Dysphoria and Anhedonia as Risk Factors for Disability or Death in Older Persons: Implications for the Assessment of Geriatric Depression

TitleDysphoria and Anhedonia as Risk Factors for Disability or Death in Older Persons: Implications for the Assessment of Geriatric Depression
Publication TypeJournal Article
Year of Publication2014
AuthorsCovinsky, KE, Cenzer, I, Yaffe, K, O'Brien, S, Blazer, DG
JournalAmerican Journal of Geriatric Psychiatry
Volume22
Issue6
Pagination606-613
KeywordsHealth Conditions and Status
Abstract

Objectives: Either dysphoria (sadness) or anhedonia (loss of interest in usually pleasurable activities) is required for a diagnosis of major depression. Although major depression is a known risk factor for disability in older persons, few studies have examined the relationship between the two core symptoms of major depression and disability or mortality. Our objective was to examine the relationship between these two core symptoms and time to disability or death. Methods: In a longitudinal cohort study, we used the nationally representative Health and Retirement Study to examine this relationship in 11,353 persons older than 62 years (mean: 73 years) followed for up to 13 years. Dysphoria and anhedonia were assessed with the Short Form Composite International Diagnostic Interview. Our outcome measure was time to either death or increased disability, defined as the new need for help in a basic activity of daily living. We adjusted for a validated disability risk index and other confounders. Results: Compared with subjects without either dysphoria or anhedonia, the risk for disability or death was not elevated in elders with dysphoria without anhedonia (adjusted hazard ratio HR : 1.11; 95 confidence interval CI : 0.91-1.36). The risk was elevated in those with anhedonia without dysphoria (HR: 1.30; 95 CI: 1.06-1.60) and those with both anhedonia and dysphoria (HR: 1.28; 95 CI: 1.13-1.46). Conclusion: Our results highlight the need for clinicians to learn whether patients have lost interest in usually pleasurable activities, even if they deny sadness.

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Times Cited: 0

DOI10.1016/j.jagp.2012.12.001
Endnote Keywords

depression/activities of daily living/anhedonia/dysphoria/health status/quality of life

Endnote ID

999999

Citation Key8105
PubMed ID23602308
PubMed Central IDPMC3766414