Depression A Killer For Older Men

Depression is not good for anyone but older men who become depressed are more likely to die than are women, according to a new study. Other studies in recent years have reached similar conclusions.

"Depression may be an early sign of impending physical decline," says the author of this recent study, Kaarin Anstey, Ph.D., of the Center for Mental Health Research at Australian National University in Canberra, Australia. "Or it may incur a physiological response that predisposes individuals to cardiovascular disease or cancer."

Anstey and co-author Mary A. Luszcz, Ph.D., of the School of Psychology and Center for Aging Studies at Flinders University in Adelaide, South Australia, analyzed data from the Australian Longitudinal Study of Aging, focusing on individuals aged 70 or older. More than 1,900 participants completed a questionnaire measuring depression in 1992; a subset of these participants completed it in 1994. The researchers tracked the health of the participants until 2000.

Participants were classified as having "incident depression" if their questionnaire scores indicated they were depressed the second time they took the test but not the first time. They received a classification of "remitted depression" if their depression had relented the second time they took the test and "chronic depression" if their scores were high on both occasions.

After taking into account factors such as smoking, alcohol and medical conditions, depression was associated with mortality for men but not women, the researchers found.

"Our findings confirm previous studies showing that late-life depression occurs more often in women, but has greater negative outcomes for men," says Anstey.

The significant effect of depression on male mortality was small but "robust," suggesting that depression may play a role in causing health changes in men, according to the study. Incident depression had the strongest association with death for men. The effects of chronic and remitted depression were not statistically significant when the researchers took medical conditions into account.

The lack of a statistically significant association between chronic depression and mortality may relate to chronically depressed participants skewing results by dropping out between the first and second questionnaires. The effects of chronic depression in this study are probably underestimated because of these dropouts, according to the study.

The finding that remitted depression was not associated with mortality "suggests that treating depression in very old adults may reduce the risk of mortality," says Anstey. The study results are published in the November/December issue of Psychosomatic Medicine.

The researchers suggest that depression may be a precursor of cardiovascular disease or dementia, or may occur in concert with these conditions.

Study in 2000 Supports Theory

A study in 2000 said both men and women with depression have an increased risk for coronary heart disease (CHD); however, men are at an increased risk of CHD mortality while women are not. according to an article published in the May 8, 2000, issue of the American Medical Association's Archives of Internal Medicine.

To investigate the differential effect depression may have on CHD incidence and death in men and women, the researchers analyzed data from 5,007 women and 2,886 men enrolled in the first National Health and Nutrition Examination Survey (NHANES I), who did not have CHD at the 1982-1984 interview and had been evaluated for depression. It was published in the May 8, 2000, issue of the American Medical Association's Archives of Internal Medicine.

The authors found that depressed women were at 73 percent greater risk for CHD events than women who were not depressed but were not at increased risk of dying from CHD. Depressed men had a 71 percent greater risk of CHD incidence and 2.34 times the risk of dying from CHD than men who were not depressed. The authors recommend further research to define the mechanism that links depression to elevated CHD risk in patients without heart disease so interventions can be established to reduce CHD risk.