Hostname: page-component-78c5997874-s2hrs Total loading time: 0 Render date: 2024-11-16T11:16:33.126Z Has data issue: false hasContentIssue false
  • English
  • Français

Factores de riesgo de la depresión mayor en los ancianos

Published online by Cambridge University Press:  12 May 2020

Reinhard Heun  and
Sandra Hein
Reinhard Heun
Affiliation:
Departamento de Psiquiatría, Universidad de Bonn, Venusberg, 53105Bonn, Alemania
Sandra Hein
Affiliation:
Departamento de Psiquiatría, Universidad de Bonn, Venusberg, 53105Bonn, Alemania
Get access

Resumen

Antecedentes.

Se ha identificado varios factores de riesgo de la depresión en estudios retrospectivos así como en algunos prospectivos en ancianos. Se necesita confirmación en muestras independientes. El presente estudio de seguimiento investigó prospectivamente los factores de riesgo de la depresión en una muestra alemana de ancianos.

Métodos.

Se estudió de nuevo a 1.431 sujetos procedentes de un estudio familiar después de 4,7 ± 2,5 años. Se utilizaron análisis de regresión logística hacia delante bivariantes y multivariantes para identificar los factores de riesgo del desarrollo de una nueva depresión en los ancianos.

Resultados.

Los factores de riesgo de un nuevo episodio depresivo en 1.408 ancianos sin depresión actual fueron la edad, el género femenino, una depresión anterior, el deterioro subjetivo de la memoria, la ansiedad previa y los trastornos somatomorfos. La presencia de demencia o deterioro cognitivo leve fue un factor de riesgo significativo en el análisis bivariante, pero no en el multivariante, controlando las posibles variables de confusión. Los factores de riesgo de un primer episodio depresivo geriátrico fueron la edad, el género y el deterioro subjetivo de la memoria; la edad fue el único factor de riesgo significativo en el análisis multivariante.

Conclusiones.

Esta investigatión confirma estudios anteriores de otros países referentes a la pertinencia de los factores de riesgo para la depresión en los ancianos. El conocimiento de los factores de riesgo podría ayudar a identificar a los sujetos con aumento del riesgo de depresión para enfoques de interventión temprana. Los ancianos con antecedentes de depresión tienen el riesgo más alto.

Keywords

Depresión mayorFactores de riesgoAncianosDeterioro de la memoriaDemencia
Type
Artículo original
Information
European Psychiatry (Ed. Española) , Volume 12 , Issue 6 , September 2005 , pp. 323 - 329
Copyright
Copyright © European Psychiatric Association 2005

