By Lisa Rapaport
(Reuters Health) – Many people in their last year of life suffer from worsening depression symptoms, and a US study suggests that women, younger adults, and poor people may be at particular risk.
In one study, the researchers examined data on 3,274 adults who participated in the National Health and Retirement Study and died within one year of assessment. All participants completed mental health questionnaires and provided information on any medical issues and demographic factors such as income and educational attainment.
The rate of depressive symptoms increased in the last year of life, especially in recent months. the study showed. By the last month of life, 59% of participants had enough symptoms to be positive for the diagnosis of depression, even though they were not officially evaluated and diagnosed by physicians.
"Patients with depression have worse survival outcomes than non-depressive patients," Elissa Kozlov of the Rutgers University Institute for Health, Health and Aging Research in New Brunswick, New Jersey, and colleagues write in the Journal of The American Geriatrics Society.
And "mental symptoms such as depression have a negative impact on the quality of life of patients at the end of life," write Kozlov and colleagues.
Researchers had asked participants if they have experienced eight things in the past week: depression, sadness, restless sleep, dissatisfaction, the feeling that everything is exhausting, lack of motivation and loneliness. People with at least three symptoms could be tested positive for depression, according to the study team.
About 23% of participants were in the total population of health and retirement studies, including those who did not die within a year of their last assessment. The researchers also found at least three of these symptoms.
In the current analysis, the depression rates between 12 and 4 months before death remained relatively stable and then increased steadily. At four months of age, 42% had at least three signs of depression and 59% had symptoms of depression in one month remaining.
One year before death, women had higher levels of depression symptoms, with an average of nearly three symptoms, about two for men. Within one month of life, both men and women had three or more symptoms and there was no significant difference between the sexes.
Differences in age and income depression levels were more pronounced and larger one year before death. However, the study found that the youngest and poorest participants had the highest levels of depression at all times.
As death approached, non-white participants also exhibited increasingly high depression scores.
And one month before death, people without a school-leaving certificate showed the highest levels of depression with an average of five symptoms.
The study should not prove whether or how an incurable disease could affect mental health or vice versa
Nonetheless, the findings underscore the importance of screening for mental health problems and treating conditions such as depression in recent months, the researchers conclude.
"Give When choosing options for treating depression, untreated depressive symptoms in the last year of life must be a focus in both quality assessment and improvement," the authors of the study write. "End-of-life depressive symptoms are common but treatable and need to be proactively addressed to reduce stress and ensure that everyone has the opportunity to experience good death without depressive symptoms."
SOURCE: https: //bit.ly/2O7BY5q Journal of the American Geriatrics Society, online, November 5, 2019.