Association of depression and gender with mortality in old age: Results from the Amsterdam Study of the Elderly (AMSTEL)

Background: The association between depression and increased mortality risk in older persons may depend on the severity of the depressive disorder and gender. Aims: To investigate the association between major and mild depressive syndromes and excess mortality in community-living elderly men and women. Method: Depression (Geriatric Mental State AGECAT) was assessed in 4051 older persons, with a 6-year follow-up of community death registers. The mortality risk of neurotic and psychotic depression was calculated after adjustment for demographic variables, physical illness, cognitive decline and functional disabilities. Results: A total of 75% of men and 41% of women with psychotic depression had died at follow-up. Psychotic depression was associated with significant excess mortality in both men and women. Neurotic depression was associated with a 1.67-fold higher mortality risk in men only. Conclusions: In the elderly, major depressive syndromes increase the risk of death in both men and women, but mild depression increases the risk of death only in men. Declaration of interest: Grants from the Netherlands Health Research Programme and the Netherlands Fund of Mental Health (see Acknowledgements).