Hostname: page-component-586b7cd67f-vdxz6 Total loading time: 0 Render date: 2024-11-23T11:13:48.808Z Has data issue: false hasContentIssue false

Gender differences in the trajectories of late-life depressive symptomology and probable depression in the years prior to death

Published online by Cambridge University Press:  09 July 2013

R. A. Burns*
Affiliation:
Centre for Research on Ageing, Health and Wellbeing, The Australian National University, Canberra, Australian Capital Territory, Australia
M. A. Luszcz
Affiliation:
Flinders Centre for Ageing Studies and School of Psychology, Flinders University, Adelaide, South Australia, Australia
K. M. Kiely
Affiliation:
Centre for Research on Ageing, Health and Wellbeing, The Australian National University, Canberra, Australian Capital Territory, Australia
P. Butterworth
Affiliation:
Centre for Research on Ageing, Health and Wellbeing, The Australian National University, Canberra, Australian Capital Territory, Australia
C. Browning
Affiliation:
School of Primary Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
P. Mitchell
Affiliation:
Centre for Vision Research, Westmead Millennium Institute and Department of Ophthalmology, University of Sydney, Sydney, New South Wales, Australia
K. J. Anstey
Affiliation:
Centre for Research on Ageing, Health and Wellbeing, The Australian National University, Canberra, Australian Capital Territory, Australia
*
Correspondence should be addressed to: Richard Burns, Centre for Research on Ageing, Health and Wellbeing, Building 63, Eggleston Road, The Australian National University, Canberra ACT 0200, Australia. Phone: +61-2-6125 3132; Fax: +61-2-6125 0733. Email: [email protected].

Abstract

Background:

Gender differences in depression are well established. Whether these differences persist into late life and in the years preceding death is less clear. There is a suggestion that there is no increased likelihood of depression in late life, but that there is an increase in depressive symptomology, particularly with proximity to death. We compared trajectories of probable depression and depressive symptomology between men and women over age and distance-to-death metrics to determine whether reports of depressive symptoms are more strongly related to age or mortality.

Methods:

Participants (N = 2,852) from the Dynamic Analyses to Optimise Ageing (DYNOPTA) project had a mean age of 75 years (SD = 5.68 years) at baseline and were observed for up to 16 years prior to death. Multi-level regression models estimated change in depressive symptomology and probable depression over two time metrics, increasing age, and distance-to-death.

Results:

Increases in depressive symptomology were reported over increasing age and in the years approaching death. Only male participants reported increased probable depression in the years preceding death. Models that utilized distance-to-death metrics better represented changes in late-life depression, although any changes in depression appear to be accounted for by co-varying physical health status.

Conclusions:

As death approaches, there are increases in the levels of depressive symptomology even after controlling for socio-demographic and health covariates. In line with increases in suicide rates in late life, male participants were at greater risk of reporting increases in depressive symptomology.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

