Depressive symptoms and mortality in older Mexican Americans

PURPOSE: We examined the prevalence of comorbid depressive symptomatology a nd leading chronic medical conditions, and their influence on death rates i n older Mexican Americans. METHODS: Data from the Hispanic.Established Population for the Epidemiologi c Study of the Elderly (EPESE) were used. Differences in death rates across sociodemographics, self ratings of health, and health conditions were exam ined with analysis of variance statistics. Logistic regression models were used to examine main effects and interaction effects of each medical condit ion separately and in conjunction with depressive symptomatology. RESULTS: Bivariate analyses indicated that death rates were substantially h igher when a high level of depressive symptoms was comorbid with diabetes ( OR = 3.84, 95% CI = 2.55-5.78), cardiovascular disease (OR = 4.04, 95% CI = 2.36-6.91), hypertension (OR = 2.27, 95% CI = 1.57-3.27), stroke (OR = 3.0 0, 95% CI = 1.44-6.15), and cancer (OR = 4.46, 95% CI = 2.48-8.01). Multiva riate analyses indicated a synergistic effect for comorbid diabetes and dep ressive symptoms such that the odds of having died among diabetics with hig h levels of depressive symptoms (OR = 4.03, 95% CI = 2.67-6.11) were three times that of diabetics without high levels of depressive symptoms (OR = 1. 36, 95% CI = 0.89-2.06). CONCLUSIONS: High levels of depressive symptoms concomitant with major chro nic medical condi tions elevate the risk for death among older Mexican Amer icans. Given the fact that depression is often unrecognized and undertreate d in the elderly, awareness of the potential for loss of life as well as th e potential for treatment may help to improve this situation not only for o lder Mexican Americans, but for older adults in general. (C) 1998 Elsevier Science Inc.