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Community-based case–control study of depression in older people

Cases and sub-cases from the MRC–ALPHA study

Published online by Cambridge University Press:  31 January 2018

J. R. M. Copeland ,
Ruoling Chen ,
Michael Dewey ,
C. F. M. McCracken ,
Chris Gilmore ,
B. Larkin  and
K. C. M. Wilson
J. R. M. Copeland*
Affiliation:
Department of Psychiatry, Royal Liverpool University Hospital, Liverpool
Ruoling Chen
Affiliation:
Department of Psychiatry, Royal Liverpool University Hospital, Liverpool
Michael Dewey
Affiliation:
Trent Institute for Health Services Research, Queen's Medical Centre, Medical School, Nottingham
C. F. M. McCracken
Affiliation:
Department of Psychiatry, Royal Liverpool University Hospital, Liverpool
Chris Gilmore
Affiliation:
West Cheshire Hospital, Chester
B. Larkin
Affiliation:
Steeping Hill Hospital, Stockport
K. C. M. Wilson
Affiliation:
Department of Psychiatry, University of Liverpool
*
Professor J. R. M. Copeland, Department of Psychiatry, Royal Liverpool University Hospital, Liverpool L69 3GA
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Abstract

Background

Risk factors of depression in later life, particularly for sub-cases and for psychotic and neurotic types of depression, are unclear.

Aims

To identify such risk factors.

Method

Over 5200 older people ($65 years), randomly selected from Liverpool, were interviewed using the Geriatric Mental State (GMS)and the Minimum Data Set (MDS). The computer-assisted diagnosis AGECAT identified 483 cases and 575 sub-cases of depression and 2451 with no mental problems. Logistic regression was employed to examine factors relevant to caseness.

Results

In multiple logistical regression, odds ratios (ORs) were significantly high for being female (2.04, 95% CI 1.56–2.69), widowed (2.00, 1.18–3.39), having alcohol problems (4.37, 1.40–2.94), physical disablement (2.03, 1.40–2.94), physical illness (1.98,.1.25–3.15), taking medications to calm down (10.04, 6.41 −15.71), and dissatisfaction with life (moderate 4.54, 3.50–5.90; more severe 29.00, 16.00–52.59). Good social networks reduced the ORs. If sub-cases were included as controls, the statistical significance was reduced.

Conclusions

Age was not associated with depression in later life whereas gender, physical disablement and dissatisfaction with life were. The sub-cases shared many risk factors with cases, suggesting that prevention may need to be attempted at an early stage.

Type
Papers
Information
The British Journal of Psychiatry , Volume 175 , Issue 4 , October 1999 , pp. 340 - 347
Copyright
Copyright © 1999 The Royal College of Psychiatrists 

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Footnotes

Declaration of interest

Funding from the Medical Research Council.

