Originally created 05/04/02

Women live longer with mild depression in old age



Chin up, positive mental attitude, keep plugging along, don't let it get ya down.

Most aging experts - and most people - figure that being depressed, or anything but chipper, is a ticket toward illness and a shorter life.

But a new study challenges this view with a finding that older women with mild depression actually live longer than women who aren't experiencing any symptoms of depression.

Women 65 and older with mild depression are only 60 percent as likely to die as senior women who are not depressed or who are suffering more severe symptoms of depression.

"It's a preliminary finding that certainly needs to be rechecked by others, but it sure seems that if you're a woman, being mildly depressed has some protective effect," said Dr. Dan Blazer, a professor of psychiatry at Duke University Medical Center and a co-author of the study to be published Thursday in The American Journal of Geriatric Psychiatry.

"We're not ready to say having mild depression some days is a positive thing, but neither does it seem to be all negative, either," he added.

"We want to stress that we're talking about people showing several symptoms of depression, not someone with so many symptoms that they're obviously clinically depressed. Those people are still at risk and need to get treatment," Blazer said.

Blazer and colleagues at Duke's Center for the Study of Aging and Human Development analyzed data from a long-term set of surveys conducted on a population of more than 4,100 elderly North Carolinians at three-year intervals between 1986 and 1997.

The health assessments included questions that reflected symptoms of depression. There was a particular focus on participants with six to eight symptoms of depression, not sufficient to be considering clinically depressed but enough to show that they were suffering from a mild, yet significant, "sub-threshold depression."

"When we looked at men we didn't see any effect on mortality, but when we looked at women we saw what seemed to be a striking, protective effect from this form of depression," Blazer said.

The researchers went back and adjusted their analysis to consider other factors associated with mortality - age, marital status and socioeconomic class - that could have skewed the results. Yet women with mild depression still appeared to live longer.

Blazer and his team argue that " a less severe, depressed mood in elderly women is not damaging, but is, rather, a biological or psychological response to protect women from future risk."

"This is just speculation on our part, but it may be that women take their low mood as a signal to slow down, to engage in less stressful, less risky behavior. Rather than go out to lunch and then the mall and then play bridge and hit a concert after dinner, they decide maybe to stay in and read a book for the afternoon," Blazer said.

The researchers think their findings support earlier work by Dr. Randolph Neese of the University of Michigan, who has written that "depression may be adaptive by increasing an organism's ability to cope."

"It's become sort of unfashionable to admit to any level of depression in this country, particularly since treatment for more severe depressive episodes has become so readily available. But feeling a little down may allow some people to withdraw and regroup in the face of a debilitating situation rather than push ahead at all costs," Blazer said.

He added that "we don't know why we're seeing this result in women rather than men, but it may be that women learn to use this form of adaptive behavior earlier in life and continue using it from time to time throughout their lives."

On the Net:

http://ajgp.psychiatryonline.org/

www.geri.duke.edu