Prevalence of depression and correlates of depressive symptoms for residents in the urban part of Jeju Island, Korea

AIMS: This study examined the prevalence of depression and depressive symptoms, and the correlates of depressive symptoms, and proposes some methods for reducing risk of depression in residents of the urban part of Jeju Island in Korea. METHODS: In all, 1050 residents were selected using multiphasic cluster sampling to represent each district. Of the 981 respondents, 413 were men and 568 were women. The Center for Epidemiologic Studies Depression Scale (CES-D) was used to evaluate depression (CES-D score over 25) and depressive symptoms (CES-D score over 21). Multiple logistic regression analysis was performed for comparisons. RESULTS: The prevalence of depression in males and females was comparable, at 9.47 and 11.36%, respectively. The prevalence of depressive symptoms in men was 15.01%, while in women the level rose to 18.37%. Those with high self-assessed level of stress scores were significantly more likely to have depressive symptoms than those with low self-assessed level of stress scores (odds ratio (OR) = 5.73 (95% confidence interval (95% CI), 1.29-25.36)). Residents at high risk of problem drinking (CAGE score over 3) were significantly more likely to have depressive symptoms than those with a CAGE score under 1 (OR = 3.43 95% CI, 1.77-6.66). Respondents who slept poorly had more depressive symptoms than respondents who slept well (OR = 2.11 95% CI, 1.37-3.23). Females were significantly more likely to have more depressive symptoms than males (OR = 1.70 95% CI, 1.08-2.68). CONCLUSIONS: The prevalence of depression and depressive symptoms in urban Jeju Island is similar to that in a nation-wide sample. By providing intensive mental health services to those who have high stress levels, problem drinking, and poor health behavior, early detection of depressive symptoms in the community will be important for improving general health status.     

Optimism and depression as predictors of physical and mental health functioning: The normative aging study

Dispositional optimism has been linked in previous studies to better health outcomes. We sought to examine the independent associations of dispositional optimism and depressive symptoms with physical and mental functioning in a cohort of healthy middle-aged and older men. The study was conducted among 659 subjects in the Veterans Administration (VA) Normative Aging Study. Dispositional optimism and depressive symptomatology were measured in 1991 and 1990, respectively, by the Life Orientation Test and the Center for Epidemiologic Studies--Depression Scale (CES-D). The dependent variables, functioning and well-being, were measured in 1992 by the Medical Outcomes Study Short-Form Health Survey (SF-36). In multivariate regression models, optimism was associated with higher levels of general health perceptions, vitality, and mental health, and lower levels of bodily pain, but not to physical functioning, social functioning, or role limitations due to physical or emotional problems. Depressive symptomatology was associated with reduced levels of functioning across all SF-36 domains. The findings for optimism and depression were statistically significant after mutual adjustment in multivariate regression models. Optimism and depression are independent predictors of functional status among aging men.     

Physical Function Assessment of Older Veterans With Serious Mental Illness

ObjectiveTo characterize the physical function of older veterans with serious mental illness (SMI) across endurance, strength, and mobility domains.DesignRetrospective analysis of clinical performance data.SettingGerofit program, a national outpatient supervised exercise program for older veterans, delivered in Veterans Health Administration sites.ParticipantsOlder veterans aged 60 and older (n = 166 with SMI, n = 1,441 without SMI) enrolled across eight national Gerofit sites between 2010 and 2019.MeasurementsPerformance measures of physical function covering endurance (6-minute walk test), strength (chair stands, arm curls), and mobility (10-m walk, 8-foot-up-and-go), were administered at Gerofit enrollment. Baseline data from these measures were analyzed to characterize the functional profiles of older veterans with SMI. One sample t tests were examined to compare functional performance of older veterans with SMI to age- and sex-based reference scores. Propensity score matching (1:3) and linear mixed effects models were used to evaluate differences in function between veterans with and without SMI.ResultsOlder veterans with SMI performed worse on all measures of function (chair stands, arm curls, 10-m walk, 6-minute walk test, 8-foot-up-and-go) compared to age- and sex-based reference scores with statistically significant differences present in the male sample. Functional performance of those with SMI was also worse compared to propensity-score matched older veterans without SMI with statistically significant differences on chair stands, 6-minute walk test, and 10-m walk.ConclusionOlder veterans with SMI have compromised strength, mobility, and endurance. Physical function should be a core component of screening and treatment for this population.     

