The Association of Depression and Multimorbidity in the Elderly: Implications for the Assessment of Depression

Psychogeriatrics. 2011 Dec;11(4):227-34. doi: 10.1111/j.1479-8301.2011.00375.x. Epub 2011 Oct 27.


Background: Depression and multimorbidity are common in the elderly. Assessing depression might be difficult because of the overlap of depressive and somatic symptoms, possibly leading to confounded results.

Methods: This study investigates the frequency of depression, multimorbidity and their association, the potential impact of multimorbidity on the assessment of depression by the Patient Health Questionnaire, and whether using a cut point might cause misleading results in the elderly German population (60-85 years, n= 1659).

Results: Depressive syndromes are significantly more frequent in multimorbid respondents. Multimorbidity is associated with higher item scores, especially in the somatic items, and multimorbid respondents show higher depression severity levels in comparison to non-multimorbid persons.

Conclusion: There are associations between multimorbidity and depressive symptoms, therefore potentially confounding prevalence rates. As such, causal pathways of these associations should be studied under a longitudinal perspective in future studies.

MeSH terms

  • Age Distribution
  • Aged
  • Aged, 80 and over
  • Analysis of Variance
  • Comorbidity
  • Cross-Sectional Studies
  • Depressive Disorder / diagnosis*
  • Depressive Disorder / epidemiology*
  • Diagnosis, Differential
  • Female
  • Geriatric Assessment / methods*
  • Geriatric Assessment / statistics & numerical data
  • Germany / epidemiology
  • Health Status
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Prevalence
  • Psychophysiologic Disorders / diagnosis*
  • Psychophysiologic Disorders / epidemiology*
  • Quality of Life
  • Severity of Illness Index
  • Sex Distribution
  • Surveys and Questionnaires