Prevalence of depression and its treatment in an elderly population: The Cache County study

Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27710, USA.
Archives of General Psychiatry (Impact Factor: 14.48). 07/2000; 57(6):601-7.
Source: PubMed


Previous estimates of the prevalence of geriatric depression have varied. There are few large population-based studies; most of these focused on individuals younger than 80 years. No US studies have been published since the advent of the newer antidepressant agents.
In 1995 through 1996, as part of a large population study, we examined the current and lifetime prevalence of depressive disorders in 4,559 nondemented individuals aged 65 to 100 years. This sample represented 90% of the elderly population of Cache County, Utah. Using a modified version of the Diagnostic Interview Schedule, we ascertained past and present DSM-IV major depression, dysthymia, and subclinical depressive disorders. Medication use was determined through a structured interview and a "medicine chest inventory."
Point prevalence of major depression was estimated at 4.4% in women and 2.7% in men (P= .003). Other depressive syndromes were surprisingly uncommon (combined point prevalence, 1.6%). Among subjects with current major depression, 35.7% were taking an antidepressant (mostly selective serotonin reuptake inhibitors) and 27.4% a sedative/hypnotic. The current prevalence of major depression did not change appreciably with age. Estimated lifetime prevalence of major depression was 20.4% in women and 9.6% in men (P<.001), decreasing with age.
These estimates for prevalence of major depression are higher than those reported previously in North American studies. Treatment with antidepressants was more common than reported previously, but was still lacking in most individuals with major depression. The prevalence of subsyndromal depressive symptoms was low, possibly because of unusual characteristics of the population.

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    • "Depression is the most prevalent psychiatric disorder in older adults aged 60 and above (Blazer, 2003; Mulsant & Ganguli, 1999; Steffens et al., 2000), contributing to an increased rate of morbidity and greatly decreasing quality of life (Lopez, Mathers, Ezzati, Jamison, & Murray, 2006). While prevalence rates in this population do not seem to be higher than that found in the general population , suicide rates were found to be particularly high in older depressed patients (Bostwick & Pankratz, 2000; Conwell, Duberstein, & Caine, 2002). "
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    ABSTRACT: Depression is the most prevalent psychiatric disorder in the general population. Despite a large demand for efficient treatment options, the majority of older depressed adults does not receive adequate treatment: Additional low-threshold treatments are needed for this age group. Over the past two decades, a growing number of randomized controlled trials (RCT) have been conducted, testing the efficacy of physical exercise in the alleviation of depression in older adults. This meta-analysis systematically reviews and evaluates these studies; some subanalyses testing specific effects of different types of exercise and settings are also performed. In order to be included, exercise programs of the RCTs had to fulfill the criteria of exercise according to the American College of Sports Medicine, including a sample mean age of 60 or above and an increased level of depressive symptoms. Eighteen trials with 1,063 participants fulfilled our inclusion criteria. A comparison of the posttreatment depression scores between the exercise and control groups revealed a moderate effect size in favor of the exercise groups (standardized mean difference (SMD) of –0.68, p < .001). The effect was comparable to the results achieved when only the eleven trials with low risk of bias were included (SMD = –0.63, p < .001). The subanalyses showed significant effects for all types of exercise and for supervised interventions. The results of this meta-analysis suggest that physical exercise may serve as a feasible, additional intervention to fight depression in older adults. However, because of small sample sizes of the majority of individual trials and high statistical heterogeneity, results must be interpreted carefully.
    No preview · Article · Dec 2015 · GeroPsych: The Journal of Gerontopsychology and Geriatric Psychiatry
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    • " depressed to old age itself and are discouraged from seeking help or reporting symptoms ( Sarkisian et al . , 2003 ) . Others have subclinical disorders that do not meet the diagnostic criteria for psychiatric disorders but require attention ( Xavier et al . , 2013 ) , contributing significantly to morbidity and mortality ( Gallo et al . , 1997 ; Steffens et al . , 2000 ) . The prevalence of these disorders approaches 33% in people 70 years and over ( the Berlin Aging Study ) ( Helmchen et al . , 1999 ) . In Portugal , the annual prevalence of mental disorders is 22 . 9% , with 7 . 3% reported as mild , 11 . 6% as moderate and 4% as severe ( Caldas de Almeida and Xavier , 2013 ) . The Portuguese Nation"
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    ABSTRACT: In the face of limited resources and an aging population with increasingly care needs, healthcare systems must identify community-dwelling older adults with mental health problems at higher risk of adverse outcomes such as institutionalization, hospitalization and death, in order to deliver timely and efficient care. The objectives of this study were to assess the prevalence of mental health concerns and the associated perceived risk of adverse outcomes in a large sample of older patients in primary care (PC). We trained general practitioners and nurses to use the Risk Instrument for Screening in the Community to rank perceived risk of mental health concerns (including neurocognitive and mood disorders) from 1 (mild) to 3 (severe). The mean age of the 4499 people assessed was 76.3 years (SD = 7.3) and 2645 (58.8%) were female. According to the PC team 1616 (35.9%) were perceived to have mental health concerns of whom 847 (52.4%) were mild, 559 (34.6%) were moderate and 210 (13%) were severe. Patients with mental health concerns had higher odds of perceived risk of adverse outcomes (OR = 2.22, 95% CI 1.83–2.69 for institutionalization; OR = 1.66, 95% CI 1.41–1.94 for hospitalization; OR = 1.69, 95% CI 1.42–2.01 for death). These results suggest a high prevalence of mental health concerns among older adults and supports the need for early identification of patients at high-risk of adverse healthcare outcomes.
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    • "Studies have shown that depression is very prevalent among the geriatric age group and is a common cause of disability in them. Among its consequences are reduced life satisfaction and quality, social deprivation, loneliness, cognitive decline, impairments in activities of daily living, suicide and increased mortality [1]. "
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    ABSTRACT: Depression is a pathological state of the mind characterised lack of self-confidence and self-esteem. The cause of depression is multifactorial and various physical, psychological, environmental and genetic factors have been implicated in the causation of depression. Despite being a serious condition in all age groups, depression is more common and significant in the geriatric population as it is associated with significant morbidity and mortality. Various scales have been developed to assess depression of which the Geriatric Depression Scale is most suited for elderly population. It has a long form and short form, the latter being more appropriate for elderly patients with dementia. In our study, we aim to analyse the prevalence of depression among elderly patients visiting the outpatient departments of a tertiary care hospital and determine the factors influencing depression in them. The study was an Observational cross-sectional study carried out on 51 elderly patients over the age of 60 years attending the various outpatient departments of PSG Hospital. The Geriatric Depression Scale Short form was used to determine the prevalence of depression. A self-designed questionnaire considering various factors causing depression was administered to determine the factors influencing depression. It was found that among 51 elders in the age group of 60 to 80 years, 58.8% were depressed of which 54% were males and 68% were females. Financial fears regarding future and income insufficiency were the most important factors contributing to depression. This shows that monetary fear is a major factor resulting in depression. The most effective strategy to combat depression is to ensure appropriate self-report. The government and other organizations must ensure that better support, both financial and other services like healthcare are provided to the elderly in order to prevent depressive illnesses.
    Full-text · Article · Jul 2015
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