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
JournalAm J Geriatr Psychiatry
Date Published2014 Jun
ISSN Number1545-7214
KeywordsAge Factors, Aged, Aged, 80 and over, Anhedonia, depression, Disabled Persons, Female, Humans, Interview, Psychological, Longitudinal Studies, Male, Middle Aged, Mortality, Risk Factors

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.


Times Cited: 0

User Guide Notes


Endnote Keywords

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

Endnote ID


Alternate JournalAm J Geriatr Psychiatry
Citation Key8105
PubMed ID23602308
PubMed Central IDPMC3766414
Grant ListK24AG029812 / AG / NIA NIH HHS / United States
R01AG028481 / AG / NIA NIH HHS / United States
K24 AG029812 / AG / NIA NIH HHS / United States
R01 AG028481 / AG / NIA NIH HHS / United States
P30 AG044281 / AG / NIA NIH HHS / United States