Factors associated with recovery and recurrence of depression in older people: A prospective study

Abstract

SUMMARYThe Liverpool Continuing Health in the Community Study has followed up 1070 elderly community subjects over 6 years. In the first year 123 subjects had case-level depression. Three years later 49 (39.8%) of the previously depressed were recovered, 33 (26.8%) were depressed, 16 (13%) were not available for interview and 25 (20.3%) were dead. This study looks at factors associated with the 3-year outcome of patients who were depressed at year 0. Two outcome groups that were compared were a recovered depression group and a recurrent/persistent depression group. The factors that were significantly associated with a recurrence of depression (or persistent depression) at year 3 were bereavement of a close figure in the 6 months before interview, loneliness and life dissatisfaction at year 3. A variety of traditional risk factors for depression (including age, marital status, physical ill-health and incapacity) failed to attain significance in predicting recurrent or persistent depression. When combined, both recovered and recurrently depressed groups at year 3 had significantly higher levels of pain and a higher number of serious upsets in the past 6 months and 6 weeks compared to a control group. The depressed at year 0 were more likely to have entered more dependent forms of accommodation by year 3.

Drug treatment of older people with affective disorders in the community: lessons from an attempted clinical trial

“…This may be related to undertreatment, as the two studies which reported the number of depressed people taking antidepressants both found very low rates (2/123, Green et al, 1994;and 11%, Livingston et al, 1997). Many older people living at home with anxiety and depression do not receive treatment for these disorders and do not improve with time alone.…”

Marital Status, Self-Rated Health, and Mortality

“…These pathways may be especially useful to maintain good levels of health and reduce the likelihood of health's deteriorating more so than influencing recovery once the level of health is more severe. Being married did not significantly influence one-year recovery from a state of exhaustion among older adults (Whitson et al 2011) or the recovery or recurrence of depression over three years among older adults (Green et al 1994). Married people had lower proportions of improvements in severity of disability over five years (Grundy and Glaser 2000), and marriage was not significantly associated with improvement in activities of daily living (ADL) in Israel or Italy (Gindin et al 2007).…”

Sleep Disturbance and Depression Recurrence in Community-Dwelling Older Adults: A Prospective Study

“…For example, whereas sleep disturbance has been shown to predict depression relapse and recurrence in late life (11–16), these data are limited to convenience samples of specialty clinics. Other studies have examined factors associated with persistence of depression, as opposed to recurrence, in community-based older adults (17–20), but none have tested the contribution of sleep disturbance. Moreover, in testing the association between sleep disturbance and late-life depression (i.e., including both first incidence and recurrence), no prior work took into account the role of other depressive symptoms and prior depression (21–29).…”