TY - JOUR
T1 - The importance of social activity to risk of major depression in older adults
AU - Ryu, Euijung
AU - Jenkins, Gregory D.
AU - Wang, Yanshan
AU - Olfson, Mark
AU - Talati, Ardesheer
AU - Lepow, Lauren
AU - Coombes, Brandon J.
AU - Charney, Alexander W.
AU - Glicksberg, Benjamin S.
AU - Mann, J. John
AU - Weissman, Myrna M.
AU - Wickramaratne, Priya
AU - Pathak, Jyotishman
AU - Biernacka, Joanna M.
N1 - Publisher Copyright:
Copyright © The Author(s), 2021. Published by Cambridge University Press.
PY - 2023/4/12
Y1 - 2023/4/12
N2 - Background Several social determinants of health (SDoH) have been associated with the onset of major depressive disorder (MDD). However, prior studies largely focused on individual SDoH and thus less is known about the relative importance (RI) of SDoH variables, especially in older adults. Given that risk factors for MDD may differ across the lifespan, we aimed to identify the SDoH that was most strongly related to newly diagnosed MDD in a cohort of older adults. Methods We used self-reported health-related survey data from 41 174 older adults (50-89 years, median age = 67 years) who participated in the Mayo Clinic Biobank, and linked ICD codes for MDD in the participants' electronic health records. Participants with a history of clinically documented or self-reported MDD prior to survey completion were excluded from analysis (N = 10 938, 27%). We used Cox proportional hazards models with a gradient boosting machine approach to quantify the RI of 30 pre-selected SDoH variables on the risk of future MDD diagnosis. Results Following biobank enrollment, 2073 older participants were diagnosed with MDD during the follow-up period (median duration = 6.7 years). The most influential SDoH was perceived level of social activity (RI = 0.17). Lower level of social activity was associated with a higher risk of MDD [hazard ratio = 2.27 (95% CI 2.00-2.50) for highest v. lowest level]. Conclusion Across a range of SDoH variables, perceived level of social activity is most strongly related to MDD in older adults. Monitoring changes in the level of social activity may help identify older adults at an increased risk of MDD.
AB - Background Several social determinants of health (SDoH) have been associated with the onset of major depressive disorder (MDD). However, prior studies largely focused on individual SDoH and thus less is known about the relative importance (RI) of SDoH variables, especially in older adults. Given that risk factors for MDD may differ across the lifespan, we aimed to identify the SDoH that was most strongly related to newly diagnosed MDD in a cohort of older adults. Methods We used self-reported health-related survey data from 41 174 older adults (50-89 years, median age = 67 years) who participated in the Mayo Clinic Biobank, and linked ICD codes for MDD in the participants' electronic health records. Participants with a history of clinically documented or self-reported MDD prior to survey completion were excluded from analysis (N = 10 938, 27%). We used Cox proportional hazards models with a gradient boosting machine approach to quantify the RI of 30 pre-selected SDoH variables on the risk of future MDD diagnosis. Results Following biobank enrollment, 2073 older participants were diagnosed with MDD during the follow-up period (median duration = 6.7 years). The most influential SDoH was perceived level of social activity (RI = 0.17). Lower level of social activity was associated with a higher risk of MDD [hazard ratio = 2.27 (95% CI 2.00-2.50) for highest v. lowest level]. Conclusion Across a range of SDoH variables, perceived level of social activity is most strongly related to MDD in older adults. Monitoring changes in the level of social activity may help identify older adults at an increased risk of MDD.
KW - Biobank
KW - depression
KW - electronic health records
KW - major depressive disorder
KW - social activity
KW - social determinants of health
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U2 - 10.1017/S0033291721004566
DO - 10.1017/S0033291721004566
M3 - Article
C2 - 34763736
AN - SCOPUS:85119445375
SN - 0033-2917
VL - 53
SP - 2634
EP - 2642
JO - Psychological Medicine
JF - Psychological Medicine
IS - 6
ER -