Skip to main content Accessibility help
×
Home

Community-based case–control study of depression in older people: Cases and sub-cases from the MRC–ALPHA study

  • J. R. M. Copeland (a1), Ruoling Chen (a1), Michael Dewey (a2), C. F. M. McCracken (a1), Chris Gilmore (a3), B. Larkin (a4) and K. C. M. Wilson (a5)...

Abstract

Background

Risk factors of depression in later life, particularly for sub-cases and for psychotic and neurotic types of depression, are unclear.

Aims

To identify such risk factors.

Method

Over 5200 older people ($65 years), randomly selected from Liverpool, were interviewed using the Geriatric Mental State (GMS)and the Minimum Data Set (MDS). The computer-assisted diagnosis AGECAT identified 483 cases and 575 sub-cases of depression and 2451 with no mental problems. Logistic regression was employed to examine factors relevant to caseness.

Results

In multiple logistical regression, odds ratios (ORs) were significantly high for being female (2.04, 95% CI 1.56–2.69), widowed (2.00, 1.18–3.39), having alcohol problems (4.37, 1.40–2.94), physical disablement (2.03, 1.40–2.94), physical illness (1.98,.1.25–3.15), taking medications to calm down (10.04, 6.41 −15.71), and dissatisfaction with life (moderate 4.54, 3.50–5.90; more severe 29.00, 16.00–52.59). Good social networks reduced the ORs. If sub-cases were included as controls, the statistical significance was reduced.

Conclusions

Age was not associated with depression in later life whereas gender, physical disablement and dissatisfaction with life were. The sub-cases shared many risk factors with cases, suggesting that prevention may need to be attempted at an early stage.

Copyright

Corresponding author

Professor J. R. M. Copeland, Department of Psychiatry, Royal Liverpool University Hospital, Liverpool L69 3GA

Footnotes

Hide All

Declaration of interest

Funding from the Medical Research Council.