Depressive symptoms and severity of illness in multiple sclerosis: epidemiologic study of a large community sample

OBJECTIVE: Previous research has shown high prevalence rates of depression in multiple sclerosis patients seen in specialty clinics. The relationships among depressive symptoms and severity, duration, and course of multiple sclerosis are controversial. METHOD: A survey was mailed to members of the Multiple Sclerosis Association of King County (Wash.). Of the 1,374 eligible participants, 739 returned the survey, a response rate of 53.8%. Data about demographic characteristics, employment, and duration and course of multiple sclerosis were collected. Severity of multiple sclerosis was determined by the Expanded Disability Status Scale, self-report version. Severity of depressive symptoms was evaluated with the Center for Epidemiologic Studies Depression Scale (CES-D Scale). Analysis of covariance was used to compare mean CES-D Scale scores across categories of multiple sclerosis, and logistic regression was used to identify variables associated with clinically significant depression. RESULTS: Clinically significant depressive symptoms (CES-D Scale score > or =16) were found in 41.8% of the subjects, and 29.1% of the subjects had moderate to severe depression (score > or =21). Subjects with advanced multiple sclerosis were much more likely to experience clinically significant depressive symptoms than subjects with minimal disease. Shorter duration of multiple sclerosis was associated with a greater likelihood of significant depressive symptoms, but the pattern of illness progression was not. CONCLUSIONS: In this large community sample, the severity of multiple sclerosis was more strongly associated with depressive symptoms than was pattern of illness. Clinicians should evaluate depression in patients with recent diagnoses of multiple sclerosis, major changes in functioning, or limited social support.     

Depressive symptoms,cognitive decline,and risk of AD in older persons

BACKGROUND: Cross-sectional and retrospective case-control studies suggest an association of depression symptoms with cognitive impairment and AD, but there have been few prospective studies and their results have been inconsistent. METHODS: Participants are Catholic clergy members who were aged > or =65 years and who did not have clinical evidence of AD. During a 7-year period, they underwent annual clinical evaluations that included clinical classification of AD and detailed cognitive function testing from which global and specific measures of cognition were derived. Number of depressive symptoms was assessed at baseline with a modified, 10-item Center for Epidemiologic Studies Depression Scale (CES-D). The association of CES-D score with incident AD, using proportional hazards models, and cognitive decline, using random effects models, was examined. RESULTS: At baseline, participants reported an average of about one depressive symptom on the CES-D scale (range, 0 to 8). During the 7 years of follow-up, 108 persons developed AD. In analyses that controlled for selected demographic and clinical variables including baseline level of cognitive function, CES-D score was associated with both risk of AD and rate of cognitive decline. For each depressive symptom, risk of developing AD increased by an average of 19%, and annual decline on a global cognitive measure increased by an average of 24%. CONCLUSIONS: The results raise the possibility that depressive symptoms in older persons may be associated with risk of developing AD.     

Conjugal loss and syndromal depression in a sample of elders aged 70 years or older.

