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Depression in Later Life

A Comparison of Symptoms and Risk Factors in Early and Late Onset Cases

Published online by Cambridge University Press:  02 January 2018

R. C. Baldwin  and
Barbara Tomenson
R. C. Baldwin*
Affiliation:
Manchester Royal Infirmary
Barbara Tomenson
Affiliation:
University Department of Psychiatry, Manchester
*
Dr Baldwin, York House, Manchester Royal Infirmary, Oxford Road, Manchester M13 9BX. Fax: 0161 276 5317
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Abstract

Background

Depression in later life is often thought to differ from that at other times of adulthood. The evidence for this is controversial but is important to any proposed organic model of depression in the elderly. Here, early- and late-onset depressions in later life are compared.

Method

Fifty-seven depressed patients with a mean age of 74 were studied, 21 with an early onset (aged 59 or less) and 36 with a late onset. All were suffering from major depression according to DSM–III–R. The measures at entry included severity and symptoms, cognitive function, antecedent life events, physical health and vascular risk factors and/or vascular disease. We also recorded any family history of mood disorders, as well as the course of illness.

Results

The anxiety item scores of the Hamilton Depression Rating Scale were significantly higher in those with an early onset, but otherwise symptoms differed little. Heritability was greater in the early-onset group. There was a striking association of vascular disease and/or risk with late-onset patients.

Conclusions

Vascular disease is associated with late-onset depression. This is consistent with the hypothesis that depression in later life is a more ‘biological’ disorder.

Type
Papers
Information
The British Journal of Psychiatry , Volume 167 , Issue 5 , November 1995 , pp. 649 - 652
Copyright
Copyright © 1995 The Royal College of Psychiatrists 

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References

Abas, M. A., Sahakian, B. J. & Levy, R. (1990) Neuropsychological deficits and CT scan changes in elderly depressives. Psychological Medicine, 20, 507–520.CrossRefGoogle ScholarPubMed
American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM–III–R). Washington, DC: APA.Google Scholar
Baldwin, R. C. (1993) Late life depression and structural brain changes: a review of recent Magnetic Resonance Imaging. International Journal of Geriatric Psychiatry, 8, 115–123.CrossRefGoogle Scholar
Blazer, D., George, L. & Landerman, R. (1986) The phenomenology of late life depression. In Psychiatric Disorders in the Elderly (eds Bebbington, P. E. & Jacoby, R.). London: Mental Health Foundation.Google Scholar
Brodaty, H., Peters, K., Boyce, P., et al (1991) Age and depression. Journal of Affective Disorders, 23, 137–149.CrossRefGoogle ScholarPubMed
Copeland, J. R., Kelleher, M. J., Kellett, J. M., et al (1976) A semi-structured clinical interview for the assessment of diagnosis and mental state in the elderly. Psychological Medicine, 6, 439–449.Google Scholar
Folstein, M. F., Folstein, S. E. & McHugh, P. R. (1975) “Mini-Mental State”: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 185–198.CrossRefGoogle ScholarPubMed
Gurland, B. J. (1976) The comparative frequency of depression in various adult age groups. Journal of Gerontology, 31, 283–292.Google Scholar
Hamilton, M. (1960) A rating scale for depression. Journal of Neurology, Neurosurgery and Psychiatry, 23, 56–62.Google Scholar
Jacoby, R. J. & Levy, R. (1980) Computed tomography in the elderly 3: affective disorder. British Journal of Psychiatry, 136, 270–275.CrossRefGoogle ScholarPubMed
Kiyak, A., Liang, J. & Kahana, E. (1976) A methodological enquiry into a schedule of recent life events. Proceedings of the American Psychological Association, Washington, DC.Google Scholar
Krishnan, K. R. R., Hays, J. C., Tupler, L. A., et al (1995) Clinical and phenomenological comparisons of late-onset and early-onset depression. American Journal of Psychiatry, 152, 785–788.Google ScholarPubMed
Lindgren, A., Roijer, A., Rudling, O., et al (1994) Cerebral lesions on Magnetic Resonance Imaging, heart disease, and vascular risk factors in subjects without stroke: a population-based study. Stroke, 25, 929–934.CrossRefGoogle ScholarPubMed
Manolio, T. A., Kronmal, R. A., Burke, G. L., et al (1994) Magnetic resonance abnormalities and cardiovascular disease in older adults: the cardiovascular health study. Stroke, 25, 318–327.CrossRefGoogle ScholarPubMed
Mendelwicz, J. (1976) The age factor in depressive illness: some genetic considerations. Journal of Gerontology, 31, 300–303.Google Scholar
Meyers, B. S. & Greenberg, R. (1986) Late-life delusional depression. Journal of Affective Disorders, 11, 133–137.Google Scholar
Musetti, L., Perugi, G., Soriani, A., et al (1989) Depression before and after age 65: a re-examination. British Journal of Psychiatry, 155, 330–336.CrossRefGoogle ScholarPubMed
Norusis, M. J. (1988) Statistical Package for Social Sciences. PC+. Chicago: SPSS Inc.Google Scholar
Pearlson, G. D., Rabins, P. V., Kim, W. S., et al (1989) Structural brain CT changes and cognitive deficits in elderly depressives with and without reversible dementia (‘pseudodementia’). Psychological Medicine, 19, 573–584.Google Scholar
Post, F. (1968) The factor of ageing in affective disorder. In Recent Developments in Affective Disorders (eds Coppen, A. & Walk, A.), pp. 105–116. Royal Medico-Psychological Association Publication No. 2. Kent: Headley Bros.Google Scholar
Robinson, R. G., Starr, L. B. & Price, T. R. (1984) A two year longitudinal study of post stroke mood disorders: prevalence and duration at six months follow up. British Journal of Psychiatry, 144, 256–262.Google Scholar
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