The prognosis of depressive disorder in elderly primary care patients. An exploratory observational study: course at 6 and 12 months.
OBJECTIVE
To assess the course of depression or borderline depression and its determinants in elderly primary care patients.


METHODS
An observational cohort study with three measurements, at inclusion and after 6 and 12 months.


METHODS
14 general practitioners (GPs) in the western region of the Netherlands.


METHODS
From a baseline random sample of 582 consecutive elderly patients 65+ years of age, a total of 39 patients with depression and 60 with borderline depression were available for this cohort study.


METHODS
Diagnostic assessment was carried out in the patients' homes by trained interviewers according to the Diagnostic Interview. Schedule (plus additional questions to assess minor depression).


RESULTS
Of the 39 patients with depression at baseline, 20 had depression after 6 months, and 18 after 12 months. Of the 60 patients with borderline depression at baseline, 53 had no evidence of depression after 6 months, and 54 had no evidence after 12 months. However, 7 patients had depression at 6 months and 6 patients at 12 months. Two determinants were related to a depressed state at 6 or 12 months among the patients with borderline depression: recognition by the GP and living with a partner.


CONCLUSIONS
The results suggest that once elderly patients suffer from depression, this condition remains present for a long time. The prognosis for borderline depression was better, although 20% became depressed at 6 and/or 12 months. Future studies should aim to identify this group of patients.
Department of General Practice, Leiden University, The Netherlands.
H
H
van Marwijk
J
J
Hermans
M P
MP
Springer
D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D015331:Cohort Studies; D003866:Depressive Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D011320:Primary Health Care / Q000706:statistics & numerical data*