Depressive symptoms and mortality in a prospective study of 2,558 older adults.

Objective: The authors report results from a 7-year prospective study of depression and mortality in 2,558 Medicare recipients age 65 and older.

Methods: This report is based on a secondary data analysis of a randomized controlled trial that evaluated the cost-effectiveness of preventive services for older enrollees in an HMO.

Results: Subjects with mild-to-moderate depression at baseline did not have an increased risk of mortality compared with those without significant depression. The 3% of older adults with the most severe depressive syndromes, however, had significant increases in mortality, even after adjusting for demographics, health risk behaviors, and chronic medical disorders.

Conclusion: The increase in mortality in this group of older adults was comparable to that in participants with chronic medical disorders such as emphysema or heart disease.