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bibliografía

[1] Aalto-Setala, T, Marttunen, M, Tualio-Hennksson, A, Poikolainen, K, Lonnqvist, J. Depressive symptoms in adolescence as predictors of early adulthood depressive disorders and maladjustment. Am J Psychiatry 2002;159(7):1235–7.Google ScholarPubMed
[2] American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 3rd ed. rev. Washington DC: American Psychiatric Association; 1987.Google Scholar
[3] Andreasen, NC, Endicott, J, Spitzer, RL, Winokur, G. The family history method using diagnostic criteria. Reliability and validity. Arch Gen Psychiatry 1977;34(10):1229–35.CrossRefGoogle ScholarPubMed
[4] Ballard, CG, Cassidy, G, Bannister, C, Mohan, RNC. Prevalence, symptom profile, and aetiology of depression in dementia sufferers. J Affect Disord 1993;29:1–6.CrossRefGoogle ScholarPubMed
[5] Barkow, K, Heun, R, Ustun, TB, Maier, W. Identification of items which predict later development of depression in primary health care. Eur Arch Psychiatry Clin Neurosci 2001;251(2):21–6.CrossRefGoogle ScholarPubMed
[6] Barkow, K, Maier, W, UstOn, TB, Gansicke, M, Wittchen, HU, Heun, R. Risk factors for new depressive episodes in primary health care: an international prospective 12-month follow-up study. Psychol Med 2002;32:595–607.CrossRefGoogle ScholarPubMed
[7] Beekman, AT, Deeg, DJ, Geerlings, SW, Schoevers, RA, Smit, JH, Van Tilburg, W. Emergente and persistence of late life depression: a 3- year follow-up of the Longitudinal Aging Study Amsterdam. J Affect Disord 2001;65(2):131–8.CrossRefGoogle Scholar
[8] Berger, AK, Small, BJ, Forsell, Y, Winblad, B, Backman, L. Preclinical symptoms of major depression in the very old age: a prospective longitudinal study. Am J Psychiatry 1998;155(8):1039–43.CrossRefGoogle ScholarPubMed
[9] Berger, AK, Fratiglioni, L, Forsell, Y, Winblad, B, Backman, L. The occurrence of depressive symptoms in the preclinical phase of AD: a population-based study. Neurology 1999;53(9): 1998–2002.CrossRefGoogle ScholarPubMed
[10] Blazer, D, Burchett, B, Service, C, George, LK. The association of age and depression among the elderly: an epidemiologic exploration. J Gerontol 1991;46(6):M210–M215.CrossRefGoogle ScholarPubMed
[11] Breslau, N, Kilbey, MM, Andreski, P. Nicotine dependence and major depression. New evidence from a prospective investigation. Arch Gen Psychiatry 1993;50(l):31-5.CrossRefGoogle ScholarPubMed
[12] Breslau, N, Schultz, L, Peterson, E. Sex differences in depression: a role for preexisting anxiety. Psychiatry Res 1995;58:1–2.CrossRefGoogle ScholarPubMed
[13] Charney, DS, Reynolds, CF 3rd, Lewis, L, Lebowitz, BD, Sunderland, T, Alexopoulos, GS, et al. Depression and bipolar support alliance. Depression and bipolar support alliance consensus statement on the unmet needs in diagnosis and treatment of mood disorders in late life. Arch Gen Psychiatry 2003;60(7):664–72.Google ScholarPubMed
[14] Copeland, JR, Davidson, IA, Dewey, ME, Gilmore, C, Larkin, BA, McWilliam, C, et al. Alzheimer's disease, other dementias, depression and pseudodementia: prevalence, incidence and 3-year outcome in Liverpool. Br J Psychiatry 1992;161:230–9.CrossRefGoogle Scholar
[15] Copeland, JR, Beekman, AT, Dewey, ME, Jordan, A, Lawlor, BA, Linden, M, et al. Cross-cultural comparison of depressive symptoms in Europe does not support stereotypes of ageing. Br J Psychiatry 1999; 174:322–9.CrossRefGoogle Scholar
[16] Coryell, W, Endicott, J, Keller, M. Major depression in a nonclinical sample. Demographic and clinical risk factors for first onset. Arch Gen Psychiatry 1992;49(2):117–25.Google Scholar
