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Role of severity and gender in the association between late-life depression and all-cause mortality

Published online by Cambridge University Press:  21 December 2012

Hyun-Ghang Jeong
Department of Psychiatry, Korea University Guro Hospital, College of Medicine, Korea University, Seoul, Korea
Jung Jae Lee
Department of Psychiatry, Kyungbook National University Hospital, Daegu, Korea
Seok Bum Lee
Department of Psychiatry, Dankook University Hospital, Chungcheongnamdo, Korea
Joon Hyuk Park
Department of Neuropsychiatry, Jeju National University Hospital, Jeju, Korea
Yoonseok Huh
Department of Neuropsychiatry, Seoul National University Bundang Hospital. Seongnam, Korea
Ji Won Han
Department of Neuropsychiatry, Seoul National University Bundang Hospital. Seongnam, Korea
Tae Hui Kim
Department of Neuropsychiatry, Seoul National University Bundang Hospital. Seongnam, Korea
Ho Jun Chin
Department of Internal Medicine, Seoul National University Bundang Hospital, Gyeonggido, Korea
Ki Woong Kim*
Department of Internal Medicine, Seoul National University Bundang Hospital, Gyeonggido, Korea Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
Correspondence should be addressed to: Ki Woong Kim, Department of Neuropsychiatry, Seoul National University Bundang Hospital, 173-82 Gumi-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707, Korea. Phone: +82-31-7877439; Fax: +82-31-7874058. Email:


Background: Mortality associated with depression may be influenced by severity of depression and gender. We investigated the differential impacts on all-cause mortality of late-life depression by the type of depression (major depressive disorder, MDD; minor depressive disorder, MnDD; subsyndromal depression, SSD) and gender after adjusting comorbid conditions in the randomly sampled elderly.

Methods: One thousand community-dwelling elderly individuals were enrolled. Standardized face-to-face clinical interviews, neurological examination, and physical examination were conducted to diagnose depressive disorders and comorbid cognitive disorders. Depressive disorders were diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) criteria and SSD to study-specific operational criteria. Five-year survivals were compared between groups using Cox proportional hazards models.

Results: By the end of 2010, 174 subjects (17.4%) died. Depressive disorder (p = 0.001) and its interaction term with gender (p < 0.001) were significant in predicting five-year survival. MDD was an independent risk factor for mortality in men (hazard ratio = 3.65, 95% confidence interval = 1.67–7.96) whereas MnDD and SSD were not when other risk factors were adjusted.

Conclusions: MDD may directly confer the risk of mortality in elderly men whereas non-major depression may be just an indicator of increased mortality in both genders.

Research Article
Copyright © International Psychogeriatric Association 2012

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