Hostname: page-component-586b7cd67f-gb8f7 Total loading time: 0 Render date: 2024-11-25T19:55:52.827Z Has data issue: false hasContentIssue false

Antidepressant use and depressive symptomatology among older people from the Australian Longitudinal Study of Ageing

Published online by Cambridge University Press:  28 January 2010

Ying Zhang*
Affiliation:
Discipline of Public Health, University of Adelaide, Adelaide, Australia
Veronica Chow
Affiliation:
Sansom Institute, School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, South Australia, Australia
Agnes I. Vitry
Affiliation:
Sansom Institute, School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, South Australia, Australia
Philip Ryan
Affiliation:
Discipline of Public Health, University of Adelaide, Adelaide, Australia
Elizabeth E. Roughead
Affiliation:
Sansom Institute, School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, South Australia, Australia
Gillian E. Caughey
Affiliation:
Sansom Institute, School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, South Australia, Australia
Emmae N. Ramsay
Affiliation:
Discipline of Public Health, University of Adelaide, Adelaide, Australia
Andrew L. Gilbert
Affiliation:
Sansom Institute, School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, South Australia, Australia
Adrian Esterman
Affiliation:
School of Nursing and Midwifery, University of South Australia, Adelaide, South Australia, Australia
Mary A. Luszcz
Affiliation:
School of Psychology and Flinders Centre for Ageing Studies, Flinders University, South Australia, Australia
*
Correspondence should be addressed to: Dr. Ying Zhang, Quality Use of Medicines and Pharmacy Research Centre, Reid Building, Frome Road, Adelaide, South Australia 5005, Australia. Phone: +61 8 83022763; Fax: +61 8 8302 1087. Email: [email protected].

Abstract

Background: Depression is one of the leading contributors to the burden of non-fatal diseases in Australia. Although there is an overall increasing trend in antidepressant use, the relationship between use of antidepressants and depressive symptomatology is not clear, particularly in the older population.

Methods: Data for this study were obtained from the Australian Longitudinal Study of Ageing (ALSA), a cohort of 2087 people aged over 65 years at baseline. Four waves of home interviews were conducted between 1992 and 2004 to collect information on sociodemographic and health status. Depressive symptoms were measured by the Center for Epidemiologic Studies – Depression Scale. Use of antidepressants was based on self-report, with the interviewer able to check packaging details if available. Longitudinal analysis was performed using logistic generalized estimating equations to detect if there was any trend in the use of antidepressants, adjusting for potential confounding factors.

Results: The prevalence of depressive symptoms was 15.2% in 1992 and 15.8% in 2004 (p > 0.05). The prevalence of antidepressant users increased from 6.5% to 10.9% (p < 0.01) over this period. Among people with depressive symptoms, less than 20% were taking antidepressants at any wave. Among people without depressive symptoms, the prevalence of antidepressant use was 5.2% in 1992 and 12.0% in 2004 (p < 0.01). Being female (OR = 1.67, 95%CI: 1.25–2.24), having poor self-perceived health status (OR = 1.17, 95%CI: 1.04–1.32), having physical impairment (OR = 1.48, 95%CI: 1.14–1.91) and having depressive symptoms (OR = 1.62, 95%CI: 1.24–2.13) significantly increased the use of antidepressants, while living in community (OR = 0.51, 95%CI: 0.37–0.71) reduced the risk of antidepressant use.

