Analyzing the Impact of Depression on All-Cause Mortality in Different Sex and Age Groups: A 11-Year Follow-Up Study of Spanish Population.

BACKGROUND

Previous studies have shown that depression has a significant impact on all-cause mortality, particularly in men. However, the link between depression and mortality across different age and gender groups is inconsistent. This study aims to explore the relationship between depression and all-cause mortality in various age and gender categories within a Spanish national cohort, while also accounting for other influencing factors over an 11-year follow-up period.

METHODS

A nationally representative sample of the Spanish adult population (n = 4,582) was followed up for 11 years. Kaplan-Meier estimates, unadjusted and adjusted Cox proportional hazard regression models were conducted to test whether baseline depression and sociodemographic characteristics (educational level, low income, marital status, feelings of loneliness, alcohol and tobacco use, and having chronic conditions) were associated with all-cause mortality for different gender and age-specific groups, separately.

RESULTS

Unadjusted analysis by age and gender indicated that depression had a significant relationship with all-cause mortality in young-and-middle-aged women (HR = 1.75; p < .01) and men (18-64 years old; HR = 2.96; p < .001) and old men (+65; HR = 1.92; p < .001). Adjusted analysis by age and gender revealed that depression was only a significant factor for all-cause mortality in men aged 65+ (HR = 1.60; p = .025).

LIMITATIONS: Cause-specific mortality was not examined. Young adults and middle-aged participants were not analyzed separately.

CONCLUSIONS

The depression and all-cause mortality relationship was found only in +65 men. These differences may be driven by gender-specific factors such as delayed help-seeking, higher levels of social isolation, and the accumulation of chronic comorbidities. Therefore, preventive interventions must prioritize age- and gender-specific strategies to address these risk patterns.