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Age and risk for depression among the elderly: a meta-analysis of the published literature

Published online by Cambridge University Press:  15 August 2012

Ke-Xiang Zhao ,
Chang-Quan Huang ,
Qian Xiao ,
Yuan Gao ,
Qing-Xiu Liu ,
Zheng-Rong Wang ,
Yong-Hong Li  and
Yi-Zhou Xie
Ke-Xiang Zhao
Affiliation:
Department of Geriatrics, the First Affiliated Hospital, Chongqing Medical University, Chongqing, China
Chang-Quan Huang
Affiliation:
Department of Geriatrics, the Third Hospital of Mianyang, Mianyang, Sichuan, China
Qian Xiao*
Affiliation:
Department of Geriatrics, the First Affiliated Hospital, Chongqing Medical University, Chongqing, China
Yuan Gao
Affiliation:
Department of Geriatrics, the First Affiliated Hospital, Chongqing Medical University, Chongqing, China
Qing-Xiu Liu
Affiliation:
Department of Geriatrics, the Third Hospital of Mianyang, Mianyang, Sichuan, China
Zheng-Rong Wang
Affiliation:
Key Laboratory of Chronobiology of Health Ministry, Basic and Forensic School, Sichuan University, Chengdu, China
Yong-Hong Li
Affiliation:
Key Laboratory of Chronobiology of Health Ministry, Basic and Forensic School, Sichuan University, Chengdu, China
Yi-Zhou Xie
Affiliation:
Key Laboratory of Chronobiology of Health Ministry, Basic and Forensic School, Sichuan University, Chengdu, China
*
*Address for correspondence: Qian Xiao, Department of Geriatrics, the First Affiliated Hospital, Chongqing Medical University, Chongqing 400016, China. (Email XiaoQian1956@126.com)
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Abstract

Objective

The goal of this study was to determine the relationship between age and risk for depression among the old and the oldest old.

Method

MEDLINE, EMBASE, and the Cochrane Library database were used to identify potential studies. The studies were divided into cross-sectional and longitudinal subsets. For each study, the numbers of the total participants, cases (for cross-sectional study), or incident cases (for longitudinal study) of depression in each age group were extracted and entered into Review Manager 4.2 software. Qualitative meta-analyses of cross-sectional studies and of longitudinal studies were performed. For prevalence and incidence rates of depression, odds risk (OR) and relative risk (RR) were calculated, respectively.

Results

The qualitative meta-analyses showed that, compared with younger participants (above vs. below 65 years, above vs. below 70 years, above vs. below 75 years, and above vs. below 80 years), older age groups had a significantly higher risk for depression. (All of the ORs and RRs were significant.) Compared with participants aged 55–89, those aged above 90 years had no higher risk for depression. (Neither the OR nor the RR was significant.)

Conclusions

Despite the methodological limitations of this meta-analysis, older age appears to be an important risk factor for depression in the general elderly population (aged below 80 years), but not in the oldest population (aged above 85 years).

Keywords

Agedepressionelderlymeta-analysis
Type
Original Research
Information
CNS Spectrums , Volume 17 , Issue 3 , September 2012 , pp. 142 - 154
Copyright
Copyright © Cambridge University Press 2012

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Footnotes

This work was supported by funding from National Foundation of Natural Science of China (No.81170752), the government of Sichuan province of china (2010FZ0061), health department in the government of Sichuan province, the government of MianYang City (09s001), and the Third Hospital of Mianyang. The authors thank the staff of Key Laboratory of Chronobiology of Health Ministry in Basic and Forensic School of Sichuan University, the Department of Geriatrics of the Third Hospital of Mianyang, and all participants (as well as their legal proxies) for their great contributions. Mr. Rebbo is also acknowledged for his language assistance.

Ke-Xiang Zhao and Chang-Quan Huang were equal contributors to this article.

