Association between age of onset and symptom profiles of late-life depression

Objective: The recognition of later late-onset (LLO) major depression (MD) is a matter of concern. Method: Cross-sectional study assessed MD with the MINI structured interview and the MADRS in a referred sample of 13 377 non-demented adult out-patients visiting their physicians. Among 6850 patients with a first episode of MD, 370 LLO (75 years of age and older) MD were compared with 814 late-onset (LO) (60-74 years old) MD and 5666 early-onset (EO) (18-59 years old) MD. Results: There are many similarities between the symptom patterns of EO, LO and LLO MDs. However, the symptom pattern of LLO MD includes more retardation/agitation, lassitude, reduced appetite and apparent sadness, and less sleep disturbances, guilt feelings, pessimism and inner tension than LO and EO MD. Conclusion: The differences in symptom profiles are very modest and between-group differences may not be meaningful on an individual level.