A six-year prospective study of the prognosis and predictors in patients with late-life depression

Hans W Jeuring; Max L Stek; Martijn Huisman; Richard C Oude Voshaar; Paul Naarding; Rose M Collard; Roos C van der Mast; Rob M Kok; Aartjan T F Beekman; Hannie C Comijs

doi:10.1016/j.jagp.2018.05.005

A six-year prospective study of the prognosis and predictors in patients with late-life depression

Hans W Jeuring, Max L Stek, Martijn Huisman, Richard C Oude Voshaar, Paul Naarding, Rose M Collard, Roos C van der Mast, Rob M Kok, Aartjan T F Beekman, Hannie C Comijs

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Abstract

OBJECTIVES: To examine the six-year prognosis of patients with late-life depression and to identify prognostic factors of an unfavorable course.

DESIGN AND SETTING: The Netherlands Study of Depression in Older Persons (NESDO) is a multisite naturalistic prospective cohort study with six-year follow-up.

PARTICIPANTS: Three hundred seventy-eight clinically depressed patients (according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Text Revision criteria) and 132 nondepressed comparisons were included at baseline between 2007 and 2010.

MEASUREMENTS: Depression was measured by the Inventory of Depressive Symptomatology at 6-month intervals and a diagnostic interview at 2- and 6-year follow-up. Multinomial regression and mixed model analyses were both used to identify depression-related clinical, health, and psychosocial prognostic factors of an unfavorable course.

RESULTS: Among depressed patients at baseline, 46.8% were lost to follow-up; 15.9% had an unfavorable course, i.e., chronic or recurrent; 24.6% had partial remission; and 12.7% had full remission at six-year follow-up. The relative risk of mortality in depressed patients was 2.5 (95% confidence interval 1.26-4.81) versus nondepressed comparisons. An unfavorable course of depression was associated with a younger age at depression onset; higher symptom severity of depression, pain, and neuroticism; and loneliness at baseline. Additionally, partial remission was associated with chronic diseases and loneliness at baseline when compared with full remission.

CONCLUSIONS: The long-term prognosis of late-life depression is poor with regard to mortality and course of depression. Chronic diseases, loneliness, and pain may be used as putative targets for optimizing prevention and treatment strategies for relapse and chronicity.

Original language	English
Pages (from-to)	985-997
Number of pages	13
Journal	American Journal of Geriatric Psychiatry
Volume	26
Issue number	9
Early online date	17 May 2018
DOIs	https://doi.org/10.1016/j.jagp.2018.05.005
Publication status	Published - Sept 2018

Bibliographical note

Funding

The infrastructure for the NESDO study ( http://nesdo.amstad.nl ) is funded through the Fonds NutsOhra (project 0701-065 ), Stichting tot Steun VCVGZ , NARSAD The Brain and Behaviour Research Fund (grant 41080 ), and the participating universities and mental health care organizations (VU University Medical Center, Leiden University Medical Center, University Medical Center Groningen, UMC St. Radboud, GGZ inGeest, GGNet, GGZ Nijmegen, and Parnassia).

Funders	Funder number
GGZ Nijmegen
UMC St. Radboud
National Alliance for Research on Schizophrenia and Depression	41080
Fonds NutsOhra	0701-065
Stichting tot Steun Vereniging tot Christelijke Verzorging van Geestes- en Zenuwzieken

Keywords

Aged
Aged, 80 and over
Aging
Depression/diagnosis
Depressive Disorder/diagnosis
Disease Progression
Female
Follow-Up Studies
Humans
Male
Middle Aged
Netherlands/epidemiology
Outcome Assessment, Health Care
Prognosis
Prospective Studies
Remission Induction
Risk Factors

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.jagp.2018.05.005

A Six-Year Prospective Study of the Prognosis and Predictors in Patients With Late-Life DepressionFinal published version, 507 KBLicence: Article 25fa Dutch Copyright Act

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@article{4955849935054cec925ff5ab15604bf1,

title = "A six-year prospective study of the prognosis and predictors in patients with late-life depression",

abstract = "OBJECTIVES: To examine the six-year prognosis of patients with late-life depression and to identify prognostic factors of an unfavorable course.DESIGN AND SETTING: The Netherlands Study of Depression in Older Persons (NESDO) is a multisite naturalistic prospective cohort study with six-year follow-up.PARTICIPANTS: Three hundred seventy-eight clinically depressed patients (according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Text Revision criteria) and 132 nondepressed comparisons were included at baseline between 2007 and 2010.MEASUREMENTS: Depression was measured by the Inventory of Depressive Symptomatology at 6-month intervals and a diagnostic interview at 2- and 6-year follow-up. Multinomial regression and mixed model analyses were both used to identify depression-related clinical, health, and psychosocial prognostic factors of an unfavorable course.RESULTS: Among depressed patients at baseline, 46.8% were lost to follow-up; 15.9% had an unfavorable course, i.e., chronic or recurrent; 24.6% had partial remission; and 12.7% had full remission at six-year follow-up. The relative risk of mortality in depressed patients was 2.5 (95% confidence interval 1.26-4.81) versus nondepressed comparisons. An unfavorable course of depression was associated with a younger age at depression onset; higher symptom severity of depression, pain, and neuroticism; and loneliness at baseline. Additionally, partial remission was associated with chronic diseases and loneliness at baseline when compared with full remission.CONCLUSIONS: The long-term prognosis of late-life depression is poor with regard to mortality and course of depression. Chronic diseases, loneliness, and pain may be used as putative targets for optimizing prevention and treatment strategies for relapse and chronicity.",