References

1.Goodwin, RD. Association between physical activity and mental disorder among adults in the united states. Prev Med. 2003; 36: 698–703.CrossRefGoogle ScholarPubMed
2.Katon, WJ, Lin, E, Russo, J, Unutzer, J. Increased medical costs of a population-based sample of depressed elderly patients. Arch Gen Psychiatry. 2003; 60(9): 897–903.CrossRefGoogle ScholarPubMed
3.Leon, FG, Ashton, AK, DMello, DA, Dantz, B. Depression and comorbid medical illness: therapeutic and diagnostic challenges. J Fam Pract. 2003; Suppl: 19–23.Google ScholarPubMed
4.Cole, MG, Bellavance, F, Mansour, A. Prognosis of depression in elderly community and primary care populations: a systematic review and meta-analysis. Am J Psychiatry. 1999; 156: 1182–1189.CrossRefGoogle ScholarPubMed
5.Gurland, BJ, Wilkder, DE, Berkman, C. Depression and disability in the elderly: reciprocal relations and changes with age. Int J Geriatr Psychiatry. 1988; 3: 163–179.CrossRefGoogle Scholar
6.von Korff, M, Ormel, J, Katon, W, Lin, EH. Disability and depression among high utilizers of health care: a longitudinal analysis. Arch Gen Psychiatry. 1992; 49: 91–100.CrossRefGoogle ScholarPubMed
7.Wells, KB, Burman, MA. Caring for depression in America: lessons learned from early findings of the Medical Outcomes Study. Acta Psychiatr Scand. 1991; 9: 503–519.Google ScholarPubMed
8.Katon, W, von Korff, M, Lin, E, et al. . Adequacy and duration of antidepressant treatment in primary care. Med Care. 1992; 30: 67–76.CrossRefGoogle ScholarPubMed
9.Unutzer, J, Patrick, DL, Simon, G, et al. . Depressive symptoms and the cost of health services in HMO patients aged 65 and over: a 4-year prospective study. JAMA. 1997; 277: 1618–1623.CrossRefGoogle ScholarPubMed
10.Harlow, SD, Goldberg, EL, Comstock, GW. A longitudinal study of risk factors for depressive symptomatology in elderly widowed and married women. Am J Epidemiol. 1991; 134: 526–536.CrossRefGoogle ScholarPubMed
11.Green, BH, Copeland, JRM, Dewey, ME, et al. . Risk factors for depression in elderly people: a prospective study. Acta Psychiatr Scand. 1992; 86: 213–221.CrossRefGoogle ScholarPubMed
12.Gallo, JJ, Bogner, HR, Morales, KH, et al. . Depression, cardiovascular disease, diabetes, and two-year mortality among older, primary-care patients. Am J Geriatr Psychiatry. 2005; 13(9): 748–755.CrossRefGoogle ScholarPubMed
13.Sonnenberg, CM, Beekman, ATF, Deeg, DJH, van Tilburg, W. Sex differences in late-life depression. Acta Psychiatr Scand. 2000; 101: 286–292.Google ScholarPubMed
14.Livingston, G, Watkin, V, Milne, B, et al. . Who becomes depressed? The Islington study of older people. J Affect Disord. 2000; 58: 125–133.CrossRefGoogle ScholarPubMed
15.Bruce, ML, McAvay, GJ, Raue, PJ, et al. . Major depression in elderly home health care patients. Am J Psychiatry. 2002; 159: 1367–1374.CrossRefGoogle ScholarPubMed
16.Cole, MG, Dendukuri, N. Risk factors for depression among elderly community subjects: a systematic review and meta-analysis. Am J Psychiatry. 2003; 160: 1147–1156.CrossRefGoogle ScholarPubMed
17.Harpole, LH, Williams, JW Jr, Olsen, MK. Improving depression outcomes in older adults with comorbid medical illness. Gen Hosp Psychiatry. 2005; 27(1): 4–12.CrossRefGoogle ScholarPubMed
18.Biessels, GJ, Staekenborg, S, Brunner, E, et al. . Risk of dementia in diabetes mellitus: a systematic review. Lancet Neurol. 2006; 5(1): 64–74.CrossRefGoogle ScholarPubMed
19.Stroup, DF, Berlin, JA, Morton, SC, et al. . Meta-analysis of Observational Studies in Epidemiology (MOOSE): a proposal for reporting. JAMA. 2000; 283: 2008–2012.CrossRefGoogle Scholar
