The natural history of late-life depression

A. T.F. Beekman, S. W. Geerlings, D. J.H. Deeg, J. H. Smit, R. S. Schoevers, E. De Beurs, A. W. Braam, B. W.J.H. Penninx, W. Van Tilburg

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Very little is known about the longer term natural history of late life depression. There are good reasons to suspect that the prognosis of depression changes with age. Moreover, in later life the prevalence of depressive disorders fulfilling rigorous diagnostic criteria becomes relatively rare, while less well defined depressive states become more common. Our aims were to study the natural history of late life depression, systematically comparing those who did, and did not fulfil rigorous diagnostic criteria. Within the Longitudinal Aging Study Amsterdam (LASA), a large cohort of depressed elderly (n=277) was followed-up over 6 years, using 14 observations. The average symptom severity, remained above the 85% percentile of the population average. Symptoms were short-lived in only 13.7%. There were only 22.7% remissions, while 32.5% had a chronic course. Although sub-threshold disorders had the best outcome, prognosis remained unfavourable in the majority of cases, while this group was at high risk to develop DSM affective disorders. The overall conclusion was that natural history of late-life depression is poor. Sub-threshold depression is both serious and chronic in many cases.

Original languageEnglish
Pages (from-to)67-73
Number of pages7
JournalResearch and Practice in Alzheimer's Disease
Publication statusPublished - 1 Dec 2003


  • Community
  • Depression
  • Elderly
  • Predictors
  • Prognosis

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