Footnotes

References

Hide All
American Psychiatric Association (1980) Diagnostic and Statistical Manual of Mental Disorders (3rd edn) (DSM–III). Washington, DC: APA.
Beekman, A. T. F. Deeg, D. J. H., van Tilburg, T., et al (1995) Major and minor depression in later life: a study of prevalence and associated factors. Journal of Affective Disorders, 36, 6575.
Blazer, D. G., Burchett, B., Service, C. et al (1991) The association of age and depression among the elderly: an epidemiologic exploration. Journal of Gerontology, 46, 210215.
Burvill, P. W. & Hall, W. D. (1994) Predictors of increased mortality in elderly depressed patients. International Journal of Geriatric Psychiatry, 9, 219227.
Copeland, J. R. M., Kellcher, M. J., Kellett, J. M., et al (1976) “A semi-structured clinical interview for the assessment of diagnosis and mental state in the elderly”. The Geriatric Mental State Schedule I. Development and reliability. Psychological Medicine, 16, 8999.
Copeland, J. R. M., Dewey, M. E. & Griffiths-Jones, H. M. (1986) Psychiatric case nomenclature and a computerised diagnostic system for elderly subjects: GMS and AGECAT. Psychological Medicine, 16, 8999.
Copeland, J. R. M., Dewey, M. E., Henderson, A. S., et al (1988) The Geriatric Mental State (GMS) used in the community. Replication studies of the computerised diagnosis AGECAT. Psychological Medicine, 18, 219223.
Copeland, J. R. M., Dewey, M. E. & Griffiths-Jones, H. M. (1990) Dementia and depression in elderly persons: AGECAT compared with DSM–III and pervasive illness. International Journal of Geriatric Psychiatry, 5, 4751.
Copeland, J. R. M., Davidson, I. A., Dewey, M. E., et al (1992) Alzheimer's disease, other dementias, depression and pseudodementia: prevalence, incidence and three-year outcome in Liverpool. British Journal of Psychiatry, 161, 230239.
Dewey, M. E., Copeland, J. R. M., Lobo, A., et al (1992) Computerised diagnosis from a standardised history schedule: a preliminary communication about the organic section of the HAS–AGECAT system. International Journal of Geriatric Psychiatry, 7, 443446.
Green, B. H., Copeland, J. R. M., Dewey, M. E., et al (1992) Risk factors for depression in elderly people: a prospective study. Acta Psychiatrica Scandinavica, 86, 213217.
Gurland, B. J., Fleiss, J. L., Goldberg, K., et al (1976) A semi-structured clinical interview for the assessment of diagnosis and mental state in the elderly. The Geriatric Mental State Schedule 2. A factor analysis. Psychological Medicine, 6, 451459.
Gurland, B. J., Wilder, D. E., Golden, R., et al (1988) The relationship between depression and disability in the elderly – data from the Comprehensive Assessment and Referral Evaluation (CARE). In Psychological Assessment of the Elderly (eds Wattis, J. P. & Hindmarch, I.), pp. 114137. Edinburgh: Churchill Livingstone.
Hasin, D. & Link, B. (1988) Age and recognition of depression: implications for a cohort effect in major depression. Psychological Medicine, 18, 683688.
Hooijer, C., Jonker, C., Dewey, M. E., et al (1991) A standardised interview for the elderly (GMS): reliability studies comparing the Dutch language version with the original. International Journal of Geriatric Psychiatry, 6, 7179.
Kahn, H. A. & Sempos, C. T. (1989) Statistical Methods in Epidemiology. New York: Oxford University Press.
Kennedy, G. J., Kelman, H. R., Wisniewsky, W., et al (1989) Hierarchy of characteristics associated with depressive symptoms in an urban elderly sample. American Journal of Psychiatry, 146, 220225.
Murphy, E. (1982) Social origins of depression in old age. British Journal of Psychiatry, 141, 135142.
Pahkala, K., Kesti, E., Kongas-Saviaro, P., et al (1995) Prevalence of depression in an aged population in Finland. Social Psychiatry and Psychiatric Epidemiology, 30, 99106.
Prince, M., Harwood, R., Blizard, R., et al (1997a) Impairment, disability and handicap as risk factors for depression in old age. The Gospel Oak Project V. Psychological Medicine, 27, 311321.
Prince, M., Harwood, R., Blizard, R., et al (1997b) Social support deficits, loneliness and life events as risk factors for depression in old age. The Gospel Oak Project VI. Psychological Medicine, 27, 323332.
Saunders, P. A., Copeland, J. R. M., Dewey, M. E., et al (1991) Heavy drinking as a risk factor for depression and dementia in elderly men. Findings from the Liverpool Longitudinal Community Study. British Journal of Psychiatry, 159, 213216.
Saunders, P. A., Copeland, J. R. M., Dewey, M. E., et al (1993) The prevalence of dementia, depression and neurosis in later life: the Liverpool MRC–ALPHA Study. International Journal of Epidemiology, 22, 838847.
Sharma, V. I., Copeland, J. R. M., Dewey;, M. E., et al (1998) Outcome of the depressed and elderly living in the community in Liverpool: a five year follow-up. Psychological Medicine, 28, 13291337.
Wenger, G. C. (1991) A network typology: from theory to practice. Journal of Ageing Studies, 5, 147162.

Community-based case–control study of depression in older people: Cases and sub-cases from the MRC–ALPHA study

  • J. R. M. Copeland (a1), Ruoling Chen (a1), Michael Dewey (a2), C. F. M. McCracken (a1), Chris Gilmore (a3), B. Larkin (a4) and K. C. M. Wilson (a5)...

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed

Community-based case–control study of depression in older people: Cases and sub-cases from the MRC–ALPHA study

  • J. R. M. Copeland (a1), Ruoling Chen (a1), Michael Dewey (a2), C. F. M. McCracken (a1), Chris Gilmore (a3), B. Larkin (a4) and K. C. M. Wilson (a5)...
Submit a response

eLetters

No eLetters have been published for this article.

×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *