Late-Onset Depression but not Early-Onset Depression may Increase the Risk of All-Cause Mortality in Older Age: 8-Year Follow-Up of the Salus in Apulia Study

Madia Lozupone; Fabio Castellana; Rodolfo Sardone; Giuseppe Berardino; Anita Mollica; Roberta Zupo; Giovanni De Pergola; Chiara Griseta; Roberta Stallone; Maddalena La Montagna; Vittorio Dibello; Davide Seripa; Antonio Daniele; Mario Altamura; Vincenzo Solfrizzi; Antonello Bellomo; Francesco Panza

doi:10.1016/j.jamda.2022.12.005

Late-Onset Depression but not Early-Onset Depression may Increase the Risk of All-Cause Mortality in Older Age: 8-Year Follow-Up of the Salus in Apulia Study

Madia Lozupone^*, Fabio Castellana, Rodolfo Sardone, Giuseppe Berardino, Anita Mollica, Roberta Zupo, Giovanni De Pergola, Chiara Griseta, Roberta Stallone, Maddalena La Montagna, Vittorio Dibello, Davide Seripa, Antonio Daniele, Mario Altamura, Vincenzo Solfrizzi, Antonello Bellomo, Francesco Panza

^*Corresponding author for this work

Oral Kinesiology

Research output: Contribution to Journal › Article › Academic › peer-review

Abstract

Objectives: Individuals with late-life depression (LLD) may have shorter survival, but there is a lack of findings in population-based settings about health-related outcomes of LLD and its subtypes: early-onset depression (EOD) and late-onset depression (LOD). We aimed to evaluate the risk of all-cause mortality of individuals with LLD and its subtypes in an older population-based cohort. Moreover, we investigated whether inflammatory, cognitive, genetic features and multimorbidity could modify the effect of this association. Design: Longitudinal population-based study with 8-year follow-up. Setting and Participants: We analyzed data on a sample of 1479 participants, all aged >65 years, in the Salus in Apulia Study. Methods: LLD was diagnosed through DSM-IV-TR criteria and LOD and EOD according to the age of onset. Multimorbidity status was defined as the copresence of 2 or more chronic diseases. Results: The overall prevalence of LLD in this older sample from Southern Italy was 10.2%, subdivided into 3.4% EOD and 6.8% LOD. In multivariable Cox models adjusted for age, gender, education, global cognition, apolipoprotein E ε4 allele, physical frailty, interleukin-6, and multimorbidity, LLD showed a greater risk of all-cause mortality. LOD differed from EOD regarding gender, education, cognitive dysfunctions, and diabetes mellitus. There was a significantly increased risk of all-cause mortality for participants with LOD (hazard ratio:1.99; 95% CI 1.33–2.97) in the time of observation between enrollment date and death date (7.31 ± 2.17 months). Conclusions and Implication: In older age, individuals with LOD but not with EOD had a significantly decreased survival, probably related to increased inflammation, multimorbidity, and cognitive impairments.

Original language	English
Pages (from-to)	679-687
Number of pages	9
Journal	Journal of the American Medical Directors Association
Volume	24
Issue number	5
Early online date	31 Dec 2022
DOIs	https://doi.org/10.1016/j.jamda.2022.12.005
Publication status	Published - May 2023

Bibliographical note

Funding Information:
This study was funded by the Italian Ministry of Health with a “ Ricerca Corrente 2019 ” Grant. The work reported in this publication was granted by the Italian Ministry of Health , under the Studies on Aging Network, at Italian Research Hospitals (IRCCS).

Funding Information:
This study was funded by the Italian Ministry of Health with a “Ricerca Corrente 2019” Grant. The work reported in this publication was granted by the Italian Ministry of Health, under the Studies on Aging Network, at Italian Research Hospitals (IRCCS).We thank the MICOL Study group and the “Salus in Apulia” Research Team. This manuscript is the result of the research work on frailty undertaken by the “Research Network on Aging” team, supported by the resources of the Italian Ministry of Health—Research Networks of National Health Institutes. We thank M.V. Pragnell for her precious help as native English language supervisor. We thank the general practitioners of Castellana Grotte for their fundamental role in supporting the recruitment of participants in these studies: Campanella Cecilia Olga Maria, Daddabbo Annamaria, Dell'aera Giosue’ Giustiniano Rosalia Francesca, Guzzoni Iudice Massimo, Lomuscio Savino, Lucarelli Rocco, Mazzarisi Antonio, Palumbo Mariana, Persio Maria Teresa, Pesce Rosa Vincenza, Puzzovivo Gabriella, Romano Pasqua Maria, Sgobba Cinzia, Simeone Francesco, Tartaglia Paola, and Tauro Nicola. The data that support the findings of the present study are available from the corresponding author (FP) upon reasonable request. Author Contributions: Conceptualization, M.L. F.C. F.P. and R.S.; Methodology, M.L. and F.P.; Software, F.C.; Validation, F.P.; Formal Analysis, F.C.; Investigation, A.M. G.B. R.Z. C.G. R.S. and M.LaM; Data Curation, F.C. A.M. G.B.; Writing – Original Draft Preparation, M.L. and F.C.; Writing Review & Editing F.P. G.DP. V.D. A.D. V.S. M.A. A.B. R.S.; Visualization, R.S.; Supervision, F.P.; Project Administration, R.S; Funding Acquisition, R.S.

