The community prevalence of depression in older Australians

Pirkis, Jane; Pfaff, Jon J.; Williamson, Michelle; Tyson, Orla; Stocks, Nigel; Goldney, Robert D.; Draper, Brian; Snowdon, John; Lautenschlager, Nicola T.; Almeida, Osvaldo P.

doi:10.1016/j.jad.2008.08.014

Cited by 92 publications

(77 citation statements)

References 29 publications

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“…There has been quite a lot of research on depression in the elderly in recent years but this has resulted in a remarkable lack of clarity about whether the gender difference continues throughout the life span or declines beginning at age 55 or 65 or even later. Some researchers have found no gender difference or a much smaller gender difference in depressive episodes and disorders among older adults, beginning as early as age 55 [17,18,19,20,21,22], while others have found significantly higher numbers of depressive symptoms and disorders in females as compared with males over age 65 [23,24,25,26]. It is not possible to say what accounts for this inconsistency: sample sizes, demographic characteristics, countries of origin, and measures of depression varied from study to study.…”

Section: Epidemiology Of the Gender Difference In Depressionmentioning

confidence: 99%

Gender and depression

Girgus

Yang

2015

Current Opinion in Psychology

154

109

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Section: Epidemiology Of the Gender Difference In Depressionmentioning

confidence: 99%

Gender and depression

Girgus

Yang

2015

Current Opinion in Psychology

154

109

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“…This study had access to a large sample of community-dwelling older adults that was broadly representative of the Australian community (Pirkis et al, 2009), although the response rate to invitations was not optimal. We also had access to information about relevant exposures and used a well-accepted and valid approach to assess and diagnose depression amongst participants (Kroenke et al, 2001).…”

Section: N O D E P R E S S I O N M I N O R D E P R E S S I O N M a J mentioning

confidence: 99%

A practical approach to assess depression risk and to guide risk reduction strategies in later life

Almeida

Alfonso

Pirkis

et al. 2010

Int. Psychogeriatr.

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Background:Many factors have been associated with the onset and maintenance of depressive symptoms in later life, although this knowledge is yet to be translated into significant health gains for the population. This study gathered information about common modifiable and non-modifiable risk factors for depression with the aim of developing a practical probabilistic model of depression that can be used to guide risk reduction strategies.Methods:A cross-sectional study was undertaken of 20,677 community-dwelling Australians aged 60 years or over in contact with their general practitioner during the preceding 12 months. Prevalent depression (minor or major) according to the Patient Health Questionnaire (PHQ-9) assessment was the main outcome of interest. Other measured exposures included self-reported age, gender, education, loss of mother or father before age 15 years, physical or sexual abuse before age 15 years, marital status, financial stress, social support, smoking and alcohol use, physical activity, obesity, diabetes, hypertension, and prevalent cardiovascular diseases, chronic respiratory diseases and cancer.Results:The mean age of participants was 71.7 ± 7.6 years and 57.9% were women. Depression was present in 1665 (8.0%) of our subjects. Multivariate logistic regression showed depression was independently associated with age older than 75 years, childhood adverse experiences, adverse lifestyle practices (smoking, risk alcohol use, physical inactivity), intermediate health hazards (obesity, diabetes and hypertension), comorbid medical conditions (clinical history of coronary heart disease, stroke, asthma, chronic obstructive pulmonary disease, emphysema or cancers), and social or financial strain. We stratified the exposures to build a matrix that showed that the probability of depression increased progressively with the accumulation of risk factors, from less than 3% for those with no adverse factors to more than 80% for people reporting the maximum number of risk factors.Conclusions:Our probabilistic matrix can be used to estimate depression risk and to guide the introduction of risk reduction strategies. Future studies should now aim to clarify whether interventions designed to mitigate the impact of risk factors can change the prevalence and incidence of depression in later life.