OBJECTIVE: The goal of this study was to describe the association between conjugal loss and both syndromal depression and depressive symptoms in a prospective cohort study of people aged 70 years or older. METHOD: A measure of syndromal depression, the shortform Composite International Diagnostic Interview (CIDI), and a revised version of the Center for Epidemiologic Studies--Depression Scale (CES-D Scale) were administered to a group of 5,449 elders in a longitudinal cohort study. The authors compared the rates of syndromal depression (CIDI diagnosis) and depressive symptoms (six CES-D Scale symptoms) in married participants and those who lost spouses between the first and second waves of assessment. RESULTS: The rate of syndromal depression in the newly bereaved was nearly nine times as high as the rate for married individuals, and the rate of depressive symptoms was nearly four times as high. The percentage of the bereaved respondents who had scores above threshold on the revised CES-D Scale was higher for those interviewed up to 2 years after loss of a spouse than for married respondents. Age, sex, prior psychiatric history, and the expectedness of the death did not differ between depressed and nondepressed newly bereaved subjects. CONCLUSIONS: Recent bereavement is a significant risk factor for syndromal depression in the elderly. Some widows and widowers experienced high levels of depressive symptoms up to 2 years after the loss of their spouses. Neither demographic variables nor variables concerning the nature of the spouse's death predicted bereavement-related depression.     

Screening for depression in stroke patients: the reliability and validity of the Center for Epidemiologic Studies Depression Scale

This study examined the inter-observer reliability and validity of the Center for Epidemiologic Studies Depression Scale (CES-D) as a measure of depressive symptomatology in stroke patients, and its utility as a screening tool for depression in this population. The CES-D Scale is a brief questionnaire originally designed for use in community surveys. Twenty-seven non-aphasic patients enrolled in the Stroke Data Bank at the University of Maryland were interviewed by a research nurse using the CES-D. On the same day, each patient was independently evaluated by a research assistant using a psychiatric battery for depression and measures of cognitive, physical, and social functioning. Forty-one percent (11/27) of the patients were depressed according to clinical criteria for major or minor depression. With a cutpoint corresponding to the upper (most severe) 20% in community surveys, the CES-D Scale picked up 73% (8/11) of the depressed patients. In this sample no nondepressed patient scored over 16 on the CES-D (no false positives). The CES-D Scale scores correlated significantly with the other depression measures (r = .57 to r = .82, p less than .002) and did not correlate with the measures of cognitive, physical, or social functioning. Based on 24 patients who received a CES-D Scale score from both the nurse and the research assistant, inter-rater reliability was high (r = .76, p less than .001). Thus, the CES-D was found to be reliable and valid as a screening tool for assessing depression in stroke patients.     

Exploring the relationship between physical health,depressive symptoms,and depression diagnoses in Hispanic dementia caregivers

Objectives: The present study examined the relationship between self-reported physical health, depressive symptoms, and the occurrence of depression diagnosis in Hispanic female dementia caregivers. Participants: Participants were 89 Hispanic female dementia caregivers. Design: This study used a cross-sectional design. Baseline depression and physical health data were collected from participants enrolled in the ‘Reducing Stress in Hispanic Anglo Dementia Caregivers’ study sponsored by the National Institute on Aging. Measurements: Physical health was assessed using the Medical Outcome Study Short Form-36 (SF-36), a one-item self-report health rating, body mass index, and the presence or history of self-reported physical illness. Depressive symptoms were assessed using the Center for Epidemiologic Studies–Depression Scale (CES-D). The occurrence of depression diagnosis was assessed using the Clinical Interview for DSM-IV Axis I Disorders (SCID). Analysis: Multiple linear and logistic regression analysis was used to examine the extent to which indices of physical health and depressive symptoms accounted for variance in participants’ depressive symptoms and depressive diagnoses. Results. Self-reported indices of health (e.g., SF-36) accounted for a significant portion of variance in both CES-D scores and SCID diagnoses. Caregivers who reported worsened health tended to report increased symptoms of depression on the CES-D and increased likelihood of an SCID diagnosis of a depressive disorder. Conclusion. Self-reported health indices are helpful in identifying Hispanic dementia caregivers at risk for clinical levels of depression.     