Publisher Copyright:
© 2022 AMDA – The Society for Post-Acute and Long-Term Care Medicine

Keywords

frailty
interleukin-6
Late-onset depression
neuroinflammation
population-based
survival

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.jamda.2022.12.005

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Cite this

Lozupone, M., Castellana, F., Sardone, R., Berardino, G., Mollica, A., Zupo, R., De Pergola, G., Griseta, C., Stallone, R., La Montagna, M., Dibello, V., Seripa, D., Daniele, A., Altamura, M., Solfrizzi, V., Bellomo, A., & Panza, F. (2023). Late-Onset Depression but not Early-Onset Depression may Increase the Risk of All-Cause Mortality in Older Age: 8-Year Follow-Up of the Salus in Apulia Study. Journal of the American Medical Directors Association, 24(5), 679-687. https://doi.org/10.1016/j.jamda.2022.12.005

@article{4aa7cf0acf0a404dac09e26443d7ef48,

title = "Late-Onset Depression but not Early-Onset Depression may Increase the Risk of All-Cause Mortality in Older Age: 8-Year Follow-Up of the Salus in Apulia Study",

abstract = "Objectives: Individuals with late-life depression (LLD) may have shorter survival, but there is a lack of findings in population-based settings about health-related outcomes of LLD and its subtypes: early-onset depression (EOD) and late-onset depression (LOD). We aimed to evaluate the risk of all-cause mortality of individuals with LLD and its subtypes in an older population-based cohort. Moreover, we investigated whether inflammatory, cognitive, genetic features and multimorbidity could modify the effect of this association. Design: Longitudinal population-based study with 8-year follow-up. Setting and Participants: We analyzed data on a sample of 1479 participants, all aged >65 years, in the Salus in Apulia Study. Methods: LLD was diagnosed through DSM-IV-TR criteria and LOD and EOD according to the age of onset. Multimorbidity status was defined as the copresence of 2 or more chronic diseases. Results: The overall prevalence of LLD in this older sample from Southern Italy was 10.2%, subdivided into 3.4% EOD and 6.8% LOD. In multivariable Cox models adjusted for age, gender, education, global cognition, apolipoprotein E ε4 allele, physical frailty, interleukin-6, and multimorbidity, LLD showed a greater risk of all-cause mortality. LOD differed from EOD regarding gender, education, cognitive dysfunctions, and diabetes mellitus. There was a significantly increased risk of all-cause mortality for participants with LOD (hazard ratio:1.99; 95% CI 1.33–2.97) in the time of observation between enrollment date and death date (7.31 ± 2.17 months). Conclusions and Implication: In older age, individuals with LOD but not with EOD had a significantly decreased survival, probably related to increased inflammation, multimorbidity, and cognitive impairments.",

keywords = "frailty, interleukin-6, Late-onset depression, neuroinflammation, population-based, survival",

author = "Madia Lozupone and Fabio Castellana and Rodolfo Sardone and Giuseppe Berardino and Anita Mollica and Roberta Zupo and {De Pergola}, Giovanni and Chiara Griseta and Roberta Stallone and {La Montagna}, Maddalena and Vittorio Dibello and Davide Seripa and Antonio Daniele and Mario Altamura and Vincenzo Solfrizzi and Antonello Bellomo and Francesco Panza",

