Mortality risk varies according to gender and change in depressive status in very old adults

Objective: We aimed to evaluate whether gender and different patterns of change in depressive status over 2 years were associated with different risks of mortality in the subsequent 6 years. Methods: Depression (CES-D) was assessed in 1947 participants in 1992 and a smaller proportion of the sample in 1994. The mortality risk at July 30, 2000, associated with depression and change in depression was estimated using proportional hazards models. Results: After controlling for demographic variables, smoking, alcohol, and medical conditions, depression was associated with mortality for men but not women. In men, incident depression was associated with mortality after controlling for all other variables. Chronic depression and remitted depression were also associated with mortality, but this effect was explained by medical conditions. In women, change in depressive status was not associated with mortality. Conclusions: Depression confers a greater risk of mortality for men than women with incident depression in old age representing the greatest risk for men. The course of depressive illness must be considered when evaluating mortality risk.