Association of depression and gender with mortality in old age - Results from the Amsterdam Study of the Elderly (AMSTEL)

Background The association between depression and increased mortality risk in older persons may depend on the severity of the depressive disorder and gender. Aims To investigate the association between major and mild depressive syndr omes and excess mortality in community-living elderly men and women. Method Depression(Geriatric Mental State AGECAT) was assessed in 4051 older persons, with a 6-year follow-up of community death registers. The mortali ty risk of neurotic and psychotic depression was calculated after adjustmen t for demographic variables, physical illness, cognitive decline and functi onal disabilities. Results A total of 75% of men and 41% of women with psychotic depression ha d died at follow-up. Psychotic depression was associated with significant e xcess mortality in both men and women. Neurotic depression was associated w ith a 1.67-fold higher mortality risk in men only. Conclusions In the elderly, major depressive syndromes increase the risk of death in both men and women, but mild depression increases the risk of dea th only In men.