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The combination of depressive symptoms and smoking shorten life expectancy among the aged

Published online by Cambridge University Press:  12 December 2011

Cristina Fortes*
Affiliation:
Clinical Epidemiology Unit, IDI-IRCSS, Rome, Italy
Simona Mastroeni
Affiliation:
Clinical Epidemiology Unit, IDI-IRCSS, Rome, Italy
Sperati Alessandra
Affiliation:
Agency for Public Health of Lazio Region, Rome, Italy
Juliana Lindau
Affiliation:
Department of Psychiatry, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
Sara Farchi
Affiliation:
Agency for Public Health of Lazio Region, Rome, Italy
Francesco Franco
Affiliation:
Agency for Public Health of Lazio Region, Rome, Italy
Roberta Pacifici
Affiliation:
National Institute of Health, Rome, Italy
PierGiorgio Zuccaro
Affiliation:
National Institute of Health, Rome, Italy
Eva Mazzotti
Affiliation:
Oncology Unit, IDI-IRCCS, Rome, Italy
Paolo Pasquini
Affiliation:
Clinical Epidemiology Unit, IDI-IRCSS, Rome, Italy
Piero Borgia
Affiliation:
Agency for Public Health of Lazio Region, Rome, Italy
*
Correspondence should be addressed to: Dr. Cristina Fortes, BSc, MSc, PhD, Clinical Epidemiology Unit, Istituto Dermopatico dell'Immacolata, IDI, Via dei Monti di Creta, 104, 00167 Roma, Italia. Phone: +39-06-6646.4305; Fax: +39-06-6646.4307. Email: [email protected].
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Abstract

Background: Depression is a potential risk factor for mortality among the aged and it is also associated with other chronic diseases and unhealthy lifestyles that may also affect mortality. The purpose of this study was to investigate the association between depressive symptoms and mortality, controlling for health, nutritional status, and life-style factors.

Methods: A cohort of elderly people (N = 167) was followed-up for ten years. Information on socio-demographic characteristics, medical history, smoking, and alcohol consumption was collected. The primary outcome was all-cause mortality; the secondary outcome was cancer-specific mortality. The Geriatric Depression Scale (GDS-15) was used to assess depression. Using a multivariable Cox proportional hazards regression, we examined the association between depressive symptoms and mortality.

Results: Elderly people with depression (scoring above the depression cut-off of 7) had a 53% increased risk of mortality (relative risk (RR) 1.53; 95%CI: 1.05–2.24) compared to non-depressed subjects. The combination of depressive symptoms with smoking was associated with a particularly higher risk of mortality (RR: 2.61; 95%CI: 1.28–5.31), after controlling for potential confounders.

Conclusions: Depressive symptoms are associated with a significantly increased risk of all-cause mortality. The combination of depressive symptoms and smoking shorten life expectancy among the aged.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2011

