title: The Impact of Depressive Symptoms on Healthcare Costs in Late Life: Longitudinal Findings From the AgeMooDe Study.
abstract: OBJECTIVE
  To examine whether depressive symptoms affect healthcare costs in old age longitudinally.
  
  
  METHODS
  Multicenter prospective observational cohort study (two waves with nt1= 1,195 and nt2= 951) in Germany.
  
  
  METHODS
  Community.
  
  
  METHODS
  Participants aged 75 years and older recruited via general practitioners.
  
  
  METHODS
  Depressive symptoms were assessed by the Geriatric Depression Scale (GDS). The health-related resource use was measured retrospectively from a societal perspective based on a questionnaire, covering outpatient services, inpatient treatment, pharmaceuticals, as well as formal and informal nursing care. Hybrid regression models were used to determine the between- and within-effect of depressive symptoms on healthcare costs, adjusting for important covariates.
  
  
  RESULTS
  Six-month total cost increased from €3,090 (t1) to €3,748 (t2). The hybrid random effects models showed that individuals with more depressive symptoms had higher healthcare costs compared with individuals with less depressive symptoms (between-effect). Moreover, an intra-individual increase in depressive symptoms increased healthcare costs by €539.60 (within-effect) per symptom on GDS.
  
  
  CONCLUSIONS
  Our findings emphasize the economic importance of depressive symptoms in old age. Appropriate interventions to treat depressive symptoms in old age might also be a promising strategy to reduce healthcare costs.
authors.affiliation: Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, Hamburg, Germany. Electronic address: j.bock@uke.de.
authors.forename: Jens-Oliver
authors.initials: JO
authors.lastname: Bock
authors.affiliation: Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, Hamburg, Germany.
authors.forename: André
authors.initials: A
authors.lastname: Hajek
authors.affiliation: Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany.
authors.forename: Siegfried
authors.initials: S
authors.lastname: Weyerer
authors.affiliation: Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany.
authors.forename: Jochen
authors.initials: J
authors.lastname: Werle
authors.affiliation: Department of Psychiatry, University of Bonn and German Center for Neurodegenerative Diseases within the Helmholtz Association, Bonn, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Wagner
authors.affiliation: Department of Psychiatry, University of Bonn and German Center for Neurodegenerative Diseases within the Helmholtz Association, Bonn, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Maier
authors.affiliation: Institute of Primary Medical Care, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Anne
authors.initials: A
authors.lastname: Stark
authors.affiliation: Institute of General Practice, Medical Faculty, University of Kiel, Kiel, Germany.
authors.forename: Hanna
authors.initials: H
authors.lastname: Kaduszkiewicz
authors.affiliation: Institute for General Practice, Working Group Medical Statistics and IT-Infrastructure, Hannover Medical School, Hannover, Germany.
authors.forename: Birgitt
authors.initials: B
authors.lastname: Wiese
authors.affiliation: Institute for General Practice, Working Group Medical Statistics and IT-Infrastructure, Hannover Medical School, Hannover, Germany.
authors.forename: Lilia
authors.initials: L
authors.lastname: Moor
authors.affiliation: Institute of Social Medicine, Occupational Health and Public Health, Medical Faculty, University of Leipzig, Leipzig, Germany.
authors.forename: Janine
authors.initials: J
authors.lastname: Stein
authors.affiliation: Institute of Social Medicine, Occupational Health and Public Health, Medical Faculty, University of Leipzig, Leipzig, Germany.
authors.forename: Steffi G
authors.initials: SG
authors.lastname: Riedel-Heller
authors.affiliation: Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, Hamburg, Germany.
authors.forename: Hans-Helmut
authors.initials: HH
authors.lastname: König
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003863:Depression / Q000188:drug therapy / Q000191:economics*; D005260:Female; D005858:Germany; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data*; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012044:Regression Analysis; D011795:Surveys and Questionnaires
keywords: Depression; depressive symptoms; economic burden; healthcare costs; old age