[17] Coryell, W, Winokur, G, Keller, M, Scheftner, W, Endicott, J. Alcoholism and primary major depression: a family study approach to coexisting disorders. J Affect Disord 1992;24(2):93–9.CrossRefGoogle Scholar
[18] Crum, RM, Cooper-Patrick, L, Ford, DE. Depressive symptoms among general medical patients: prevalence and 1-year outcome. Psychsom Med 1994;56(2):109–17.CrossRefGoogle Scholar
[19] Dufouil, C, Fuhrer, R, Dartigues, JF, Alperovitch, A. Longitudinal analysis of the association between depressive symptomatology and cognitive detonation. Am J Epidemiol 1996;144(7):634–41.CrossRefGoogle Scholar
[20] Fava, M, Rankin, MA, Wright, EC, Alpert, JE, Nierenberg, AA, Pava, J, et al. Anxiety disorders in major depression. Compr Psychiatry 2000;41(2):97–102.CrossRefGoogle ScholarPubMed
[21] Fichter, MM, Bruce, ML, Schroppel, H, Meller, I, Merikangas, K. Cognitive impairment and depression in the oldest old in a German and in US communities. Eur Arch Psychiatry Clin Neurosci 1995;245:31925.CrossRefGoogle Scholar
[22] Flint, AJ. Epidemiology and comorbidity of anxiety disorders in the elderly. Am J Psychiatry 1994;151:640–9.Google ScholarPubMed
[23] Folstein, MF, Folstein, SE, McHugh, PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975;12(3): 189–98.Google Scholar
[24] Ford, DE, Cooper-Patrick L. Sleep disturbances and mood disorders: an epidemiologic perspective. Depress Anxiety 2001;14:3–6.CrossRefGoogle Scholar
[25] Fuhrer, R, Antonucci, M, Gagnon, M, Dartigues, JF, Barberger-Gateau, P, Alperovitch, A. Depressive symptomatology and cognitive functioning: an epidemiological survey in an elderly community sample in France. Psychol Med 1992;22:159–72.CrossRefGoogle Scholar
[26] Gater, R, Tansella, M, Korten, A, Tiemens, BG, Mavreas, VG, Olatawura, MO. Sex differences in the prevalence and detection of depressive and anxiety disorders in general health care settings. Arch Gen Psychiatry 1998;55:405–13.CrossRefGoogle ScholarPubMed
[27] Hammen, C. Live events and depression: the plot thickens. Am J Community Psychol 1992;20(2):179–93.CrossRefGoogle Scholar
[28] Harlow, BL, Cohen, LS, Otto, MW, Spiegelman, D, Cramer, DW. Prevalence and predictors of depressive symptoms in older premenopausal women: the Harvard Study of Moods and Cycles. Arch Gen Psychiatry 1999;56(5):418–24.CrossRefGoogle ScholarPubMed
[29] Henderson, AS, Jorm, AF, Mackinnon, A, Christensen, H, Scott, LR, Korten, AE, et al. The prevalence of depressive disorders and the distribution of depressive symptoms in later life: a survey using Draft ICD-10 and DSM-III-R. Psychol Med 1993;23:719–29.Google ScholarPubMed
[30] Heun, R, Muller, H. Interinformant reliability of family history information on psychiatric disorders in relatives. Eur Arch Psychiatry Clin Neurosci 1998;248(2): 104–9.CrossRefGoogle ScholarPubMed
[31] Heun, R, Burkart, M, Maier, W. Selection bieses during recruitment of patients and relatives for a family study in the elderly. J Psychiatry Res 1995;29(6):491–504.CrossRefGoogle ScholarPubMed
[32] Heun, R, Hardt, J, Burkart, M, Maier, W. Validity of the family history method in relatives of gerontopsychiatric patients. Psychiatry Res 1996;62(3):227–38.CrossRefGoogle ScholarPubMed
[33] Heun, R, Muller, H, Papassotiropoulos, A. Differential validity of informant-based diagnoses of dementia and depression in index subjects and in their first degree relatives. Soc Psychiatry Psychiatr Epidemiol 1998;33(10):510–3.CrossRefGoogle ScholarPubMed
[34] Heun, R, Papassotiropoulos, A, lessen, F, Maier, W, Breitner, JCS. A family study of Alzheimer's disease and early-onset and late-onset depression in elderly patients. Arch Gen Psychiatry 2001;58(2):190–6.CrossRefGoogle ScholarPubMed
