Personality and risk for depression in a birth cohort of 70-year-olds followed for 15 years.

BACKGROUND: The association between personality traits and the first lifetime onset of clinically significant depression has not been studied in older adults. METHOD: Experienced psychiatrists conducted interviews and chart reviews at baseline and throughout the 15-year follow-up period. Survival analyses were conducted on the presence/absence of a DSM-III-R mood disorder at follow-up. RESULTS: There were 59 cases of first lifetime episodes of depression. Analyses showed that Neuroticism [hazard ratio (HR) per one point increase in the Maudsley Personality Inventory (MPI)=1.05, 95% confidence interval (CI) 1.02-1.08] but not Extroversion (HR 1.02, 95% CI 0.97-1.06) amplified risk for mood disorder. CONCLUSIONS: This prospective study on a randomly sampled birth cohort of older adults showed that Neuroticism confers risk for a first lifetime episode of clinically significant depression. Findings have implications for understanding the etiology of late-life depression (LLD) and could also aid in the identification and treatment of people at risk.

The incidence of first-onset psychotic symptoms and paranoid ideation in a representative population sample followed from age 70-90 years. Relation to mortality and later development of dementia.

BACKGROUND: Limited data are available on the incidence of psychotic symptoms in the elderly. OBJECTIVE: To elucidate the incidence of first-onset psychotic symptoms in the elderly and their relation to mortality and later development of dementia. METHOD: A population-sample (n = 392) born 1901-1902 was assessed from age 70-90 with psychiatric examinations, medical record reviews and from age 85, also with key-informant interviews. Individuals developing dementia were excluded. RESULT: The cumulative incidence of first-onset psychotic symptoms was 4.8% (8.0% including key-informant reports in the total sample) and 19.8 % in those who survived to age 85. Sixty-four percent of those with first-onset hallucinations later developed dementia, compared to 30% of those with delusions and 25% of those without psychotic symptoms. CONCLUSIONS: One fifth of non-demented elderly who survives up to age 85 develops first-onset psychotic symptoms. Hallucinations predict dementia, but most elderly individuals with first-onset psychotic symptoms do not develop dementia.

The incidence of first-onset depression in a population followed from the age of 70 to 85.

BACKGROUND: Due to the limited data available, it is not clear whether the incidence of first-onset depression varies with age in the elderly. METHODS: A representative sample of individuals born 1901-2 (N = 392) was examined at the ages of 70, 75, 79, 81, 83 and 85 years by psychiatrists using a semi-structured schedule. Information on depressive episodes was also collected from self-report and examination of case records. Depression was diagnosed according to the DSM-III-R criteria. RESULTS: The incidence of depression was 12 per 1,000 person-years in men and 30 per 1,000 person-years in women between the ages of 70 and 85 (sex difference P = 0.001). The incidence increased from 17 per 1,000 person-years (men 8.7, women 23.2, P = 0.007) between the ages of 70 and 79 to 44 per 1,000 person years (men 27.0, women 52.8, P = 0.166) between 79 and 85 (age difference: RR 2.6, P < 0.001; men RR 3.1, P = 0.036; women RR 2.3, P = 0.003). A diagnosis of depression was associated with increased mortality and refusal rate during the 15-year follow-up. Previous episodes of depression were associated with an increased risk of further episodes. The prevalence of depression increased from 5.6% at the age of 70 to 13.0% at the age of 85. The lifetime prevalence of depression was 23% in men and 45% in women. CONCLUSIONS: Both the incidence and prevalence of depression increased with age in this longitudinally followed birth cohort, and the incidence was higher in women than in men.