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Predictors of incident depression an...

Haddad, Kathleen M.

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Predictors of incident depression and correlates of treatment in older women.

Record Type:	Language materials, printed : Monograph/item
Title/Author:	Predictors of incident depression and correlates of treatment in older women./
Author:	Haddad, Kathleen M.
Description:	159 p.
Notes:	Adviser: Judith D. Kasper.
Contained By:	Dissertation Abstracts International68-04B.
Subject:	Gerontology. -
Online resource:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=3262423

Predictors of incident depression and correlates of treatment in older women.
Haddad, Kathleen M.

Predictors of incident depression and correlates of treatment in older women. - 159 p.

Adviser: Judith D. Kasper.

Thesis (Ph.D.)--The Johns Hopkins University, 2007.

Latelife depression is a common health problem of the elderly, frequently unrecognized and untreated. In addition to the personal suffering geriatric depression causes, it is associated with increased physical and cognitive disability, heart disease, excess mortality, and excess health care costs. These analyses examine predictors of incident depression, trends in antidepressant treatment and type, and correlates of treatment and type. DATA: the Women's Health and Aging Study, a longitudinal survey of 1002 moderately to severely disabled cognitively intact elderly women living in Baltimore city and county conducted every 6 months for 3½ years. The WHAS ascertained depression status, disease, functional status, social support, and health care utilization. Methods. Two separate analyses were conducted. The first used logistic regression to examine predictors of incident depression among the 684 women not depressed at baseline. The second used logistic regression with GEE estimation to examine correlates of antidepressant treatment and receipt of an SSRI versus TCA. Results. Oldest age, white race, social support deficits, having an unhealthy spouse, financial stress, and severe disease burden independently predicted incident depression. Heart disease had a borderline effect. Prevalence of antidepressant prescription for all women rose from 8.0% at baseline (when TCAs were the most common type) to 12.1% in round 7 (when SSRIs became most common). Race was the strongest predictor of antidepressant prescription, with white women three times more likely than blacks to have an antidepressant (OR 3.26, 95% CI 1.93, 5.51). Other predictive factors were moderate to severe depression (OR 1.38, 95% CI 1.05, 1.82), visual impairment (OR 1.34, 95% CI 1.06, 1.71), moderate to severe cognitive impairment (OR 3.17, 95% CI 1.35, 7.47), mild cognitive impairment (OR 1.47, 95% CI 1.13, 1.47), having 4 or more chronic diseases (OR 2.28, 95% CI 1.30, 4.03), and having 5 or more recent physician visits (OR 1.30, 95% CI 1.07, 1.57). Drug coverage had a borderline effect. Conclusion. Most cases of geriatric depression are unrecognized and untreated. Opportunities exist for secondary and tertiary prevention of depression at the physician, community, and family levels. Reasons for racial differences in depression occurrence and treatment remain poorly understood.Subjects--Topical Terms:

533633
Gerontology.

Predictors of incident depression and correlates of treatment in older women.
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035 $a (UMI)AAI3262423
035 $a AAI3262423
040 $a UMI $c UMI
100 1 $a Haddad, Kathleen M. $3 1272359
245 1 0 $a Predictors of incident depression and correlates of treatment in older women.
300 $a 159 p.
500 $a Adviser: Judith D. Kasper.
500 $a Source: Dissertation Abstracts International, Volume: 68-04, Section: B, page: 2291.
502 $a Thesis (Ph.D.)--The Johns Hopkins University, 2007.
520 $a Latelife depression is a common health problem of the elderly, frequently unrecognized and untreated. In addition to the personal suffering geriatric depression causes, it is associated with increased physical and cognitive disability, heart disease, excess mortality, and excess health care costs. These analyses examine predictors of incident depression, trends in antidepressant treatment and type, and correlates of treatment and type. DATA: the Women's Health and Aging Study, a longitudinal survey of 1002 moderately to severely disabled cognitively intact elderly women living in Baltimore city and county conducted every 6 months for 3½ years. The WHAS ascertained depression status, disease, functional status, social support, and health care utilization. Methods. Two separate analyses were conducted. The first used logistic regression to examine predictors of incident depression among the 684 women not depressed at baseline. The second used logistic regression with GEE estimation to examine correlates of antidepressant treatment and receipt of an SSRI versus TCA. Results. Oldest age, white race, social support deficits, having an unhealthy spouse, financial stress, and severe disease burden independently predicted incident depression. Heart disease had a borderline effect. Prevalence of antidepressant prescription for all women rose from 8.0% at baseline (when TCAs were the most common type) to 12.1% in round 7 (when SSRIs became most common). Race was the strongest predictor of antidepressant prescription, with white women three times more likely than blacks to have an antidepressant (OR 3.26, 95% CI 1.93, 5.51). Other predictive factors were moderate to severe depression (OR 1.38, 95% CI 1.05, 1.82), visual impairment (OR 1.34, 95% CI 1.06, 1.71), moderate to severe cognitive impairment (OR 3.17, 95% CI 1.35, 7.47), mild cognitive impairment (OR 1.47, 95% CI 1.13, 1.47), having 4 or more chronic diseases (OR 2.28, 95% CI 1.30, 4.03), and having 5 or more recent physician visits (OR 1.30, 95% CI 1.07, 1.57). Drug coverage had a borderline effect. Conclusion. Most cases of geriatric depression are unrecognized and untreated. Opportunities exist for secondary and tertiary prevention of depression at the physician, community, and family levels. Reasons for racial differences in depression occurrence and treatment remain poorly understood.
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710 2 $a The Johns Hopkins University. $3 1017431
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