Trajectory classes of depressive symptoms in a community sample of older adults

Kuchibhatla MN, Fillenbaum GG, Hybels CF, Blazer DG. Trajectory classes of depressive symptoms in a community sample of older adults. Objective: To identify trajectories of depressive symptoms in older community residents. Method: Depressive symptomatology, based on a modified Center for Epidemiological StudiesDepression scale, was obtained at years 0, 3, 6, and 10, in the Duke Established Populations for Epidemiologic Studies of the Elderly (n = 4162). Generalized growth mixture models identified the latent class trajectories present. Baseline demographic, health, and social characteristics distinguishing the classes were identified using multinomial logistic regression. Results: Four latent class trajectories were identified. Class 1 stable low depressive symptomatology (76.6% of the sample); class 2 initially low depressive symptomatology, increasing to the subsyndromal level (10.0%); class 3 stable high depressive symptomatology (5.4%); class 4 high depressive symptomatology improving over 6 years before reverting somewhat (8.0%). Class 1 was younger, male gender, with better education, health, and social resources, in contrast to class 3. Class 2 had poorer cognitive functioning and higher death rate. Class 4 had better health and social resources. Conclusion: Reduction in high depressive symptomatology is associated with more education, better health, fewer stressful events, and a larger social network. Increasing depressive symptomatology is accompanied by poorer physical and cognitive health, more stressful life events, and greater risk of death.