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The Influence of Depressive Mood on Mortality in Elderly with Different Health Status: Evidence from the Taiwan Longitudinal Study on Aging (TLSA)

Author

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  • Shen-Ju Tsai

    (Department of Family Medicine, Everan Hospital, Taichung 411001, Taiwan
    Institute of Public Health, National Yang Ming Chiao Tung University, Taipei 112304, Taiwan)

  • Yu-Han Hsiao

    (Department of Family Medicine, Taichung Hospital, Ministry of Health and Welfare, Taichung 403301, Taiwan
    College of Management, Chaoyang University of Technology, Taichung 413310, Taiwan
    Department of Public Health, Chung Shan Medical University, Taichung 402306, Taiwan)

  • Miao-Yu Liao

    (Department of Family Medicine, Taichung Hospital, Ministry of Health and Welfare, Taichung 403301, Taiwan)

  • Meng-Chih Lee

    (Department of Family Medicine, Taichung Hospital, Ministry of Health and Welfare, Taichung 403301, Taiwan
    College of Management, Chaoyang University of Technology, Taichung 413310, Taiwan
    Institute of Population Health Sciences, National Health Research Institutes, Miaoli 350401, Taiwan
    Institute of Medicine, Chung Shan Medical University, Taichung 402306, Taiwan)

Abstract

Depression and related syndromes are well identified in older adults. Depression has been reported to increase the incidence of a multitude of somatic disorders. In older adults, the severity of depression is associated with higher mortality rates. The aim of the study is to examine whether the effect of depression screening on mortality is different between individuals with different physical health status. In order to meet this aim, we will first reprove the relationship between depression and mortality rate, and then we will set a subgroup analysis by using self-reported health (SRH) status. Our data source, Taiwan Longitudinal Study on Aging (TLSA), is a population-based prospective cohort study that was initiated by the Health Promotion Administration, Ministry of Health and Welfare, Taiwan. The depression risk was evaluated by 10-items Center for Epidemiologic Studies Depression (CES-D-10), we set 3 CES-D-10 cutting points (5, 10, and 12) and cut our subjects into four groups. Taking mortality as an end point, we use the Taiwan National Death Registry (TNDR) record from 1999 to 2012. Self-rated health (SRH) was taken as an effect modifier between depression and mortality in the elderly group, and stratification took place into three groups (good, fair, poor). The case numbers of 4 CES-D-10 groups were 2253, 939, 285 and 522, respectively. After dividing into 4 CES-D-10 groups, the mortality prevalence rose as the CES-D-10 level grew (40.7%, 47.82%, 54.39% and 67.62%, respectively). In the subgroup analysis, although the p -value of log-rank test showed <0.05 in three groups, as the SRH got worse the Hazard Ratio became more significant ( p = 0.122, 0.033, <0.001, respectively). Kaplan–Meier (K-M) survival estimates for different CES-D groups in SRH were poor, and we can see the curves representing second and third CES-D group going almost together, which may suggest the cutting point of CES-D-10 in predicting depression risk should be adjusted in the relatively unhealthy elderly. The importance of the relationship between depression and mortality is re-emphasized in our study. Moreover, through joining SRH in our analysis, we can conclude that in self-rated poor health any sign of depression may lead to a rise in mortality. Therefore, we should pay attention to the old age group’s psychological status, and remember that depressive mood should be scrutinized more carefully in the elderly who feel themselves to be unhealthy.

Suggested Citation

  • Shen-Ju Tsai & Yu-Han Hsiao & Miao-Yu Liao & Meng-Chih Lee, 2022. "The Influence of Depressive Mood on Mortality in Elderly with Different Health Status: Evidence from the Taiwan Longitudinal Study on Aging (TLSA)," IJERPH, MDPI, vol. 19(11), pages 1-11, June.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:11:p:6922-:d:832267
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    References listed on IDEAS

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    1. Gemma Vilagut & Carlos G Forero & Gabriela Barbaglia & Jordi Alonso, 2016. "Screening for Depression in the General Population with the Center for Epidemiologic Studies Depression (CES-D): A Systematic Review with Meta-Analysis," PLOS ONE, Public Library of Science, vol. 11(5), pages 1-17, May.
    2. Fleur E P van Dooren & Giesje Nefs & Miranda T Schram & Frans R J Verhey & Johan Denollet & François Pouwer, 2013. "Depression and Risk of Mortality in People with Diabetes Mellitus: A Systematic Review and Meta-Analysis," PLOS ONE, Public Library of Science, vol. 8(3), pages 1-11, March.
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