Epidemiology of depressive symptoms in the National Longitudinal Study of Adolescent Health

OBJECTIVE: To describe the range of depressive symptoms reported by adolescents in a nationally representative U.S. sample and to examine factors associated with persistent depressive symptoms. METHOD: Secondary analysis was done on National Longitudinal Study of Adolescent Health (AddHealth) data from 13,568 adolescents who completed the initial survey in 1995 and follow-up 1 year later. Main outcomes of Center for Epidemiologic Studies-Depression Scale (CES-D) scores were analyzed by chi2 comparisons and sample-weighted logistic regression. RESULTS: Over 9% of adolescents reported moderate/severe depressive symptoms at baseline (CES-D > or = 24). Females, older adolescents, and ethnic minority youths were more likely to report depressive symptoms at baseline. Only 3% of adolescents with low initial CES-D scores (CES-D < 16) developed moderate/severe depressive symptoms at follow-up. Factors associated with persistent depressive symptoms at 1-year follow-up included: female gender, fair/poor general health, school suspension, weaker family relationships, and health care utilization. Other factors, including race and socioeconomics, did not predict persistent depressive symptoms. CONCLUSIONS: Depressive symptoms are common in adolescents and have a course that is difficult to predict. Most adolescents with minimal symptoms of depression maintain their status and appear to be at low risk for depression; however, adolescents with moderate/severe depressive symptoms warrant long-term follow-up and reevaluation.     

Late-life depressive symptoms are associated with both hyperactivity and hypoactivity of the hypothalamo-pituitary-adrenal axis.

OBJECTIVE: Although depression has been associated with hyperactivity of the hypothalamo-pituitary-adrenal (HPA) axis, recent studies among depressed elderly have found decreased cortisol levels, which may be due to underlying physical frailty associated with HPA-axis hypoactivity. The authors examined the relationship between urinary cortisol level and late-life depressive symptoms. The authors also explored whether hypo- and hypercortisolemic depressive symptoms are qualitatively different. METHODS: Data are from 881 community-dwelling participants, average age 74.2 years, of the Aging in the Chianti Area Study. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale (CES-D) scale and cortisol levels were determined in 24-hour urine samples. RESULTS: Mean urinary cortisol level was 98.9 microg/24 hours (SD=47.8), and 31% of the sample had significant depressive symptoms (CES-D > or =16). There was no linear association between urinary cortisol level and depressive symptoms; however, there was a nonlinear association between urinary cortisol level and depressive symptoms. Older persons in the lowest and highest urinary cortisol deciles were 2.2 and 1.9 times more likely to have significant depressive symptoms than older persons in all other deciles. Depressed persons with low cortisol presented more physical frailty than depressed persons with high cortisol. CONCLUSION: Late-life depressive symptoms are associated with both hyperactivity and hypoactivity of the HPA axis, which suggests distinct mechanisms for these associations.     

Religious denomination as a symptom-formation factor of depression in older Dutch citizens

OBJECTIVES: The type of symptoms in depression is likely to be influenced by cultural environment. As religion represents an important cultural resource for older adults, it is hypothesised that religious denomination represents a symptom-formation factor of depression in the older generation. Focusing on older Dutch citizens, it is expected that depressed Calvinists report: (1) less depressed affect, (2) more vegetative symptoms, and (3) more guilt feelings, than Roman Catholics and non-church members. METHODS AND PROCEDURES: The Center for Epidemiologic Studies Depression Scale (CES-D) was used to distinguish depressed (N=395) and non-depressed (N=2333) older adults, and to assess depressive symptom-profiles. The Diagnostic Interview Schedule (DIS) was used to assess major depressive episodes and criterion-symptoms of depression. RESULTS: Depressed Calvinists, especially males, had higher scores on the vegetative CES-D subscale. The same was found for non-church members with Calvinist parents. Among those who have had a major depressive episode in later life (N=84), support was found for all hypotheses. Feelings of guilt were also more prevalent among Roman Catholics. CONCLUSIONS: Religious denomination modified the type of symptoms in late-life depression. As a Calvinist background was associated with less depressive affect and more inhibition, there is a risk of underdiagnosis of major depression in older Calvinists in The Netherlands.     