[35] Husaini, BA. Predictors of depression among the elderly: racial differences over time. Am J Orthopsychiatr 1997;67(l):48–58.CrossRefGoogle ScholarPubMed
[36] Judd, LL. Social phobia: a clinical overview. J Clin Psychiatry 1994;55:5–9.Google ScholarPubMed
[37] Judd, LL, Akiskal, HS, Paulas, MRThe role and clinical significance of subsyndromal depressive symptoms (SSD) in unipolar major depressive disorder. J Affect Disord 1997;45(l-2):17-8.CrossRefGoogle Scholar
[38] Kendler, KS, Thornton, LM, Gardner, CO.Genetic risk, number of previous depressive episodes, and stressful life events predicting onset of major depression. Am J Psychiatry 2001;158(4):582–6.CrossRefGoogle ScholarPubMed
[39] Kennedy, GJ, Kelman, HR, Thomas, C, Wisniewski, W, Metz, H, Bijur, PE. Hierarchy of characteristics associated with depressive symptoms in an urban elderly sample. Am J Psychiatry 1989;146(2):220–5.Google Scholar
[40] Kennedy, GJ, Kelman, HR, Thomas, C. The emergence of depressive symptoms in late life: the importance of declining health and increasing disability. J Community Health 1990;15(2):93–104.CrossRefGoogle ScholarPubMed
[41] Kessler, RC, McGonagle, KA, Nelson, CB, Hughes, M, Swartz, M, Blazer, DG. Sex and depression in the National Comorbidity Survey. II: Cohort effects. J Affect Disord 1994;30:15–26.Google ScholarPubMed
[42] Kivela, SL, Kongas-Saviaro, P, Laippala, P, PaLkala, K, Kesti, E. Social and psychosocial factors predicting depression in old age: a longitudinal study. Int Psychogeriatr 1996;8(4):635–44.CrossRefGoogle ScholarPubMed
[43] Leckman, JF, Sholomskas, D, Thompson, WD, Belanger, A, Weissman, MM. Best estimate of lifetime psychiatric diagnoses: a methodological study. Arch Gen Psychiatry 1982;39(8):879–83.CrossRefGoogle ScholarPubMed
[44] Lehtinen, V, Joukamaa, M. Epidemiology of depression: prevalence, risk factors and treatment situation. Acta Psychiatr Scand 1994;377:7–10.CrossRefGoogle ScholarPubMed
[45] Lichtenberg, PA, Ross, T, Millis, SR, Manning, CA. The relationship between depression and cognition in older adults: a cross-validation study. J Gerontol 1995;50(l):5–32.Google ScholarPubMed
[46] Lieb, R, Isensee, B, Hofler, M, Pfister, H, Wittchen, HU. Parental major depression and the risk of depression and other mental disorders in the offspring: a prospective-longitudinal community study. Arch Gen Psychiatry 2002;59(4):365–74.CrossRefGoogle ScholarPubMed
[47] Lindeman, S, Kapno, J, Isometsa, E, Poikplainen, K, Heikkinen, M, Hamalainen, J, et al. Spousal resemblance for history of major depressive episode in the previous year. Psychol Med 2002;32(2):363–7.CrossRefGoogle ScholarPubMed
[48] Livingston, G, Blizard, B, Mann, A. Does sleep disturbance predict depression in elderly people? A study in inner London. Br J Gen Pract 1993;43(382):236.Google ScholarPubMed
[49] Maier, W. Onset and course of affective disorders in subjects at risk: a prospective family study. Psychiatr Annu 1996;26(6):315–9.CrossRefGoogle Scholar
[50] Maier, W, Lichtermann, D, Minges, J, Heun, R, Hallmayer, J, Klingler, T. Unipolar depression in the aged: determinants of familial aggregation. J Affect Disord 1991;23(2):53–61.CrossRefGoogle ScholarPubMed
[51] Meller, I, Fichter, MM, Schropel, H. Risk factors and psychosocial consequences in depression of octo- and nonagenerians: results of an epidemiological study. Eur Arch Psychiatry Clin Neurosci 1997;247(5):278–87.Google ScholarPubMed
