Depressive symptomatology as a predictor of physical illness and mortality among older Mexican Americans

The prospective relationship between depression and physical illness has received more attention recently but has not been studied extensively among Latinos. Latinos have low depression treatment rates and are at an increased risk of developing chronic illnesses including cardiovascular disease and type 2 diabetes. Therefore, it may be of particular importance to investigate this relationship among Latinos. The current study utilized data from Hispanic Established Populations for Epidemiologic Studies of the Elderly to examine depressive symptomatology as a predictor of physical illness and mortality in a sample of 3050 elderly Mexican Americans. Depressive symptoms were measured at baseline with the CES-D. Stroke, myocardial infarction, type 2 diabetes, and mortality were assessed at seven-year follow-up. Gender, acculturation, and nativity were examined as potential moderators of the relationships studied. Logistic regression was utilized for the statistical analyses. Prospective analyses found that baseline depressive symptoms significantly predicted myocardial infarction (OR=1.16, p<.01, 95% CI:1.05-1.29) but not diabetes or stroke. Baseline depressive symptoms also significantly predicted mortality (OR=1.36, p<.01, 95% CI:1.25-1.49). Nativity was a significant moderator of the relationships between baseline depressive symptoms and diabetes at seven-year follow-up and between baseline depressive symptoms and subsequent mortality. The findings add support to research on depression as a precursor of physical illness and highlight the salience of nativity when studying the health of elderly Mexican Americans. In addition, the current findings identify depression screening and treatment as a viable target for preventive efforts in a population at increased risk of morbidity and mortality associated with chronic disease.