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Natural history of depression in the oldest old: Population-based prospective study

  • Max L. Stek (a1), David J. Vinkers (a2), Jacobijn Gussekloo (a2), Roos C. Van Der Mast (a3), Aartjan T. F. Beekman (a4) and Rudi G. J. Westendorp (a5)...

Abstract

Background

Despite its negative consequences, little is known about the natural history of depression in the oldest old.

Aims

To study the incidence, course and predictors of depression in the general population of the oldest old.

Method

The Leiden 85-plus Study is a prospective population-based study of 500 people from their 85th to their 89th birthdays. Depressive symptoms were annually assessed with the 15-item Geriatric Depression Scale, using a cut-off of 4 points.

Results

During a mean follow-up of 3.9 years, the annual risk for the emergence of depression was 6.8%. Poor daily functioning and institutionalisation predicted depression. Among the 77 participants with depression at baseline (prevalence 15%) the annual remission rate was ony 14%. In more than half of the participants with a remission of depression, we observed a relapse of depression during follow-up. No predictors of remission could be identified.

Conclusions

Among the oldest old, depression is frequent and highly persistent. More active case-finding and treatment would be potentially rewarding.

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Copyright

Corresponding author

Dr Max L. Stek, Leiden University Medical Centre, Section of Gerontology and Geriatrics, C2-R, PO Box 9600, 2300 RC Leiden, The Netherlands. Tel: +31 715266640; fax: +31 715248159; e-mail: m.l.stek@ggzba.nl

Footnotes

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Declaration of interest

None.

Footnotes

References

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American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM-111-R). Washington, DC: APA.
Beekman, A. T., Geerlings, S. W., Deeg, D. J., et al (2002) The natural history of late life depression: a 6-year prospective study in the community. Archives of General Psychiatry, 59, 605611.
Bootsma-van der Wiel, A., van Exel, E., de Craen, A. J. M., et al (2002) A high response is not essential to prevent selection bias: results from the Leiden 85-plus Study. Journal of Clinical Epidemiology, 55, 11191125.
Cole, M. G. & Dendukuri, N. (2003) Risk factors for depression among elderly community subjects: a systematic review and meta-analysis. American Journal of Psychiatry, 160, 11471157.
D'Ath, P., Katona, P., Mullan, E., et al (1994) Screening, detecting and management of depression in elderly primary care attenders. Family Practice, 11, 260266.
de Craen, A. J. M., Heeren, T. J. & Gussekloo, J. (2003) Accuracy of the 15-item Geriatric Depression Scale (GDS–15) in a community sample of the oldest old. International Journal of Geriatric Psychiatry, 18, 6366.
Folstein, M. F., Folstein, S. E. & McHugh, P. R. (1975) “Mini Mental State”: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189198.
Gallo, J. J., Rabins, P. V., Lyketsos, C. G., et al (1997) Depression without sadness: functional outcomes of nondysphoric depression in late life. Journal of the American Geriatric Society, 45, 570578.
Haynie, D. A., Berg, S., Johansson, B., et al (2001) Symptoms of depression in the oldest old: a longitudinal study. Journal of Gerontology Series B: Psychological Sciences and Social Sciences, 56, 111118.
Kempen, G. I., Miedema, I., Ormel, J., et al (1996) The assessment of disability with the Groningen Activity Restriction Scale. Conceptual framework and psychometric properties. Social Science and Medicine, 43, 16011610.
Lyness, M., Noel, T. K., Cox, C., et al (1997) Screening for depression in the elderly primary care patients. Archives of Internal Medicine, 157, 449454.
Meller, I., Fichter, M. M. & Schroppel, H. (1996) Incidence of depression in octo- and nonagenarians: results of an epidemiological follow-up community study. European Archives of Psychiatry and Clinical Neuroscience, 246, 9399.
Palsson, S., Ostling, S. & Skoog, I. (2001) The incidence of first-onset depression in a population followed from the age of 70 to 85. Psychological Medicine, 31, 11591168.
Pomeroy, I. M., Clark, C. R. & Philp, I. (2001) The effectiveness of very short scales for depression screening in elderly medical patients. International Journal of Geriatric Psychiatry, 16, 321326.
Shah, A., Psongsathorn, V., Bielawska, C., et al (1996) Screening for depression among geriatric inpatients with short versions of the geriatric depression scale. International Journal of Geriatric Psychiatry, 11, 915918.
Sheik, J. A. & Yesavage, J. A. (1986) Geriatric Depression Scale (GDS): recent findings and development of a shorter version. Clinical Gerontology, 37, 819820.
Stek, M. L., Gussekloo, J., Beekman, A. T. F., et al (2004) Prevalence, correlates and recognition of depression in the oldest old: The Leiden 85-plus study. Journal of Affective Disorders, 78, 193200.
Stek, M. L., Vinkers, D. J., Gussekloo, J., et al (2005) Is depression in old age fatal only when people feel lonely? American Journal of Psychiatry, 162, 178180.
Vinkers, D. J., Gussekloo, J., Stek, M. L., et al (2004a) The 15-item Geriatric Depression Scale (GSD-15) detects changes in depressive symptoms after a major negative life event. The Leiden 85-plus Study. International Journal of Geriatric Psychiatry, 19, 8084.
Vinkers, D. J., Gussekloo, J., Stek, M. L., et al (2004b) Temporal relationship between depression and cognitive impairment in old age: prospective population based study. BMJ, 329, 881.

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Natural history of depression in the oldest old: Population-based prospective study

  • Max L. Stek (a1), David J. Vinkers (a2), Jacobijn Gussekloo (a2), Roos C. Van Der Mast (a3), Aartjan T. F. Beekman (a4) and Rudi G. J. Westendorp (a5)...
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