Depressive spectrum states in a population‐based cohort of 70‐year olds followed over 9 years
Objective Depression may be understood as a spectrum of more or less symptomatic states. Little is known about the long‐term course of these states in older populations. We examined the prevalence and course of depressive states of different severity in a Swedish population sample of older people followed over 9 years. Methods A population‐based sample of 70‐year olds without dementia (N = 563, response rate 71.1%) underwent a psychiatric examination; 450 survivors without dementia were reexamined at ages 75 and/or 79 years. Three depressive spectrum states were defined: major depression (MD), minor depression (MIND), and subsyndromal depression (SSD). Results The cumulative 9‐year prevalence of any depressive spectrum state was 55.3% (MD 9.3%, MIND 27.6%, SSD 30.9%). The cross‐sectional prevalence increased with age, especially for MIND and SSD. Among those with baseline MD and MIND, 75.0% and 66.7%, respectively, had MD or MIND during follow‐up. Among those with SSD, 47.2% had SSD also during follow‐up and 36.1% had MD or MIND. Among those with MD during follow‐up, 63.1% were in a depressive spectrum state at baseline. The corresponding proportion was 30% for those with MIND (but no MD) during follow‐up. Conclusion In this population‐based sample, over half experienced some degree of depression during their eighth decade of life. The findings give some support for the validity of a depressive spectrum in older adults. Most new episodes of major depression occurred in people who were in a depressive spectrum state already at baseline, which may have implications for late‐life depression prevention strategies.
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