An umbrella review that analyzed 30 years of data across over 1 million older adults cited aspirin use and old age as the greatest risk factors for depression. The researchers published their findings in the Journal of Affective Disorders.

The researchers searched PubMed and Web of Science for studies published between 1990 and April 11, 2021, that investigated associations between possible risk factors and depression. They looked for results in people aged 60 and over. About 1.1 million people and 82 risk factors were included in the analysis.

The risk factors that indicated convincing evidence for depression were aspirin use and being age 80 and over. Chronic sleep disturbances, hearing problems, poor vision, heart disease, diabetes and being age 75 and older were cited as highly suggestive evidence for depression.

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Of the psychologic risk factors, dementia was cited as having weak evidence, and nondementia cognitive impairment was rated insignificant for depression. Social factors commonly linked to depression, such as alcohol use and living in a nursing home, were not significant risk factors according to the analysis. Factors found to be inversely associated with depression included Omega-3 fatty acid intake, a healthy diet, and physical activity.

Why aspirin? The researchers theorize that “use of [high dose] aspirin in late life increased the risk of small cerebrovascular lesions, which would promote the incidence of depression.” The researchers also point out that people aged 80 and over tend to be in poorer health than their younger peers. They also note the public health concern over social isolation and lack of physical activity in older adults.

The researchers did say that many studies included in their analysis were of low or very low quality. They also did not include biomarker data. Further, their analysis was limited to 2 databases. However, they state their conclusions “may provide important relevant clinical implications.”


Wu Q, Feng J, Pan CW. Risk factors for depression in the elderly: an umbrella review of published meta-analyses and systematic reviews. J Affect Disord. Published online March 26, 2022. 2022;307:37-45. doi:10.1016/j.jad.2022.03.062