Older Age Associated With Worse Major Depressive Disorder Outcomes
Older age alone was found to be a consistent and significant risk factor for poorer depression outcome.
Older age was a significant risk factor for poorer major depressive disorder (MDD) course, according to study results published in The Lancet Psychiatry.
Between 2004 and 2012, baseline and 2-year follow-up data were extracted for 1042 participants from 2 existing cohort studies: the Netherlands Study of Depression and Anxiety and the Netherlands Study of Depression for Older Persons. Participants were between 18 and 88 years of age, and 690 (66%) were women. The primary outcome was 2-year MDD course, assessed by 4 indicators: depression diagnosis after 2 years, presence of a chronic symptom course, time to remission, and depression severity change. Multivariate analyses were performed to examine the associations between age and MDD course indicators.
Older age was a significant predictor of worse 2-year MDD course for all indicators (depressive disorder: odds ratio [OR] 1.08; 95% CI, 1.00-1.17; chronic symptom course: OR, 1.24; 95% CI, 1.13-1.35; time to remission: hazard ratio [HR], 0.91; 95% CI 0.87-0.96; and depression severity change: regression coefficient 1.06; P <.0001). MDD course worsened linearly with age, and patients aged 70 years or older had the worst outcomes compared with the youngest age group in depression diagnosis (OR, 2.02; 95% CI, 1.18-3.45), chronic symptom course (OR, 3.19; 95% CI, 1.74-5.84), and time to remission (HR, 0.60; 95% CI, 0.44-0.83). When adjusting for prognostic clinical factors, including comorbid anxiety and antidepressant use, these associations were only slightly reduced. The age association remained significant after additional adjustments for clinical and social factors such as loneliness and pain. As such, age-specific factors cannot alone explain the poorer MDD course associated with older age.
Older age alone was thus found to be a consistent and significant risk factor for poorer MDD outcome. Further studies on this association should be performed to highlight the most effective modes of treatment for this demographic.
Disclosures: BP has received research funding from Janssen Research and Boehringer Ingelheim, not related to this study. All other authors declare no competing interests.
Schaakxs R, Comijs HC, Lamers F, Kok RM, Beekman ATF, Penninx BWJH. Associations between age and the course of major depressive disorder: a 2-year longitudinal cohort study [published online June 7, 2018]. Lancet Psychiatry. doi:10.1016/S2215-0366(18)30166-4