When Depression Appears in Late Life, Change and Loss May Be to Blame

Even if you've never been clinically depressed, it's never too late to become so, it appears.

Paul Duberstein, Ph.D., director of the Laboratory of Personality and Development at the University of Rochester, and colleagues selected 275 70-year-olds who had never experienced a clinical depression to take part in a study of late-life depression. They followed their subjects over the next 15 years to determine whether any of them became clinically depressed. Forty-one did, psychiatric interviews revealed. Of the 41, 20 became clinically depressed during their 70s and 21 during their 80s.

The investigators also used information they had obtained about the cohort at the start of the study to glean insights into why the 41 subjects developed a clinical depression for the first time in their 70s or 80s. They found that being female and being neurotic (prone to anxiety, nervousness, and distress under stress) were significant predictors. They used the Maudsley Personality Inventory to assess neuroticism. It asked questions such as, Do you often worry about things you should have not done or said? Would you call yourself tense or high-strung? Are you an irritable person?

Yet if being female or neurotic can raise the risk that some people who have never been clinically depressed in their earlier years become so when they are older, why didn't being female or neurotic make them clinically depressed at that time as well? After all, both female gender and neuroticism are known risk factors for depression in younger persons as well as older ones.

Duberstein and his colleagues aren't sure, but they propose a possible explanation. Close friendships, rewarding occupations, physical vigor, and economic independence may protect some women and neurotic individuals from clinical depression when they are younger, but as they grow older, they may lose some of these protective factors.

“Research is needed on how subtle and significant changes in the social, economic, physical, and spiritual arenas interact with neuroticism to amplify the risk of late-life depression,” the researchers concluded in their study report, which was published in the May Psychological Medicine.

The study was funded by the University of Rochester, U.S. Public Health Service, Swedish Research Council, and Swedish Council for Working Life and Social Research.

An abstract of “Personality and Risk for Depression in a Birth Cohort of 70-Year-Olds Followed for 15 Years” can be accessed at<http://journals.cambridge.org/action/displayJournal?jid=PSM> by clicking on the May issue. ▪