An Epidemiological Approach to Depression Prevention in Old Age

Smits, Filip; Smits, Niels; Schoevers, Robert A.; Deeg, Dorly J. H.; Beekman, Aartjan T.F.; Cuijpers, Pim

doi:10.1097/jgp.0b013e3181662ab6

Cited by 66 publications

(42 citation statements)

References 38 publications

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“…In contrast, our persistence findings are lower than the Longitudinal Aging Study Amsterdam, which found that 49% of the sample had chronic depression after 3 years (8) and that after 6 years 32% had a chronic mood disorder (30) and 23% had a chronic anxiety disorder (11). Together, our study and these previous surveys of chronic disorders among older samples suggests that the prevalence of persistent disorders ranges from 16% to 49% after 1 to 6 years of follow-up.…”

Section: Discussioncontrasting

confidence: 98%

“…Although it is not surprising that disorder severity and complexity is associated with greater chronicity, our study adds to a large body of evidence indicating the strong effect of comorbid mental and physical health problems on persistence (8, 9, 15, 32–34). Although our finding that lifetime treatment seeking was associated with greater persistence at first appears counter-intuitive, this finding has been reported elsewhere (12, 33) and likely reflects that treatment seeking samples have more severe mental health presentations (29).…”

Section: Discussionmentioning

confidence: 70%

“…This information is important for two reasons. First, persistent disorders and sociodemographic characteristics associated with chronic mental health problems are sensible targets for treatment, prevention, and mental health promotion initiatives (8). Second, research focusing on persistence in the general adult population may not generalize to older adults, so that specific information pertaining to older community dwelling adults is needed.…”

mentioning

confidence: 99%

“…With respect to predictors and correlates of persistent disorders among older adults, research focusing on depression suggests the following risk factors: more severe depression at baseline, comorbid physical and mental health problems, functional limitations, poor social support, and having an external locus of control (8, 9, 13–15). Very few sociodemographic predictors have emerged from this research, although there is some suggestion that female gender (16) and older age (9) increase the risk of persistence.…”

mentioning

confidence: 99%

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Prevalence and Predictors of Persistent Versus Remitting Mood, Anxiety, and Substance Disorders in a National Sample of Older Adults

Mackenzie

El‐Gabalawy

Chou

et al. 2014

The American Journal of Geriatric Psychiatry

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Objectives Relatively little is known about whether mental disorders other than depression remit versus persist in later life, especially within nationally representative samples. Our objectives were to examine the prevalence of persistent mood, anxiety, and substance disorders in older adults, and to explore a range of physical and mental health predictors of disorder chronicity. Methods This study utilized a three-year follow-up design using Waves 1 (2001/2002) and 2 (2004/2005) of the National Epidemiologic Survey of Alcohol and Related Conditions (NESARC). Participants included 1,994 adults 55+ who had a past-year mental disorder at Wave 1 and who completed Wave 2. The primary outcome was the prevalence of persistent mood, anxiety, and substance disorders at Wave 2. Potential predictors of persistence included sociodemographic variables, physical health (chronic health conditions and physical health-related quality of life), and mental health (childhood adversity, suicide attempts, mental health-related quality of life, comorbid mental disorders, personality disorders, and lifetime treatment seeking). Results With the exception of nicotine dependence, the prevalence of persistent mood, anxiety, and substance disorders ranged from 13% to 33%. Only younger age predicted substance disorder chronicity. Significant predictors of persistent mood and anxiety disorders included physical and mental health comorbidity, physical and mental health-related quality of life, suicide attempts, comorbid personality disorders, and treatment seeking. Conclusions At least two thirds of mental disorders in older adults were not persistent. Sociodemographic variables had little influence on chronicity, whereas a number of markers of mental disorder severity and complexity predicted persistent mood and anxiety disorders. The findings have important treatment and prevention implications.

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Section: Discussioncontrasting

confidence: 98%

Section: Discussionmentioning

confidence: 70%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Prevalence and Predictors of Persistent Versus Remitting Mood, Anxiety, and Substance Disorders in a National Sample of Older Adults

Mackenzie

El‐Gabalawy

Chou

et al. 2014

The American Journal of Geriatric Psychiatry

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“…Major depression (MD) or major depressive disorder (MDD) is a leading cause of morbidity and mortality in the elderly, with an estimated prevalence of 7% of the general elderly population and it accounts for 1.6% of total disability among over 60 year olds (Institute for Health Metrics and Evaluation, 2010). If left untreated, there is evidence of an increased risk of physical and psychological morbidity and mortality, with an associated economic and societal burden (Gould et al, 2012;Lockwood et al, 2004;Smits et al, 2008). At its worst, depression can lead to suicide, highlighted by the loss of 1 million people every year worldwide (World Health Organization, 2012).…”

Section: Introductionmentioning

confidence: 98%