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Risk factors of major depression in the elderly

Published online by Cambridge University Press:  16 April 2020

Reinhard Heun  and
Sandra Hein
Reinhard Heun*
Affiliation:
Department of Psychiatry, University of Bonn, Venusberg, 53105Bonn, Germany
Sandra Hein
Affiliation:
Department of Psychiatry, University of Bonn, Venusberg, 53105Bonn, Germany
*
*Corresponding author. Tel.: +44 1325 743 779; fax: +44 1325 383 548. E-mail address: reinhard.heun@cddps.northy.nhs.uk (R. Heun).
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Abstract

Background

Several risk factors of depression have been identified in retrospective as well as some prospective studies in the elderly. Confirmation in independent samples is needed. The present follow-up study prospectively investigated risk factors of depression in an elderly German sample.

Methods

One thousand four hundred and thirty-one subjects from a family study were re-investigated after 4.7 ± 2.5 years. Bivariate and multivariate forward logistic regression analyses were used to identify risk factors of the development of new depression in the elderly.

Results

Risk factors of a new depressive episode in 1408 elderly without current depression were age, female gender, a previous depression, subjective memory impairment, previous anxiety and somatoform disorders. The presence of dementia or mild cognitive impairment were significant risk factors in bivariate, but not multivariate analysis controlling for possible confounding. Risk factors of a first geriatric depressive episode were age, gender and subjective memory impairment; age remained the only significant risk factor in multivariate analysis.

Conclusions

This investigation confirms previous studies from other countries concerning the relevance of risk factors for depression in the elderly. The knowledge of risk factors might help identify subjects at increased risk of depression for early intervention approaches. Elderly with a history of previous depression carry the highest risk.

Keywords

Major depressionRisk factorsElderlyMemory impairmentDementia
Type
Original article
Information
European Psychiatry , Volume 20 , Issue 3 , May 2005 , pp. 199 - 204
Copyright
Copyright © Elsevier SAS 2005

