Sinhyung Lee,Hyeon Ho Choi, Seung Hee Kim, Jungun Lee

Department of Family Medicine, Wonkwang University Sanbon Hospital, Wonkwang University School of Medicine, Gunpo, Korea


Background: As the course of depression and depressive symptoms over a lifetime varies between individuals, we used trajectory models based on the Korean Longitudinal Study of Aging to repeatedly measure symptoms over a follow-up period of 12 years to reveal the association with mortality.
Methods: Three thousand five hundred sixty-one (1,483 men and 2,078 women) subjects aged over 65 years were included. Using the 10-item Center for Epidemiological Studies Depression Scale (CES-D 10), a tra- jectory model was classified into different depressive symptom groups by gender. Cox proportional hazards models were used to investigate the association between depression trajectory and all-cause mortality.
Results: We identified four trajectories of depressive symptoms in both men and women characterized by low CES-D 10 scores throughout the study: Low trajectory (LT), Moderate high trajectory (MHT), High, but increas- ing trajectory (HIT), and High, but decreasing trajectory (HDT). The adjusted hazard ratios of the HIT, HDT, and MHT compared with LT in men were 2.12 (95% confidence interval [CI], 1.43-3.16), 1.52 (95% CI, 0.96-2.40), and 1.58 (95% CI, 1.10-2.26), respectively. In women, ratios of each group were 1.62 (95% CI, 1.25-2.10), 0.84 (95% CI, 0.61-1.16), and 1.20 (95% CI, 0.99-1.46).
Conclusions: Highly depressive symptoms that increased over the 12 years period were associated with the highest risk of mortality in the Korean elderly population. The trajectory group with remitting depressive symp- toms (HDT), despite having a similar baseline level of mood symptoms as the high increasing group (HIT) expe- rienced a lower mortality risk in both men and women.
Korean J Health Promot 2021;21(2):45-55