The prognosis of depression in old age

Article Abstract:

Despite its prevalence in old age, little is known about depression among the elderly. Research findings have been inconclusive and in some cases contradictory. Some have shown specific treatment effects, while others have shown that treatment has no overall bearing on prognosis. Factors affecting outcome are thought to include severity of initial illness and physical health. Thirty-seven men and 66 women, aged 60-69 years, met the criteria for major depressive illness as listed in the Diagnostic and Statistical Manual of Mental Disorders, third edition. Fifty-four percent had a prior history of depression and 38 percent reported at least one severe life event in the 12 months prior to the onset of depression. Twenty-four percent of these cases reported that the serious life event(s) occurred within the prior three months. Subjects were assessed to identify psychiatric and physical disability, pre-illness level of functioning, and demographic characteristics. After 12 months, outcome with respect to original illness was measured on the basis of two sets of criteria from other studies. It was found that the 12-month outcome was not nearly as poor as some other prognoses have suggested. Part of the difference was attributed to using more precise criteria in the present study. There is a high incidence of chronic symptoms, recurrence, or death when compared with the experience of depression in the general population, but it should be noted that the incidence of depression in old age is similar to that of the young. It was found that treatment affects outcome: aggressive treatment with planned aftercare yielded best prognosis. Prognostic risk factors were not found, although the small sample size may have precluded the identification of such relationships. Those whose severe life event was within the three months preceding the depression tended to have a better prognosis, and there was a strong relationship between severe, acute physical illness and death during the 12 months after display of depressive symptoms. (Consumer Summary produced by Reliance Medical Information, Inc.)

Aged, Elderly, Methods, Prognosis, Depression in old age, Geriatric depression

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A comparison of early-onset and late-onset depressive illness in the elderly

Article Abstract:

Early-onset depression is defined by a first episode of major depression occurring before age 60. In order to evaluate the differences between early- and late-onset depression, 103 consecutively treated depressive patients over age 60 were studied. The patients and a group of 85 nondepressed, healthy comparison subjects (controls) matched for age and sex were given a battery of tests to assess depression, mental status, personality, family history of psychiatric illness, physical health, major life events and social support. In the patient group, there were 52 early-onset depressives and 50 late-onset depressives with a fairly equal distribution between the sexes. Almost half of the late-onset patients had had a previous attack of depression. More late-onset depressives (44 percent) had experienced a severe, distressing life event in the year prior to the onset of depression than early-onset depressives (31 percent). No differences in degree of neuroticism were found between the two types of depressives, although both groups had significantly higher neuroticism scores than controls. Early-onset depressives were significantly more introverted than controls. Seventy-seven percent of the early-onset depressives had premorbid anxiety traits (existing before the onset of illness), while only 47 percent of the late-onset depressives did. Early-onset depressives were also more severely depressed than the late-onset group. Contrary to expectations, the occurrence or chronicity of physical illness and the majority of variables being studied were not significant predictors of either type of depression. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Demographic aspects, Mentally ill aged, Mentally ill elderly

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Heavy drinking as a risk factor for depression and dementia in elderly men: findings from the Liverpool Longitudinal Community Study

Article Abstract:

It is common to see patients with both alcohol problems and psychiatric symptoms, but the long-term consequences of alcohol consumption on mental health have not been addressed in the literature. It is also difficult to study the relationship between alcohol consumption and psychiatric illness because the effects of current alcohol abuse are sometimes hard to distinguish from psychiatric symptoms. Whether or not alcohol contributes to dementia is another issue of debate. Although a number of studies have found that cognitive changes are associated with heavy alcohol use, many argue that the changes reverse with abstinence. In the present study, data from a three-year longitudinal survey were gathered for 1,070 subjects aged 65 years and over. At three-year follow-up, 701 of the subjects were re-interviewed. Of the men in the sample, 9 percent had a history of heavy drinking, and 0.5 percent of women had a history of heavy drinking. Only the men were used for further analysis because of the small number of women with a history of heavy drinking. Forty-four percent of those with histories of heavy drinking were given a psychiatric diagnosis, mostly depression, compared with 12 percent of men with no such history. Sixteen percent of heavy drinkers showed signs of dementia compared with only 3.9 percent of men without a history of heavy drinking. Controlling for current drinking habits, the relationship still held. Heavy alcohol consumption earlier in life was associated with the development of psychiatric illness in the men in this study. (Consumer Summary produced by Reliance Medical Information, Inc.)

Alcoholism, Aged men, Elderly men

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