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Studying birth-cohort differences in depression incidence and their explanatory factors may provide insight into the aetiology of depression and could help to optimise prevention strategies to reduce the worldwide burden of depression.
Data were used from the Longitudinal Aging Study Amsterdam, a nationally representative study among community dwelling older adults in the Netherlands. Cohort differences in depression incidence over a 10-year-period (score ⩾16 on the Center for Epidemiologic Studies Depression scale) were tested using a cohort-sequential-longitudinal-design, comparing two identically measured cohorts of non-depressed 55–64-year-olds, born 10-years apart. Baseline measurements took place in 1992/93 (early cohort, n = 794), and 2002/03 (recent cohort, n = 771). As indicated by the dynamic equilibrium model of depression, potential explanatory factors were distinguished in risk and protective factors.
The incidence rates for depression in the early and recent cohort were 1.91 (95% confidence interval (CI) 1.59–2.27) and 1.60 (95% CI 1.31–1.94) per 100 person-years, respectively. A 29% risk reduction in depression incidence was observed in the recent cohort (HRcohort: 0.71, 95% CI 0.54–0.92, p = 0.011), as compared with the early cohort, even though average levels of risk factors such as chronic disease and functional limitations had increased. This reduction was primarily explained by increased levels of education, mastery and labour market participation.
These findings suggest that favourable developments of protective factors have counterbalanced unfavourable effects of risk factors on the incidence of depression, resulting in a net reduction of depression incidence among young-old adults. However, maintaining a good physical health must be a priority to further decrease depression rates.
Comorbid anxiety disorders are common in late-life depression and negatively
impact treatment outcome. This study aimed to examine personality
characteristics as well as early and recent life-events as possible
determinants of comorbid anxiety disorders in late-life depression, taking
previously examined determinants into account.
Using the Composite International Diagnostic Interview (CIDI 2.0), we
established comorbid anxiety disorders (social phobia (SP), panic disorder
(PD), generalized anxiety disorder (GAD), and agoraphobia (AGO)) in 350
patients (aged ≥60 years) suffering from a major depressive
disorder according to DSM-IV-TR criteria within the past six months.
Adjusted for age, sex, and level of education, we first examined previously
identified determinants of anxious depression: depression severity,
suicidality, partner status, loneliness, chronic diseases, and gait speed in
multiple logistic regression models. Subsequently, associations were
explored with the big five personality characteristics as well as early and
recent life-events. First, multiple logistic regression analyses were
conducted with the presence of any anxiety disorder (yes/no) as dependent
variable, where after analyses were repeated for each anxiety disorder,
In our sample, the prevalence rate of comorbid anxiety disorders in late-life
depression was 38.6%. Determinants of comorbid anxiety disorders were a
lower age, female sex, less education, higher depression severity, early
traumatization, neuroticism, extraversion, and conscientiousness.
Nonetheless, determinants differed across the specific anxiety disorders and
lumping all anxiety disorder together masked some determinants (education,
Our findings stress the need to examine determinants of comorbid anxiety
disorder for specific anxiety disorders separately, enabling the development
of targeted interventions within subgroups of depressed patients.
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