ABS (2012). Causes of Death 2010. Canberra: Australian Bureau of Statistics.Google Scholar
Anstey, K. J. and Luszcz, M. A. (2002 ). Mortality risk varies according to gender and change in depressive status in very old adults. Psychosomatic Medicine, 64, 880888.Google ScholarPubMed
Anstey, K. J., Hofer, S. M. and Luszcz, M. A. (2003). A latent growth curve analysis of late-life sensory and cognitive function over 8 years: evidence for specific and common factors underlying change. Psychology and Aging, 18, 714726.CrossRefGoogle ScholarPubMed
Anstey, K. J., von Sanden, C. and Luszcz, M. A. (2006a). An 8-year prospective study of the relationship between cognitive performance and falling in very old adults. Journal of the American Geriatrics Society, 54, 11691176.CrossRefGoogle ScholarPubMed
Anstey, K. J., Windsor, T., Luszcz, M. and Andrews, G. R. (2006b). Predicting driving cessation over 5 years in older adults: psychological well-being and cognitive competence are stronger predictors than physical health. Journal of the American Geriatrics Society, 54, 121126.CrossRefGoogle ScholarPubMed
Anstey, K. J.et al. (2010). Cohort profile: the Dynamic Analyses to Optimize Ageing (DYNOPTA) project. International Journal of Epidemiology, 39, 4451.CrossRefGoogle ScholarPubMed
Barefoot, J. C., Mortensen, E. L., Helms, M. J., Avlund, K. and Schroll, M. (2001). A longitudinal study of gender differences in depressive symptoms from age 50 to 80. Psychology and Aging, 16, 342345.CrossRefGoogle ScholarPubMed
Barsky, A. J., Cleary, P. D. and Klerman, G. L. (1992). Determinants for perceived health status of medical outpatients. Social Science and Medicine, 34, 11471154.CrossRefGoogle ScholarPubMed
Bartsch, L. J., Butterworth, P., Byles, J. E., Mitchell, P., Shaw, J. and Anstey, K. J. (2011). Examining the SF-36 in an older population: analysis of data and presentation of Australian adult reference scores from the Dynamic Analyses to Optimise Ageing (DYNOPTA) project. Quality of Life Research, 20, 12271236.CrossRefGoogle Scholar
Batterham, P. J., Christensen, H. and Mackinnon, A. J. (2012). Mental health symptoms associated with morbidity, not mortality, in an elderly community sample. Social Psychiatry and Psychiatric Epidemiology, 47, 7985.CrossRefGoogle ScholarPubMed
Bebbington, P. E. (1998). Sex and depression. Psychological Medicine, 28, 18.CrossRefGoogle ScholarPubMed
Bergdahl, E.et al. (2005). Depression among the oldest old: the Umea 85+ study. International Psychogeriatrics, 17, 557575.CrossRefGoogle ScholarPubMed
Blaum, C. S., Liang, J. and Liu, X. (1994). The relationship of chronic diseases and health status to the health service utilization of older Americans. Journal of the American Geriatrics Society, 42, 10871093.CrossRefGoogle Scholar
Burns, R. A., Butterworth, P., Windsor, T. D., Luszcz, M., Ross, L. A. and Anstey, K. J. (2012a). Deriving prevalence estimates of depressive symptoms throughout middle and old age in those living in the community. International Psychogeriatrics, 24, 503511.CrossRefGoogle ScholarPubMed
Burns, R. A., Byles, J., Mitchell, P. and Anstey, K. J. (2012b). Positive components of mental health provide significant protection against likelihood of falling in older women over a 13-year period. International Psychogeriatrics, 24, 14191428.CrossRefGoogle Scholar
Burns, R. A., Butterworth, P., Luszcz, M. and Anstey, K. J. (2013). Stability and change in level of probable depression and depressive symptoms in a sample of middle and older-aged adults. International Psychogeriatrics, 25, 303309.CrossRefGoogle Scholar
Conwell, Y. (1992). Depression as a “cause” of late life suicide. Crisis, 13, 5556.Google ScholarPubMed
Gerstorf, D., Ram, N., Estabrook, R., Schupp, J., Wagner, G. G. and Lindenberger, U. (2008a). Life satisfaction shows terminal decline in old age: longitudinal evidence from the German Socio-Economic Panel Study (SOEP). Developmental Psychology, 44, 11481159.CrossRefGoogle ScholarPubMed
Gerstorf, D., Ram, N., Rocke, C., Lindenberger, U. and Smith, J. (2008b). Decline in life satisfaction in old age: longitudinal evidence for links to distance-to-death. Psychology and Aging, 23, 154168.CrossRefGoogle ScholarPubMed
Gerstorf, D.et al. (2010). Late-life decline in well-being across adulthood in Germany, the United Kingdom, and the United States: something is seriously wrong at the end of life. Psychology and Aging, 25, 477485.CrossRefGoogle ScholarPubMed
Lee, Y. and Shinkai, S. (2003). A comparison of correlates of self-rated health and functional disability of older persons in the Far East: Japan and Korea. Archives of Gerontology and Geriatrics, 37, 6376.CrossRefGoogle ScholarPubMed
Maddox, G. L. (1999). Commentary on the self-reported health symposium. Research on Aging, 21, 501506.CrossRefGoogle Scholar
Mitty, E. and Flores, S. (2008). Suicide in late life. Geriatric Nursing, 29, 160165.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
Pachana, N. A., McLaughlin, D., Leung, J., Byrne, G. and Dobson, A. (2012). Anxiety and depression in adults in their eighties: do gender differences remain? International Psychogeriatrics, 24, 145150.CrossRefGoogle ScholarPubMed
Piccinelli, M. and Wilkinson, G. (2000). Gender differences in depression. Critical review. The British Journal of Psychiatry: The Journal of Mental Science, 177, 486492.CrossRefGoogle ScholarPubMed
Piccinin, A. and Hofer, S. (2008). Integrative analysis of longitudinal studies on aging: collaborative research networks, meta-analysis, and optimizing future studies. In Hofer, S. M. and Alwin, D. F. (eds.), Handbook on Cognitive Aging: Interdisciplinary Perspectives (pp. 446476). Thousand Oaks: Sage Publications.CrossRefGoogle Scholar
Saz, P. and Dewey, M. E. (2001). Depression, depressive symptoms and mortality in persons aged 65 and over living in the community: a systematic review of the literature. International Journal of Geriatric Psychiatry, 16, 622630.CrossRefGoogle ScholarPubMed
Snowdon, J. (2001). Prevalence of depression in old age. British Journal of Psychiatry, 178, 476477.CrossRefGoogle ScholarPubMed
Steffens, D. C., Fisher, G. G., Langa, K. M., Potter, G. G. and Plassman, B. L. (2009). Prevalence of depression among older Americans: the aging, demographics and memory study. International Psychogeriatrics, 21, 879888.CrossRefGoogle ScholarPubMed
van't Veer-Tazelaar, P. J.et al. (2008). Depression in old age (75+), the PIKO study. Journal of Affective Disorders, 106, 295299.CrossRefGoogle ScholarPubMed
VanItallie, T. B. (2005). Subsyndromal depression in the elderly: underdiagnosed and undertreated. Metabolism-Clinical and Experimental, 54, 3944.CrossRefGoogle ScholarPubMed
Zunzunegui, M. V.et al. (2007). Gender differences in depressive symptoms among older adults: a cross-national comparison: the CLESA project. Social Psychiatry and Psychiatric Epidemiology, 42, 198207.CrossRefGoogle ScholarPubMed