Abstract
Numerous epidemiological reports have found that adolescent, young adult, and middle-aged adult girls and women are more likely to be diagnosed with unipolar depression and report greater symptoms of depression when compared to boys and men of similar ages. What is less well-known is whether this gender difference persists into late life. This literature review examines whether the well-known gender difference in unipolar depression continues into old age, and, if it does, whether the variables that are known to contribute to the gender difference in unipolar depression from adolescence through adulthood continue to contribute to the gender difference in the elderly, and/or whether there are new variables that arise in old age and contribute to the gender difference in the elderly. In this review of 85 empirical studies from every continent except for Antarctica, we find substantial support for the gender difference in depression in individuals who are 60 and older. More research is necessary to determine which factors are the strongest predictors of the gender difference in depression in late life, and particularly whether the factors that seem to be responsible for the gender difference in depression in earlier life stages continue to predict the gender difference in the elderly, and/or whether new factors come into play in late life. Longitudinal research, meta-analyses, and model-based investigations of predictors of the gender difference in depression are needed to provide insights into how and why the gender difference in depression persists in older age.
Highlights
It is well-known that females are more likely to be depressed than males, both in terms of unipolar depressive episodes and in terms of depressive symptoms [1,2]
Nguyen & Zonderman (2006) and Mirowsky (1996) followed their participants over a 6–10 year period, and Leach et al (2008) followed their participants over a 20-year period. One of these studies found an increase in the gender difference in depression with age [76]; one of these studies found a decrease in the gender difference in depression with age [74]; and, the third study found no change in the size of the gender difference in depression with age [80]
While we have some preliminary data that suggests that sociotropy declines with age [101], it is unclear whether the gender difference in sociotropy that is still present in old age explains some of the gender difference in depression in the elderly
Summary
It is well-known that females are more likely to be depressed than males, both in terms of unipolar depressive episodes and in terms of depressive symptoms [1,2]. A thorough discussion of the gender difference in unipolar depression in older adults is largely missing from major reviews of the gender difference in depression. When older adults are included in mixed samples, analysis of gender differences may not be stratified according to age or the sample size of older adults may be too small (e.g., [5]) This results in a limited ability to analyze or interpret data on the gender difference in unipolar depression in older adults in mixed samples. The primary question we will try to answer is whether there is sufficient empirical data to support the existence of a gender difference in depression in older adults. We will try to specify the most important research questions that remain to be answered in order to develop a reasonably complete picture of the gender difference in depression throughout the life course
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