Race-related differences in depression onset and recovery in older persons over time: the health, aging, and body composition study

Abstract

Objectives: To evaluate race-related differences in depression onset and recovery in older persons, overall and by sex, and examine race-related differences in mortality according to depression.

Design: Prospective cohort study.

Setting: General community in pre-designated zip code areas in Memphis, Tennessee, and Pittsburgh, Pennsylvania.

Participants: 3,075 persons aged 70-79 years at baseline in the Health, Aging, and Body Composition study.

Measurements: Depression was assessed at eight time points over 10 years using the 10-item Center for Epidemiologic Studies-Depression scale; patients were categorized as nondepressed (score less than 8) or depressed (score of 8 or higher). We created variables for transitions across each 18-month time interval, namely, from nondepressed or depressed to nondepressed, depressed, or death, and determined the association between race and the average likelihood of these transitions over time.

Results: A higher percentage of blacks than whites were depressed at nearly all time points. Adjusting for demographics, common chronic conditions, and body mass index, blacks had a higher likelihood of experiencing depression onset than whites (odds ratio [OR]: 1.22; 95% confidence interval [CI]: 1.03-1.43); among men, blacks were more likely to experience depression onset than whites (OR: 1.44; 95% CI: 1.24-2.89). Blacks also had a higher likelihood of transitioning from nondepressed to death (OR: 1.79; 95% CI: 1.30-2.46). Overall and in sex-stratified analyses, race was not associated with recovery from depression or with the transition from depression to death.

Conclusion: Our findings highlight race differences in depression in older persons and encourage further research on the course of depression in older black patients.

Keywords: Aging; depression; depressive symptoms; epidemiology; prospective studies; race differences.