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The long-term outcome of subthreshold depression in later life

Published online by Cambridge University Press:  29 July 2016

H. W. Jeuring ,
M. Huisman ,
H. C. Comijs ,
M. L. Stek  and
A. T. F. Beekman
H. W. Jeuring*
Affiliation:
Department of Psychiatry and the EMGO Institute for Health and Care Research, GGZ inGeest – VU University Medical Center, Amsterdam, The Netherlands
M. Huisman
Affiliation:
Department of Epidemiology and Biostatistics and the EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
H. C. Comijs
Affiliation:
Department of Psychiatry and the EMGO Institute for Health and Care Research, GGZ inGeest – VU University Medical Center, Amsterdam, The Netherlands
M. L. Stek
Affiliation:
Department of Psychiatry and the EMGO Institute for Health and Care Research, GGZ inGeest – VU University Medical Center, Amsterdam, The Netherlands
A. T. F. Beekman
Affiliation:
Department of Psychiatry and the EMGO Institute for Health and Care Research, GGZ inGeest – VU University Medical Center, Amsterdam, The Netherlands
*
*Address for correspondence: H. W. Jeuring, MD, VU University Medical Center, LASA, Postal Box 7057, 1007 MB Amsterdam, The Netherlands. (Email: h.jeuring@vumc.nl)
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Abstract

Background

Subthreshold depression (SUBD) in later life is common and important as prodromal state and prominent risk factor in the development of major depressive disorder (MDD). Indicated prevention can reduce the incidence of MDD among people with SUBD substantially, but needs to be targeted to those that are truly at risk of developing MDD.

Method

N = 341 eligible participants with SUBD were included from the first (1992/1993), second (1995/1996) and third (1998/1999) cycle from the Longitudinal Aging Study Amsterdam (LASA) by using a two-stage screening design. LASA is an ongoing prospective cohort study in The Netherlands among the older population (55–85 years). At baseline (1992/1993) N = 3107 participants were interviewed and follow-up cycles were conducted every 3 years until 2008/2009, resulting in maximal 17 years of observational period. The proportion of people that developed MDD, remained SUBD, or recovered from SUBD was measured and Cox proportional regression analyses were performed to investigate 29 putative predictors of MDD and recovery from SUBD.

Results

N = 153 (44.9%) recovered from SUBD, N = 138 (40.5%) remained chronically SUBD, and N = 50 (14.7%) developed MDD (incidence rate 15.1/1000 person-years). Women, high neuroticism, more chronic diseases, high body mass index, smoking and less social support predicted conversion to MDD. Men, low neuroticism and absence of pain predicted recovery from SUBD.

Conclusions

Although older people with SUBD are clearly at risk of developing MDD, the majority did not, even after a long and thorough follow-up. Given the risk factors that were uncovered, targeting and prevention of MDD in those at very high risk is feasible.

Keywords

Courseincidencelate-life depressionmajorminorpreventionprognosisrecoveryrisk factorssubthreshold
Type
Original Articles
Information
Psychological Medicine , Volume 46 , Issue 13 , October 2016 , pp. 2855 - 2865
Copyright
Copyright © Cambridge University Press 2016 

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