Abstract P258: Association of Depressive Symptoms With Exceptional Longevity: The Women’s Health Initiative

Introduction: Older women may experience elevated levels of depressive symptoms and are particularly vulnerable to chronic diseases, including CVD, and disability. Yet, few studies have examined associations of depressive symptoms with healthy longevity. We examined the associations of depressive symptoms with survival to ages 90, 95, and 100, and with survival to age 90 with intact mobility and cognitive functioning among older women. Hypothesis: Relative to those without depressive symptoms at baseline, women with elevated depressive symptoms will have (i) lower odds of survival to ages 90, 95, or 100 and (ii) lower odds of surviving to age 90 without mobility and cognitive impairment. Methods: We studied 70,363 women ( M age = 69.9, SD = 3.9; 7.1% Black, 2.5% Hispanic/Latino, 89.6% White) enrolled in the Women’s Health Initiative with potential, due to birth year, to survive to ages 90 and older as of February 2022. Depressive symptoms were assessed at baseline (1993-1998) using an 8-item screening instrument that comprises the 6-item Center for Epidemiologic Studies Depression Scale and 2 items from the Diagnostic Interview Schedule. Depressive symptoms were classified as elevated (vs. not) using an established cut point of ≥0.06 for detecting the presence of depressive disorders. Survival (vs. death) to ages 90, 95, and 100 years was assessed through February 2022. Separate logistic regression models estimated odds ratios (OR) and 95% confidence intervals (CI) for survival to age 90, 95, and 100 and to age 90 without (vs. with) mobility and cognitive impairment, adjusting for age, race/ethnicity, education, marital status, health insurance, financial problems, diet quality, body mass index, physical activity, smoking status, alcohol consumption, history of hypertension, diabetes, stroke, heart failure, myocardial infarction, and cancer, and use of depression medication. Results: A total of 38,607 women survived to age 90 or older during WHI follow-up. After adjustment for covariates, women with elevated depressive symptoms at baseline (compared to women without symptoms) had lower odds of surviving to age 90 (OR, 0.91; 95% CI 0.86-0.96; P = .001), age 95 (OR, 0.87; 95% CI 0.80-0.96; P = .005) and similarly but non-significantly to age 100 (OR, 0.80; 95% CI 0.59-1.06; P = .14). Women with elevated depressive symptoms at baseline (compared to women without symptoms) had lower odds of surviving to age 90 without mobility and cognitive impairment (OR, 0.57; 95% CI 0.51-0.65; P < .001) vs. surviving to age 90 with mobility and cognitive impairment. Conclusions: Baseline depressive symptoms were associated with lower odds of exceptional longevity and survival to age 90 without impairment in mobility and cognitive functioning among WHI women. These findings underscore the adverse long-term impact of depressive symptoms on healthy longevity.