Feeling blue at the end of life: Trajectories of depressive symptoms from a distance-to-death perspective

This article examines the end-of-life development of depressive symptoms and characterizes prototypical groups following the same depressive symptoms development. We modeled time-to-death-related trajectories of depressive symptoms (Center for Epidemiologic Studies Depression Scale), applying a latent class growth analysis to deceased older adults from the English Longitudinal Study of Aging (Waves 1 to 5; NTime 1 (T1) = 2,219; MAge(T1) = 73.9 years, SDAge(T1) = 9.4 years; 51% male, 1% non-White). Four prototypical trajectories of depressive symptoms were identified at the end of life: a stably nondepressed group (31.2%); 2 groups with an exponential terminal symptom increase, of which 1 was nondepressed and 1 low depressed (8.3% and 38.4%, respectively); and a stably depressed group (22.2%). Using a combination of growth curve models and individual level and slope values as predictor variables showed that individuals suffering from increasing sensory, mobility, or overall health problems or decreasing quality of life were more likely to have an increase in symptoms of depression in their last years of life. Men were more likely to be stably nondepressed and women more likely to be chronically depressed. We conclude that a group-based analysis of end-of-life depressive symptoms is useful in adding to the understanding of distance-to-death psychology at large as well as pointing to preventive and intervention strategies when it comes to late-life depressive mood. (PsycINFO Database Record