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Context Depression is associated with an increased mortality risk. It is not known to what extent depression characteristics such as severity and length of exposure to depression contribute to the association with excess mortality. Objectives To investigate the association between depression severity and duration with mortality in community-living elderly. Design Two-wave prospective cohort study with 10-year follow-up of vital status. Assessment of depression at baseline and at three year follow-up (GMS-AGECAT). Cox proportional hazards analyses of mortality with depression according to severity and length of exposure, adjusted for demographic variables, physical illnesses, cognitive decline and functional disabilities. Setting and participants Randomly selected cohort of 3 746 non-demented older community-living persons in the city of Amsterdam. Main outcome measures Excess mortality of both the baseline cohort, and of non-demented subjects participating in both assessments (n = 1989). Results Both moderate (MHR 1.29, 95% CI 1.03–1.61) and severe depression (MHR 1.34, 95% CI 1.07–1.68) predicted 10-year mortality after multivariate adjustment. Chronic depression was associated with a 41% higher mortality risk in 6-year follow-up compared to subjects without depression. Conclusions Severity and chronicity of depression are associated with a higher mortality risk. In combination with other findings this is suggestive of a causal relationship and may have implications for both preventive and treatment strategies of late-life depression. Copyright © 2008 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Objectives: To review studies that have reported on the prevalence of memory complaints and the relationship between memory complaints and impairment or decline (dementia) in elderly individuals., Data Sources and Study Selection: All publications in the English language relating to memory complaints, memory impairment, cognitive disorder and dementia in MEDLINE, PSYCHLIT and EMBASE computerized databases, together with a search of relevant citations., Data Synthesis: The prevalence of memory complaints, defined as everyday memory problems, shows a large variation of approximately 25 - 50%. A high age, female gender and a low level of education are generally associated with a high prevalence of memory complaints. In community-based samples of elderly subjects an association has been found between memory complaints and memory impairment, after adjustment for depressive symptomatology. Memory complaints predict dementia after a follow-up of at least 2 years, in particular in those with mild cognitive impairment, defined as Mini Mental State Examination (MMSE) > 23. Memory complaints in highly educated elderly subjects may be predictive of dementia even when there is no indication of cognitive impairment on short cognitive screen tests. The shift in methodology which is noticeable in the recently published major studies is discussed as a possible explanation for the established association between memory complaints and decline in memory (or dementia) in elderly subjects. Three methodological factors, in particular, are responsible for the results: community-based sampling, longitudinal design and the treatment of variables such as depression, cognitive impairment and level of education., Conclusion: Memory complaints in elderly people should no longer be considered merely as an innocent age-related phenomenon or a symptom of depression. Instead, these complaints deserve to be taken seriously, at least as a possible early sign of dementia., (Copyright 2000 John Wiley & Sons, Ltd.)