Prognostic significance of depression with and without dementia in ter
ms of survival was investigated in a prospective study of persons aged
70 years (n = 1032), using mini-mental state examination (MMSE), self
-rating depression scale of Zung, clinical dementia rating (CDR), DSM-
III criteria of major depression, clinical depression (CD) and the dat
e and causes of death during the 5-year follow-up. The Zung-score (> 4
0 pts) and CD were associated with slightly increased 5-year mortality
. The 5-year mortality was significantly increased in the combination
group (MMSE-score < 24, Zung-score > 40). Excess mortality of depresse
d subjects was found in all categories of death except malignancy and
the most significant increase was found in the rate of pulmonary disea
ses. The data indicate that lowered mood, measured with the Zung-test,
is an independent risk indicator of death in the general aged populat
ion, but depression is hardly an independent risk condition of cogniti
ve decline. (C) 1998 Elsevier Science Ireland Ltd. All rights reserved
.