, "Ethnic and sex differences in suicide rates relative to major depression in the United States" 158 (158): 1652-1658, 2001

20 Mulsant BH, "Epidemiology and diagnosis of de-pression in late life" 20 : 9-15,

21 Graziane JA, "Dual trajectories of depression and cognition : a longitudinal pop-ulation-based study" 24 (24): 364-373, 2016

22 Murphy RA, "Depressive trajectories and risk of dis-ability and mortality in older adults : longitudinal findings from the health, aging, and body composition study" 71 (71): 228-235, 2016

23 Ganguli M, "Depressive symptoms and associated factors in a rural elderly population : the MoVIES project" 3 (3): 144-160, 1995

24 Kuo SY, "Depression trajectories and obesity among the elderly in Taiwan" 41 (41): 1665-1676, 2011

25 Andersen K, "Depression and the risk of Alzheimer disease" 16 (16): 233-238, 2005

26 Frasure-Smith N, "Depression and 18-month prognosis after myocardial infarction" 91 (91): 999-1005, 1995

27 Carney RM, "Can treating de-pression reduce mortality after an acute myocardial infarction" 61 (61): 666-675, 1999

28 Schulz R, "Association between depression and mortality in older adults : the cardiovascular health study" 160 (160): 1761-1768, 2000

29 Kang Y, "A validity study on the Korean mini-mental state examination(K-MMSE)in dementia patients" 15 (15): 300-308, 1997

30 Mirza SS, "10-year trajectories of depressive symptoms and risk of dementia : a population-based study" 3 (3): 628-635, 2016