The Association between Untreated Depressive Symptoms and Polypharmacy in the Elderly in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study Open Access
Ma, Albert Kuei (2011)
Published
Abstract
An abstract of
A thesis submitted to the Faculty of the
Rollins School of Public Health of Emory University
in partial fulfillment of the requirements for the degree of
Master of Public Health
in Epidemiology
2011
ABSTRACT
The Association between Untreated Depressive Symptoms and
Polypharmacy in the
Elderly in the Reasons for Geographic and Racial Differences in
Stroke (REGARDS)
Study
By Albert Ma
Background. There is growing interest in the consequences of
polypharmacy, particularly in
determining the level at which treatment or detection of
traditionally normalized chronic
conditions such as depression are excluded among the
medication-intense elderly. The goal of
this study was to determine the association between polypharmacy
and untreated
depression in a large sample of elderly U.S. adults.
Methods. We used cross-sectional data from 11,484
participants aged 65+ in the
Reasons for Geographic and Racial Differences in Stroke study.
Medication count was
collected during an in-home interview and stratified into 0-4, 5-9,
and 10+ groups.
Untreated depression was defined as no indication of antidepressant
use and a score of 4+
on the four-item questionnaire derived from the CESD scale. Data
regarding
sociodemographic factors and comorbidities were also
collected.
Results. The median medication count (IQR) was 6(3,8) for
all subjects. The prevalence
of untreated depression was nearly twice that for African Americans
(10.5%) compared to whites
(5.6%), and women (9.9%) compared to men (5.1%). The prevalence of
untreated depression
increased consistently with increasing polypharmacy strata from a
prevalence (95%CI) of 6.3 %
( 5.56, 7.04) for 0-4 medications and increasing to 7.7 %( 6.98,
8.42) and 9.5% (8.27, 10.81)
among participants with levels of 5-9 and >10 medications,
respectively. After adjusting for
demographics and comorbid conditions, the association between
polypharmacy and
untreated depression was significant for only the highest strata of
polypharmacy [OR
(95%CI) 1.12 (1.12,1.76)] compared to the lowest. The association
between the middle strata and
untreated depression was positive but non-significant [OR (95%CI):
1.17(0.98,1.40)].
Conclusion. Within a large sample of elderly adults, there
was a significant and positive
association between those taking 10 or more medications and
untreated depression after
adjusting for sociodemographic factors and comorbidities.
Table of Contents
Table of Contents
1. Literature Review/Introduction
Page 1
2. Methods
Page 23
3. Results
Page 26
4. Discussion
Page 29
5. References
Page 33
6. Tables
a. Table 1
Page 40
b. Table 2
Page 41
c. Table 3
Page 42
7. Figures
a. Figure 1
Page 43
8. Appendices
a. IRB exemption
Page 44
About this Master's Thesis
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