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The British Journal of Psychiatry (2000) 176: 453-457
© 2000 The Royal College of Psychiatrists

Three-year prognosis of depression in the community-dwelling elderly

AISLING DENIHAN, MRCPsych

Mercers Institute for Research in Ageing, St James's Hospital, Dublin

MICHAEL KIRBY, MRCPsych

Cluain Mhuire Child and Family Centre, Blackrock, Co. Dublin

IRENE BRUCE, RN and CONAL CUNNINGHAM, MRCPI

Mercers Institute for Research in Ageing, St James's Hospital, Dublin

DAVIS COAKLEY, FRCPI and BRIAN A. LAWLOR, MRCPsych

St James's Hospital, Dublin

Declaration of interest This study was partly funded by the Health Research Board of Ireland.

Correspondence: Dr Aisling Denihan, Mercers Institute for Research in Ageing, St James's Hospital, Dublin 8, Ireland. Tel: +353-1-453 7941 (ext. 2640); Fax: +353-1-454 1796; e-mail: friars{at}indigo.ie

Background Depression is the most common mental disorder in the community-dwelling elderly.

Aims To determine the three-year prognosis of depression in a cohort of 127 community-dwelling elderly subjects and identify factors relevant to outcome.

Method The subjects, diagnosed depressed at year 0 using the GMS—AGECAT package, were followed up three years later. A number of factors were investigated for an association with recovery from, or persistence of, depression.

Results At follow-up, 30.2% of the depressed subjects had died, 34.9% had persistent or relapsed case-level depression, 24.5% had other case- or subcase-level mental illness and 10.4% had recovered completely. Physical ill-health, bereavement and positive family history of depression were associated with poor outcome, whereas treatment with antidepressant medication significantly improved prognosis.

Conclusions Late-life depression in community-dwelling subjects is a chronic condition. However, the positive response to antidepressant medication suggests that it should be vigorously treated.




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