note = "Funding Information: This study was funded by the Italian Ministry of Health with a “ Ricerca Corrente 2019 ” Grant. The work reported in this publication was granted by the Italian Ministry of Health , under the Studies on Aging Network, at Italian Research Hospitals (IRCCS). Funding Information: This study was funded by the Italian Ministry of Health with a “Ricerca Corrente 2019” Grant. The work reported in this publication was granted by the Italian Ministry of Health, under the Studies on Aging Network, at Italian Research Hospitals (IRCCS).We thank the MICOL Study group and the “Salus in Apulia” Research Team. This manuscript is the result of the research work on frailty undertaken by the “Research Network on Aging” team, supported by the resources of the Italian Ministry of Health—Research Networks of National Health Institutes. We thank M.V. Pragnell for her precious help as native English language supervisor. We thank the general practitioners of Castellana Grotte for their fundamental role in supporting the recruitment of participants in these studies: Campanella Cecilia Olga Maria, Daddabbo Annamaria, Dell'aera Giosue{\textquoteright} Giustiniano Rosalia Francesca, Guzzoni Iudice Massimo, Lomuscio Savino, Lucarelli Rocco, Mazzarisi Antonio, Palumbo Mariana, Persio Maria Teresa, Pesce Rosa Vincenza, Puzzovivo Gabriella, Romano Pasqua Maria, Sgobba Cinzia, Simeone Francesco, Tartaglia Paola, and Tauro Nicola. The data that support the findings of the present study are available from the corresponding author (FP) upon reasonable request. Author Contributions: Conceptualization, M.L. F.C. F.P. and R.S.; Methodology, M.L. and F.P.; Software, F.C.; Validation, F.P.; Formal Analysis, F.C.; Investigation, A.M. G.B. R.Z. C.G. R.S. and M.LaM; Data Curation, F.C. A.M. G.B.; Writing – Original Draft Preparation, M.L. and F.C.; Writing Review & Editing F.P. G.DP. V.D. A.D. V.S. M.A. A.B. R.S.; Visualization, R.S.; Supervision, F.P.; Project Administration, R.S; Funding Acquisition, R.S. Publisher Copyright: {\textcopyright} 2022 AMDA – The Society for Post-Acute and Long-Term Care Medicine",

year = "2023",

month = may,

doi = "10.1016/j.jamda.2022.12.005",

language = "English",

volume = "24",

pages = "679--687",

journal = "Journal of the American Medical Directors Association",

issn = "1525-8610",

publisher = "Elsevier Inc.",

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Lozupone, M, Castellana, F, Sardone, R, Berardino, G, Mollica, A, Zupo, R, De Pergola, G, Griseta, C, Stallone, R, La Montagna, M, Dibello, V, Seripa, D, Daniele, A, Altamura, M, Solfrizzi, V, Bellomo, A & Panza, F 2023, 'Late-Onset Depression but not Early-Onset Depression may Increase the Risk of All-Cause Mortality in Older Age: 8-Year Follow-Up of the Salus in Apulia Study', Journal of the American Medical Directors Association, vol. 24, no. 5, pp. 679-687. https://doi.org/10.1016/j.jamda.2022.12.005

Late-Onset Depression but not Early-Onset Depression may Increase the Risk of All-Cause Mortality in Older Age: 8-Year Follow-Up of the Salus in Apulia Study. / Lozupone, Madia; Castellana, Fabio; Sardone, Rodolfo et al.
In: Journal of the American Medical Directors Association, Vol. 24, No. 5, 05.2023, p. 679-687.

Research output: Contribution to Journal › Article › Academic › peer-review

TY - JOUR

T1 - Late-Onset Depression but not Early-Onset Depression may Increase the Risk of All-Cause Mortality in Older Age

T2 - 8-Year Follow-Up of the Salus in Apulia Study

AU - Lozupone, Madia

AU - Castellana, Fabio

AU - Sardone, Rodolfo

AU - Berardino, Giuseppe

AU - Mollica, Anita

AU - Zupo, Roberta

AU - De Pergola, Giovanni

AU - Griseta, Chiara

AU - Stallone, Roberta

AU - La Montagna, Maddalena

AU - Dibello, Vittorio

AU - Seripa, Davide

AU - Daniele, Antonio

AU - Altamura, Mario

AU - Solfrizzi, Vincenzo

AU - Bellomo, Antonello

AU - Panza, Francesco

N1 - Funding Information: This study was funded by the Italian Ministry of Health with a “ Ricerca Corrente 2019 ” Grant. The work reported in this publication was granted by the Italian Ministry of Health , under the Studies on Aging Network, at Italian Research Hospitals (IRCCS). Funding Information: This study was funded by the Italian Ministry of Health with a “Ricerca Corrente 2019” Grant. The work reported in this publication was granted by the Italian Ministry of Health, under the Studies on Aging Network, at Italian Research Hospitals (IRCCS).We thank the MICOL Study group and the “Salus in Apulia” Research Team. This manuscript is the result of the research work on frailty undertaken by the “Research Network on Aging” team, supported by the resources of the Italian Ministry of Health—Research Networks of National Health Institutes. We thank M.V. Pragnell for her precious help as native English language supervisor. We thank the general practitioners of Castellana Grotte for their fundamental role in supporting the recruitment of participants in these studies: Campanella Cecilia Olga Maria, Daddabbo Annamaria, Dell'aera Giosue’ Giustiniano Rosalia Francesca, Guzzoni Iudice Massimo, Lomuscio Savino, Lucarelli Rocco, Mazzarisi Antonio, Palumbo Mariana, Persio Maria Teresa, Pesce Rosa Vincenza, Puzzovivo Gabriella, Romano Pasqua Maria, Sgobba Cinzia, Simeone Francesco, Tartaglia Paola, and Tauro Nicola. The data that support the findings of the present study are available from the corresponding author (FP) upon reasonable request. Author Contributions: Conceptualization, M.L. F.C. F.P. and R.S.; Methodology, M.L. and F.P.; Software, F.C.; Validation, F.P.; Formal Analysis, F.C.; Investigation, A.M. G.B. R.Z. C.G. R.S. and M.LaM; Data Curation, F.C. A.M. G.B.; Writing – Original Draft Preparation, M.L. and F.C.; Writing Review & Editing F.P. G.DP. V.D. A.D. V.S. M.A. A.B. R.S.; Visualization, R.S.; Supervision, F.P.; Project Administration, R.S; Funding Acquisition, R.S. Publisher Copyright: © 2022 AMDA – The Society for Post-Acute and Long-Term Care Medicine