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author = "Jeuring, {Hans W} and Stek, {Max L} and Martijn Huisman and {Oude Voshaar}, {Richard C} and Paul Naarding and Collard, {Rose M} and {van der Mast}, {Roos C} and Kok, {Rob M} and Beekman, {Aartjan T F} and Comijs, {Hannie C}",

year = "2018",

month = sep,

doi = "10.1016/j.jagp.2018.05.005",

language = "English",

volume = "26",

pages = "985--997",

journal = "American Journal of Geriatric Psychiatry",

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publisher = "Lippincott Williams and Wilkins",

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T1 - A six-year prospective study of the prognosis and predictors in patients with late-life depression

AU - Jeuring, Hans W

AU - Stek, Max L

AU - Huisman, Martijn

AU - Oude Voshaar, Richard C

AU - Naarding, Paul

AU - Collard, Rose M

AU - van der Mast, Roos C

AU - Kok, Rob M

AU - Beekman, Aartjan T F

AU - Comijs, Hannie C

PY - 2018/9

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N2 - OBJECTIVES: To examine the six-year prognosis of patients with late-life depression and to identify prognostic factors of an unfavorable course.DESIGN AND SETTING: The Netherlands Study of Depression in Older Persons (NESDO) is a multisite naturalistic prospective cohort study with six-year follow-up.PARTICIPANTS: Three hundred seventy-eight clinically depressed patients (according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Text Revision criteria) and 132 nondepressed comparisons were included at baseline between 2007 and 2010.MEASUREMENTS: Depression was measured by the Inventory of Depressive Symptomatology at 6-month intervals and a diagnostic interview at 2- and 6-year follow-up. Multinomial regression and mixed model analyses were both used to identify depression-related clinical, health, and psychosocial prognostic factors of an unfavorable course.RESULTS: Among depressed patients at baseline, 46.8% were lost to follow-up; 15.9% had an unfavorable course, i.e., chronic or recurrent; 24.6% had partial remission; and 12.7% had full remission at six-year follow-up. The relative risk of mortality in depressed patients was 2.5 (95% confidence interval 1.26-4.81) versus nondepressed comparisons. An unfavorable course of depression was associated with a younger age at depression onset; higher symptom severity of depression, pain, and neuroticism; and loneliness at baseline. Additionally, partial remission was associated with chronic diseases and loneliness at baseline when compared with full remission.CONCLUSIONS: The long-term prognosis of late-life depression is poor with regard to mortality and course of depression. Chronic diseases, loneliness, and pain may be used as putative targets for optimizing prevention and treatment strategies for relapse and chronicity.

AB - OBJECTIVES: To examine the six-year prognosis of patients with late-life depression and to identify prognostic factors of an unfavorable course.DESIGN AND SETTING: The Netherlands Study of Depression in Older Persons (NESDO) is a multisite naturalistic prospective cohort study with six-year follow-up.PARTICIPANTS: Three hundred seventy-eight clinically depressed patients (according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Text Revision criteria) and 132 nondepressed comparisons were included at baseline between 2007 and 2010.MEASUREMENTS: Depression was measured by the Inventory of Depressive Symptomatology at 6-month intervals and a diagnostic interview at 2- and 6-year follow-up. Multinomial regression and mixed model analyses were both used to identify depression-related clinical, health, and psychosocial prognostic factors of an unfavorable course.RESULTS: Among depressed patients at baseline, 46.8% were lost to follow-up; 15.9% had an unfavorable course, i.e., chronic or recurrent; 24.6% had partial remission; and 12.7% had full remission at six-year follow-up. The relative risk of mortality in depressed patients was 2.5 (95% confidence interval 1.26-4.81) versus nondepressed comparisons. An unfavorable course of depression was associated with a younger age at depression onset; higher symptom severity of depression, pain, and neuroticism; and loneliness at baseline. Additionally, partial remission was associated with chronic diseases and loneliness at baseline when compared with full remission.CONCLUSIONS: The long-term prognosis of late-life depression is poor with regard to mortality and course of depression. Chronic diseases, loneliness, and pain may be used as putative targets for optimizing prevention and treatment strategies for relapse and chronicity.

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KW - Humans

KW - Male

KW - Middle Aged

KW - Netherlands/epidemiology

KW - Outcome Assessment, Health Care

KW - Prognosis

KW - Prospective Studies

KW - Remission Induction

KW - Risk Factors

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A six-year prospective study of the prognosis and predictors in patients with late-life depression

Abstract

Bibliographical note

Funding

Keywords

UN SDGs

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