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References

Almeida, O. P. and Almeida, S. A. (1999). Short versions of the geriatric depression scale: a study of their validity for the diagnosis of a major depressive episode to ICD-10 and DSM-IV. International Journal of Geriatric Psychiatry, 14, 858865.3.0.CO;2-8>CrossRefGoogle Scholar
Antoni, M. H. et al. (2006). The influence of bio-behavioural factors on tumour biology: pathways and mechanisms. Nature Reviews Cancer, 6, 240248.CrossRefGoogle ScholarPubMed
Barefoot, J. C. and Schroll, M. (1996). Symptoms of depression, acute myocardial infarction, and total mortality in a community sample. Circulation, 93, 19761980.CrossRefGoogle Scholar
Beckman, A. T. F., Copeland, J. R. N. and Prince, M. J. (1999). Review of community prevalence of depression in late life. British Journal of Psychiatry, 174, 307311.CrossRefGoogle Scholar
Brettingham, M. (2004). Depression and obesity are major causes of maternal death in Britain. BMJ, 329, 1205.CrossRefGoogle ScholarPubMed
Colditz, G. A., Sellers, T. A. and Trapido, E. (2006). Epidemiology: Identifying the causes and preventability of cancer? Nature Reviews Cancer, 6, 7583.CrossRefGoogle ScholarPubMed
Eaton, W. W., Martins, S. S., Nestadt, G., Bienvenu, O. J., Clark, D. and Alexandre, P. (2008). The burden of mental disorders. Epidemiologic Reviews, 30, 114.CrossRefGoogle ScholarPubMed
Egede, L. E. (2007). Major depression in individuals with chronic medical disorders: Prevalence, correlates and association with health resource utilization, lost productivity and functional disability. General Hospital Psychiatry, 29, 409416.CrossRefGoogle ScholarPubMed
Fortes, C. et al. (2003). Depressive symptoms lead to impaired cellular immune response. Psychotherapy and Psychosomatics, 72, 253260.CrossRefGoogle ScholarPubMed
Fredman, L. et al. (1989). The association between depressive symptoms and mortality among older participants in the Epidemiologic Catchment Area: Piedmont Health Survey. Journal of Gerontology, 44, 149156.CrossRefGoogle ScholarPubMed
Ganguli, M., Dodge, H. H. and Mulsant, B. H. (2002). Rates and predictors of mortality in an aging, rural, community-based cohort. Archives of General Psychiatry, 59, 10461052.CrossRefGoogle Scholar
Giese-Davis, J., Collie, K., Rancourt, K. M., Neri, E., Kraemer, H. C. and Spiegel, D. (2011). Decrease in depression symptoms is associated with longer survival in patients with metastatic breast cancer: a secondary analysis. Journal of Clinical Oncology, 29, 413420.CrossRefGoogle ScholarPubMed
Herbert, T. B. and Cohen, S. (1993). Depression and immunity: a meta-analytic review. Psychological Bulletin, 113, 472486.CrossRefGoogle ScholarPubMed
Kawamura, T., Shioiri, T., Takahashi, K., Ozdemir, V. and Someya, T. (2007). Survival rate and causes of mortality in the elderly with depression: a 15-year prospective study of a Japanese community sample, the Matsunoyama-Niigata suicide prevention project. Journal of Investigative Medicine, 55, 106114.CrossRefGoogle ScholarPubMed
Livingston, G., Watkin, V., Milne, B., Manela, M. and Katona, C. (1997). The natural history of depression and the anxiety disorders in older people. Journal of Affective Disorders, 46, 255262.CrossRefGoogle ScholarPubMed
Lohman, T., Roche, A. F. and Martorell, R. (1988). Anthropometric Standardisation Reference Manual. Champaign, IL: Human Kinetics Books.Google Scholar
Mineur, Y. S. and Picciotto, M. R. (2009). Biological basis for the co-morbidity between smoking and mood disorders. Journal of Dual Diagnosis, 5, 122130.CrossRefGoogle ScholarPubMed
Moussavi, S., Chatterji, S., Verdes, E., Tandon, A., Patel, V. and Ustun, B. (2007). Depression, chronic diseases, and decrements in health: results from the World Health Surveys. Lancet, 370, 851858.CrossRefGoogle ScholarPubMed
Murphy, E., Smith, R., Lindesay, J. and Slatterly, J. (1988). Increased mortality rates in late-life depression. British Journal of Psychiatry, 152, 347353.CrossRefGoogle ScholarPubMed