20.Huang, CQ, Zhang, XM, Dong, BR, et al. . Health status and risk for depression among the elderly: a meta-analysis of published literature. Age Ageing. 2009; 38(11): 1–8.Google Scholar
21.Al-Shammari, SA, Al-Subaie, A. Prevalence and correlates of depression among Saudi elderly. Int J Geriatr Psychiatry. 1999; 14: 739–747.3.0.CO;2-1>CrossRefGoogle ScholarPubMed
22.Barry, KL, Fleming, MF, Manwell, BL, et al. . Prevalence of and factors associated with current and lifetime depression in older adult primary care patients. Fam Med. 1998; 30(5): 366–371.Google ScholarPubMed
23.Blay, SL, Andreoli, SB, Fillenbaum, GG, Gastal, FL. Depression morbidity in later life: prevalence and correlates in a developing country. Am J Geriatr Psychiatry. 2007; 15(9): 790–799.CrossRefGoogle ScholarPubMed
24.Blazer, D, Williams, CD. Epidemiology of dysphoria and depression in an elderly population. Am J Psychiatry. 1980; 137: 439–444.Google Scholar
25.Carvalhais, SMM, Lima-Costa, MF, Peixoto, SV, et al. . The influence of socio-economic conditions on the prevalence of depressive symptoms and its covariates in an elderly population with slight income differences: the Bambuí Health and Aging Study (Bhas). Int J Soc Psychiatry. 2008; 54: 447–456.CrossRefGoogle Scholar
26.Chen, R, Li, W, Zhi, H, et al. . Depression in older people in rural China. Arch Intern Med. 2005; 165: 2019–2025.CrossRefGoogle ScholarPubMed
27.Chi, I, Yip, PS, Chiu, HF, et al. . Prevalence of depression and its correlates in Hong Kong's Chinese older adults. Am J Geriatr Psychiatry. 2005; 13(5): 409–416.CrossRefGoogle Scholar
28.Chong, MY, Tsang, HY, Chen, CS, et al. . Community study of depression in old age in Taiwan: prevalence, life events and socio-demographic correlates. Br J Psychiatry. 2001; 178(1): 29–35.CrossRefGoogle ScholarPubMed
29.Friedman, B, Conwell, Y, Delavan, RL. Correlates of late-life major depression: a comparison of urban and rural primary care patients. Am J Geriatr Psychiatry. 2007; 15(1): 28–41.CrossRefGoogle Scholar
30.Girling, DM, Barkley, C, Paykel, ES, et al. . The prevalence of depression in a cohort of the very elderly. J Affect Disord. 1995; 34(4): 319–329.CrossRefGoogle Scholar
31.Gostynski, M, Ajdacic-Gross, V, Gutzwiller, F, et al. . Depression among the elderly in Switzerland. Nervenarzt. 2002; 73(9): 851–860.CrossRefGoogle ScholarPubMed
32.Heok, KE, Meng, KS, Calvin, FSL, Li, TS. Comorbidity of depression in the elderly—an epidemiological study in a Chinese community. Int. J. Geriatr. Psychiatry. 1996; 11: 699–704.3.0.CO;2-8>CrossRefGoogle Scholar
33.Kivela, SL, Pahkala, K, Laippala, P. Prevalence of depression in an elderly population in Finland. Acta Psychiatr Scand. 1988; 78(4): 401–413.CrossRefGoogle Scholar
34.Kulaksizoglu, IB, Gurvit, H, Polat, A, et al. . Unrecognized depression in community-dwelling elderly persons in Istanbul. Int Psychogeriatr. 2005; 17(2): 303–312.CrossRefGoogle ScholarPubMed
35.Licht-Strunk, E, van der Kooij, KG, van Schaik, DJ, et al. . Prevalence of depression in older patients consulting their general practitioner in the Netherlands. Int J Geriatr Psychiatry. 2005; 20(11): 1013–1019.CrossRefGoogle ScholarPubMed
36.Madianos, MG, Gournas, G, Stefanis, CN. Depressive symptoms and depression among elderly people in Athens. Acta Psychiatr Scand. 1992; 86(4): 320–326.CrossRefGoogle ScholarPubMed
37.McDougall, FA, Matthews, FE, Kvaal, K, et al. . Prevalence and symptomatology of depression in older people living in institutions in England and Wales. Age Ageing. 2007; 36: 562–568.CrossRefGoogle ScholarPubMed
38.Naarding, P, de Koning, I, dan Kooten, F, et al. . Depression in vascular dementia. Int J Geriatr Psychiatry. 2003; 18(4): 325–330.CrossRefGoogle ScholarPubMed