References

American Psychiatric Association (1980) Diagnostic and Statistical Manual of Mental Disorders (3rd edn) (DSM–III). Washington, DC: APA.Google Scholar
Beekman, A. T. F. Deeg, D. J. H., van Tilburg, T., et al (1995) Major and minor depression in later life: a study of prevalence and associated factors. Journal of Affective Disorders, 36, 65–75.Google Scholar
Blazer, D. G., Burchett, B., Service, C. et al (1991) The association of age and depression among the elderly: an epidemiologic exploration. Journal of Gerontology, 46, 210–215.Google Scholar
Burvill, P. W. & Hall, W. D. (1994) Predictors of increased mortality in elderly depressed patients. International Journal of Geriatric Psychiatry, 9, 219–227.Google Scholar
Copeland, J. R. M., Kellcher, M. J., Kellett, J. M., et al (1976) “A semi-structured clinical interview for the assessment of diagnosis and mental state in the elderly”. The Geriatric Mental State Schedule I. Development and reliability. Psychological Medicine, 16, 89–99.Google Scholar
Copeland, J. R. M., Dewey, M. E. & Griffiths-Jones, H. M. (1986) Psychiatric case nomenclature and a computerised diagnostic system for elderly subjects: GMS and AGECAT. Psychological Medicine, 16, 89–99.CrossRefGoogle Scholar
Copeland, J. R. M., Dewey, M. E., Henderson, A. S., et al (1988) The Geriatric Mental State (GMS) used in the community. Replication studies of the computerised diagnosis AGECAT. Psychological Medicine, 18, 219–223.Google Scholar
Copeland, J. R. M., Dewey, M. E. & Griffiths-Jones, H. M. (1990) Dementia and depression in elderly persons: AGECAT compared with DSM–III and pervasive illness. International Journal of Geriatric Psychiatry, 5, 47–51.Google Scholar
Copeland, J. R. M., Davidson, I. A., Dewey, M. E., et al (1992) Alzheimer's disease, other dementias, depression and pseudodementia: prevalence, incidence and three-year outcome in Liverpool. British Journal of Psychiatry, 161, 230–239.Google Scholar
Dewey, M. E., Copeland, J. R. M., Lobo, A., et al (1992) Computerised diagnosis from a standardised history schedule: a preliminary communication about the organic section of the HAS–AGECAT system. International Journal of Geriatric Psychiatry, 7, 443–446.Google Scholar
Green, B. H., Copeland, J. R. M., Dewey, M. E., et al (1992) Risk factors for depression in elderly people: a prospective study. Acta Psychiatrica Scandinavica, 86, 213–217.Google Scholar
Gurland, B. J., Fleiss, J. L., Goldberg, K., et al (1976) A semi-structured clinical interview for the assessment of diagnosis and mental state in the elderly. The Geriatric Mental State Schedule 2. A factor analysis. Psychological Medicine, 6, 451–459.Google Scholar
Gurland, B. J., Wilder, D. E., Golden, R., et al (1988) The relationship between depression and disability in the elderly – data from the Comprehensive Assessment and Referral Evaluation (CARE). In Psychological Assessment of the Elderly (eds Wattis, J. P. & Hindmarch, I.), pp. 114–137. Edinburgh: Churchill Livingstone.Google Scholar
Hasin, D. & Link, B. (1988) Age and recognition of depression: implications for a cohort effect in major depression. Psychological Medicine, 18, 683–688.Google Scholar
Hooijer, C., Jonker, C., Dewey, M. E., et al (1991) A standardised interview for the elderly (GMS): reliability studies comparing the Dutch language version with the original. International Journal of Geriatric Psychiatry, 6, 71–79.Google Scholar
Kahn, H. A. & Sempos, C. T. (1989) Statistical Methods in Epidemiology. New York: Oxford University Press.Google Scholar
Kennedy, G. J., Kelman, H. R., Wisniewsky, W., et al (1989) Hierarchy of characteristics associated with depressive symptoms in an urban elderly sample. American Journal of Psychiatry, 146, 220–225.Google Scholar
Murphy, E. (1982) Social origins of depression in old age. British Journal of Psychiatry, 141, 135–142.Google Scholar
Pahkala, K., Kesti, E., Kongas-Saviaro, P., et al (1995) Prevalence of depression in an aged population in Finland. Social Psychiatry and Psychiatric Epidemiology, 30, 99–106.Google Scholar
Prince, M., Harwood, R., Blizard, R., et al (1997a) Impairment, disability and handicap as risk factors for depression in old age. The Gospel Oak Project V. Psychological Medicine, 27, 311–321.Google Scholar
Prince, M., Harwood, R., Blizard, R., et al (1997b) Social support deficits, loneliness and life events as risk factors for depression in old age. The Gospel Oak Project VI. Psychological Medicine, 27, 323–332.Google Scholar
Saunders, P. A., Copeland, J. R. M., Dewey, M. E., et al (1991) Heavy drinking as a risk factor for depression and dementia in elderly men. Findings from the Liverpool Longitudinal Community Study. British Journal of Psychiatry, 159, 213–216.Google Scholar
Saunders, P. A., Copeland, J. R. M., Dewey, M. E., et al (1993) The prevalence of dementia, depression and neurosis in later life: the Liverpool MRC–ALPHA Study. International Journal of Epidemiology, 22, 838–847.Google Scholar
Sharma, V. I., Copeland, J. R. M., Dewey;, M. E., et al (1998) Outcome of the depressed and elderly living in the community in Liverpool: a five year follow-up. Psychological Medicine, 28, 1329–1337.Google Scholar
Wenger, G. C. (1991) A network typology: from theory to practice. Journal of Ageing Studies, 5, 147–162.Google Scholar
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