Conclusions: Use of antidepressants increased, while depressive symptoms remained stable, in the ALSA over a 12-year period. Use of antidepressants was low for people with depressive symptoms.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Anstey, K. J. and Luszcz, M. A. (2002). Selective non-response to clinical assessment in the longitudinal study of ageing: Implications for estimating population levels of cognitive function and dementia. International Journal of Geriatric Psychiatry, 17, 704709.CrossRefGoogle ScholarPubMed
Anstey, K. J., van Sanden, C., Sargent-Cox, K. and Luszcz, M. A. (2007). Prevalence and risk factors for depression in a longitudinal, population based study including individuals in the community and residential care. American Journal of Geriatric Psychiatry, 165, 497505.CrossRefGoogle Scholar
Australian Government and Department of Health and Ageing (2008). Australian Statistics on Medicines 2006. Canberra: Australian Government and Department of Health and Ageing.Google Scholar
Ballinger, G. A. (2004). Using generalized estimating equations for longitudinal data analysis. Organizational Research Methods, 7, 127150.CrossRefGoogle Scholar
Blazer, D. G., Hybels, C. F., Fillenbaum, G. G. and Pieper, C. F. (2005). Predictors of antidepressant use among older adults: have they changed over time? American Journal of Psychiatry, 162, 705710.CrossRefGoogle ScholarPubMed
Charles, J., Britt, H., Fahridin, S. and Miller, G. (2007). Mental health in general practice. Australian Family Physician, 36, 200201.Google ScholarPubMed
Clarke, D. M., Cook, K., Smith, G. C. and Piterman, L. (2008). What do general practitioners think depression is? A taxonomy of distress and depression for general practice. Medical Journal of Australia, 188, S110113.CrossRefGoogle ScholarPubMed
Esposito, D., Wahl, P., Daniel, G., Stoto, M. A., Erder, M. H. and Croghan, T. W. (2009). Results of a retrospective claims database analysis of differences in antidepressant treatment persistence associated with escitalopram and other selective serotonin reuptake inhibitors in the United States. Clinical Therapeutics, 31, 644656.CrossRefGoogle ScholarPubMed
Esposito, E., Wang, J. L., Adair, C. E., Williams, J. V., Dobson, K. and Schopflocher, D. (2007). Frequency and adequacy of depression treatment in a Canadian population sample. Canadian Journal of Psychiatry, 52, 780789.CrossRefGoogle Scholar
Folstein, M. F., Robins, L. N. and Helzer, J. E. (1983). The Mini-mental State Examination. Archives of General Psychiatry, 40, 812.CrossRefGoogle ScholarPubMed
Folstein, M., Anthony, J. C. and Parhad, I. (1985). The meaning of cognitive impairment in the elderly. Journal of the American Geriatrics Society, 33, 228235.CrossRefGoogle ScholarPubMed
Healy, D. and Aldred, G. (2005). Anti-depressant drug use and the risk of suicide. International Review of Psychiatry, 17, 163172.CrossRefGoogle Scholar
Henderson, S., Andrews, G. and Hall, W. (2000). Australia's mental health: an overview of the general population survey. Australian and New Zealand Journal of Psychiatry, 34, 197205.CrossRefGoogle ScholarPubMed
Jureidini, J. and Tonkin, A. (2006). Overuse of antidepressant drugs for the treatment of depression. CNS Drugs, 20, 623632.CrossRefGoogle ScholarPubMed
Kendrick, T., Dowrick, C., McBride, A., Howe, A., Clarke, P. and Maisey, S. (2009). Management of depression in UK general practice in relation to scores on depression severity questionnaires: analysis of medical record data. BMJ, 338, b750.CrossRefGoogle ScholarPubMed
Kerse, N., Flicker, L., Pfaff, J. J., Draper, B., Lautenschlager, N. T. and Sim, M. (2008). Falls, depression and antidepressants in later life: a large primary care appraisal. PLoS One, 3, e2423.CrossRefGoogle ScholarPubMed
Kirsch, I., Deacon, B. J., Huedo-Medina, T. B., Scoboria, A., Moore, T. J. and Johnson, B. T. (2008). Initial severity and antidepressant benefits: a meta-analysis of data submitted to the Food and Drug Administration. PLoS Med, 5, e45.CrossRefGoogle ScholarPubMed
Krupinski, J. and Tiller, J. W. (2001). The identification and treatment of depression by general practitioners. Australian and New Zealand Journal of Psychiatry, 35, 827832.CrossRefGoogle ScholarPubMed
Kwon, A., Bungay, K. M., Pei, Y., Rogers, W. H., Wilson, I. B. and Zhou, Q. (2003). Antidepressant use: concordance between self-report and claims records. Medical Care, 41, 368374.CrossRefGoogle ScholarPubMed
