The Impact of Depressive Symptoms on Healthcare Costs in Late Life: Longitudinal Findings From the AgeMooDe Study

Objective: To examine whether depressive symptoms affect healthcare costs in old age longitudinally. Design: Multicenter prospective observational cohort study (two waves with n(t1)=1,195 and n(t2)=951) in Germany. Setting: Community. Participants: Participants aged 75 years and older recruited via general practitioners. Measurements: Depressive symptoms were assessed by the Geriatric Depression Scale (GDS). The healthrelated resource use was measured retrospectively from a societal perspective based on a questionnaire, covering outpatient services, inpatient treatment, pharmaceuticals, as well as formal and informal nursing care. Hybrid regression models were used to determine the between-and within-effect of depressive symptoms on healthcare costs, adjusting for important covariates. Results: Six-month total cost increased from (sic)3,090 (t1) to (sic)3,748 (t2). The hybrid random effects models showed that individuals with more depressive symptoms had higher healthcare costs compared with individuals with less depressive symptoms (between-effect). Moreover, an intra-individual increase in depressive symptoms increased healthcare costs by (sic)539.60 (within-effect) per symptom on GDS. Conclusions: Our findings emphasize the economic importance of depressive symptoms in old age. Appropriate interventions to treat depressive symptoms in old age might also be a promising strategy to reduce healthcare costs.