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Community-based case–control study of depression in older people

Cases and sub-cases from the MRC–ALPHA study

Published online by Cambridge University Press:  31 January 2018

J. R. M. Copeland ,
Ruoling Chen ,
Michael Dewey ,
C. F. M. McCracken ,
Chris Gilmore ,
B. Larkin  and
K. C. M. Wilson
J. R. M. Copeland*
Affiliation:
Department of Psychiatry, Royal Liverpool University Hospital, Liverpool
Ruoling Chen
Affiliation:
Department of Psychiatry, Royal Liverpool University Hospital, Liverpool
Michael Dewey
Affiliation:
Trent Institute for Health Services Research, Queen's Medical Centre, Medical School, Nottingham
C. F. M. McCracken
Affiliation:
Department of Psychiatry, Royal Liverpool University Hospital, Liverpool
Chris Gilmore
Affiliation:
West Cheshire Hospital, Chester
B. Larkin
Affiliation:
Steeping Hill Hospital, Stockport
K. C. M. Wilson
Affiliation:
Department of Psychiatry, University of Liverpool
*
Professor J. R. M. Copeland, Department of Psychiatry, Royal Liverpool University Hospital, Liverpool L69 3GA
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Abstract

Background

Risk factors of depression in later life, particularly for sub-cases and for psychotic and neurotic types of depression, are unclear.

Aims

To identify such risk factors.

Method

Over 5200 older people ($65 years), randomly selected from Liverpool, were interviewed using the Geriatric Mental State (GMS)and the Minimum Data Set (MDS). The computer-assisted diagnosis AGECAT identified 483 cases and 575 sub-cases of depression and 2451 with no mental problems. Logistic regression was employed to examine factors relevant to caseness.

Results

In multiple logistical regression, odds ratios (ORs) were significantly high for being female (2.04, 95% CI 1.56–2.69), widowed (2.00, 1.18–3.39), having alcohol problems (4.37, 1.40–2.94), physical disablement (2.03, 1.40–2.94), physical illness (1.98,.1.25–3.15), taking medications to calm down (10.04, 6.41 −15.71), and dissatisfaction with life (moderate 4.54, 3.50–5.90; more severe 29.00, 16.00–52.59). Good social networks reduced the ORs. If sub-cases were included as controls, the statistical significance was reduced.

Conclusions

Age was not associated with depression in later life whereas gender, physical disablement and dissatisfaction with life were. The sub-cases shared many risk factors with cases, suggesting that prevention may need to be attempted at an early stage.

Type
Papers
Information
The British Journal of Psychiatry , Volume 175 , Issue 4 , October 1999 , pp. 340 - 347
Copyright
Copyright © 1999 The Royal College of Psychiatrists 

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Footnotes

Declaration of interest

Funding from the Medical Research Council.

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