Brief reportDepression and smoking amongst older general practice patients
Introduction
Depression is a disabling disorder, affecting as many as 12% of the population of older adults at any one point in time (Copeland et al., 1999). The results of neuroimaging and neuropathological studies indicate that the brains of elderly people with depression have significant cerebrovascular disease (Thomas et al., 2002, Thomas et al., 2004). As a result, there is increasing interest about the potential role that risk factors for cerebrovascular disease might play in facilitating the clinical expression of depression.
Cigarette smoking is an important, but potentially reversible, risk factor for cardiovascular diseases (Burns, 2003, Wolf et al., 1988). Smoking has already been linked to depression amongst young adults (Fergusson et al., 2003, Hämäläinen et al., 2001), but limited information exists as to the relevance of such an association in later life. We designed the present study to systematically address this issue.
Section snippets
Study population
The study population consisted of patients attending 1 of 54 randomly selected GPs in Western Australia. Patients taking part in the study were required to be: (1) aged 60 years or older, (2) fluent in written English, and (3) give written informed consent to participate.
Survey methods and instruments
A consecutive series of patients awaiting general practice consultations were given the study's self-report questionnaire package by the practice nurse or receptionist. This questionnaire gathered information on age, gender,
Results
A total of 1061 subjects agreed to take part in the study, of whom 1030 provided information about smoking. Their mean age was 72.1 (S.D. = 7.4) years (range: 60–101) and 57.2% were female. Thirty percent of the participants were ex-light smokers, 24.0% ex-heavy smokers and 5.6% current smokers. Table 1 summarises subjects' basic demographic, social and clinical information according to their smoking status.
There were more males amongst ex-heavy than never smokers. Ex-heavy smokers were also more
Discussion
The results of this study show that there was a significant trend for CES-D scores to increase according to the smoking status of participants, although such an association was not linear. Depression was more frequent and severe in later life amongst ex-heavy smokers and current smokers than ex-light and never smokers.
Previous observational studies investigating the association between smoking and depression in young adults reported similar findings. Lasser et al. (2000) found that more than
Acknowledgements
The authors wish to thank all general practitioners and older adults who took part in this study. This paper was produced as part of a research program funded by the National Suicide and Prevention Strategy of Australia, National Health and Medical Research Council (NHMRC), the Alcohol Education and Research Foundation (AERF), and Healthway-WA.
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