Social Activity and Improvement in Depressive Symptoms in Older People: A Prospective Community Cohort Study

Objective: To investigate: i) the association between level of social activity and late-life depressive symptoms and ii) the association between level of social activity and improvement in depressive symptoms over a 2-year period among people scoring above case level. Design: A secondary analysis of data from a prospective community-based study. Setting: Montpellier district, France. Participants: Community residents aged 65 and older (N = 1,849), 85.4% of whom were reassessed after a 2-year interval. Measurements: Depressive symptoms were assessed using the Center for Epidemiological Studies Depression scale at baseline and follow-up, and the standard 16 = cutoff was applied to define case-level symptomatology. The primary independent variable assessed at baseline was three levels of social activity defined from a 33-point scale. Other covariates included age, gender, marital status, education, alcohol consumption, chronic illness, cognitive impairment, disability, life events, and antidepressant use at baseline and follow-up. Results: In the sample at baseline (N = 1,849), higher social activity was negatively associated with case-level depressive symptomatology after adjustment for potential confounders (odds ratio across three groups 0.7, 95% confidence interval 0.6-0.8). In a prospective analysis of participants above case level at baseline (N = 463), high-social activity at baseline was the only variable associated with improvement in depressive symptoms and remained significant after adjustment for all other factors (odds ratio = 1.6; 95% confidence interval = 1.2-2.2). Conclusions: In a large community sample, higher social activity was associated with a lower risk of late-life depressive symptoms at baseline and, in those with case-level baseline symptoms, was the principal factor predicting improvement over 2-year follow-up. (Am J Geriatr Psychiatry 2009; 17: 688-696)