Mykletun, A., Bjerkeset, O., Overland, S., Prince, M., Dewey, M. and Stewart, R. (2009). Levels of anxiety and depression as predictors of mortality: the HUNT study. British Journal of Psychiatry, 195, 118125.CrossRefGoogle ScholarPubMed
Okoro, C. A., Strine, T. W., Balluz, L. S., Crews, J. E. and Mokdad, A. H. (2010). Prevalence and correlates of depressive symptoms among United States adults with disabilities using assistive technology. Preventive Medicine, 50, 204209.CrossRefGoogle ScholarPubMed
Osborn, D. P. et al. (2002). Geriatric Depression Scale Scores in a representative sample of 14 545 people aged 75 and over in the United Kingdom: results from the MRC Trial of Assessment and Management of Older People in the Community. International Journal of Geriatric Psychiatry, 17, 375382.CrossRefGoogle Scholar
Paradiso, K. G. and Steinbach, J. N. (2003). Nicotine is highly effective at producing desensitization of rat alpha4beta2 neuronal nicotinic receptors. Journal of Physiology, 553, 857871.CrossRefGoogle ScholarPubMed
Rapp, M. A., Gerstorf, D., Helmchen, H. and Smith, J. (2008). Depression predicts mortality in the young old but not in the oldest old: Results from the Berlin Aging Study. American Journal of Geriatric Psychiatry, 16, 844852.CrossRefGoogle Scholar
Rinaldi, P. et al. (2003). Validation of the five-item geriatric depression scale in elderly subjects in three different settings. Journal of the American Geriatrics Society, 51, 694698.CrossRefGoogle ScholarPubMed
Royal College of Physicians of London and British Geriatrics Society (1992). Standardised Assessment Scales for Elderly People: A Report of Joint Workshops of the Research Unit of the Royal College of Physicians of London and the British Geriatrics Society. London: Royal College of Physicians of London.Google Scholar
Schoevers, R. A., Geerlings, M. I., Deeg, D. J., Holwerda, T. J., Jonker, C. and Beekman, A. T. (2009). Depression and excess mortality: evidence for a dose response relation in community living elderly. Journal of Geriatric Psychiatry, 24, 169176.CrossRefGoogle ScholarPubMed
Schuller, H. M. (2009). Is cancer triggered by altered signalling of nicotinic acetylcholine receptors? Nature Reviews Cancer, 9, 195205.CrossRefGoogle ScholarPubMed
Segulin, N. and Deponte, A. (2007). The evaluation of depression in the elderly: a modification of the Geriatric Depression Scale (GDS). Archives of Gerontology and Geriatrics, 44, 105112.CrossRefGoogle ScholarPubMed
Surtees, P. G., Wainwright, N. W. J., Luben, R. N., Wareham, N. J., Bingham, S. A. and Khaw, K. T. (2008). Depression and ischemic heart disease mortality: evidence from the EPIC-Norfolk United Kingdom prospective cohort study. American Journal of Psychiatry, 165, 515523.CrossRefGoogle ScholarPubMed
van der Weele, G., Gussekloo, J., de Waal, M. W. M., de Craen, A. J. M. and van der Mast, R. C. (2009). Co-occurrence of depression and anxiety in elderly subjetcs aged 90 years and its relationship with functional status, quality of life and mortality. International Journal of Geriatric Psychiatry, 24, 595601.CrossRefGoogle Scholar
Whooley, M. A. and Browner, W. S. (1998). Association between depressive symptoms and mortality in older women. Archives of Internal Medicine, 158, 21292135.CrossRefGoogle ScholarPubMed
Wulsin, L. R., Vaillant, G. E. and Wells, E. W. (1999). A systematic review of the mortality of depression. Psychosomatic Medicine, 61, 617.CrossRefGoogle ScholarPubMed
Yaffe, K., Edwuards, E. R., Covinsky, K. E., Lui, L. Y. and Eng, C. (2003). Depressive symptoms and risk of mortality in frail, community-living elderly persons. American Journal of Geriatric Psychiatry, 11, 561567.CrossRefGoogle ScholarPubMed
Zhang, J. P., Kahana, B., Kahana, E., Hu, B. and Pozuelo, L. (2009). Joint modeling of longitudinal changes in depressive symptoms and mortality in a sample of community-dwelling elderly people. Psychosomatic Medicine, 71, 704714.CrossRefGoogle Scholar