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Can Fam Physician
Vol. 55, No. 6, June 2009, pp.e1 - e5
Copyright © 2009 by The College of Family Physicians of Canada
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Research

Does a single-item measure of depression predict mortality?

Philip Donald St John, MD MPH FRCPC
Geriatrician practising in Winnipeg, Man, and an Assistant Professor and the Acting Head of the Section of Geriatrics at the University of Manitoba.

Patrick Montgomery, MD FRCPC
Geriatrician practising in Winnipeg and is an Associate Professor of Medicine at the University of Manitoba.

Correspondence: Dr St John, Section of Geriatrics, University of Manitoba, GG 441 Health Sciences Centre, 820 Sherbrook St, Winnipeg, MB R3A 1R9; telephone 204 787-3365; fax 204 787-4826; e-mailpstjohn{at}hsc.mb.ca

OBJECTIVE To determine if a single-item measure of depression predicts mortality over 5 years.

DESIGN Secondary analysis of a population-based cohort study.

SETTING Province of Manitoba.

PARTICIPANTS A total of 1751 community-dwelling adults aged 65 years or older.

MAIN OUTCOME MEASURES Self-reported depression; age, sex, education, functional status, and cognition; death over 5 years. Depression was measured with 1 item drawn from the Center for Epidemiologic Studies Depression (CES-D) scale: "I felt depressed." Bivariate and multivariate analyses were conducted.

RESULTS Those with self-reported depression had a 5-year mortality of 30.2% versus 19.7% in those without self-reported depression (P < .001, {chi}2). This association persisted after adjustment for age, sex, education, functional status, and cognition: adjusted odds ratio for mortality 1.35 (95% confidence interval 1.03 to 1.76). Among those with cognitive impairment, however, neither the CES-D scale nor the single-item measure predicted mortality.

CONCLUSION A simple measure of depression drawn from the CES-D predicts mortality among cognitively intact community-dwelling older adults, but not among cognitively impaired older adults. Further study is needed in order to determine the usefulness of this question in clinical practice.






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Copyright © 2009 by The College of Family Physicians of Canada.