Depression and Depression Treatment in a Population-Based Study of Individuals Over 60 Years Old Without Dementia

Objective: To estimate the prevalence of depression in a population-based sample of older adults, and to identify the individual profile of people who received depression treatment. Design: Cross-sectional. Setting: Central area (Kungsholmen) in Stockholm, Sweden. Participants: A randomized population-based sample of individuals aged 60 years and older (N = 3,084) without dementia from the Swedish National Study of Aging and Care in Kungsholmen examined between 2001 and 2004. Measurements: Experienced physicians carried out a semi-structured psychiatric examination including the Comprehensive Psychopathological Rating Scale. Depression was diagnosed according to DSM-IV-TR and DSM-5 criteria. Information regarding drug treatment and psychotherapy was collected during the examination and is based on self-report. Results: The prevalence of depression was 5.9% (major depression: 0.8%, minor depression: 5.1%). In the total sample, 8.3% were prescribed an antidepressant and 0.9% were treated with psychotherapy. Among individuals with depression, fewer than one-third received treatment with psychotherapy or antidepressants, but almost half were prescribed anxiolytic or hypnotic drugs. Individuals with self-reported depression and anxiety were more likely to receive depression treatment whereas individuals with depression who reported insomnia were less likely to receive depression treatment. Conclusions: Our findings indicate that even in a central urban area of a country with an advanced healthcare system depression in old age is often unrecognized and untreated. In addition, almost half of those with depression received potentially inappropriate drug treatment with anxiolytics or hypnotics.