Depressive Disorders in the Elderly in European and Associated Countries

Psychiatry Advisor Contributing Writer
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Negative feelings about aging can affect hearing and memory in older people
Negative feelings about aging can affect hearing and memory in older people
Researchers found a significant gender difference for both major depressive disorder and dysthymia, for which men were at a lower risk compared with women.

Clinical and sociodemographic characteristics are significantly associated with major depressive disorder (MDD) and dysthymia among elderly survey respondents in European and associated countries, and only 64.8% of the elderly with past-year MDD and 41.4% with dysthymia received mental health treatment, according to a study published in PLoS One.

The aim of this study was to investigate the comorbidity patterns, sociodemographic correlates, use of mental healthcare services, and relationships between severity of symptoms and quality of life, impairment, and disability in a community-dwelling sample of participants aged between 65 and 84 years. Data were taken from the MentDis_ICF65+ project, a representative, stepwise, cross-sectional survey on mental disorders in the elderly conducted in England, Germany, Italy, Israel, Spain, and Switzerland (N=3142), with a subsample of 476 elderly participants with any depressive disorder.

A significant gender difference was found for both MDD and dysthymia, for which men were at a lower risk compared with women (odds ratio [OR] major depression, 0.50; 95% CI, 0.32- 0.91; P <.01; OR dysthymia, 0.58; 95% CI, 0.36–0.94; P <.05). Compared with participants aged 65 to 74 years, there was a lower likelihood of MDD at age 75 to 79 years (OR, 0.45; 95% CI, 0.28-0.72; P <.01) and age 80 to 84 years (OR, 0.49; 95% CI, 0.24-0.98; P <.05). This finding was also true for dysthymia, but only for participants aged 80 years or older (OR, 0.33; 95% CI, 0.12-0.92; P <.05). After controlling for study center, age, and gender, a significant correlation was identified between lower education level and dysthymia (OR, 0.92; 95% CI, 0.86-0.97; P <.01). Participants with past-year depressive disorders were significantly more likely to suffer from past-year post-traumatic stress disorder (OR, 8.66; 95% CI, 2.32-32.38; P <.005), past-year anxiety disorder (OR, 4.17; 95% CI, 2.69-6.47; P <.001), and any somatoform disorder (OR, 3.10; 95% CI, 2.34-4.11; P <.001). The likelihood of a reported physical illness more than doubled for participants suffering any past-year depressive disorder (OR, 2.34; 95% CI, 1.43-3.84; P <.005).

Overall, only 64.8% of participants with past-year MDD and 41.4% of participants with dysthymia reported receiving some type of treatment. The combination of both medication and psychotherapy was the most frequently reported therapy (49.4% in the MDD group and 46.5% in the dysthymia group).

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Although the study was limited by excluding participants with serious cognitive impairment and by between-country differences in prevalence rates for depressive disorders and the availability of mental healthcare services, the investigators concluded that “elderly individuals with depression are more impaired than elderly individuals without a depressive disorder. Furthermore, our results show that adequate interventions for the majority of older depressed individuals are lacking. One major strength of this study stems from the development and use of a reliable and valid age-specific structured-standardized interview, which has resulted in higher prevalence rates that illustrate the need for policy for one of the most frequent mental disorders in old age.”

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Reference

Andreas S, Dehoust M, Volkert J, et al. Affective disorders in the elderly in different European countries: Results from the MentDis_ICF65+ study [published online November 11, 2019]. PLoS One. doi: 10.1371/journal.pone.0224871