39.O'Hara, MW, Kohout, FJ, Wallace, RB. Depression among the rural elderly: a study of prevalence and correlates. J Nerv Ment Dis. 1985; 173(10): 582–589.CrossRefGoogle ScholarPubMed
40.Pitkälä, K, Kähönen-Väre, M, Valvanne, J, et al. . Long-term changes in mood of an aged population: repeated Zung-tests during a 10-year follow-up. Arch Gerontol Geriatr. 2003; 36(2): 185–195.CrossRefGoogle ScholarPubMed
41.Rokke, PD, Klenow, DJ. Prevalence of depressive symptoms among rural elderly: examining the need for mental health services. Psychotherapy. 1998; 35(4): 545–558.CrossRefGoogle Scholar
42.Saks, K, Kolk, H, Allev, R, et al. . Health status of the older population in Estonia. Croat Med J. 2001; 42(6): 663–668.Google ScholarPubMed
43.Teresi, J, Abrams, R, Holmes, D, et al. . Prevalence of depression and depression recognition in nursing homes. Soc Psychiatry Psychiatr Epidemiol. 2001; 36(12): 613–620.CrossRefGoogle ScholarPubMed
44.Valvanne, J, Juva, K, Erkinjuntti, T, Tilvis, R. Community studies: major depression in the elderly: a population study in Helsinki. Int Psychogeriatr. 1996; 8: 437–443.CrossRefGoogle Scholar
45.van der Wurff, FB, Beekman, AT, Dijkshoorn, H, et al. . Prevalence and risk-factors for depression in elderly Turkish and Moroccan migrants in the Netherlands. J Affect Disord. 2004; 41: 33–41.CrossRefGoogle Scholar
46.Walters, K, Breeze, E, Wilkinson, P, et al. . Local area deprivation and urban-rural differences in anxiety and depression among people older than 75 years in Britain. Am J Public Health. 2004; 94(10): 1768–1774.CrossRefGoogle ScholarPubMed
47.Woo, J, Ho, SC, Lau, J, et al. . The prevalence of depressive symptoms and predisposing factors in an elderly Chinese population. Acta Psychiatr Scand. 1994; 89(1): 8–13.CrossRefGoogle Scholar
48.de Beurs, E, Beekman, A, Geerlings, S, et al. . On becoming depressed or anxious in late life: similar vulnerability factors but different effects of stressful life events. Br J Psychiatry. 2001; 179: 426–431.CrossRefGoogle ScholarPubMed
49.Forsell, Y. Predictors for depression, anxiety and psychotic symptoms in a very elderly population: data from a 3-year follow-up study. Soc Psychiatry Psychiatr Epidemiol. 2000; 35(6): 259–263.CrossRefGoogle Scholar
50.Giltay, EJ, Zitman, FG, Kromhout, D. Dispositional optimism and the risk of depressive symptoms during 15 years of follow-up: the Zutphen Elderly Study. J Affect Disord. 2006; 91: 45–52.CrossRefGoogle ScholarPubMed
51.Harris, T, Cook, DG, Victor, C, et al. . Onset and persistence of depression in older people—results from a 2-year community follow-up study. Age Ageing. 2006; 35: 25–32.CrossRefGoogle ScholarPubMed
52.Kivela, SL, Kongas-Saviard, P, Kimmo, P, et al. . Health, health behaviour and functional ability predicting depression in old age: a longitudinal study. Int J Geriatr. 2006; 21: 237–245.Google Scholar
53.Meller, I, Fichter, MM, Schröppel, H. Risk factors and psychosocial consequences in depression of octo- and nonagenerians: results of an epidemiological study. Eur Arch Psychiatry Clin Neurosci. 1997; 17: 278–287.CrossRefGoogle Scholar
54.Roberts, RE, Shema, SJ, Kaplan, GA, Strawbridge, WJ. Sleep complaints and depression in an aging cohort: a prospective perspective. Am J Psychiatry. 2000; 157(1): 81–88.CrossRefGoogle Scholar
55.Schoevers, RA, Beekman, AT, Deeg, DJ, et al. . Risk factors for depression in later life: results of a prospective community based study (AMSTEL). J Affect Disord. 2000; 59(2): 127–137.CrossRefGoogle ScholarPubMed
56.Turvey, C, Carney, S, Arndt, R, et al. . Conjugal loss and syndromal depression in a sample of elders aged 70 years or older. Am J Psychiatry. 1999; 156: 1596–1601.CrossRefGoogle ScholarPubMed