The association between, depression, anxiety, and mortality in older people across eight low- and middle-income countries: Results from the 10/66 cohort study

Yu-Tzu Wu, Carolina Kralj, Daisy Acosta, Mariella Guerra, Yueqin Huang, Amuthavalli T Jotheeswaran, Ivonne Z Jimenez-Velazquez, Zhaorui Liu, Juan J Llibre Rodriguez, Aquiles Salas, Ana Luisa Sosa, Rasha Alkholy, Martin Prince, A Matthew Prina

Research output: Contribution to journalArticlepeer-review

22 Citations (Scopus)

Abstract

OBJECTIVES: Depression and anxiety are common mental disorders in later life. Few population-based studies have investigated their potential impacts on mortality in low- and middle-income countries (LMICs). The aim of this study is to examine the associations between depression, anxiety, their comorbidity, and mortality in later life using a population-based cohort study across eight LMICs.

METHODS: This analysis was based on the 10/66 cohort study including 15 991 people aged 65 years or above in Cuba, Dominican Republic, Venezuela, Mexico, Peru, Puerto Rico, China, and India, with an average follow-up time of 3.9 years. Subthreshold and clinical levels of depression were determined using EURO-D and ICD-10 criteria, and anxiety was based on Geriatric Mental State (GMS)-Automated Geriatric Examination for Computer Assisted Taxonomy (AGECAT). Cox proportional hazard modelling was used to estimate how having depression, anxiety, or both was associated with mortality adjusting for sociodemographic and health factors.

RESULTS: Participants with clinical depression (hazard ratio [HR]: 1.45; 95% CI, 1.24-1.70) and subthreshold anxiety (HR: 1.26; 95% CI, 1.15-1.38) had higher risk of mortality than those without the conditions after adjusting for sociodemographic factors and health conditions. Comorbidity of depression and anxiety was associated with a 30% increased risk of mortality but the effect sizes varied across countries (Higgins I2 = 58.8%), with the strongest association in India (HR: 1.99; 95% CI, 1.21-3.27).

CONCLUSIONS: Depression and anxiety appear to be associated with mortality in older people living in LMICs. Variation in effect sizes may indicate different barriers to health service access across countries. Future studies may investigate underlying mechanisms and identify potential interventions to reduce the impact of common mental disorders.

Original languageEnglish
Pages (from-to)29-36
Number of pages8
JournalInternational Journal of Geriatric Psychiatry
Volume35
Issue number1
DOIs
Publication statusPublished - Jan 2020

Keywords

  • anxiety
  • common mental disorders
  • depression
  • epidemiology
  • mortality

Fingerprint

Dive into the research topics of 'The association between, depression, anxiety, and mortality in older people across eight low- and middle-income countries: Results from the 10/66 cohort study'. Together they form a unique fingerprint.

Cite this