Risk factors for late-life depression: A prospective cohort study among older women

PREVENTIVE MEDICINE

卷:91

Article

Chang, Shun-Chiao¹  Pan, An²  Kawachi, Ichiro³  Okereke, Olivia I.^1,3 

[1] Harvard Med Sch, Brigham & Womens Hosp, Boston, MA USA

[2] Huazhong Univ Sci & Technol, Tongji Med Coll, Sch Publ Hlth, Wuhan, Huhei, Peoples R China

[3] Harvard TH Chan Sch Publ Hlth, Boston, MA USA

关键词: Cohort;    Depressive disorders;    Epidemiology;    Geriatrics;    Prevention;    Risk factors;   

DOI  :  10.1016/j.ypmed.2016.08.014

来源: Elsevier

【 摘 要 】

Depression prevention requires identifying key risk contributors. Prior studies have identified several factors related to late-life depression but have seldom addressed factors jointly or in dose-response fashion. This study aimed to examine a wide range of potential predisposing factors and to estimate individual and joint contributions to risk of late-life depression in women. A total of 21,728 women aged >= 65 years, without prior depression, in the Nurses' Health Study conducted in the United States were followed from 2000 to 2010. Demographic, social, lifestyle/behavioral and health variables were selected a priori from the literature or previous findings in this cohort. Depression was defined as physician/clinician-diagnosed depression, regular antidepressant use, or the presence of severe depressive symptoms. During 10-year follow-up, 3945 incident cases were identified. After simultaneous multivariable-adjustment, multiple factors in the domains of social stress (lower self-rated societal position and high volume of caregiving to disabled/ill relatives), unfavorable lifestyle (smoking, physical inactivity, heavy or binge drinking), and poor physical health (multiple comorbidity burden, excessive sleep, difficulty falling/staying asleep, bodily pain, and physical/functional limitation or disability) were significantly associated with higher depression risk; many featured dose-response relationships. Sensitivity analyses that excluded outcomes within 2 years yielded similar estimates. The total population attributable fraction for all factors was 55.5%. Physical/functional limitation accounted for one-quarter of population attributable fraction, followed by problematic sleep, inadequate exercise, and pain (combining for one-third of population attributable fraction). Efforts to remediate or prevent these factors may contribute to an efficient strategy for late-life depression prevention in women. (C) 2016 Elsevier Inc. All rights reserved.

【 授权许可】

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