Depression significantly affected the lifestyles of about one-fifth of participants in a study focusing on women 65 and older, researchers say.

The records of more than 7,200 women located at four clinic sites from 1988 to 2009 were examined. Severe depression or increasing symptoms in the study subjects were associated with unhealthy old age, high rates of disability, comorbid physical illness, and unhealthy lifestyles, the research shows.

"These associations support the need for intervention and prevention strategies to reduce depressive symptoms into the oldest-old years," wrote the authors, who were led by Amy L. Byers, Ph.D., MPH, University of California, San Francisco, Veterans Affairs Medical Clinic.

The ongoing prospective cohort study showed women with severe depression were more likely to have diabetes, obesity, myocardial infarction, and physical disabilities. In addition, they were more likely to smoke and to be physically inactive and socially isolated than women with minor depressive symptoms.

They also noted that more long-term investigations of depressive symptoms in this 80-and-older age group are needed since it is the fastest growing age cohort in the United States.

"Given the increased life expectancy, the health and economic costs of depression, and the projected expansion of the older populations, the potential public health burdens of late-life depressive disorders implicated by our study are concerning,” the researchers noted.

The goal of the study was to characterize the natural course of depressive symptoms among "young" older women by providing follow-up into the ninth and tenth decades of life, a period that has been little studied.

Four types of symptoms were identified: minimal depressive symptoms (27.8%), persistently low depressive symptoms (54.0%), increasing depressive symptoms (14.8%), and persistently high depressive symptoms (3.4%).

Antidepressant use among study subjects was low for all groups but increased with severity. The drugs' use was only 7.1% among women with persistently high depressive symptoms.

REFERENCE:

Twenty-Year Depressive Trajectories Among Older Women

Amy L. Byers, PhD, MPH; Eric Vittinghoff, PhD, MPH; Li-Yung Lui, MA, MS; Tina Hoang, MPH; Dan G. Blazer, MD; Kenneth E. Covinsky, MD, MPH; Kristine E. Ensrud, MD, MPH; Jane A. Cauley, DrPH; Teresa A. Hillier, MD, MS; Lisa Fredman, PhD; Kristine Yaffe, MD

Arch Gen Psychiatry. 2012;69(10):1073-1079. doi:10.1001/archgenpsychiatry.2012.43.

ABSTRACT:

Context Despite the frequent occurrence of depressive symptoms among older adults, especially women, little is known about the long-term course of late-life depressive symptoms.

Objective To characterize the natural course of depressive symptoms among older women (from the young old to the oldest old) followed up for almost 20 years.

Design Using latent-class growth-curve analysis, we analyzed women enrolled in an ongoing prospective cohort study (1988 through 2009).

Setting Clinic sites in Baltimore, Maryland; Minneapolis, Minnesota; the Monongahela Valley near Pittsburgh, Pennsylvania; and Portland, Oregon.

Participants We studied 7240 community-dwelling women 65 years or older.

Main Outcome Measure The Geriatric Depression Scale short form (score range, 0-15) was used to routinely assess depressive symptoms during the follow-up period.

Results Among older women, we identified 4 latent classes during 20 years, with the predicted probabilities of group membership totaling 27.8% with minimal depressive symptoms, 54.0% with persistently low depressive symptoms, 14.8% with increasing depressive symptoms, and 3.4% with persistently high depressive symptoms. In an adjusted model for latent class membership, odds ratios (ORs) for belonging in the increasing depressive symptoms and persistently high depressive symptoms classes, respectively, compared with a group having minimal depressive symptoms were substantially and significantly (P < .05) elevated for the following variables: baseline smoking (ORs, 4.69 and 7.97), physical inactivity (ORs, 2.11 and 2.78), small social network (ORs, 3.24 and 6.75), physical impairment (ORs, 8.11 and 16.43), myocardial infarction (ORs, 2.09 and 2.41), diabetes mellitus (ORs, 2.98 and 3.03), and obesity (ORs, 1.86 and 2.90).

Conclusions During 20 years, almost 20% of older women experienced persistently high depressive symptoms or increasing depressive symptoms. In addition, these women had more comorbidities, physical impairment, and negative lifestyle factors at baseline. These associations support the need for intervention and prevention strategies to reduce depressive symptoms into the oldest-old years.