1. Chronic and remitting trajectories of depressive symptoms in the elderly. Characterization and risk factors
- Author
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Karen Ritchie, Joanne Ryan, Amandine Farré, Marie-Laure Ancelin, Cécile Proust-Lima, Isabelle Carrière, Neuropsychiatrie : recherche épidémiologique et clinique (PSNREC), Université Montpellier 1 (UM1)-Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Epidémiologie et Biostatistique [Bordeaux], Université Bordeaux Segalen - Bordeaux 2-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), Department of Paediatrics [Melbourne], Melbourne Medical School [Melbourne], Faculty of Medicine, Dentistry and Health Sciences [Melbourne], University of Melbourne-University of Melbourne-Faculty of Medicine, Dentistry and Health Sciences [Melbourne], University of Melbourne-University of Melbourne, Dept of Epidemiology and Public Health, Imperial College London, The 3C Study is conducted under a partnership agreement between the Institut National de la Santé et de la Recherche Médicale (Inserm), Victor-Segalen Bordeaux 2 University, and Sanofi-Aventis. The 3C-Study was also supported by the Caisse Nationale Maladie des Travailleurs Salariés, Direction Générale de la Santé, MGEN, the Institut de la Longévité, Agence Française de Sécurité Sanitaire des Produits de Santé, the Regional Governments of Aquitaine, Bourgogne and Languedoc-Roussillon, the Fondation de France, the Ministry of Research-Inserm Programme 'Cohorts and collection of biological material', Novartis, the 'ANR-Agence Nationale de la Recherche-The French National Research Agency' under the 'Programme National de Recherche en Alimentation et nutrition humaine', project 'COGINUT ANR-06-PNRA-005', the 'Programme Longévité et vieillissement', project 07-LVIE-004' and 07-LVIE 003 01, the Institut de Recherche en Santé Publique (IReSP), Paris, France., ANR-06-PNRA-0005,COGINUT,COGINUT : Cognition, anti-oxydants, acides gras: approche interdisciplinaire du rôle de la nutrition dans le vieillissement du cerveau(2006), ANR-07-LVIE-0004,ESPRIT-VIE,Interaction entre la vulnérabilité génétique, la dysrégulation biologique et le stress dans la dépression du sujet âgé(2007), and ANR-07-LVIE-0003,COGICARE,Histoire naturelle du déclin cognitif et du besoin de soins chez le sujet âgé(2007)
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Male ,medicine.medical_specialty ,Epidemiology ,Population ,Comorbidity ,Article ,03 medical and health sciences ,0302 clinical medicine ,depressive symptoms ,cohort studies ,Diabetes mellitus ,Diabetes Mellitus ,Prevalence ,medicine ,Humans ,risk factors ,Prospective Studies ,Mortality ,education ,Psychiatry ,Prospective cohort study ,Depression (differential diagnoses) ,Aged, 80 and over ,Depressive Disorder ,education.field_of_study ,Depression ,Public Health, Environmental and Occupational Health ,Odds ratio ,medicine.disease ,Confidence interval ,3. Good health ,030227 psychiatry ,Psychiatry and Mental health ,aged ,Socioeconomic Factors ,Cardiovascular Diseases ,[SDV.MHEP.PSM]Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health ,Female ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,France ,Independent Living ,Psychology ,030217 neurology & neurosurgery ,Demography ,Cohort study - Abstract
Background.In elderly general population sub-syndromal clinically significant levels of depressive symptoms are highly prevalent and associated with high co-morbidity and increased mortality risk. However changes in depressive symptoms over time and etiologic factors have been difficult to characterise notably due to methodological shortcomings. Our objective was to differentiate trajectories of depressive symptoms over 10 years in community-dwelling elderly men and women using statistical modelling methods which take into account intra-subject correlation and individual differences as well as to examine current and life-time risk factors associated with different trajectories.Methods.Participants aged 65 and over were administered standardised questionnaires and underwent clinical examinations at baseline and after 2, 4, 7 and 10 years. Trajectories over time of the Center for Epidemiologic Studies Depression scores were modelled in 517 men and 736 women separately with latent class mixed models which include both a linear mixed model to describe latent classes of trajectories and a multinomial logistic model to characterise the latent trajectories according to baseline covariates (socio-demographic, lifestyle, clinical, genetic characteristics and stressful life events).Results.In both genders two different profiles of symptom changes were observed over the 10-year follow-up. For 9.1% of men and 25% of women a high depressive symptom trajectory was found with a trend toward worsening in men. The majority of the remaining men and women showed decreasing symptomatology over time, falling from clinically significant to very low levels of depressive symptoms. In large multivariate class membership models, mobility limitations [odds ratio (OR) = 4.5, 95% confidence interval (CI) 1.6–12.9 and OR = 4.9, 95% CI 2.3–10.7, in men and women respectively], ischemic pathologies (OR = 2.9, 95% CI 1.0–8.3 and OR = 3.1, 95% CI 1.0–9.9), and recent stressful events (OR = 4.5, 95% CI 1.1–18.5, OR = 3.2, 95% CI 1.6–6.2) were associated with a poor symptom course in both gender as well as diabetes in men (OR = 3.5, 95% CI 1.1–10.9) and childhood traumatic experiences in women (OR = 3.1, 95% CI 1.6–5.8).Conclusions.This prospective study was able to differentiate patterns of chronic and remitting depressive symptoms in elderly people with distinct symptom courses and risk factors for men and women. These findings may inform prevention programmes designed to reduce the chronic course of depressive symptomatology.
- Published
- 2017