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References

Aalto-Setala, T, Marttunen, M, Tuulio-Henriksson, A, Poikolainen, K, Lonnqvist, JDepressive symptoms in adolescence as predictors of early adulthood depressive disorders and maladjustment. Am. J Psychiatry 2002;159(7):1235–1237.CrossRefGoogle ScholarPubMed
American Psychiatric Association Diagnostic and statistical manual of mental disorders. 3rd ed. rev. Washington DC: American Psychiatric Association; 1987.Google Scholar
Andreasen, NC, Endicott, J, Spitzer, RL, Winokur, GThe family history method using diagnostic criteria. Reliability and validity. Arch Gen Psychiatry 1977;34(10):1229–1235.CrossRefGoogle ScholarPubMed
Ballard, CG, Cassidy, G, Bannister, C, Mohan, RNCPrevalence, symptom profile, and aetiology of depression in dementia sufferers. J Affect Disord 1993;29:1–6.CrossRefGoogle ScholarPubMed
Barkow, K, Heun, R, Ustun, TB, Maier, WIdentification of items which predict later development of depression in primary health care. Eur Arch Psychiatry Clin Neurosci 2001;251(2):21–26.CrossRefGoogle ScholarPubMed
Barkow, K, Maier, W, Üstün, TB, Gänsicke, M, Wittchen, HU, Heun, RRisk factors for new depressive episodes in primary health care: an international prospective 12-month follow-up study. Psychol Med 2002;32:595–607.CrossRefGoogle ScholarPubMed
Beekman, AT, Deeg, DJ, Geerlings, SW, Schoevers, RA, Smit, JH, Van Tilburg, WEmergence and persistence of late life depression: a 3-year follow-up of the Longitudinal Aging Study Amsterdam. J Affect Disord 2001;65(2):131–138.CrossRefGoogle ScholarPubMed
Berger, AK, Small, BJ, Forsell, Y, Winblad, B, Backman, LPreclinical symptoms of major depression in the very old age: a prospective longitudinal study. Am J Psychiatry 1998;155(8):1039–1043.CrossRefGoogle ScholarPubMed
Berger, AK, Fratiglioni, L, Forsell, Y, Winblad, B, Backman, LThe occurrence of depressive symptoms in the preclinical phase of AD: a population-based study. Neurology 1999;53(9):1998–2002.CrossRefGoogle ScholarPubMed
Blazer, D, Burchett, B, Service, C, George, LKThe association of age and depression among the elderly: an epidemiologic exploration. J Gerontol 1991;46(6):M210–M215.CrossRefGoogle ScholarPubMed
Breslau, N, Kilbey, MM, Andreski, PNicotine dependence and major depression. New evidence from a prospective investigation. Arch Gen Psychiatry 1993;50(1):31–35.CrossRefGoogle ScholarPubMed
Breslau, N, Schultz, L, Peterson, ESex differences in depression: a role for preexisting anxiety. Psychiatry Res 1995;58:1–2.CrossRefGoogle ScholarPubMed
Charney, DS, Reynolds, CF, Lewis, L, Lebowitz, BD, Sunderland, T, Alexopoulos, GSet al.Depression and bipolar support alliance. Depression and bipolar support alliance consensus statement on the unmet needs in diagnosis and treatment of mood disorders in late life. 3rd Arch Gen Psychiatry 2003;60(7):664–672.CrossRefGoogle ScholarPubMed
Copeland, JR, Davidson, IA, Dewey, ME, Gilmore, C, Larkin, BA, McWilliam, Cet al.Alzheimer’s disease, other dementias, depression and pseudodementia: prevalence, incidence and 3-year outcome in Liverpool. Br J Psychiatry 1992;161:230–239.CrossRefGoogle Scholar
Copeland, JR, Beekman, AT, Dewey, ME, Jordan, A, Lawlor, BA, Linden, Met al.Cross-cultural comparison of depressive symptoms in Europe does not support stereotypes of ageing. Br J Psychiatry 1999;174:322–329.CrossRefGoogle Scholar
Coryell, W, Endicott, J, Keller, MMajor depression in a nonclinical sample. Demographic and clinical risk factors for first onset. Arch Gen Psychiatry 1992;49(2):117–125.CrossRefGoogle Scholar
Coryell, W, Winokur, G, Keller, M, Scheftner, W, Endicott, JAlcoholism and primary major depression: a family study approach to co-existing disorders. J Affect Disord 1992;24(2):93–99.CrossRefGoogle ScholarPubMed
Crum, RM, Cooper-Patrick, L, Ford, DEDepressive symptoms among general medical patients: prevalence and 1-year outcome. Psychsom Med 1994;56(2):109–117.CrossRefGoogle Scholar
Dufouil, C, Fuhrer, R, Dartigues, JF, Alperovitch, ALongitudinal analysis of the association between depressive symptomatology and cognitive detoriation. Am J Epidemiol 1996;144(7):634–641.CrossRefGoogle Scholar
Fava, M, Rankin, MA, Wright, EC, Alpert, JE, Nierenberg, AA, Pava, Jet al.Anxiety disorders in major depression. Compr Psychiatry 2000;41(2):97–102.CrossRefGoogle ScholarPubMed
Fichter, MM, Bruce, ML, Schröppel, H, Meller, I, Merikangas, KCognitive impairment and depression in the oldest old in a German and in US communities. Eur Arch Psychiatry Clin Neurosci 1995;245:319–325.CrossRefGoogle Scholar
Flint, AJEpidemiology and comorbidity of anxiety disorders in the elderly. Am J Psychiatry 1994;151:640–649.Google ScholarPubMed
