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Patterns of association between depressive symptoms and chronic medical morbidities in older adults


Agustini, B and Lotfaliany, M and Woods, RL and McNeil, JJ and Nelson, MR and Shah, RC and Murray, AM and Ernst, ME and Reid, CM and Tonkin, A and Lockery, JE and Williams, LJ and Berk, M and Mohebbi, M, ASPREE Investigator Group, Patterns of association between depressive symptoms and chronic medical morbidities in older adults, Journal of the American Geriatrics Society, 68, (8) pp. 1834-1841. ISSN 0002-8614 (2020) [Refereed Article]

Copyright Statement

2020 The American Geriatrics Society

DOI: doi:10.1111/jgs.16468


Objectives: To investigate the association between depressive symptoms and several medical morbidities, and their combination, in a large older population. Design: Cross-sectional study of baseline data from the ASPirin in Reducing Events in the Elderly (ASPREE) trial.

Setting: Multicentric study conducted in Australia and the United States.

Participants: A total of 19,110 older adults (mean age = 75 years [standard deviation = 4.5]).

Measurements: Depressive symptoms were measured using the Center for Epidemiological Studies Depression (CES-D 10) scale. Medical morbidities were defined according to condition-specific methods. Logistic regression was used to calculate odds ratios (ORs) with 95% confidence intervals (CIs) to test associations before and after accounting for possible confounders.

Results: Depressive symptoms were significantly associated with obesity (OR = 1.19; 95% CI = 1.07-1.32), diabetes (OR = 1.22; 95% CI = 1.05-1.42), gastroesophageal reflux disease (GERD) (OR = 1.41; 95% CI = 1.28-1.57), metabolic syndrome (OR = 1.16; 95% CI = 1.03-1.29), osteoarthritis (OR = 1.41; 95% CI = 1.27-1.57), respiratory conditions (OR = 1.25; 95% CI = 1.10-1.42), history of cancer (OR = 1.19; 95% CI = 1.05-1.34), Parkinson's disease (OR = 2.56; 95% CI = 1.83-3.56), polypharmacy (OR = 1.60; 95% CI = 1.44-1.79), and multimorbidity (OR = 1.29; 95% CI = 1.12-1.49). No significant association was observed between depressive symptoms and hypertension, chronic kidney disease, dyslipidemia, and gout (P > .05). A significant dose-response relationship was evident between the number of medical comorbidities and the prevalence of depression (OR = 1.18; 95% CI = 1.13-1.22).

Conclusion: Late-life depressive symptoms are significantly associated with several medical morbidities, and there appears to be a cumulative effect of the number of somatic diseases on the prevalence of depression. These findings augment the evidence for a complex relationship between mental and physical health in an otherwise healthy older population and might guide clinicians toward early recognition of high-risk individuals.

Item Details

Item Type:Refereed Article
Keywords:depression, late-life depression, medical comorbidity, polypharmacy, somatic conditions
Research Division:Biomedical and Clinical Sciences
Research Group:Clinical sciences
Research Field:Geriatrics and gerontology
Objective Division:Health
Objective Group:Specific population health (excl. Indigenous health)
Objective Field:Health related to ageing
UTAS Author:Nelson, MR (Professor Mark Nelson)
ID Code:139273
Year Published:2020
Web of Science® Times Cited:21
Deposited By:Menzies Institute for Medical Research
Deposited On:2020-06-04
Last Modified:2021-04-26

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