Relationship between multidimensional prognostic index and incident depressive symptoms in older people: Findings from the Irish Longitudinal Study on Ageing.

ABSTRACT

OBJECTIVES: The multidimensional prognostic index (MPI) is a useful prognostic tool for evaluating adverse health outcomes in older individuals. However, the association between MPI and depressive symptoms has never been explored, despite depression being a common condition in older people. We therefore aimed to evaluate whether MPI may predict incident depressive symptoms. METHODS: Longitudinal, cohort study, with 2 years of follow-up (W1 October 2009-February 2011; W2 April 2012-January 2013), including people aged ≥65 years without depressive symptoms at baseline. A comprehensive geriatric assessment including information on functional, nutritional, cognitive status, mobility, comorbidities, medications, and cohabitation status was used to calculate the MPI dividing the participants into low, moderate, or severe risk. Those who scored ≥16/60 with the Center of Epidemiology Studies Depression (CES-D) tool were considered to have depressive symptoms. Multivariable logistic regression models were built to explore the association between MPI and incident depressive symptoms. RESULTS: The sample consisted of 1854 participants (mean age 72.8 ± SD 5.1 years; females 52.1%). The prevalence of incident depressive symptoms by MPI tertiles at baseline were low 2.5%, moderate 3.9%, and severe 6.7%. In multivariable analyses, baseline MPI values were significantly associated with incident depressive symptoms (increase in 0.1 points in MPI odds ratio, OR = 1.47; 95% confidence intervals, CI 1.17-1.85; MPI tertile severe vs low OR = 2.96; 95%CI 1.50-5.85). CONCLUSION: Baseline MPI values were associated with incident depressive symptoms indicating that multidimensional assessment of older people may lead to early identification of individuals at increased risk of depression onset.