Folstein, MF, Folstein, SE, McHugh, PR“Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975;12(3):189–198.CrossRefGoogle ScholarPubMed
Ford, DE, Cooper-Patrick, LSleep disturbances and mood disorders: an epidemiologic perspective. Depress Anxiety 2001;14:3–6.CrossRefGoogle Scholar
Fuhrer, R, Antonucci, M, Gagnon, M, Dartigues, JF, Barberger-Gateau, P, Alperovitch, ADepressive symptomatology and cognitive functioning: an epidemiological survey in an elderly community sample in France. Psychol Med 1992;22:159–172.CrossRefGoogle Scholar
Gater, R, Tansella, M, Korten, A, Tiemens, BG, Mavreas, VG, Olatawura, MOSex differences in the prevalence and detection of depressive and anxiety disorders in general health care settings. Arch Gen Psychiatry 1998;55:405–413.CrossRefGoogle ScholarPubMed
Hammen, CLive events and depression: the plot thickens. Am J Community Psychol 1992;20(2):179–193.CrossRefGoogle Scholar
Harlow, BL, Cohen, LS, Otto, MW, Spiegelman, D, Cramer, DWPrevalence and predictors of depressive symptoms in older premenopausal women: the Harvard Study of Moods and Cycles. Arch Gen Psychiatry 1999;56(5):418–424.CrossRefGoogle ScholarPubMed
Henderson, AS, Jorm, AF, Mackinnon, A, Christensen, H, Scott, LR, Korten, AEet al.The prevalence of depressive disorders and the distribution of depressive symptoms in later life: a survey using Draft ICD-10 and DSM-III-R. Psychol Med 1993;23:719–729.CrossRefGoogle ScholarPubMed
Heun, R, Muller, HInterinformant reliability of family history information on psychiatric disorders in relatives. Eur Arch Psychiatry Clin Neurosci 1998;248(2):104–109.CrossRefGoogle ScholarPubMed
Heun, R, Burkart, M, Maier, WSelection biases during recruitment of patients and relatives for a family study in the elderly. J Psychiatry Res 1995;29(6):491–504.CrossRefGoogle ScholarPubMed
Heun, R, Hardt, J, Burkart, M, Maier, WValidity of the family history method in relatives of gerontopsychiatric patients. Psychiatry Res 1996;62(3):227–238.CrossRefGoogle ScholarPubMed
Heun, R, Muller, H, Papassotiropoulos, ADifferential validity of informant-based diagnoses of dementia and depression in index subjects and in their first degree relatives. Soc Psychiatry Psychiatr Epidemiol 1998;33(10):510–513.CrossRefGoogle ScholarPubMed
Heun, R, Papassotiropoulos, A, Jessen, F, Maier, W, Breitner, JCSA family study of Alzheimer’s disease and early-onset and late-onset depression in elderly patients. Arch Gen Psychiatry 2001;58(2):190–196.CrossRefGoogle Scholar
Husaini, BAPredictors of depression among the elderly: racial differences over time. Am J Orthopsychiatr 1997;67(1):48–58.CrossRefGoogle ScholarPubMed
Judd, LLSocial phobia: a clinical overview. J Clin Psychiatry 1994;55:5–9.Google ScholarPubMed
Judd, LL, Akiskal, HS, Paulus, MPThe role and clinical significance of subsyndromal depressive symptoms (SSD) in unipolar major depressive disorder. J Affect Disord 1997;45(1–2):17–18.CrossRefGoogle Scholar
Kendler, KS, Thornton, LM, Gardner, COGenetic risk, number of previous depressive episodes, and stressful life events predicting onset of major depression. Am J Psychiatry 2001;158(4):582–586.CrossRefGoogle ScholarPubMed
Kennedy, GJ, Kelman, HR, Thomas, C, Wisniewski, W, Metz, H, Bijur, PEHierarchy of characteristics associated with depressive symptoms in an urban elderly sample. Am J Psychiatry 1989;146(2):220–225.Google Scholar
Kennedy, GJ, Kelman, HR, Thomas, CThe emergence of depressive symptoms in late life: the importance of declining health and increasing disability. J. Community Health 1990;15(2):93–104.CrossRefGoogle ScholarPubMed
Kessler, RC, McGonagle, KA, Nelson, CB, Hughes, M, Swartz, M, Blazer, DGSex and depression in the National Comorbidity Survey. II: Cohort effects. J Affect Disord 1994;30:15–26.CrossRefGoogle ScholarPubMed
Kivelä, SL, Kongas-Saviaro, P, Laippala, P, Pahkala, K, Kesti, ESocial and psychosocial factors predicting depression in old age: a longitudinal study. Int Psychogeriatr 1996;8(4):635–644.CrossRefGoogle Scholar
Leckman, JF, Sholomskas, D, Thompson, WD, Belanger, A, Weissman, MMBest estimate of lifetime psychiatric diagnoses: a methodological study. Arch Gen Psychiatry 1982;39(8):879–883.CrossRefGoogle ScholarPubMed
Lehtinen, V, Joukamaa, MEpidemiology of depression: prevalence, risk factors and treatment situation. Acta Psychiatr Scand 1994;377:7–10.CrossRefGoogle ScholarPubMed
Lichtenberg, PA, Ross, T, Millis, SR, Manning, CAThe relationship between depression and cognition in older adults: a cross-validation study. J Gerontol 1995;50(1):5–32.Google ScholarPubMed
Lieb, R, Isensee, B, Hofler, M, Pfister, H, Wittchen, HUParental major depression and the risk of depression and other mental disorders in the offspring: a prospective-longitudinal community study. Arch Gen Psychiatry 2002;59(4):365–374.CrossRefGoogle ScholarPubMed