Gender differences in depression: a study of older unlike-sex twins

Gender differences in depressive symptoms, in the diagnosis of major/minor depression, and in the use of antidepressant medication were investigated. The sample included 249 pairs of unlike-sex twins, who were between 70 and 80 years of age at the initial, baseline assessment. A follow-up, in which both members of 145 twin pairs participated, was carried out four years later. Participants completed the Centre for the Epidemiologic Studies Depression Scale (CES-D) for depressive symptoms. Current use of antidepressant medicine was assessed. Medical records of major/minor depression from the period 1985-1998, including a summary of those diagnoses in earlier years, were gathered from several sources. Women had a higher frequency of depressive symptoms and depression diagnoses than their twin brothers. Depressive symptoms and diagnosis of depression increased over time, slightly more among men. The gender difference and increase over time in the depressive symptoms were related to differences in socio-economic status and physical functioning in men and women. No gender difference was found in the use of antidepressant medication.     

Gender differences in burden and depression among informal caregivers of demented elders in the community

BACKGROUND: Earlier studies have yielded inconsistent findings regarding gender differences with respect to burden and depression among informal community caregivers of dementia patients. OBJECTIVES: The aim of the study was to determine whether or not there were gender differences in the prevalence of burden and depression among informal caregivers of community-residing dementia patients. METHODS: Data from 259 female and 68 male caregivers who were part of the Canadian Study of Health and Aging were analyzed. Depressive symptoms were measured using the Center for Epidemiologic Studies--Depression Scale (CES-D). Burden was assessed using Zarit's Burden Interview. Associations between the outcome variables (depressive symtoms and burden) and the independent variable, gender, were examined using logistic regression. RESULTS: In multivariable analysis, female caregivers were found to have significantly higher odds than male caregivers of having a score of 33 or higher on Zarit's Burden Interview (OR=2.6; 95% CI 1.0, 6.7). The OR comparing women to men with respect to a high level of depressive symptoms (defined as a score of 16 or more on the CES-D) was not significant (OR=1.3; 95% CI 0.6, 2.9). Poor perceived caregivers health and more behavior disturbance in the patient were associated with significantly higher odds of high levels of caregiver burden and depression. CONCLUSIONS: Adequate assistance must be given to women caregivers to ensure that they are not strained beyond what is clinically healthy. In addition, interventions should target caregivers of behaviorally disturbed patients as well as caregivers who report poor physical health to reduce the negative psychological impact of caregiving.     

Prevalence of Depressive Symptoms and Related Factors in Japanese Employees as Measured by the Center for Epidemiologic Studies Depression Scale (CES-D)

This study aimed to examine the prevalence of depressive symptoms and related factors in Japan. For this purpose, a questionnaire including the Center for Epidemiologic Studies Depression Scale (CES-D) was administered to employees from Akita prefecture, Japan. The cutoff point for CES-D scores was 16 or above (high scorers). We analyzed the results of this survey in order to identify relationships between the prevalence of high scores on the CES-D, sociodemographic status, and employment-related variables. In total, 2,220 employees—of whom 1,069 were men and 1,151, women—satisfactorily responded, and their responses indicated that 45.0 % (41.4 % for men, 48.2 % for women) had high scores on the CES-D. The identified sociodemographic and occupation-related factors from the binomial multivariate logistic regression for high scorers were as follows: a high risk of depression was associated with being women, short and/or long sleep durations, the occasional consumption of alcohol in men, and professional work and over 8 h of work per day in women. Older age groups and non-smoking women were associated with a lower risk. These results can be used in the future as CES-D benchmark values, and might be useful in predicting the occurrence of depressive disorders.     