Luszcz, M. A., Giles, L., Eckermann, S., Edwards, P., Browne-Yung, K. and Hayles, C. (2007). The Australian Longitudinal Study of Ageing: 15 Years of Ageing in South Australia. Adelaide: South Australian Department of Families and Communities.Google Scholar
Mamdani, M., Rapoport, M., Shulman, K. I., Herrmann, N. and Rochon, P. A. (2005). Mental health-related drug utilization among older adults: prevalence, trends, and costs. American Journal of Geriatric Psychiatry, 13, 892900.CrossRefGoogle ScholarPubMed
Mant, A., Rendle, V. A., Hall, W. D., Mitchell, P. B., Montgomery, W. S. and McManus, P. R. (2004). Making new choices about antidepressants in Australia: the long view 1975–2002. Medical Journal of Australia, 181, S2124.CrossRefGoogle Scholar
Mathers, C. D., Vos, E. T., Stevenson, C. E. and Begg, S. J. (2000). The Australian Burden of Disease Study: measuring the loss of health from diseases, injuries and risk factors. Medical Journal of Australia, 172, 592596.CrossRefGoogle ScholarPubMed
McManus, P., Mant, A., Mitchell, P. B., Montgomery, W. S., Marley, J. and Auland, M. E. (2000). Recent trends in the use of antidepressant drugs in Australia, 1990–1998. Medical Journal of Australia, 173, 458461.CrossRefGoogle ScholarPubMed
McManus, P., Mant, A., Mitchell, P., Britt, H. and Dudley, J. (2003). Use of antidepressants by general practitioners and psychiatrists in Australia. Australian and New Zealand Journal of Psychiatry, 37, 184189.CrossRefGoogle ScholarPubMed
Montagnier, D., Barberger-Gateau, P., Jacqmin-Gadda, H., Dartigues, J.-F., Rainfray, M. and Peres, K. (2006). Evolution of prevalence of depressive symptoms and antidepressant use between 1988 and 1999 in a large sample of older French people: results from the Personnes Agées Quid Study. Journal of the American Geriatrics Society, 54, 18391845.CrossRefGoogle Scholar
Page, A. N., Swannell, S., Martin, G., Hollingworth, S., Hickie, I. B. and Hall, W. D. (2009). Sociodemographic correlates of antidepressant utilisation in Australia. Medical Journal of Australia, 190, 479483.CrossRefGoogle ScholarPubMed
Pandya, R., Metz, L. and Patten, S. B. (2005). Predictive value of the CES-D in detecting depression among candidates for disease-modifying multiple sclerosis treatment. Psychosomatics, 46, 131134.CrossRefGoogle ScholarPubMed
Parker, G. (2007). Is depression overdiagnosed? Yes. BMJ, 335, 328.CrossRefGoogle ScholarPubMed
Pfaff, J. J., Draper, B. M., Pirkis, J. E., Stocks, N. P., Snowdon, J. A. and Sim, M. G. (2009). Medical morbidity and severity of depression in a large primary care sample of older Australians: the DEPS-GP project. Medical Journal of Australia, 190, S7580.CrossRefGoogle Scholar
Radloff, L. (1977). The CES-D scale: a self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385401.CrossRefGoogle Scholar
Rubin, D. B. (1987). Multiple Imputation for Nonresponse in Surveys. New York: J. Wiley & Sons.CrossRefGoogle Scholar
Sawada, N., Uchida, H., Suzuki, T., Watanabe, K., Kikuchi, T. and Handa, T. (2009). Persistence and compliance to antidepressant treatment in patients with depression: A chart review. BMC Psychiatry, 9:38doi:10.1186/1471-244X-9-38.CrossRefGoogle ScholarPubMed
Schafer, J. L. and Graham, J. W. (2002). Missing data: our view of the state of the art Psychological Methods, 7, 147177.CrossRefGoogle ScholarPubMed
Sonnenberg, C. M., Deeg, D. J., Comijs, H. C., van Tilburg, W. and Beekman, A. T. (2008). Trends in antidepressant use in the older population: results from the LASA-study over a period of 10 years. Journal of Affective Disorders, 111, 299305.CrossRefGoogle Scholar
StataCorp (2001). Statistical Software: Release 9.0. College Station, TX: Stata Corporation.Google Scholar
Turner, E. H., Matthews, A. M., Linardatos, E., Tell, R. A. and Rosenthal, R. (2008). Selective publication of antidepressant trials and its influence on apparent efficacy. New England Journal of Medicine, 358, 252260.CrossRefGoogle ScholarPubMed
van Weel, C., van Weel-Baumgarten, E. and van Rijswijk, E. (2009). Treatment of depression in primary care. BMJ, 338, b934.CrossRefGoogle ScholarPubMed
Whiteford, H. A. (2008). Depression in primary care: expanding the evidence base for diagnosis and treatment. Medical Journal of Australia, 188, S101102.CrossRefGoogle ScholarPubMed
Zautra, A. J., Maxwell, B. M. and Reich, John W. (1989). Relationship among physical impairment, distress, and well-being in older adults. Journal of Behavioral Medicine, 12, 543557.CrossRefGoogle ScholarPubMed
Zeger, S. L., Liang, K. and Albert, P. S. (1988). Models for longitudinal data: a generalized estimating equation approach. Biometrics, 44, 10491060.CrossRefGoogle Scholar