title: Social support deficits, loneliness and life events as risk factors for depression in old age. The Gospel Oak Project VI.
abstract: BACKGROUND
  A companion paper reported a very strong cross-sectional association between handicap and late-life depression. Adjusting for handicap weakened associations between sociodemographic variables and depression. It was unclear whether handicap was a confounder, or a useful summary variable, mediating the effect of a range of sociodemographic disadvantages. This paper focuses on the cross-sectional relationship between depression and demographic variables, social support, and life events.
  
  
  METHODS
  A community survey of all residents over the age of 65 years of an electoral district in London, UK.
  
  
  RESULTS
  There was a moderate association between SHORT-CARE pervasive depression and the number of life events experienced over the previous year. Personal illness, bereavement and theft were the most salient events. There was a stronger, graded, relationship between the number of social support deficits (SSDs) and depression. Number of SSDs also related to age, handicap, loneliness and use of homecare services. Loneliness was itself strongly associated with depression; odds ratio 12.4 (7.6-20.0).
  
  
  CONCLUSIONS
  Problems of collinearity, and the cross-sectional design of the study limited interpretation of the exact nature of the relationship between social support, loneliness, handicap and depression. However, the clustering of these four factors can be used to define a large part of the elderly population with a poor quality of life. An important avenue for future research will be the development and implementation of population intervention strategies designed to address some or all of these problems among older people in general.
authors.affiliation: Institute of Psychiatry, Royal Free Hospital, London.
authors.forename: M J
authors.initials: MJ
authors.lastname: Prince
authors.forename: R H
authors.initials: RH
authors.lastname: Harwood
authors.forename: R A
authors.initials: RA
authors.lastname: Blizard
authors.forename: A
authors.initials: A
authors.lastname: Thomas
authors.forename: A H
authors.initials: AH
authors.lastname: Mann
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016000:Cluster Analysis; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D006233:Persons with Disabilities / Q000523:psychology*; D016330:Frail Elderly / Q000523:psychology*; D006801:Humans; D008016:Life Change Events; D008131:London / Q000453:epidemiology; D008132:Loneliness; D010552:Personality Assessment / Q000706:statistics & numerical data; D011594:Psychometrics; D012307:Risk Factors; D012944:Social Support; D014505:Urban Population / Q000706:statistics & numerical data*