Social Activity and Improvement in Depressive Symptoms in Older People: A Prospective Community Cohort Study Vivian Isaac, M.Sc., Robert Stewart, M.D., Sylvaine Artero, M.D., Marie-Laure Ancelin, Ph.D., Karen Ritchie, Ph.D. 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 commu- nity-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 antide- pressant 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 partici- pants 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) Key Words: Social activity, depressive symptoms, population study, prospective study, aging Received September 7, 2008; revised March 3, 2009; accepted March 9, 2009. From the King’s College London, Institute of Psychiatry, Section of Epidemiology, London (VI, RS); and INSERM U888, Montpellier F-34093, France (RS, SA, M-LA, KR). Send correspondence and reprint requests to Dr. Robert Stewart, Section of Epidemiology (Box 60), Institute of Psychiatry, De Crespigny Park, London SE5 8AF, UK. e-mail: r.stewart@iop.kcl.ac.uk © 2009 American Association for Geriatric Psychiatry Am J Geriatr Psychiatry 17:8, August 2009 688