Depressive symptoms and mortality in older Mexican Americans

PURPOSE: We examined the prevalence of comorbid depressive symptomatology and leading chronic medical conditions, and their influence on death rates in older Mexican Americans. METHODS: Data from the Hispanic.Established Population for the Epidemiologic Study of the Elderly (EPESE) were used. Differences in death rates across sociodemographics, self ratings of health, and health conditions were examined with analysis of variance statistics. Logistic regression models were used to examine main effects and interaction effects of each medical condition separately and in conjunction with depressive symptomatology. RESULTS: Bivariate analyses indicated that death rates were substantially higher when a high level of depressive symptoms was comorbid with diabetes (OR = 3.84, 95% CI = 2.55-5.78), cardiovascular disease (OR = 4.04, 95% CI = 2.36-6.91), hypertension (OR = 2.27, 95% CI = 1.57-3.27), stroke (OR = 3.00, 95% CI = 1.44-6.15), and cancer (OR = 4.46, 95% CI = 2.48-8.01). Multivariate analyses indicated a synergistic effect for comorbid diabetes and depressive symptoms such that the odds of having died among diabetics with high levels of depressive symptoms (OR = 4.03, 95% CI = 2.67-6.11) were three times that of diabetics without high levels of depressive symptoms (OR = 1.36, 95% CI = 0.89-2.06). CONCLUSIONS: High levels of depressive symptoms concomitant with major chronic medical condi tions elevate the risk for death among older Mexican Americans. Given the fact that depression is often unrecognized and undertreated in the elderly, awareness of the potential for loss of life as well as the potential for treatment may help to improve this situation not only for older Mexican Americans, but for older adults in general. (C) 1998 Elsevier Science Inc.