Major depression in community-dwelling middle-aged and older adults: prevalence and 2- and 4-year follow-up symptoms

Psychol Med. 2004 May;34(4):623-34. doi: 10.1017/S0033291703001764.

Abstract

Background: Although major depression is a common condition across the age range, there is some evidence from clinical studies that it may be more persistent and disabling in older adults. This study examined the demographic, socio-economic and clinical factors associated with major depression and with persistence of depressive symptoms at 2- and 4-year follow-ups in a large population sample of middle-aged and older adults.

Method: In a sample of 9747 participants aged over 50 in the 1996 wave of the US Health and Retirement Study, the authors assessed the 12-month prevalence of major depression using the Composite International Diagnostic Interview-Short Form (CIDI-SF). Significant depressive symptoms at the time of 1996, 1998 and 2000 interviews were assessed using a short form of the Center for Epidemiological Studies Depression Scale (CES-D).

Results: The 12-month prevalence of CIDI-SF major depression was 6.6%. With age, prevalence declined, but the likelihood of significant depressive symptoms at follow-ups increased. Both prevalence and persistence of significant depressive symptoms at follow-ups were associated with socio-economic disadvantage and physical illness. Persistence of depressive symptoms at follow-ups was also associated with symptoms of anhedonia, feelings of worthlessness, and thoughts of death at baseline.

Conclusions: Sociodemographic, physical health and a specific profile of depressive symptoms are associated with a poorer course of major depression in the middle-aged and older adults. These indicators may identify a subgroup of patients in need of more careful follow-up and intensive treatment.

Publication types

  • Comparative Study
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Age Factors
  • Aged
  • Depressive Disorder, Major / epidemiology*
  • Depressive Disorder, Major / ethnology
  • Female
  • Follow-Up Studies
  • Health Status
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Prevalence
  • Residence Characteristics* / statistics & numerical data
  • Sex Factors
  • Socioeconomic Factors
  • Time Factors
  • United States / epidemiology