Prevalence and risk factors for depression in a longitudinal, population-based study including individuals in the community and residential care

Objective: The authors report the population prevalence of depression in older adults living in the community and in residential care. Demographic, medical, health behavior, functional and cognitive measures, and transition to residential care are evaluated as risk factors for depression over eight years. Methods: Depression prevalence estimates were obtained from the initial electoral role sample of the Australian Longitudinal Study of Ageing that included persons living in residential care. A subsample (N = 1,116) based on follow-up data were included in longitudinal multilevel analyses that evaluated between-person and within-person predictors associated with scores from the Center for Epidemiology - Depression Scale. Results: At wave 1, 14.4% of community-dwelling and 32.0% of residential care-dwelling participants were depressed (15.2% of total cases). Increase in depression was associated with antidepressant status, sex, education, and marital status, but not history of hypertension, stroke, diabetes, heart disease, or smoking. Time-varying predictors, including residential care, activities of daily living, instrumental activities of daily living, self-rated health, and Mini-Mental State Examination, predicted depressive symptoms both between and within persons. Conclusions: Depression is strongly linked with factors indicating increased dependency. Risk assessment and targeting of intervention strategies to prevent depression in late life should incorporate changes in functional capacity, mental status, and need for residential care.