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Comorbidity of Cognitive Impairment and Late-Life Depression Increase Mortality: Results From a Cohort of Community-Dwelling Elderly Individuals in Rural Greece
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.ORCID iD: 0000-0002-8692-3652
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2016 (English)In: Journal of Geriatric Psychiatry and Neurology, ISSN 0891-9887, E-ISSN 1552-5708, Vol. 29, no 4, 195-204 p.Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: To investigate the association of cognitive impairment (COGI) and depression with all-cause mortality and cardiovascular-specific mortality among community-dwelling elderly individuals in rural Greece.

METHODS: Cognition and depressive symptomatology of 676 Velestino town residents aged ≥60 years were assessed using Mini-Mental State Examination (MMSE) and Geriatric Depression Scale (GDS), respectively. Eight-year all-cause mortality and cardiovascular mortality were explored by multivariate Cox regression models controlling for major confounders.

RESULTS: Two hundred and one patients died during follow-up. Cognitive impairment (MMSE ≤ 23) was independently associated with all-cause mortality (hazard ratio [HR]: 1.57, 95% confidence interval [CI]: 1.13-2.18) and cardiovascular mortality (HR: 1.57, 95%CI: 1.03-2.41). Moderate to severe depression (GDS > 10) was significantly associated only with a 51% increase in all-cause mortality. A male-specific association was noted for moderate to severe depression, whereas the effect of COGI was limited to females. Noteworthy, COGI and depression comorbidity, rather than their sole presence, increased all-cause mortality and cardiovascular mortality by 66% and 72%, respectively. The mortality effect of COGI was augmented among patients with depression and of depression among patients with COGI.

CONCLUSION: COGI and depression, 2 entities often coexisting among elderly individuals, appear to increase all-cause mortality and cardiovascular mortality. Gender-specific modes may prevail but their comorbidity should be carefully assessed, as it seems to represent an independent index of increased frailty, which eventually shortens life expectancy.

Place, publisher, year, edition, pages
2016. Vol. 29, no 4, 195-204 p.
Keyword [en]
cognitive impairment; dementia; depression; elderly; survival; mortality
National Category
Psychiatry
Identifiers
URN: urn:nbn:se:uu:diva-279109DOI: 10.1177/0891988716632913ISI: 000379121600004PubMedID: 26917554OAI: oai:DiVA.org:uu-279109DiVA: diva2:907576
Available from: 2016-02-29 Created: 2016-02-29 Last updated: 2017-11-30Bibliographically approved

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Papadopoulos, Fotios C

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