Chronic disease burden and baseline symptom severity were identified as consistent risk factors for negative depression trajectories in older adults, according to study results published in the International Journal of Geriatric Psychiatry.

Researchers conducted a population-based study of 15,661 patients age ≥51 years with major depression. Data was obtained from the US Health and Retirement Study from 2008 to 2016. Depression trajectories were detected using a group-based trajectory model and predictors of trajectories were assessed using multinomial logistic regression. The team used the Composite International Diagnostic Interview to evaluate major depression in study participants.

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After statistical analysis, the researchers detected four depression trajectory groups: persistently moderate/high (4.7%), increasing (6.3%), decreasing (3.2%), and never (85.8%). The risk for unfavorable trajectories was consistently higher in correlation with chronic disease burden and baseline symptom severity, which represent possible targets for intervention and screening. Younger age, male sex, and non-Hispanic African American race were associated with a lower risk of the 3 trajectories.

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One key study limitation was the short duration of follow-up.

“Our findings suggest that the natural course of major depression in late life is chronic and unremitting,” the researchers wrote.

“Future studies should investigate the extent of treatment utilization and how this affects the depression course to identify treatment gaps and potential targets for service delivery innovation,” they concluded.


Xiang X, Cheng J. Trajectories of major depression in middle-aged and older adults: A population-based study [published online June 9, 2019]. Int J Geriatr Psychiatry. doi:10.1002/gps.5161

This article originally appeared on Psychiatry Advisor