Psychological Medicine

Original Article

The incidence of first-onset depression in a population followed from the age of 70 to 85 1

S. P.  PÁLSSON  c1 a1, S.  ÖSTLING  a1 and I.  SKOOG  a1
a1 From the Institute of Clinical Neuroscience, Department of Psychiatry, Sahlgrenska University Hospital, Göteborg University, Göteborg, Sweden


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 1000 person-years in men and 30 per 1000 person-years in women between the ages of 70 and 85 (sex difference P = 0·001). The incidence increased from 17 per 1000 person-years (men 8·7, women 23·2, P = 0·007) between the ages of 70 and 79 to 44 per 1000 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.

c1 Address for correspondence: Dr Sigurþur P. Pálsson, Department of Psychiatry, Sahlgrenska University Hospital, S-413 45 Göteborg, Sweden.


1 From the gerontological and geriatric population studies in Göteborg, Sweden. Project leader: before 1988, Professor Alvar Svanborg; after 1988, Professor Bertil Steen.