Depression in later life: Three etiologically different subgroups

Marjan D. Van den Berg, Albertine J. Oldehinkel, Antoinette L. Bouhuys, Els I. Brilman, Aartjan T.F. Beekman, Johan Ormel

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75 Citations (Scopus)


Background: Various studies support the notion that early onset depression and late onset depression have different etiological pathways. Late onset depression has been found to be a heterogeneous group. This study attempts to divide the late onset group in two subgroups with different aetiology and find evidence for the vascular depression hypothesis. Methods: Subjects were 132 depressed elderly persons from the general population, general practitioners and mental health care outpatient clinics. Sixty-four had early-onset depression (<60), 69 had late-onset depression (≥60). The latter group was divided into subjects with (n=15) and without (n=15) severe life stress. The groups were compared with respect to a variety of variables including vascular risk factors. Results: Early-onset depression was associated with neuroticism and parental history. Subjects with late-onset depression and no severe life stress had higher vascular risk factors than whose depression was preceded by a severe stressor did. Conclusions: Our findings suggest that late life depression can be divided into subgroups with different etiological pathways: (1) early-onset with longstanding psychobiological vulnerability; (2) late-onset as reaction to severe life stress; and (3) late-onset with vascular risk factors.

Original languageEnglish
Pages (from-to)19-26
Number of pages8
JournalJournal of affective disorders
Issue number1
Publication statusPublished - 2001


  • Depression
  • Early-onset
  • Late-onset
  • Vascular depression
  • Vulnerability

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