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The etiology of late-life affective disorders is undoubtedly multifactorial (see Table 15–2). Twin and family studies, along with studies focusing on molecular genetics, provide strong evidence for a heritable contribution to the etiology of major depression and bipolar disorder (Gatz et al. 1992). Evidence that these genetic factors weigh heavily in the etiology of bipolar disorders in late life is virtually nonexistent, although the biological nature of this disorder would suggest some genetic contribution. Evidence from studies of unipolar depression in late life suggests that the genetic contribution is weaker in late-life depression than in depression at earlier stages of the life cycle. In a study of elderly twins in Sweden, genetic influences accounted for 16% of the variance in total depression scores on the CES-D and 19% of the somatic symptoms. In contrast, genetic influences minimally contributed to the variance of symptoms of depressed mood and positive affect (Gatz et al. 1992).

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Table Reference Number
Table 15–2. Origins of late-life depression

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