Prognosis of depression with and without dementia in old age

Prognostic significance of depression with and without dementia in terms of survival was investigated in a prospective study of persons aged 70 years (n=1032), using mini-mental state examination (MMSE), self-rating depression scale of Zung, clinical dementia rating (CDR), DSM-III criteria of major depression, clinical depression (CD) and the date and causes of death during the 5-year follow-up. The Zung-score (>40 pts) and CD were associated with slightly increased 5-year mortality. The 5-year mortality was significantly increased in the combination group (MMSE-score <24, Zung-score >40). Excess mortality of depressed subjects was found in all categories of death except malignancy and the most significant increase was found in the rate of pulmonary diseases. The data indicate that lowered mood, measured with the Zung-test, is an independent risk indicator of death in the general aged population, but depression is hardly an independent risk condition of cognitive decline.