Depression in older people tends to be more severe, last longer and be less likely to remit than the same disease in younger people, a new study concludes. The reason remains unknown, but it is apparently unconnected to known risk factors like social isolation or the chronic diseases of old age.
In a study published in Lancet Psychiatry, Dutch researchers followed 1,042 people ages 18 to 88 with diagnoses of major depression. They tracked four indicators of disease over two years: the likelihood of still having the diagnosis at the end of the study, how persistent symptoms were over time, the likelihood of reaching remission and the degree of improvement in depression severity.
By all four measures, depression worsened steadily with age, and people over 70 had worse outcomes than any other age group.
Factors other than age — loneliness, social support and network size, pain, number of chronic diseases, functional impairment, antidepressant use — explained only part of the effect. Old age by itself remained a significant risk factor.
“I think it’s important to note that depression is not the same across a lifetime,” said the lead author, Roxanne Schaakxs, a researcher at VU University Medical Center in Amsterdam. “It’s important to note the context in which it is happening. Old age really matters in the course of depression, and it really has to be investigated in more detail.”