A practical approach to assess depression risk and to guide risk reduction strategies in later life

Almeida, OP, Alfonso, H, Pirkis, J, Kerse, N, Sim, M, Flicker, L, Snowdon, J, Draper, B, Byrne, G, Goldney, R, Lautenschlager, NT, Stocks, N, Scazufca, M, Huisman, M, Araya, R and Pfaff, J (2011) A practical approach to assess depression risk and to guide risk reduction strategies in later life. International Psychogeriatrics, 23 2: 280-291. doi:10.1017/S1041610210001870


Author Almeida, OP
Alfonso, H
Pirkis, J
Kerse, N
Sim, M
Flicker, L
Snowdon, J
Draper, B
Byrne, G
Goldney, R
Lautenschlager, NT
Stocks, N
Scazufca, M
Huisman, M
Araya, R
Pfaff, J
Title A practical approach to assess depression risk and to guide risk reduction strategies in later life
Journal name International Psychogeriatrics   Check publisher's open access policy
ISSN 1041-6102
1741-203X
Publication date 2011-03
Year available 2010
Sub-type Article (original research)
DOI 10.1017/S1041610210001870
Volume 23
Issue 2
Start page 280
End page 291
Total pages 12
Place of publication Cambridge, IL, United Kingdom
Publisher Cambridge University Press
Collection year 2011
Language eng
Formatted abstract
Background: Many factors have been associated with the onset and maintenance of depressive symptoms in later life, although this knowledge is yet to be translated into significant health gains for the population. This study gathered information about common modifiable and non-modifiable risk factors for depression with the aim of developing a practical probabilistic model of depression that can be used to guide risk reduction strategies.

Methods: A cross-sectional study was undertaken of 20,677 community-dwelling Australians aged 60 years or over in contact with their general practitioner during the preceding 12 months. Prevalent depression (minor or major) according to the Patient Health Questionnaire (PHQ-9) assessment was the main outcome of interest. Other measured exposures included self-reported age, gender, education, loss of mother or father before age 15 years, physical or sexual abuse before age 15 years, marital status, financial stress, social support, smoking and alcohol use, physical activity, obesity, diabetes, hypertension, and prevalent cardiovascular diseases, chronic respiratory diseases and cancer.

Results: The mean age of participants was 71.7 ± 7.6 years and 57.9% were women. Depression was present in 1665 (8.0%) of our subjects. Multivariate logistic regression showed depression was independently associated with age older than 75 years, childhood adverse experiences, adverse lifestyle practices (smoking, risk alcohol use, physical inactivity), intermediate health hazards (obesity, diabetes and hypertension), comorbid medical conditions (clinical history of coronary heart disease, stroke, asthma, chronic obstructive pulmonary disease, emphysema or cancers), and social or financial strain. We stratified the exposures to build a matrix that showed that the probability of depression increased progressively with the accumulation of risk factors, from less than 3% for those with no adverse factors to more than 80% for people reporting the maximum number of risk factors.

Conclusions: Our probabilistic matrix can be used to estimate depression risk and to guide the introduction of risk reduction strategies. Future studies should now aim to clarify whether interventions designed to mitigate the impact of risk factors can change the prevalence and incidence of depression in later life.
Keyword Comorbidity survey replication
Primary-health-care
General-practice
Older-adults
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes First published online 30 September 2010.

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2011 Collection
School of Medicine Publications
 
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Created: Sun, 06 Mar 2011, 00:11:47 EST