The tide has turned: incidence of depression declined in community living young-old adults over one decade.

H.W Jeuring,A.T.F Beekman,E.O Hoogendijk,H.C Comijs,M.L Stek,M Huisman,D.J.H Deeg

doi:10.1017/s2045796018000811

H.W Jeuring, A.T.F Beekman + Show 5 more

Open Access

https://doi.org/10.1017/s2045796018000811

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Abstract

Studying birth-cohort differences in depression incidence and their explanatory factors may provide insight into the aetiology of depression and could help to optimise prevention strategies to reduce the worldwide burden of depression. Data were used from the Longitudinal Aging Study Amsterdam, a nationally representative study among community dwelling older adults in the Netherlands. Cohort differences in depression incidence over a 10-year-period (score ⩾16 on the Center for Epidemiologic Studies Depression scale) were tested using a cohort-sequential-longitudinal-design, comparing two identically measured cohorts of non-depressed 55-64-year-olds, born 10-years apart. Baseline measurements took place in 1992/93 (early cohort, n = 794), and 2002/03 (recent cohort, n = 771). As indicated by the dynamic equilibrium model of depression, potential explanatory factors were distinguished in risk and protective factors. The incidence rates for depression in the early and recent cohort were 1.91 (95% confidence interval (CI) 1.59-2.27) and 1.60 (95% CI 1.31-1.94) per 100 person-years, respectively. A 29% risk reduction in depression incidence was observed in the recent cohort (HRcohort: 0.71, 95% CI 0.54-0.92, p = 0.011), as compared with the early cohort, even though average levels of risk factors such as chronic disease and functional limitations had increased. This reduction was primarily explained by increased levels of education, mastery and labour market participation. These findings suggest that favourable developments of protective factors have counterbalanced unfavourable effects of risk factors on the incidence of depression, resulting in a net reduction of depression incidence among young-old adults. However, maintaining a good physical health must be a priority to further decrease depression rates.

Highlights

It needs no introduction that depression is a major contributor to the global burden of disease at all ages (Ferrari et al, 2013)
This study found a substantial cohort difference in the 10-year incidence of depression between two cohorts of 55–64-year-olds: those from the recent cohort developed incident depression less often than the earlier cohort
Had risk factors, such as chronic diseases and functional limitations, not increased in the recent cohort compared with the earlier cohort, the incidence difference would have been even larger

Summary

Introduction

It needs no introduction that depression is a major contributor to the global burden of disease at all ages (Ferrari et al, 2013). There has been an increasing awareness in the recent decades of the need to better recognise and treat depression (Kohls et al, 2017), a majority of studies have observed an increase in depression rates among recent generations (Wittchen and Uhmann, 2010). These findings have been largely based on prevalence studies Information on trends in incidence rates and their underlying mechanisms is essential for the design of prevention strategies to help to reduce the worldwide burden of depression

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