Depressive symptoms and 6-year mortality among elderly community-dwelling women

Depression is associated with an increased risk of mortality in studies tha t included adults of all ages, but results of studies restricted to older a dults are less consistent. This study evaluated the association between dep ressive symptoms and mortality among 764 white women aged 65+ years in Balt imore, Maryland, and examined methodologic and conceptual issues regarding this association. The Center for Epidemiologic Studies-Depression Scale (CE S-D) was administered in face-to-face interviews in 1984. Mortality data we re collected through 1990. The 6-year risk of death was 14.5% among women w ith CES-D scores of 0-1, 24% to 28% among women with scores of 2-24, and 47 % among those with scores over 24. The adjusted hazards ratio (RR) comparin g women with the high est (25-58) vs lowest (0-1) scores was 1.77 (95% conf idence interval (CI) = 0.91-3.42). Depressive symptoms were only weakly ass ociated with mortality when using the CES-D scale dichotomized at the tradi tional cutpoint of 16 (RR = 1.10, CI = 0.73-1.66), or when the follow up pe riod was 2 years. Furthermore, depressive symptoms were associated with mor tality only among women in poor health. The association between depressive symptoms and mortality risk appeared to be affected by baseline physical he alth, length of follow-up, and measurement of depression.