Genetic Liability for Depression,Social Factors and Their Interaction Effect in Depressive Symptoms and Depression Over Time in Older Adults

ObjectivesThe objectives of this study were to investigate the effect of genetic and social factors on depressive symptoms and depression over time and to test whether social factors moderate the relationship between depressive symptoms and its underlying genetics in later life.MethodsThe study included 2,279 participants with a mean follow-up of 15 years from the Longitudinal Aging Study Amsterdam with genotyping data. The personal genetic loading for depression was estimated for each participant by calculating a polygenic risk scores (PRS-D), based on 23,032 single nucleotide polymorphisms associated with major depression in a large genome-wide association study. Partner status, network size, received and given emotional support were assessed via questionnaires and depressive symptoms were assessed using the CES-D Scale. A CES-D Scale of 16 and higher was considered as clinically relevant depression.ResultsHigher PRS-D was associated with more depressive symptoms whereas having a partner and having a larger network size were independently associated with less depressive symptoms. After extra adjustment for education, cognitive function and functional limitations, giving more emotional support was also associated with less depressive symptoms. No evidence for gene-environment interaction between PRS-D and social factors was found. Similar results were found for clinically relevant depression.ConclusionGenetic and social factors are independently associated with depressive symptoms over time in older adults. Strategies that boost social functioning should be encouraged in the general population of older adults regardless of the genetic liability for depression.     

Association between physical and cognitive function in healthy elderly: the health, aging and body composition study

Performance measures of physical function (gait speed, chair stands, standing balance) and cognitive function [Teng-modified Mini-Mental Status Exam (3MS) and digit symbol substitution test (DSST)] were assessed at baseline in 3,075 participants in the Health, Aging and Body Composition Study. Each physical function measure was examined for the strength and magnitude of association with cognitive function. All physical function measures were associated with both the 3MS and DSST scores (p < 0.001), and in multivariate analysis each relationship was independent of demographic characteristics, weight, physical activity and comorbid health conditions of participants. The association of motor performance was consistently greater for the DSST than the 3MS and, among the motor tests, gait speed retained a significant association with both cognitive measures independent of demographic, weight, physical activity and comorbid health conditions. In this large cohort of high-functioning older adults, the correlation between physical and cognitive function was not entirely explained by demographics. Longitudinal studies are needed to determine the direction of causality in this relationship.     

Depression and smoking across 25 years of the Normative Aging Study

OBJECTIVE: The majority of past findings indicate that smokers are more likely than non-smokers to report depressive symptoms and that depression may act as an impediment to smoking cessation. The aim of the present study is to examine the stability of the relationship between depressive symptoms and smoking status and to determine whether the presence of depressive symptoms predicts continued smoking. METHODS: Subjects were initially healthy men (n = 2208) from the Veterans Administration Normative Aging Study, an ongoing cohort of older men who have been re-assessed every 3-5 years for a period of 25 years. Depressive symptoms measures employed were the Cornell Medical Index, the MMPI-2 Content Depression Scale, and the Center for Epidemiological Studies Depression Scale. RESULTS: Depression scores were higher among continuing smokers compared to never and former smokers and those who quit after entering the study. None of the three depressive symptoms measures were associated with decreased likelihood of smoking cessation. The change in MMPI-2 depression scores observed in a 4-year follow-up was the same among those who quit and those who remained smokers. CONCLUSIONS: Higher prevalence of depressive symptoms among male smokers is stable across time and is likely to contribute to higher morbidity and mortality among these smokers. However, presence of depressive symptoms did not have a significant impact on smoking cessation.     

Detection of subthreshold depression and subthreshold anxiety in the elderly.

