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Stability of clinically relevant depression symptoms in old‐age across 11 cohorts: a multi‐state study

2019; Wiley; Volume: 140; Issue: 6 Linguagem: Inglês

10.1111/acps.13107

1600-0447

Alejandro de la Torre‐Luque, Javier de la Fuente, Albert Sánchez‐Niubò, Francisco Félix Caballero, Matthew Prina, Graciela Muñiz‐Terrera, Josep María Haro, José Luís Ayuso‐Mateos,

Aging and Gerontology Research

Aims To study the temporal dynamics of depression symptom episodes in old‐age and the related influence of risk factors. Methods Data from 41 362 old adults (54.61% women; mean age = 75.30, SD = 6.20) from the Ageing Trajectories of Health – Longitudinal Opportunities and Synergies (ATHLOS) project were used. Depressive symptoms were followed over an 18‐year period. A multi‐state model, comprising three statuses (no depression, new clinically relevant episode of symptoms and episode persistence), was fitted. Multinomial regression was used to study the role of risk factors in status transition. Results Almost 85% of participants showed no depression, but prevalence became lower over time ( B = −0.25, P < 0.001). New episode point prevalence was over 5.30% with a significant probability of moving to persistence status (transition probability = 0.27). Episode persistence became evident in 9.86% of episode status transitions, with increasing rate over time ( B = 0.54, P < 0.01). Loneliness was proven to be the strongest predictor of episode emergence ( OR = 17.76) and persistence ( OR = 5.93). Conclusions The course of depression tends to become chronic and unremitting in old‐age. This study may help to plan interventions to tackle symptom escalation and risk factor influence.