Lindeman, S, Kaprio, J, Isometsa, E, Poikplainen, K, Heikkinen, M, Hamalainen, Jet al.Spousal resemblance for history of major depressive episode in the previous year. Psychol Med 2002;32(2):363–367.CrossRefGoogle ScholarPubMed
Livingston, G, Blizard, B, Mann, ADoes sleep disturbance predict depression in elderly people? A study in inner London. Br J Gen Pract 433821993 236Google ScholarPubMed
Maier, WOnset and course of affective disorders in subjects at risk: a prospective family study. Psychiatr Annu 1996;26(6):315–319.CrossRefGoogle Scholar
Maier, W, Lichtermann, D, Minges, J, Heun, R, Hallmayer, J, Klingler, TUnipolar depression in the aged: determinants of familial aggregation. J Affect Disord 1991;23(2):53–61.CrossRefGoogle ScholarPubMed
Meller, I, Fichter, MM, Schropel, HRisk factors and psychosocial consequences in depression of octo- and nonagenerians: results of an epidemiological study. Eur Arch Psychiatry Clin Neurosci 1997;247(5):278–287.CrossRefGoogle ScholarPubMed
Prigerson, HG, Reynolds, CF, Frank, E, Kupfer, DJ, George, CJ, Houck, PRStressful life events, social rhythms, and depressive symptoms among the elderly: an examination of hypothesized causal linkages. Psychiatry Res 3rd 1994;51(1):33–49.CrossRefGoogle ScholarPubMed
Prince, MJ, Harwood, RH, Blizard, RA, Thomas, A, Mann, AHSocial support deficits, loneliness and life events as risk factors for depression in old age. The Gospel Oak Project VI. Psychol Med 1997;27(2):323–332.CrossRefGoogle ScholarPubMed
Prince, MJ, Harwood, RH, Thomas, A, Mann, AHA prospective population-based cohort study of the effects of disablement and social milieu on the onset and maintenance of late-life depression. The Gospel Oak Project VII. Psychol Med 1998;28(2):337–350.CrossRefGoogle ScholarPubMed
Prince, MJ, Beekman, ATF, Deeg, DLH, Fuhrer, R, Kivela, SL, Lawlor, BAet al.Depression symptoms in late life assessed using the EURO-D scale. Br J Psychiatry 1999;174:339–345.CrossRefGoogle ScholarPubMed
Ptok, U, Seeher, C, Jessen, F, Papassotiropoulos, A, Heun, RInter-rater reliability of family-history information on psychiatric disorders in relatives. Eur Arch Psychiatry Clin Neurosci 2001;251(6):279–283.CrossRefGoogle ScholarPubMed
Roberts, RE, Kaplan, GA, Shema, SJ, Strawbridge, WJDoes growing old increase the risk for depression?. Am J Psychiatry 1997;154:1384–1390.Google ScholarPubMed
Roberts, RE, Kaplan, GA, Shema, SJ, Strawbridge, WJPrevalence and correlates of depression in an aging cohort: The Almeda County Study. J Gerontol 1997;52b(5):252–258.CrossRefGoogle Scholar
Salokangas, RKR, Poutanen, ORisk factors for depression in primary care. Findings of the TADEP project. J Affect Disord 1998;48:171–180.CrossRefGoogle ScholarPubMed
Schoevers, RA, Beekman, AT, Deeg, DJ, Geerlings, MI, Jonker, C, Van Tilburg, WRisk factors for depression in later life; results of a prospective community based study (AMSTEL). J Affect Disord 2000;59(2):127–137.CrossRefGoogle Scholar
Sherbourne, CD, Wells, KB, Hays, RD, Rogers, W, Burnam, MA, Judd, LLSubthreshold depression and depressive disorder: clinical characteristics of general medical and mental health speciality outpatients. Am J Psychiatry 1994;151:1777–1784.Google Scholar
Small, GW, Chen, ST, Komo, S, Ercoli, L, Miller, K, Siddarth, Pet al.Memory self-appraisal and depressive symptoms in people at genetic risk for Alzheimer’s disease. Int J Geriatr. Psychiatry 2001;16(11):1071–1077.CrossRefGoogle ScholarPubMed
Steffens, DC, Skoog, I, Norton, MC, Hart, AD, Tschanz, JT, Plassman, BLet al.Prevalence of depression and its treatment in an elderly population. Arch Gen Psychiatry 2000;57:601–607.CrossRefGoogle Scholar
Stein, MB, Fuetsch, M, Muller, N, Hofler, M, Lieb, R, Wittchen, HUSocial anxiety disorder and the risk of depression: a prospective community study of adolescents and young adults. Arch Gen Psychiatry 2001;58(3):251–256.CrossRefGoogle ScholarPubMed
Van Ojen, R, Hooijer, C, Bezemer, D, Jonker, C, Lindeboom, J, Van Tilburg, WLate-life depressive disorder in the community. Br J Psychiatry 1995;166:311–315.CrossRefGoogle Scholar
Wang, J, Patten, SBProspective study of frequent heavy alcohol abuse and the risk of major depression in the Canadian general population. Depress Anxiety 2002;15(1):42–45.CrossRefGoogle ScholarPubMed
Weyerer, S, Hafner, H, Mann, AH, Ames, D, Graham, NPrevalence and course of depression among elderly residential home admissions in Mannheim and Camden, London. Int Psychogeriatr 1995;7(4):479–493.CrossRefGoogle ScholarPubMed
World Health Organization Composite international diagnostic interview Geneva: World Health Organization, Division of Mental Health; 1990.Google Scholar
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