Anhedonia and anergia predict mortality in older Australians living in residential aged care

Abstract

Objectives

Depression is common in older adults and is linked to morbidity and mortality. The aim of this study was to investigate whether specific symptoms of depression (dysphoria, anhedonia and anergia) predicted mortality in older Australian Aged Care residents.

Methods

Eighty older adults (M = 83.16 ± 7.14) without cognitive impairment residing in 14 Residential Aged Care facilities located in Melbourne, Australia, completed the 15-item Geriatric Depression Scale—Short Form (GDS-15) and the Standardized Mini Mental State Examination. Residential Aged Care facilities provided the primary end-point of all-cause mortality at follow-up (M = 5.4 years ± 0.1).

Results

Univariate Kaplan-Meier survival curves and Cox Proportional Hazards regression analyses were used to evaluate whether symptoms of depression predicted all-cause mortality, with known prognostic factors controlled. The results indicated that anhedonia (Hazard Ratio = 2.931 [95% CI 1.278–6.722], p = .011) and anergia (Hazard Ratio = 2.783 [95% CI 1.065–7.276], p = .037) were associated with almost a threefold increased risk of mortality in older adults living in RAC in adjusted analyses. Dysphoria did not predict mortality.

Conclusions

These findings advance understanding of the mortality risks of anhedonia and anergia in an understudied population. Symptoms of anhedonia and anergia should be targeted for screening in older adults living in Aged Care to increase the detection and potential for referral to treatment for depressive presentation.

Keywords:

• Depression
• mortality
• anhedonia
• anergia
• dysphoria
• older adults
• residential aged care

Acknowledgements

We gratefully acknowledge the research team for their assistance. Special thanks to residents and staff at participating Aged Care facilities, without whom this study would not have been possible.

Disclosure statement

The authors report no conflict of interest.

Additional information

Funding

This work was supported by the JO & JR Wicking Trust under Grant CT 9048.