Depression in the elderly community: II. Outcome in a 4.5 years follow-up

Abstract

-Background and Objectives:In this study, we test to what extent negative outcomes of depression reported in different countries may be confirmed in a Southern European population.Methods: This is a follow-up (mean 4.5 years) of the elderly sample interviewed in the baseline of the Zaragoza Study (or ZARADEMP 0). The general methodology is described in the previous paper. The same two-phase procedure completed at baseline was also implemented at follow-up and the same standardized instruments were used. Cases of depression at follow-up were diagnosed with AGECAT criteria. Operational criteria were also used for definition of both "incident case of depression" and "chronic case of depression".Results: Six hundred and sixty three elderly (61.4%) were reassessed at follow-up, and 216 died in the follow-up period. A negative outcome of both, major and minor depression was observed. Taken together, the pessimistic outcome (death, chronicity or conversion to other psychiatric diagnosis) was observed in 70.5% of cases of depression, but only in 30.8% of "non-cases", the differences being statistically significant (Z = 6.7; p < 0.001). Similarly, a high proportion of subcases of depression had a negative prognosis (48.5%), the differences with "non-cases" also being statistically significant (Z = 2.7; p < 0.005).Incidence rate of depression was 14.4 (95% C.I.: 11.0-18.6) the rate being significantly higher in women when compared to men.Conclusions: This is the first report of a negative outcome of depression in a representative sample of the elderly in a Southern European city. Subcases of depression also had a negative outcome. The clinical significance in AGECAT cases of depression is emphasized.

Evidence of depression affecting multimorbidity in survey data from the Brazilian population

“…It has been shown that the direction of this association seems to run from multimorbidity to depression 4,5 . As individuals age, they tend to become alone, losing friends and family members, which renders them susceptible to depressive symptoms 6 . Furthermore, with age they are subject to brain vascular injury due to hypertension, diabetes mellitus, obesity, and high blood cholesterol 7 .…”

Avaliação geriátrica global dos idosos mais velhos residentes em Ribeirão Preto (SP) e Caxias do Sul (RS): indicadores para envelhecimento longevo

“…O número de sintomas depressivos não foi significativamente maior nos diferentes grupos etários avaliados, seja em RP ou CS, o que corrobora com os achados de Morais (2007) num estudo com idosos longevos no RS. Entretanto, outros autores verificaram que a idade está positivamente associada a um aumento de sintomas depressivos entre idosos em geral, tanto em estudos nacionais (GAZALLE et al, 2004;CASTRO-COSTA et al, 2008), quanto internacionais (WEYERER et al, 2008;CAMARA et al, 2008).…”

“…Os autores verificaram ainda que houve uma associação significativa entre depressão e baixo nível educacional, ser viúvo ou morar sozinho. Camara et al (2008) avaliaram os desfechos negativos da depressão num estudo de coorte com idosos espanhóis (idade média = 78 anos) e evidenciaram que 70% dos casos de depressão, seja leve ou severa, evoluíram para a morte, cronicidade ou conversão para outros diagnósticos psiquiátricos, contra 31% dos não casos.…”