Epidemiological findings indicate that although older adults are less likely to have a clinically diagnosable depressive disorder than younger adults, depressive symptoms appear to increase in later life. Although these symptoms often do not reach the level of clinically diagnosable depression, they are associated with a variety of negative outcomes, such as lower quality of life and worse physical health. An article in JAMA Psychiatry reports on a study that tracked the depressive symptoms and health of more than 2,000 participants over a period of 30 years, and found that depressive symptoms are highest in young adulthood, decrease during middle adulthood, and often increase again in later adulthood.
The study involved data from the ongoing Baltimore Longitudinal Study of Aging. Participants had a slightly higher level of education than the general population, but the sample includes a diverse population of older adults, and the researchers had a variety of demographic and health data about the participants. Participants were administered a widely used scale of depressive symptoms, which involved three subscales: depressed affect (or mood), somatic complaints (physical pains), and interpersonal problems. The authors used these subscales to see whether these different types of depressive symptoms had the same patterns throughout the life span, and whether different demographic groups might differ across these subscales. Further, somatic symptoms of depression may be particularly closely associated with physical ailments.
Within the sample, men and women experienced a similar total number of depressive symptoms, though women were more likely to experience negative mood in early adulthood, while men were more likely to as older adults. Higher levels of education were associated with fewer somatic symptoms and interpersonal problems. White participants had slightly lower levels of interpersonal complaints, but were more likely to see a rise in such complaints in older adulthood, and were more likely to report somatic complaints, than non-white participants.
The researchers examined whether these later-life increases in depressive symptoms were a result of decreased physical well-being or related to approaching death. While illness, functional difficulties, and impending death were associated with higher levels of depressive symptoms, the association was not strong enough to account for all of the increase in depressive symptoms. This suggests the need to understand which other social and psychological factors might negatively impact well-being in late adulthood. The authors suggest that these data indicate the need for clinicians to pay attention to depressive symptoms even when they do not meet the level of clinically diagnosable depression.
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