PY - 2023/5

Y1 - 2023/5

N2 - Objectives: Individuals with late-life depression (LLD) may have shorter survival, but there is a lack of findings in population-based settings about health-related outcomes of LLD and its subtypes: early-onset depression (EOD) and late-onset depression (LOD). We aimed to evaluate the risk of all-cause mortality of individuals with LLD and its subtypes in an older population-based cohort. Moreover, we investigated whether inflammatory, cognitive, genetic features and multimorbidity could modify the effect of this association. Design: Longitudinal population-based study with 8-year follow-up. Setting and Participants: We analyzed data on a sample of 1479 participants, all aged >65 years, in the Salus in Apulia Study. Methods: LLD was diagnosed through DSM-IV-TR criteria and LOD and EOD according to the age of onset. Multimorbidity status was defined as the copresence of 2 or more chronic diseases. Results: The overall prevalence of LLD in this older sample from Southern Italy was 10.2%, subdivided into 3.4% EOD and 6.8% LOD. In multivariable Cox models adjusted for age, gender, education, global cognition, apolipoprotein E ε4 allele, physical frailty, interleukin-6, and multimorbidity, LLD showed a greater risk of all-cause mortality. LOD differed from EOD regarding gender, education, cognitive dysfunctions, and diabetes mellitus. There was a significantly increased risk of all-cause mortality for participants with LOD (hazard ratio:1.99; 95% CI 1.33–2.97) in the time of observation between enrollment date and death date (7.31 ± 2.17 months). Conclusions and Implication: In older age, individuals with LOD but not with EOD had a significantly decreased survival, probably related to increased inflammation, multimorbidity, and cognitive impairments.

AB - Objectives: Individuals with late-life depression (LLD) may have shorter survival, but there is a lack of findings in population-based settings about health-related outcomes of LLD and its subtypes: early-onset depression (EOD) and late-onset depression (LOD). We aimed to evaluate the risk of all-cause mortality of individuals with LLD and its subtypes in an older population-based cohort. Moreover, we investigated whether inflammatory, cognitive, genetic features and multimorbidity could modify the effect of this association. Design: Longitudinal population-based study with 8-year follow-up. Setting and Participants: We analyzed data on a sample of 1479 participants, all aged >65 years, in the Salus in Apulia Study. Methods: LLD was diagnosed through DSM-IV-TR criteria and LOD and EOD according to the age of onset. Multimorbidity status was defined as the copresence of 2 or more chronic diseases. Results: The overall prevalence of LLD in this older sample from Southern Italy was 10.2%, subdivided into 3.4% EOD and 6.8% LOD. In multivariable Cox models adjusted for age, gender, education, global cognition, apolipoprotein E ε4 allele, physical frailty, interleukin-6, and multimorbidity, LLD showed a greater risk of all-cause mortality. LOD differed from EOD regarding gender, education, cognitive dysfunctions, and diabetes mellitus. There was a significantly increased risk of all-cause mortality for participants with LOD (hazard ratio:1.99; 95% CI 1.33–2.97) in the time of observation between enrollment date and death date (7.31 ± 2.17 months). Conclusions and Implication: In older age, individuals with LOD but not with EOD had a significantly decreased survival, probably related to increased inflammation, multimorbidity, and cognitive impairments.

KW - frailty

KW - interleukin-6

KW - Late-onset depression

KW - neuroinflammation

KW - population-based

KW - survival

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U2 - 10.1016/j.jamda.2022.12.005

DO - 10.1016/j.jamda.2022.12.005

M3 - Article

C2 - 36596468

AN - SCOPUS:85146355870

SN - 1525-8610

VL - 24

SP - 679

EP - 687

JO - Journal of the American Medical Directors Association

JF - Journal of the American Medical Directors Association

IS - 5

ER -

Late-Onset Depression but not Early-Onset Depression may Increase the Risk of All-Cause Mortality in Older Age: 8-Year Follow-Up of the Salus in Apulia Study

Abstract

Bibliographical note

Keywords

UN SDGs

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