Depression, cardiovascular disease, diabetes, and two-year mortality among older, primary-care patients

Am J Geriatr Psychiatry. 2005 Sep;13(9):748-55. doi: 10.1176/appi.ajgp.13.9.748.


Objective: Depression is a major contributor to death and disability, but few follow-up studies of depression have been carried out in the primary-care setting. The authors sought to assess whether depression in older patients is associated with increased mortality after a 2-year follow-up interval and to estimate the population-attributable fraction (PAF) of depression on mortality in older primary-care patients.

Methods: Longitudinal cohort analysis was carried out in 20 primary-care practices. Participants were identified though a two-stage, age-stratified (60-74 or 75+) depression screening of randomly sampled patients; enrollment included patients who screened positive and a random sample of screened-negative patients. In all, 1,226 persons were assessed at baseline. Vital status at 2 years was the outcome of interest.

Results: Of 1,226 persons in the sample, 598 were classified as depressed. After 2 years, 64 persons had died. Persons with depression at baseline were more likely to die at the end of the 2-year follow-up interval than were persons without depression, even after accounting for potentially influential covariates such as whether the participant reported a history of myocardial infarction (MI) or diabetes.

Conclusions: Among older, primary-care patients over the course of a 2-year follow-up interval, depression contributed as much to mortality as did MI or diabetes.

Publication types

  • Multicenter Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Age Factors
  • Aged
  • Cardiovascular Diseases / mortality*
  • Causality
  • Cause of Death
  • Comorbidity
  • Depression / complications*
  • Depression / diagnosis
  • Depression / mortality
  • Diabetes Mellitus, Type 2 / complications*
  • Diabetes Mellitus, Type 2 / diagnosis
  • Diabetes Mellitus, Type 2 / mortality
  • Female
  • Follow-Up Studies
  • Geriatric Assessment / statistics & numerical data
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction / mortality
  • Primary Health Care / statistics & numerical data
  • Risk Factors
  • Sampling Studies
  • Survival Analysis