Late-life depression: an introduction

doi:10.1017/CBO9780511543654.003

1 - Late-life depression: an introduction

Published online by Cambridge University Press: 18 December 2009

Carolyn A. Chew-Graham ,

Robert Baldwin and

Alistair Burns

Ken Wilson ,

Carolyn Chew-Graham ,

Robert Baldwin and

Waquas Waheed

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Carolyn A. Chew-Graham: Affiliation:
University of Manchester
Robert Baldwin: Affiliation:
Manchester Mental Health and Social Care NHS Trust
Alistair Burns: Affiliation:
University of Manchester
Ken Wilson: Affiliation:
Consultant in Old-Age Psychiatry, Wirral Community Healthcare NHS Trust
Carolyn Chew-Graham: Affiliation:
University of Manchester
Robert Baldwin: Affiliation:
Manchester Mental Health and Social Care Trust
Waquas Waheed: Affiliation:
Academic Consultant Psychiatrist Lancashire NHS Trust Honorary Lecturer, University of Manchester

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Summary

The epidemiology of depression in later life

There is debate about the prevalence of depression in later life. Some authors argue that the prevalence of depression is substantially less than in younger populations (Regier et al. 1993); others, for example Osborn et al. (2003), have found an increase with age in the very old in a large community sample. Recent European studies have found prevalence estimates of between 8.8% and 23.6% (Copeland et al. 1999). This variability reflects a wide range of issues which include the various definitions used, and in particular, the associated diagnostic instruments.

Strict criteria which have high specificity or are mainly designed for research purposes are likely to identify fewer depressed individuals in population studies when compared to instruments adopting broader definitions of depression. The Diagnostic and Statistical Manual (DSM-IV) has tightly defined criteria, whereas the Geriatric Mental State Examination identifies a broader range of depressive conditions. Consequently, when compared with DSM-IV criteria, the latter identifies cases across a number of different DSM-IV syndromes, provided that the individual presents with depressive symptoms of a severity warranting therapeutic intervention. This instrument also identifies people with adjustment disorder and dysthymia as well as major depressive disorder (Newman et al. 1998, Schaub et al. 2003). The close relationship between depression, physical illness and dementia also presents problems for epidemiological investigation. A significant minority of the very old may also experience dementia or high levels of physical illness both of which can mask the clinical presentation of depression.

Type: Chapter
Information: Integrated Management of Depression in the Elderly , pp. 1 - 16

DOI: https://doi.org/10.1017/CBO9780511543654.003 [Opens in a new window]

Publisher: Cambridge University Press

Print publication year: 2008

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