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“…5,6 Recent attempts to reduce the prevalence of depression in the Osvaldo P. Almeida, MD, PhD, Jane Pirkis, BSc, PhD 4 Ngaire Kerse, MB, ChB, PhD, FRNZCGP 5 Moira Sim, MB, FRACGP 6 Leon Flicker, MBBS, PhD, FRACP 2,7,8 John Snowdon, MD, MPhil, FRCPsych 9 Brian Draper, MD, MBBS, FRANZCP 10 Gerard Byrne, MBBS, PhD, FRANZCP 11 Robert Goldney, MBBS, MD, FRANZCP 12 Nicola T. Lautenschlager, MBBS, MD 1,2,13 Nigel Stocks, DipPH, MD, FRACGP 14 Helman Alfonso, MD, MHGen, PhD 12,13 Screening and case finding are the approaches most frequently used to identify people with depression in populations at risk, particularly in general practice settings. A metaanalysis of 16 randomized trials, however, found that the systematic use of screening instruments or case-finding procedures increased the recognition of depression by 27% but had no effect on the adoption of treatments or the outcome of patients.…”

Section: Introductionmentioning

confidence: 99%

A Randomized Trial to Reduce the Prevalence of Depression and Self-Harm Behavior in Older Primary Care Patients

Almeida

Pirkis²,

Kerse³

et al. 2012

The Annals of Family Medicine

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PURPOSE We wanted to determine whether an educational intervention targeting general practitioners reduces the 2-year prevalence of depression and self-harm behavior among their older patients. METHODSOur study was a cluster randomized controlled trial conducted between July 2005 and June 2008. We recruited 373 Australian general practitioners and 21,762 of their patients aged 60 years or older. The intervention consisted of a practice audit with personalized automated audit feedback, printed educational material, and 6 monthly educational newsletters delivered over a period of 2 years. Control physicians completed a practice audit but did not receive individualized feedback. They also received 6 monthly newsletters describing the progress of the study, but they were not offered access to the educational material about screening, diagnosis and management of depression, and suicide behavior in later life. The primary outcome was a composite measure of clinically signifi cant depression (Patient Health Questionnaire score ≥10) or self-harm behavior (suicide thoughts or attempt during the previous 12 months). Information about the outcomes of interest was collected at the baseline assessment and again after 12 and 24 months. We used logistic regression models to estimate the effect of the intervention in a complete case analysis and intention-to-treat analysis by imputed chain equations (primary analysis). RESULTSOlder adults treated by general practitioners assigned to the intervention experienced a 10% (95% CI, 3%-17%) reduction in the odds of depression or self-harm behavior during follow-up compared with older adults treated by control physicians. Post hoc analyses showed that the relative effect of the intervention on depression was not signifi cant (OR = 0.93; 95% CI, 0.83-1.03), but its impact on self-harm behavior over 24 months was (OR = 0.80; 95% CI, 0.68-0.94). The benefi cial effect of the intervention was primarily due to the relative reduction of self-harm behavior among older adults who did not report symptoms at baseline. The intervention had no obvious effect in reducing the 24-month prevalence of depression or self-harm behavior in older adults who had symptoms at baseline.CONCLUSIONS Practice audit and targeted education of general practitioners reduced the 2-year prevalence of depression and self-harm behavior by 10% compared with control physicians. The intervention had no effect on recovery from depression or self-harm behavior, but it prevented the onset of new cases of self-harm behavior during follow-up. Replication of these results is required before we can confi dently recommend the roll-out of such a program into normal clinical practice. 2012;10:347-356. doi:10.1370/afm.1368. Ann Fam Med BACKGROUNDD epression is a common and disabling disorder that affects people of all ages [1][2][3][4] and about 5% to 10% of adults older than 60 years. 5,6 Recent attempts to reduce the prevalence of depression in the Osvaldo P. Almeida, MD, PhD, Jane Pirkis, BSc, PhD 4 Ngaire Kerse, MB, C...

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The community prevalence of depression in older Australians

Cited by 92 publications

References 29 publications

Gender and depression

Gender and depression

A practical approach to assess depression risk and to guide risk reduction strategies in later life

A Randomized Trial to Reduce the Prevalence of Depression and Self-Harm Behavior in Older Primary Care Patients

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