TY - JOUR
T1 - Associations between low sex hormone concentrations and depression in older women
T2 - An observational study
AU - Islam, Rakibul M.
AU - Bell, Robin J.
AU - Berk, Michael
AU - Handelsman, David J.
AU - McNeil, John J.
AU - Wolfe, Rory
AU - Woods, Robyn L.
AU - Davis, Susan R.
N1 - Funding Information:
The ASPREE trial was supported by the National Institute on Aging and the National Cancer Institute at the National Institutes of Health (Grant U01AG029824 ); the National Health and Medical Research Council (NHMRC) of Australia (Grant 34047 , 1127060 ); Monash University (Australia); and the Victorian Cancer Agency (Australia). The ASPREE Healthy Ageing Biobank was funded by the CSIRO (Flagship Grant), the National Cancer Institute (Grant U01 AG029824 ) and Monash University . This analysis of sex hormones was funded by an NHMRC of Australia Project Grant (No. 1105305 ). MB is an Australian NHMRC Senior Principal Research Fellows (Grant 1156072 ), SRD holds an NHMRC Investigator Grant ( 2016627 ).
Publisher Copyright:
© 2023 Elsevier B.V.
PY - 2023/10
Y1 - 2023/10
N2 - Objective: We investigated whether low sex hormone concentrations are associated with depression in older women. Study design: This was a cross-sectional study of Australian women, aged at least 70 years, not taking medications modulating sex hormone levels. Associations between hormones, measured by liquid chromatography-tandem mass spectrometry, and depression were examined by logistic regression adjusted for potential confounders. Main outcome measures: The primary outcome was a Center for Epidemiologic Studies Depression score >10, designated as ‘depression’, with an expanded definition that included anti-depressant use as a secondary outcome. Results: For the 5535 participants in the analysis, median age 74.0 years (interquartile range 71.7–77.7), depression prevalence was 5.8 % (95 % CI 5.2–6.4 %). In the adjusted models, a statistically significantly greater likelihood of depression was seen for women with testosterone and oestrone blood concentrations in quartile 1 compared with quartiles 2–4 (odds ratio 1.33, 95 % CI 1.04 to 1.70, p = 0.022; and 1.37, 95 % CI 1.06 to 1.78, p = 0.017, respectively). For the expanded definition, the odds ratios for the lowest testosterone and oestrone quartile compared with other quartiles were 1.47 (95 % CI 1.24 to 1.75, p < 0.001) and 1.31 (95 % CI 1.09 to 1.58, p < 0.001), respectively. A significant association for low DHEA was seen only for the expanded definition of depression (1.36, 95 % CI 1.13 to 1.64, p = 0.001). Receiver operating characteristic curves showed that the contribution of each sex hormone to the likelihood of depression was small. Conclusions: Amongst older women not taking medications that influence sex hormone concentrations, low testosterone and oestrone levels are associated with a greater likelihood of depression, but the effects are small. Trial registration: International Standard Randomized Controlled Trial Number Register (ISRCTN83772183) and clinicaltrials.gov (NCT01038583).
AB - Objective: We investigated whether low sex hormone concentrations are associated with depression in older women. Study design: This was a cross-sectional study of Australian women, aged at least 70 years, not taking medications modulating sex hormone levels. Associations between hormones, measured by liquid chromatography-tandem mass spectrometry, and depression were examined by logistic regression adjusted for potential confounders. Main outcome measures: The primary outcome was a Center for Epidemiologic Studies Depression score >10, designated as ‘depression’, with an expanded definition that included anti-depressant use as a secondary outcome. Results: For the 5535 participants in the analysis, median age 74.0 years (interquartile range 71.7–77.7), depression prevalence was 5.8 % (95 % CI 5.2–6.4 %). In the adjusted models, a statistically significantly greater likelihood of depression was seen for women with testosterone and oestrone blood concentrations in quartile 1 compared with quartiles 2–4 (odds ratio 1.33, 95 % CI 1.04 to 1.70, p = 0.022; and 1.37, 95 % CI 1.06 to 1.78, p = 0.017, respectively). For the expanded definition, the odds ratios for the lowest testosterone and oestrone quartile compared with other quartiles were 1.47 (95 % CI 1.24 to 1.75, p < 0.001) and 1.31 (95 % CI 1.09 to 1.58, p < 0.001), respectively. A significant association for low DHEA was seen only for the expanded definition of depression (1.36, 95 % CI 1.13 to 1.64, p = 0.001). Receiver operating characteristic curves showed that the contribution of each sex hormone to the likelihood of depression was small. Conclusions: Amongst older women not taking medications that influence sex hormone concentrations, low testosterone and oestrone levels are associated with a greater likelihood of depression, but the effects are small. Trial registration: International Standard Randomized Controlled Trial Number Register (ISRCTN83772183) and clinicaltrials.gov (NCT01038583).
KW - Depression
KW - DHEA
KW - Mental disorders
KW - Oestrone
KW - Testosterone
KW - Women
UR - http://www.scopus.com/inward/record.url?scp=85168349552&partnerID=8YFLogxK
U2 - 10.1016/j.maturitas.2023.107822
DO - 10.1016/j.maturitas.2023.107822
M3 - Article
C2 - 37591034
AN - SCOPUS:85168349552
SN - 0378-5122
VL - 176
JO - Maturitas
JF - Maturitas
M1 - 107822
ER -