Please use this identifier to cite or link to this item: https://hdl.handle.net/11000/30512

Depression and excess mortality in the elderly living in lowand middle‐income countries: Systematic review and meta‐analysis

Title:
Depression and excess mortality in the elderly living in lowand middle‐income countries: Systematic review and meta‐analysis
Authors:
Brandão, Diego José  
Ferreira Fontenelle, Leonardo
Almeida da Silva, Simone
Rossi Menezes, Paulo
Pastor-Valero, Maria  
Editor:
Wiley
Department:
Departamentos de la UMH::Salud Pública, Historia de la Ciencia y Ginecología
Issue Date:
2018-09
URI:
https://hdl.handle.net/11000/30512
Abstract:
Objective To investigate the association between depression and mortality in the elderly living in low- and middle-income countries. Methods A systematic review and meta-analysis was performed. We searched in five electronic databases for observational studies investigating the association between mortality and depression. Two reviewers worked independently to select articles, extract data, and assess study quality. Results A total of 10 studies including 13 828 participants (2402 depressed and 11 426 nondepressed) from six countries (Brazil, four articles; China, two articles; Botswana, India, South Africa, and South Korea, one article) were included. The overall unadjusted relative risk (RR) of mortality in depressed relative to nondepressed participants was 1.62 (95% CI, 1.39-1.88; P < 0.001), with high heterogeneity (I2 = 66%; 95% CI, 33-83; P < 0.005). After adjustment for publication bias, the overall RR decreased to 1.60 (95% CI, 1.37-1.86; P < 0.001). No significant differences were observed between subgroups except those defined by study quality. The high-quality studies had a pooled RR of 1.48 (95% CI, 1.32-1.67; P < 0.001), while the low-quality studies resulted had a pooled RR of 1.82 (95% CI, 1.25-2.65; P < 0.005). Conclusions Depression is associated with excess mortality in the elderly living in low- and middle-income countries. In addition, this excess mortality does not differ substantially from that found in high-income countries. This suggests environmental factors occurring in low- and middle-income countries might not have a direct association with the excess mortality in the depressed elderly.
Keywords/Subjects:
depression
low‐ and middle‐income countries
mortality
Knowledge area:
CDU: Ciencias aplicadas: Medicina
Type of document:
application/pdf
Access rights:
info:eu-repo/semantics/openAccess
Attribution-NonCommercial-NoDerivatives 4.0 Internacional
DOI:
https://doi.org/10.1002/gps.5008
Appears in Collections:
Artículos Salud Pública, Historia de la Ciencia y Ginecología



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