Late life depression is a serious problem amongst elderly
since it becomes a life long chronic condition. It is the interaction of three
factors - vulnerability, stress and protective factors - that are responsible
for the development of depression and its course over time.
Studies highlight that personality, genetic factors as well
as problems at work and in family relationships play a larger role in the onset
of depression at early age, whereas late-life depression has been seen to be more strongly associated with frailty associated processes and neurodegenerative biological
Loneliness, loss in social environment, inflammation, inability to do
the day to day chores, memory loss, and cognitive limitations are factors
contributing to depression amongst old people.
Not only do chronic diseases contribute to late life
depression but depression, stress, and loneliness could lead to the development
of conditions like cardiovascular disease, diabetes mellitus and of physical
Compared to younger depressed adults, older depressed
persons were found to show disturbances such as fatigue and sleep disturbance
and more apathy.
To be able to make a direct comparison between early- and
late-life depression there has been a need for studies that have sufficient
numbers of depressed persons in all age ranges.
Therefore the Netherlands Study of Depression in Older
Persons (NESDO) designed a study in which the course of late-life depression
and its co morbidities will be followed up in detail.
2007 until 2010, NESDO recruited depressed and non-depressed people. The NESDO
sample consists of 378 depressed and 132 non-depressed persons aged 60 through
93 years. The baseline assessment included written questionnaires, interviews,
medical examination, cognitive tests and collection of blood and saliva
samples. Information was gathered about mental health outcomes and demographic,
psychosocial, biological, cognitive and genetic determinants.
It aims to -
1. Examine the reasons of behind late-life depression.
2. Find out the course and the consequences of depressive
disorders in older persons.
3. Compare late life depression with early-life depression.
results showed that -
• 95 percent
of the individuals were seen to have major depression.
• Mean age of
onset of the depressive disorder was around 49 year.
• 41 percent
of the depressed persons had a co morbid anxiety disorder.
is an ongoing study and the follow up assessments are currently going on with 6
monthly written questionnaires and face-to-face interviews after 2 and 6 years.
The study helps to provide an insight into the
neurobiological, psychosocial and physical determinants of depression and its
long-term course in older persons.
Since a large
number of individuals are being studied in the Netherlands Study of Depression
and Anxiety, data can be pooled with the earlier studies and analysed further
with respect to the etiology, prognosis and the course of late life depression
amongst elderly population.
The Netherlands study
of depression in older persons (NESDO); a prospective cohort study; Hannie et
al; BMC Research Notes 2011.