TY - JOUR
T1 - Depression Symptoms Declining Among Older Adults
T2 - Birth Cohort Analyses From the Rust Belt
AU - Sullivan, Kevin J.
AU - Liu, Anran
AU - Dodge, Hiroko H.
AU - Andreescu, Carmen
AU - Chang, Chung Chou H.
AU - Ganguli, Mary
N1 - Funding Information:
Conflict of Interests and Sources of Funding: KJS reports grants from NIH, during the conduct of the study; AL reports grants from NIH, during the conduct of the study; HHD reports grants from NIH, during the conduct of the study; CA reports grants from NIH, during the conduct of the study; CHC reports grants from NIH, during the conduct of the study; other from Alzheimer's Association, outside the submitted work; MG reports grants from the NIH, during the conduct of the study; personal fees and other from NIH Center for Scientific Review, personal fees and other from Biogen Pharma, personal fees and other from University of Southern California, other from Centre for Brain Research, Indian Institute of Science, Bangalore, India, personal fees and other from Dalhousie University, Halifax, NS, Canada, other from Alzheimer's Association, other from Mt. Sinai Medical Center, Miami Beach, FL, other from University of Texas Health Sciences at San Antonio, TX, outside the submitted work. This work was supported by the National Institute on Aging at the National Institutes of Health ( R01 AG023651 , U01 AG06782 , R01 AG07562 , P30 AG053760 , P30 AG008017 and T32 AG000181 ).
Publisher Copyright:
© 2019 American Association for Geriatric Psychiatry
Copyright:
Copyright 2019 Elsevier B.V., All rights reserved.
PY - 2020/1
Y1 - 2020/1
N2 - Objectives: To investigate potential birth cohort effects in depression symptoms in older adults. Design: Population-based prospective cohort. Setting: Small-town communities in Pennsylvania. Participants: Three thousand two hundred and twenty seven older adults (average baseline age = 71.6) born between 1902 and 1941. Measurements: Four decade-long birth cohorts were the primary predictors in this study: 1902–1911, 1912–1921, 1922–1931, and 1932–1941. The outcome was symptoms of depression assessed at baseline and follow-up study visits using a modified Center for Epidemiologic Studies Depression Scale (mCES-D). The depression outcome was operationalized as: 1). A binary outcome of having greater than equal to 5 depression symptoms on the total mCES-D at any study visit, and 2). A continuous outcome of four factor-analyzed component scores of the mCES-D including depressed mood, anergia/hopelessness, withdrawal, and poor self-esteem. All analyses were jointly modeled with attrition and adjusted for age, sex, education, Mini Mental State Examination score, antidepressant medications, and total prescription medications. Results: Participants from more recently born cohorts were significantly less likely to have a study visit in which they reported greater than or equal to 5 depression symptoms, controlling for attrition. Specifically, in comparison to the 1902–1911 referent cohort, the 1912–1921 birth cohort was 43% less likely (odds ratio [OR] = 0.566, 95% confidence interval [CI]: 0.341–0.939), the 1922–1931 birth cohort was 63% less likely (OR = 0.0369, 95% CI: 0.215–0.632), and the 1932–1941 cohort was 79% less likely (OR = 0.205, 95% CI: 0.106–0.399). The cohort effect was most evident in the depressed mood and anergia/hopelessness symptom composites. Conclusion: Reduced rates of depression symptoms observed in successive birth cohorts of older adults may reflect compression of morbidity or other secular trends.
AB - Objectives: To investigate potential birth cohort effects in depression symptoms in older adults. Design: Population-based prospective cohort. Setting: Small-town communities in Pennsylvania. Participants: Three thousand two hundred and twenty seven older adults (average baseline age = 71.6) born between 1902 and 1941. Measurements: Four decade-long birth cohorts were the primary predictors in this study: 1902–1911, 1912–1921, 1922–1931, and 1932–1941. The outcome was symptoms of depression assessed at baseline and follow-up study visits using a modified Center for Epidemiologic Studies Depression Scale (mCES-D). The depression outcome was operationalized as: 1). A binary outcome of having greater than equal to 5 depression symptoms on the total mCES-D at any study visit, and 2). A continuous outcome of four factor-analyzed component scores of the mCES-D including depressed mood, anergia/hopelessness, withdrawal, and poor self-esteem. All analyses were jointly modeled with attrition and adjusted for age, sex, education, Mini Mental State Examination score, antidepressant medications, and total prescription medications. Results: Participants from more recently born cohorts were significantly less likely to have a study visit in which they reported greater than or equal to 5 depression symptoms, controlling for attrition. Specifically, in comparison to the 1902–1911 referent cohort, the 1912–1921 birth cohort was 43% less likely (odds ratio [OR] = 0.566, 95% confidence interval [CI]: 0.341–0.939), the 1922–1931 birth cohort was 63% less likely (OR = 0.0369, 95% CI: 0.215–0.632), and the 1932–1941 cohort was 79% less likely (OR = 0.205, 95% CI: 0.106–0.399). The cohort effect was most evident in the depressed mood and anergia/hopelessness symptom composites. Conclusion: Reduced rates of depression symptoms observed in successive birth cohorts of older adults may reflect compression of morbidity or other secular trends.
KW - Depression
KW - birth cohort
KW - epidemiology
KW - subsyndromal depression
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U2 - 10.1016/j.jagp.2019.06.002
DO - 10.1016/j.jagp.2019.06.002
M3 - Article
C2 - 31300193
AN - SCOPUS:85068481172
VL - 28
SP - 99
EP - 107
JO - American Journal of Geriatric Psychiatry
JF - American Journal of Geriatric Psychiatry
SN - 1064-7481
IS - 1
ER -