Highlights
- •Compared to younger adults, is MDD in older adults symptomatically different, more common, difficult to treat, chronic, and more often caused by psychological factors?
- •MDD is less common in late-life, but has a more chronic course than younger adults. Older adults with subclinical depression report functional impairment similar to MDD.
- •Depression in late-life may be symptomatically different but more research is needed to separate impact of medical comorbidity.
- •Older adults respond to treatment as well as younger adults; antidepressants may be less efficacious in late-life, while older age is a favorable predictor of ECT response.
- •While older adults may benefit from enhanced ability to regulate emotions, research suggests that several age-related biological processes contribute to MDD in late-life.
Is depression among older adults symptomatically different than younger adults? Is
it more common or chronic or difficult to treat? Is depression in late life more likely
to be attributed to psychological problems? Twenty-years ago, Dan Blazer, a pioneer
known for his groundbreaking work on depression in older adulthood, conducted an important
review of the existing literature to refute five commonly held beliefs about depression
in late life. Now, two decades later, we call upon selected articles that are representative
of our current knowledge to provide an update and identify research priorities. The
research consensus spanning the past 20 years suggests that when compared with their
younger counterparts, depression in older adults is not more common and is not more
often caused by psychological factors. Although some studies have suggested that depression
in late life may be symptomatically different and characterized by a more somatic
presentation, there is insufficient empirical evidence to conclude that depression
presents differently across adulthood. Overall, older adults respond to psychological
interventions as well as younger adults, although evidence suggests that antidepressants
are less efficacious in late life. Finally, compared with middle-aged adults, depression
in older adults is associated with a more chronic course (i.e., higher rate of relapse),
which is likely moderated by medical comorbidity. This special article summarizes
our current understanding of the nature and treatment of late-life depression and
highlights areas of inquiry in need of further study.
Key Words
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Article info
Publication history
Published online: June 16, 2017
Accepted:
June 14,
2017
Received in revised form:
June 14,
2017
Received:
April 7,
2017
Identification
Copyright
© 2017 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.
