Almeida, Osvaldo P. McCaul, Kieran Hankey, Graeme J. Yeap, Bu B. Golledge, Jonathan Norman, Paul E. and Flicker, Leon 2016. Duration of diabetes and its association with depression in later life: The Health In Men Study (HIMS). Maturitas, Vol. 86, p. 3.
Almeida, Osvaldo P. Marsh, Kylie Murray, Karen Hickey, Martha Sim, Moira Ford, Andrew and Flicker, Leon 2016. Reducing depression during the menopausal transition with health coaching: Results from the healthy menopausal transition randomised controlled trial. Maturitas, Vol. 92, p. 41.
Almeida, Osvaldo P. Hankey, Graeme J. Yeap, Bu B. Golledge, Jonathan Norman, Paul E. and Flicker, Leon 2015. Depression, Frailty, and All-Cause Mortality: A Cohort Study of Men Older than 75 Years. Journal of the American Medical Directors Association, Vol. 16, Issue. 4, p. 296.
Smith, Marianne Haedtke, Christine Shibley, Deborah and Butcher, Howard K. 2015. Evidence-Based Practice Guideline: Late-Life Depression Detection. Journal of Gerontological Nursing, Vol. 41, Issue. 2, p. 18.
Tully, Phillip J. Newland, Richard F. and Baker, Robert A. 2015. Cardiovascular risk profile before coronary artery bypass graft surgery in relation to depression and anxiety disorders: An age and sex propensity matched study. Australian Critical Care, Vol. 28, Issue. 1, p. 24.
Tully, Phillip J. Winefield, Helen R. Baker, Robert A. Denollet, Johan Pedersen, Susanne S. Wittert, Gary A. and Turnbull, Deborah A. 2015. Depression, anxiety and major adverse cardiovascular and cerebrovascular events in patients following coronary artery bypass graft surgery: a five year longitudinal cohort study. BioPsychoSocial Medicine, Vol. 9, Issue. 1,
Almeida, Osvaldo P. 2014. Prevention of depression in older age. Maturitas, Vol. 79, Issue. 2, p. 136.
Almeida, Osvaldo P. Hankey, Graeme J. Yeap, Bu B. Golledge, Jonathan McCaul, Kieran and Flicker, Leon 2013. A risk table to assist health practitioners assess and prevent the onset of depression in later life. Preventive Medicine, Vol. 57, Issue. 6, p. 878.
Almeida, Osvaldo P. Alfonso, Helman Yeap, Bu B. Hankey, Graeme J. and Flicker, Leon 2013. Cardiovascular diseases do not influence the mental health outcome of older men with depression over 6 years. Journal of Affective Disorders, Vol. 144, Issue. 3, p. 248.
Kelley, Keith W. O’Connor, Jason C. Lawson, Marcus A. Dantzer, Robert Rodriguez-Zas, Sandra L. and McCusker, Robert H. 2013. Aging leads to prolonged duration of inflammation-induced depression-like behavior caused by Bacillus Calmette-Guérin. Brain, Behavior, and Immunity, Vol. 32, p. 63.
Krauskopf, Katherine A. Sofianou, Anastasia Goel, Mita S. Wolf, Michael S. Wilson, Elizabeth A.H. Martynenko, Melissa E. Halm, Ethan A. Leventhal, Howard Feldman, Jonathan M. Federman, Alex D. and Wisnivesky, Juan P. 2013. Depressive Symptoms, Low Adherence, and Poor Asthma Outcomes in the Elderly. Journal of Asthma, Vol. 50, Issue. 3, p. 260.
Almeida, Osvaldo P. 2012. Approaches to decrease the prevalence of depression in later life. Current Opinion in Psychiatry, Vol. 25, Issue. 6, p. 451.
Almeida, Osvaldo P. Draper, Brian Pirkis, Jane Snowdon, John Lautenschlager, Nicola T. Byrne, Gerard Sim, Moira Stocks, Nigel Kerse, Ngaire Flicker, Leon and Pfaff, Jon J. 2012. Anxiety, depression, and comorbid anxiety and depression: risk factors and outcome over two years. International Psychogeriatrics, Vol. 24, Issue. 10, p. 1622.
Almeida, Osvaldo P. Pirkis, Jane Kerse, Ngaire Sim, Moira Flicker, Leon Snowdon, John Draper, Brian Byrne, Gerard Lautenschlager, Nicola T. Stocks, Nigel Alfonso, Helman and Pfaff, Jon J. 2012. Socioeconomic disadvantage increases risk of prevalent and persistent depression in later life. Journal of Affective Disorders, Vol. 138, Issue. 3, p. 322.
Almeida, O. P. Draper, B. Snowdon, J. Lautenschlager, N. T. Pirkis, J. Byrne, G. Sim, M. Stocks, N. Flicker, L. and Pfaff, J. J. 2012. Factors associated with suicidal thoughts in a large community study of older adults. The British Journal of Psychiatry, Vol. 201, Issue. 6, p. 466.
Byles, Julie E. Gallienne, Lucy Blyth, Fiona M. and Banks, Emily 2012. Relationship of age and gender to the prevalence and correlates of psychological distress in later life. International Psychogeriatrics, Vol. 24, Issue. 06, p. 1009.
Almeida, Osvaldo P. 2011. Evolution, depression and the interplay between chance and choices. International Psychogeriatrics, Vol. 23, Issue. 07, p. 1021.
Background: Many factors have been associated with the onset and maintenance of depressive symptoms in later life, although this knowledge is yet to be translated into significant health gains for the population. This study gathered information about common modifiable and non-modifiable risk factors for depression with the aim of developing a practical probabilistic model of depression that can be used to guide risk reduction strategies.
Methods: A cross-sectional study was undertaken of 20,677 community-dwelling Australians aged 60 years or over in contact with their general practitioner during the preceding 12 months. Prevalent depression (minor or major) according to the Patient Health Questionnaire (PHQ-9) assessment was the main outcome of interest. Other measured exposures included self-reported age, gender, education, loss of mother or father before age 15 years, physical or sexual abuse before age 15 years, marital status, financial stress, social support, smoking and alcohol use, physical activity, obesity, diabetes, hypertension, and prevalent cardiovascular diseases, chronic respiratory diseases and cancer.
Results: The mean age of participants was 71.7 ± 7.6 years and 57.9% were women. Depression was present in 1665 (8.0%) of our subjects. Multivariate logistic regression showed depression was independently associated with age older than 75 years, childhood adverse experiences, adverse lifestyle practices (smoking, risk alcohol use, physical inactivity), intermediate health hazards (obesity, diabetes and hypertension), comorbid medical conditions (clinical history of coronary heart disease, stroke, asthma, chronic obstructive pulmonary disease, emphysema or cancers), and social or financial strain. We stratified the exposures to build a matrix that showed that the probability of depression increased progressively with the accumulation of risk factors, from less than 3% for those with no adverse factors to more than 80% for people reporting the maximum number of risk factors.
Conclusions: Our probabilistic matrix can be used to estimate depression risk and to guide the introduction of risk reduction strategies. Future studies should now aim to clarify whether interventions designed to mitigate the impact of risk factors can change the prevalence and incidence of depression in later life.
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