Drug treatment in depressed elderly in the Dutch community.
OBJECTIVE
In older people, a diagnosis of depression is frequently missed, and proper treatment is subsequently hampered. We investigated antidepressant and benzodiazepine use in an older community sample, and assessed possible risk factors associated with non-treatment in depressed elderly.


METHODS
Data were used from the baseline measurements of the Longitudinal Aging Study Amsterdam (LASA). In a random, age and sex stratified community sample of 3107 older Dutch people (55 to 85 years), respondents were screened on depression with the Center for Epidemiologic Studies Depression Scale (CES-D). In the depressed subsample depressive disorder according to DSM-III was assessed using the Diagnostic Interview Schedule (DIS). The use of antidepressants and anxiolytics (benzodiazepines) in the depressed subsample was measured, and associations with age, sex, cognitive impairment, physical health and anxiety symptoms were investigated.


RESULTS
Only 16% of the respondents with a major depressive disorder used antidepressants. More than half of them used non-therapeutic dosages. Lower antidepressant use was associated with cognitive impairment. Benzodiazepine use was more likely than antidepressant use, which was especially evident in females in the major depressive disorder group.


CONCLUSIONS
Depressed older people were undertreated, particularly when they were cognitively impaired. A high rate of benzodiazepine use was found, particularly in females.
Sonnenberg
Caroline M
CM
Department of Psychiatry, Faculty of Medicine, LASA, Room H-061, Vrije Universiteit, Van de Boechorststraat 7, 1081 BT Amsterdam, The Netherlands. cm.sonnenberg.emgo@med.vu.nl
Beekman
Aartjan T F
AT
Deeg
Dorly J H
DJ
an Tilburg
V
V
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D014151:Anti-Anxiety Agents / Q000008:administration & dosage*; D000928:Antidepressive Agents / Q000008:administration & dosage*; D001569:Benzodiazepines; D003072:Cognition Disorders / Q000150:complications; D003156:Community Mental Health Services / Q000592:standards*; D003866:Depressive Disorder / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D012737:Sex Factors
D014151:Anti-Anxiety Agents; D000928:Antidepressive Agents; D001569:Benzodiazepines