Late‐life depression: the differences between early‐ and late‐onset illness in a community‐based sample

Abstract

In a community-based sample we did not detect clear differences in etiology and phenomenology between EOD and LOD. This discrepancy with reports from clinical samples could be due to selection bias in clinical studies. Consequently, all patients with late-life depression deserve a diagnostic work-up of both psychosocial and somatic risk factors and treatment interventions should be focused accordingly.

Late life depression: a comparison of risk factors and symptoms according to age of onset in community dwelling older adults

“…The finding of increased cognitive impairment in subjects with late onset depression has also been reported by other investigators (Salloway et al, 1996, Lesser et al, 1996 although a large number of studies have not demonstrated this finding (Brodaty et al, 2001, Baldwin andTomenson, 1995). Specifically, with regard to studies based in the community dwelling elderly, one study using similar methodology found an association between later age of onset and cognitive impairment (van Ojen et al, 1995a) while another found no significant association after adjustment for confounders (Janssen et al, 2006). It has been argued that differences in selection processes and methodology may account for some of this variability in research findings (Brodaty et al, 2001).…”

“…The majority of studies which have examined age of onset of depressive disorder in relation to phenomenological and aetiological variables have either included patients who self-presented to primary care or were referred for specialist treatment. To the best of our knowledge, only a small number of studies have examined these hypotheses in community-based samples (Janssen et al, 2006, van Ojen et al, 1995b, Corruble et al, 2008. Given that a minority of patients with depression in the community are referred to secondary care and that such patients tend to have more severe and enduring illness means that findings from hospital samples may not necessarily generalise to community populations (Eustace et al, 2001).…”

Late-onset depression: issues affecting clinical care

“…Not all studies find an association between late-onset depression and vascular pathology. Janssen et al (2006) found no such association in an elderly (55-85 years of age) community-based sample. However, this may be explained by the possibility that depression in a community sample is less likely to be complicated by factors such as comorbid vascular disease.…”

“…People with early-onset depression tend to have more depressive cognitions, including suicidal thoughts, thoughts of worthlessness (Reinhard et al, 2000;Janssen et al, 2006) and neuroticism (Baldwin & Tomenson, 1995;Van den Berg et al, 2001). Individuals with late-onset depression tend to present more with symptoms of psychomotor change, anhedonia, cognitive impairments (Hickie et al, 2001;Rapp et al, 2005) and weight loss (Janssen et al, 2006).…”

“…Individuals with late-onset depression tend to present more with symptoms of psychomotor change, anhedonia, cognitive impairments (Hickie et al, 2001;Rapp et al, 2005) and weight loss (Janssen et al, 2006).…”