High incidence of clinically relevant depressive symptoms in vulnerable persons of 75 years or older living in the community.
OBJECTIVE
Clinically relevant depressive symptoms are highly prevalent in people who are 75 years of age or older. However, very old people with a vulnerable health status are under-represented in studies focussing on incidence and risk factors, while the risk of developing depressive symptoms is expected to be very high in this group. The incidence rates of clinically relevant depressive symptoms and their predictors were investigated in a vulnerable elderly population.


METHODS
In a community-based cohort, 651 vulnerable elderly (75+) people were identified by means of the COOP-WONCA charts (Dartmouth Coop Functional Health Assessment Charts/World Organisation of Family Doctors). To study the incidence of clinically relevant symptoms of depression and their predictors, 266 people with no symptoms (Centre for Epidemiologic Studies Depression Scale, CES-D score <16 at baseline) were selected and measured again at six and 18 months. The incidence of clinically relevant symptoms of depression was defined as a CES-D score > or =16, in combination with at least a five-point change between measurements. Logistic regression analyses were applied to determine risk indicators.


RESULTS
After 18 months, the incidence rate of all clinically relevant symptoms of depression was 48% (95% confidence interval, CI 44.2-51.8). No specific risk factors were identified within this population.


CONCLUSIONS
Our estimates of the incidence of depressive symptoms were considerably higher than those previously found in elderly populations living in the community. A vulnerable health status is associated with a high risk of depressive symptoms.
Dozeman
Els
E
Department of General Practice, VU University Medical Center, Amsterdam, The Netherlands. els.dozeman@vumc.nl
van Marwijk
Harm W J
HW
van Schaik
Digna J F
DJ
Stek
Max L
ML
van der Horst
Henriette E
HE
Beekman
Aartjan T F
AT
van Hout
Hein P
HP
D000203:Activities of Daily Living / Q000523:psychology; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology / Q000523:psychology*; D003863:Depression / Q000453:epidemiology / Q000503:physiopathology / Q000517:prevention & control / Q000523:psychology; D004522:Educational Status; D016330:Frail Elderly / Q000523:psychology; D015577:Geriatric Assessment / Q000379:methods; D006801:Humans; D007398:Interpersonal Relations; D009426:Netherlands / Q000453:epidemiology; D011580:Psychological Techniques; D012112:Residential Facilities; D012307:Risk Factors; D012649:Self Concept; D057566:Self Report; D012737:Sex Factors; D012944:Social Support; D013223:Statistics as Topic