Objectives: To describe the evolution of prevalence of depressive symptoms and antidepressant use between 1988 and 1999 in a large representative sample of older community-dwelling French people.
Design: Prospective cohort designed in 1988/89 to study cerebral and functional aging.
Setting: Urban and rural communities in southwestern France.
Participants: Three thousand six hundred thirty-seven adults aged 65 and older living in noninstitutional settings at baseline.
Measurements: Participants were interviewed 3, 5, 8, and 10 years after the initial data collection. Depressive symptomatology was evaluated using a French version of the Center for Epidemiological Studies Depression Scale. Longitudinal analysis of the prevalence of depressive symptomatology was performed using a logistic mixed model adjusted for antidepressant use, sex, age, education level, living conditions, psychiatric antecedents, drug consumption, and diagnosis of dementia.
Results: Over the 10 years of follow-up, the prevalence of depressive symptomatology decreased from 13.8% to 8.3%. This decrease was statistically significant even after adjustment (odds ratio = 0.88 per increased year, 95% confidence interval = 0.85-0.90) and was more pronounced in subjects having reported previous depression at baseline. During the same period, antidepressant use rose from 5.2% to 11.9%, mainly due to increased use of selective serotonin reuptake inhibitors. Furthermore, the proportion of subjects who had depressive symptoms and did not use antidepressants decreased from 11.8% to 6.2%.
Conclusion: This study suggests better management of late-life depression in the last decade and illustrates the heterogeneity of depression disorder in late life.