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Beom-Woo Nam 1 Article
Independent predictors of depressive symptoms and social isolation on 2-year all-cause mortality among the Korean elderly in a population-based cohort study: gender differences
Hyunsuk Jeong, Hyeon Woo Yim, Beom-Woo Nam
Epidemiol Health. 2022;44:e2022012.   Published online January 8, 2022
DOI: https://doi.org/10.4178/epih.e2022012
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AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
This study examined whether depressive symptoms and social isolation were independent predictors of 2-year all-cause mortality among the elderly using data from a population-based cohort study.
METHODS
In total, 1,033 participants (320 men and 713 women) older than 60 years of age participated in this study. Depressive symptoms, social isolation status, and socio-demographic and health-related covariates were assessed at baseline. The primary outcome measure was 2-year all-cause mortality. Data were collected through in-person interviews by trained interviewers. The GENMOD procedure was used to calculate relative risks (RRs).
RESULTS
Of the 1,033 participants, 102 (40 men and 62 women) died within the follow-up period of 2 years. During the 2-year follow-up period, 17.8% of depressed men and 12.3% of depressed women died, and 29.8% of socially isolated men and 14.9% of socially isolated women died. Social isolation was an independent predictor of mortality in elderly men (adjusted relative risk [aRR], 4.6, 95% confidence interval [CI], 2.0 to 10.2), while depressive symptoms were an independent predictor of mortality in elderly women (aRR, 2.0; 95% CI, 1.2 to 3.6) when controlling for potential confounding factors. However, the depressive symptoms detected using the geriatric depression scale were not associated with mortality in men, and social isolation was not associated with mortality in women.
CONCLUSIONS
The effects of depressive symptoms and social isolation on 2-year all-cause mortality within an elderly population differed according to gender. Gender-specific community-based interventions must be developed to potentially reduce 2-year all-cause mortality among the elderly.
Summary
Korean summary
본 연구는 지역사회 거주하는 저소득층 노인을 대상으로 한 코호트 연구로 2년 추적조사를 수행하여 사망 원인의 예측인자를 분석하였다. 남성노인에서는 사회적 고립이, 여성노인에서는 우울증상이 2년 모든 사망원인의 독립적인 예측인자였다. 노인의 사망율을 줄이기 위한 지역사회 개입 프로그램은 남성에게는 사회적 고립을 해소를, 여성에게는 우울증상 개선을 위한 프로그램이 요구된다.
Key Message
The effects of depressive symptoms and so¬cial isolation on 2-year all-cause mortality among the elderly dif¬fered according to gender. For elderly men, social isolation increased the risk of 2-year all-cause mortality by 4.6 times compared to those who were not socially isolated. However, the depressive symptoms identified by the GDS-15 were not associated with 2-year all-cause mortality in men. From a public health perspective, these findings suggest that gender-specific community-based interventions are needed to mitigate all-cause mortality among the elderly.

Epidemiol Health : Epidemiology and Health