Late-life depression in older Chinese adults is associated with increased risks of mortality from all-cause and cardiovascular and respiratory diseases, according to local research.
In a large cohort of 61-to-96-year-old Singapore Chinese Health Study participants, depressive symptoms were associated with a 20-percent increased risk of all-cause mortality (95 percent confidence interval [CI], 1.11–1.30), 24-percent increased risk of CVD mortality (95 percent CI, 1.06–1.44), and 38-percent increased risk of ischaemic heart disease (IHD) mortality (95 percent CI, 1.14–1.67). [BMJ Public Health 2026;4:e004404]
Depressive symptoms were also associated with a 41-percent higher risk of infectious respiratory disease mortality (95 percent CI, 1.16–1.70) and 91-percent higher risk of chronic, non-malignant respiratory disease mortality (95 percent CI, 1.13–3.21).
The associations between depressive symptoms and mortality were more pronounced among smokers vs non-smokers, particularly for all-cause mortality (HR, 1.55 vs 1.15; p=0.012) and IHD mortality (HR, 2.27 vs 1.27; p=0.049). Similarly, the association for IHD mortality was stronger among participants aged <75 vs ≥75 years (HR, 1.89 vs 1.16; p=0.019).
“These findings suggest that depressive symptoms identified through population-based screening have prognostic significance for mortality risk among older adults,” especially smokers and those aged <75 years, the investigators said.
“Given the increasing prevalence and frequent underdiagnosis of late-life depression, early identification of depressive symptoms may help recognize older adults at elevated mortality risk and inform targeted management to address late-life depressive symptoms and its adverse health outcomes,” they added.
The study included 16,782 Singaporean Chinese (mean age at follow-up 73.2 years), among whom 4,440 (26.5 percent) had late-life depression, defined as having ≥5 symptoms on the 15-item Geriatric Depression Scale.
Participants with late-life depressive symptoms were older and more likely to be female and current smokers compared with those without depressive symptoms. Those with depressive symptoms also tended to have poorer diet quality, suboptimal sleep duration, more comorbidities, worse functional status and cognitive health, and lower levels of social support.
There were 2,960 deaths documented over a mean follow-up of 6.9 years. These included 520 deaths from IHD, 134 deaths from other chronic heart diseases, 169 deaths from stroke, 662 deaths from respiratory diseases, and 984 deaths from cancer.
“Late-life depression is associated with increased all-cause mortality across diverse populations,” the investigators said.
The present study addresses the lack of evidence on cause-specific mortalities in Asian populations, they added.