Abstract
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.
| Original language | English (US) |
|---|---|
| Journal | American Journal of Geriatric Psychiatry |
| DOIs | |
| State | Published - Jan 1 2019 |
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Keywords
- birth cohort
- Depression
- epidemiology
- subsyndromal depression
ASJC Scopus subject areas
- Geriatrics and Gerontology
- Psychiatry and Mental health
Cite this
Depression Symptoms Declining Among Older Adults : Birth Cohort Analyses From the Rust Belt. / Sullivan, Kevin J.; Liu, Anran; Dodge, Hiroko; Andreescu, Carmen; Chang, Chung Chou H.; Ganguli, Mary.
In: American Journal of Geriatric Psychiatry, 01.01.2019.Research output: Contribution to journal › Article
}
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
AU - Andreescu, Carmen
AU - Chang, Chung Chou H.
AU - Ganguli, Mary
PY - 2019/1/1
Y1 - 2019/1/1
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 - birth cohort
KW - Depression
KW - epidemiology
KW - subsyndromal depression
UR - http://www.scopus.com/inward/record.url?scp=85068481172&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85068481172&partnerID=8YFLogxK
U2 - 10.1016/j.jagp.2019.06.002
DO - 10.1016/j.jagp.2019.06.002
M3 - Article
JO - American Journal of Geriatric Psychiatry
JF - American Journal of Geriatric Psychiatry
SN - 1064-7481
ER -