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Cambridge University Press, Psychological Medicine, 08(41), p. 1665-1676

DOI: 10.1017/s0033291710002473

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Depression Trajectories and Obesity among the Elderly in Taiwan

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This paper is available in a repository.

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Abstract

BACKGROUND: The present study aimed to (a) characterize 10- year trajectory patterns of depressive symptoms and (b) investigate the association between depressive trajectory and subsequent obesity, metabolic function and cortisol level. METHOD: In a prospective study of Taiwanese adults aged ≥60 years (n=3922) between 1989 and 1999, depression was assessed using a 10-item short-form of the Center for Epidemiologic Studies Depression Scale and information on body mass index (BMI) was collected by self- report. A subsample (n=445) of the original cohort in 1989 was drawn to assess metabolic variables and cortisol levels in a 2000 follow-up. After trajectory analyses were performed, multinomial logistic regression analyses were used to estimate the association estimates. RESULTS: We identified four distinctive trajectories of depressive symptoms: class 1 (persistent low, 41.8%); class 2 ( persistent mild, 46.8%); class 3 (late peak, 4.2%); and class 4 (high-chronic, 7.2%). The results from both complete cases and multiple imputation analyses indicated that the odds of obesity were lower in the class 2, 3 or 4 elderly, as compared with those in class 1, while the odds of underweight were higher. The classes of older adults with more and persistent depressive symptoms showed a trend toward having both a lower BMI (p=0.01) and a higher cortisol level (p=0.04) compared with those with low depressive symptoms. CONCLUSIONS: Incremental increases in depressive symptoms over time were associated with reduced risk of obesity and higher cortisol levels. ; 公共衛生學系 ; 公共衛生學院 ; 期刊論文