[52] Prigerson, HG, Reynolds, CE 3rd, Frank, E, Kupfer, DJ, George, CJ, Honck, PR. Stressful life events, social rhythms, and depressive symptoms among the elderly: an examination of hypothesized causal linkages. Psychiatry Res 1994,5l(I):33–49.Google Scholar
[53] Prince, MJ, Harwood, RH, Blizard, RA, Thomas, A, Mann, AH. Social support deficits, loneliness and life events as risk factors for depression in old age. The Gospel Oak Project VI. Psychol Med 1997;27(2):323–32.Google ScholarPubMed
[54] Prince, MJ, Harwood, RH, Thomas, A, Mann, AH. A prospective population-based cohort study of the effects of disablement and social milieu on the onset and maintenance of late-life depression. The Gospel Oak Project VII. Psychol Med 1998;28(2):337–50.Google ScholarPubMed
[55] Prince, MJ, Beekman, ATF, Deeg, DLH, Fuhrer, R, Kivela, SL, Lawlor, BA, et al. Depression symptoms in late life assessed using the EURO-D scale. Br J Psychiatry 1999;174:339–45.CrossRefGoogle ScholarPubMed
[56] Ptok, U, Seeher, C, Jessen, F, Papassotiropoulos, A, Heun, R. Interrater reliability of family-history information on psychiatric disorders in relatives. Eur Arch Psychiatry Clin Neurosci 2001;251(6):279–83.CrossRefGoogle Scholar
[57] Roberts, RE, Kaplan, GA, Shema, SJ, Strawbridge, WJ. Does growing old increase the risk for depression? Am J Psychiatry 1997;154:1384–90.Google ScholarPubMed
[58] Roberts, RE, Kaplan, GA, Shema, SJ, Strawbridge, WJ. Prevalence and correlates of depression in an aging cohort: The Almeda County Study. J Gerontol 1997;52b(5):252-8.CrossRefGoogle Scholar
[59] Salokangas, RKR, Poutanen, O. Risk factors for depression in primary care. Findings of the TADEP project. J Affect Disord 1998;48:17180.CrossRefGoogle ScholarPubMed
[60] Schoevers, RA, Beekman, AT, Deeg, DJ, Geerlings, MI, Jonker, C, Van Tilburg, W. Risk factors for depression in later lite; results of a prospective community basad study (AMSTEL). J Affect Disord 2000;59(2): 127–37.CrossRefGoogle Scholar
[61] Sherbourne, CD, Wells, KB, Hays, RD, Rogers, W, Burnam, MA, Judd, LL. Subthreshold depression and depressive disorder: clinical characteristics of general medical and mental health speciality outpatients. Am J Psychiatry 1994;151:1777–84.Google Scholar
[62] Small, GW, Chen, ST, Komo, S, Ercoli, L, Miller, K, Siddarth, P, et al. Memory self-appraisal and depressive symptoms in people at genetic risk for Alzheimer's disease. Int J Geriatr Psychiatry 2001;16(11):1071–7.CrossRefGoogle ScholarPubMed
[63] Steffens, DC, Skoog, I, Norton, MC, Hart, AD, Tschanz, JT, Plassman, BL, et al. Prevalence of depression and its treatment in an elderly population. Arch Gen Psychiatry 2000;57:601–7.CrossRefGoogle Scholar
[64] Stein, MB, Fuetsch, M, Muller, N, Hofler, M, Lieb, R, Wittchen, HU. Social anxiety disorder and the risk of depression: a prospective community study of adolescents and young adults. Arch Gen Psychiatry 2001;58(3):251–6.CrossRefGoogle ScholarPubMed
[65] Van Ojen, R, Hooijer, C, Bezemer, D, Jonker, C, Lindeboom, J, Van Tilburg, W. Late-life depressive disorder in the community. Br J Psychiatry 1995;166:311–5.CrossRefGoogle Scholar
[66] Wang, J, Patten, SB. Prospective study of frequent heavy alcohol abuse and the risk of major depression in the Canadian general population. Depress Anxiety 2002; 15(l):42-5.CrossRefGoogle ScholarPubMed
[67] Weyerer, S, Hafner, H, Mann, AH, Ames, D, Graham, N. Prevalence and course of depression among elderly residential home admissions in Mannheim and Camden, London. Int Psychogeriatr 1995;7(4):479–93.CrossRefGoogle ScholarPubMed
[68] World Health Organization. Composite international diagnostic interview. Geneva: World Health Organization, Division of Mental Health; 1990Google Scholar