The mortality risk is particularly high for patients aged younger than 70 with major depression and for depressed men, says the Australian-UK team.

Although depression and higher-than-average mortality rates have been linked in the past, the influence of potential confounding variables in high-risk populations has not been fully assessed.

Dr Melanie Abas, from the University of Auckland in New Zealand, and UK colleagues conducted a long-term follow-up study of 2,584 individuals who took part in the Medical Research Council Elderly Hypertension Trial.

Participants were aged between 65 and 75 years at the time of enrolment and were followed up for 11 years. All subjects completed the 12-item SelfCARE-D questionnaire to assess levels of depression. Cognitive function was also assessed at baseline and during follow-up.

Cardiovascular risk factors were recorded, alongside clinical measures of systolic blood pressure, evidence of cardiac ischaemia or arrhythmia and body mass index.

Over the study period, 744 participants died. Thirty-six per cent of those who died had depression and 32 per cent had possible depression, as assessed by the SelfCARE-D scale, compared to 8 and 4.9 per cent of the population at baseline, respectively.

After controlling for gender, depression was found to be independently associated with mortality, with a modest effect identified even after cardiovascular risk factors, cognitive decline and use of antidepressants were taken into account.

Dr Abas and colleagues conclude that, after controlling for gender, depression is an independent predictor of mortality.

Writing in the British Journal of Psychiatry they add, “The findings here…suggest the need to investigate the effect on mortality of vigorous treatment of confirmed depression.”

Reference: Abas et al, British Journal of Psychiatry 2002;181:123-128

© Health Media Ltd 2002
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