Neurobiological and Psychosocial Disorders Due to Depression in Older Persons: The Netherland Study

Late life depression is a serious problem amongst elderly. Depression, stress, loneliness could lead to the development of conditions like cardiovascular disease, diabetes and physical impairment.

With the increase in the aging population in the near future, the number of older persons suffering from chronic depression too will grow drastically. So, ‘it is of great importance to uncover mechanisms responsible for its chronic course and co morbidity’, says the Netherlands Study of Depression in Older Persons (NESDO).

Late life depression is a serious problem amongst elderly since it becomes a life long chronic condition. It is the interaction of three factors – vulnerability, stress and protective factors – that are responsible for the development of depression and its course over time.

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Studies highlight that personality, genetic factors as well as problems at work and in family relationships play a larger role in the onset of depression at early age, whereas late-life depression has been seen to be more strongly associated with frailty associated processes and neurodegenerative biological abnormalities. Loneliness, loss in social environment, inflammation, inability to do the day to day chores, memory loss, and cognitive limitations are factors contributing to depression amongst old people.

Not only do chronic diseases contribute to late life depression but depression, stress, and loneliness could lead to the development of conditions like cardiovascular disease, diabetes mellitus and of physical impairment.

Compared to younger depressed adults, older depressed persons were found to show disturbances such as fatigue and sleep disturbance and more apathy.

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To be able to make a direct comparison between early- and late-life depression there has been a need for studies that have sufficient numbers of depressed persons in all age ranges.

Therefore the Netherlands Study of Depression in Older Persons (NESDO) designed a study in which the course of late-life depression and its co morbidities will be followed up in detail.

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From 2007 until 2010, NESDO recruited depressed and non-depressed people. The NESDO sample consists of 378 depressed and 132 non-depressed persons aged 60 through 93 years. The baseline assessment included written questionnaires, interviews, medical examination, cognitive tests and collection of blood and saliva samples. Information was gathered about mental health outcomes and demographic, psychosocial, biological, cognitive and genetic determinants.

It aims to –

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1. Examine the reasons of behind late-life depression.

2. Find out the course and the consequences of depressive disorders in older persons.

3. Compare late life depression with early-life depression.

The results showed that –

• 95 percent of the individuals were seen to have major depression.

• Mean age of onset of the depressive disorder was around 49 year.

• 41 percent of the depressed persons had a co morbid anxiety disorder.

It is an ongoing study and the follow up assessments are currently going on with 6 monthly written questionnaires and face-to-face interviews after 2 and 6 years.

The study helps to provide an insight into the neurobiological, psychosocial and physical determinants of depression and its long-term course in older persons. Since a large number of individuals are being studied in the Netherlands Study of Depression and Anxiety, data can be pooled with the earlier studies and analysed further with respect to the etiology, prognosis and the course of late life depression amongst elderly population.

Reference: The Netherlands study of depression in older persons (NESDO); a prospective cohort study; Hannie et al; BMC Research Notes 2011.

Source-Medindia