OBJECTIVE: To assess the ability of screening instruments to detect subthreshold depression or subthreshold anxiety and to make suggestions for the improvement of instrument performance. DESIGN: Group definition relied on the presence or absence of major psychiatric disorders or of subthreshold disorders (Composite International Diagnostic Interview). SETTING: A community-based study in Germany. PARTICIPANTS: The total sample comprised 274 subjects over 60 years of age; 57 subjects suffered from acute subthreshold depression, 26 subjects suffered from acute subthreshold anxiety, 173 subjects were defined as being healthy (i.e. no acute or lifetime major psychiatric disorder, no acute subthreshold disorder). MEASURES: The short version of the General Health Questionnaire (GHQ-12), the Center for Epidemiologic Studies--Depression Scale (CES-D), the Structured Interview for the Diagnosis of Dementia of the Alzheimer-type, Multiinfarct Dementia and Dementias of other Etiology (SIDAM) for cognitive impairment. RESULTS: Subjects with subthreshold disorders scored higher on the CES-D and the GHQ-12 than healthy individuals. The most distinct increase was observed in the CES-D score of subjects with subthreshold anxiety. The CES-D factor for the presence of somatic/vegetative symptoms performed slightly better compared to the other CES-D factors. CONCLUSIONS: The CES-D moderately detected subthreshold anxiety. Subthreshold depression could not be efficiently detected by either questionnaire. The combination of items indicating the presence of somatic symptoms and depressive affect could improve instrument performance when screening for subthreshold anxiety but not for subthreshold depression.     

Short sleep is associated with more depressive symptoms in a multi-ethnic cohort of older adults

ObjectivesTo evaluate cross-sectional and prospective associations between short and long sleep duration and depressive symptoms in older adults (aged >65 years).MethodsThe data from a subsample of the racially/ethnically diverse Northern Manhattan Study were analyzed. Depressive symptoms were assessed twice with the Center for Epidemiologic Studies Depression Scale (CES-D), approximately 5 years apart. The presence of depressive symptoms was defined as a CES-D score ≥16 or use of antidepressants. Self-reports of short (<6 h), intermediate (6–8 h) and long (≥9 h) sleep were assessed prior to the initial CES-D. Logistic regression was used to evaluate the cross-sectional associations between short and long sleep durations with depressive symptoms, using intermediate sleep as the reference. The prospective association between sleep duration and depression in a sample of participants without depressive symptoms at first CES-D was also analyzed. All models were adjusted for demographic, behavioral, and vascular risk factors.ResultsThe initial sample consisted of 1110 participants: 62% women, 69% Hispanic, 17% black, 14% white. Short sleep was reported by 25%, intermediate sleep by 65%, and long sleep by 9%. Depressive symptoms were described in 25% of the initial sample. Short sleep, but not long sleep, was associated with depressive symptoms at baseline (adjusted OR 1.8, 95% CI 1.3–2.6), and at follow-up (adjusted OR 1.9, 95% CI 1.1–3.5; median follow-up = 5.1 years).ConclusionShort sleep duration had a cross-sectional and prospective association with depressive symptoms in an urban multi-ethnic cohort of older adults.     

Sex differences in the relationship between subthreshold depression and mortality in a community sample of older adults.

The authors investigated the increased risk of mortality from subthreshold depression and examined differences in risk by gender. Data from the Duke University Established Populations for Epidemiologic Studies of the Elderly (EPESE) longitudinal study of 4,162 community-dwelling adults age 65 or older were used for these analyses. Depression was measured with a modified version of the Center for Epidemiologic Studies Depression Scale (CES-D). Three follow-up periods were assessed, 1986-1989, 1989-1992, and 1992-1996. Using logistic regression, they determined the odds of mortality from both CES-D depression (> or =9 symptoms) and subthreshold depression (6-8 symptoms) by sex for each follow-up period, controlling for sociodemographic factors, physical and cognitive health and functioning, and health behaviors. CES-D depression was not associated with mortality in either men or women. Subthreshold depression was also not associated with mortality in men; in women, however, subthreshold depression was negatively related to mortality (OR=0.60; p=0.002) across the three periods. Subthreshold depression may result in different outcomes in women, possibly mediating against mortality.