Skip to main content
    • Aa
    • Aa

Secular trends in the prevalence of dementia and depression in Swedish septuagenarians 1976–2006

  • P. Wiberg (a1), M. Waern (a1), E. Billstedt (a1), S. Östling (a1) and I. Skoog (a1)...

It is not clear whether the prevalence of dementia and depression among the elderly has changed during the past 30 years.


Population-based samples from Gothenburg, Sweden were examined with identical psychiatric and neuropsychiatric examinations at age 70 years in 1976–1977 (n = 404, response rate 78.8%) and 2000–2001 (n = 579, response rate 66.4%), and at age 75 in 1976–1977 (n = 303, response rate 78%) and 2005–2006 (n = 753, response rate 63.4%). Depression was diagnosed according to DSM-IV and dementia according to Kay's criteria. General linear models (GLMs) were used to test for differences between groups.


Dementia was related to age but not to birth cohort or sex. Major depression was related to sex (higher in women) but not to birth cohort or age. Minor depression was related to birth cohort, sex (higher in women), age (higher at age 75) and the interaction effect of birth cohort × age; that is, the prevalence of minor depression increased with age in the 2000s but not in the 1970s. Thus, the prevalence of minor depression was higher in 2005–2006 than in 1976–1977 among 75-year-olds for both men (12.4% v. 3.7%) and women (19.1% v. 5.6%) whereas there were no birth cohort differences at age 70.


Secular changes were observed only for minor depression, which is considered to be related more to psychosocial factors than major depression. The high prevalence of minor depression in later-born birth cohorts emphasizes the importance of detecting minor depression in the elderly.

Corresponding author
*Address for correspondence: I. Skoog, M.D., Ph.D., Neuropsychiatric Epidemiology Unit, Neuropsykiatri SU/Mölndal, Wallinsgatan 6, SE-431 41 Mölndal, Sweden. (Email:
Hide All
N Beckman , M Waern , D Gustafson , I Skoog (2008). Secular trends in self reported sexual activity and satisfaction in Swedish 70 year olds: cross sectional survey of four populations, 1971–2001. British Medical Journal 337, 151154.

AT Beekman , DJ Deeg , T van Tilburg , JH Smit , C Hooijer , W van Tilburg (1995). Major and minor depression in later life: a study of prevalence and risk factors. Journal of Affective Disorders 36, 6575.

AL Byers , K Yaffe , KE Covinsky , MB Friedman , ML Bruce (2010). High occurrence of mood and anxiety disorders among older adults: the National Comorbidity Survey Replication. Archives of General Psychiatry 67, 489496.

WM Compton , KP Conway , FS Stinson , BF Grant (2006). Changes in the prevalence of major depression and comorbid substance use disorders in the United States between 1991–1992 and 2001–2002. American Journal of Psychiatry 163, 21412147.

FM Culbertson (1997). Depression and gender: an international review. The American Psychologist 52, 2531.

WW Eaton , A Kalaydjian , DO Scharfstein , B Mezuk , Y Ding (2007). Prevalence and incidence of depressive disorder: the Baltimore ECA follow-up, 1981–2004. Acta Psychiatrica Scandinavica 116, 182188.

C Ernst , J Angst (1995). Depression in old age: is there a real decrease in prevalence? A review. European Archives of Psychiatry and Clinical Neuroscience 245, 272287.

P Ghisletta , D Spini (2004). An introduction to generalized estimating equations and an application to assess selectivity effects in a longitudinal study on very old individuals. Journal of Educational and Behavioral Statistics 29, 421437.

S Grigoriadis , GE Robinson (2007). Gender issues in depression. Annals of Clinical Psychiatry 19, 247255.

KS Hall , S Gao , O Baiyewu , KA Lane , O Gureje , J Shen , A Ogunniyi , JR Murrell , FW Unverzagt , J Dickens , V Smith-Gamble , HC Hendrie (2009). Prevalence rates for dementia and Alzheimer's disease in African Americans: 1992 versus 2001. Alzheimer's and Dementia 5, 227233.

AF Jorm (1987). Sex and age differences in depression: a quantitative synthesis of published research. Australian and New Zealand Journal of Psychiatry 21, 4653.

AF Jorm (2000). Does old age reduce the risk of anxiety and depression? A review of epidemiological studies across the adult life span. Psychological Medicine 30, 1122.

AF Jorm , AE Korten , AS Henderson (1987). The prevalence of dementia: a quantitative integration of the literature. Acta Psychiatrica Scandinavica 76, 465479.

S Kasen , P Cohen , H Chen , D Castille (2003). Depression in adult women: age changes and cohort effects. American Journal of Public Health 93, 20612066.

DW Kay , M Roth , P Beamish (1964). Old age mental disorders in Newcastle upon Tyne. II. A study of possible social and medical causes. British Journal of Psychiatry 110, 668682.

RC Kessler , O Demler , RG Frank , M Olfson , HA Pincus , EE Walters , P Wang , KB Wells , AM Zaslavsky (2005). Prevalence and treatment of mental disorders, 1990 to 2003. New England Journal of Medicine 352, 25152523.

GL Klerman , PW Lavori , J Rice , T Reich , J Endicott , NC Andreasen , MB Keller , RM Hirschfield (1985). Birth-cohort trends in rates of major depressive disorder among relatives of patients with affective disorder. Archives of General Psychiatry 42, 689693.

GL Klerman , MM Weissman (1989). Increasing rates of depression. Journal of the American Medical Association 261, 22292235.

PW Lavori , GL Klerman , MB Keller , T Reich , J Rice , J Endicott (1987). Age-period-cohort analysis of secular trends in onset of major depression: findings in siblings of patients with major affective disorder. Journal of Psychiatric Research 21, 2335.

A Lobo , P Saz , G Marcos , JL Dia , C De-la-Camara , T Ventura , JA Montanes , A Lobo-Escolar , S Aznar (2007). Prevalence of dementia in a southern European population in two different time periods: the ZARADEMP Project. Acta Psychiatrica Scandinavica 116, 299307.

FA McDougall , K Kvaal , FE Matthews , E Paykel , PB Jones , ME Dewey , C Brayne (2007). Prevalence of depression in older people in England and Wales: the MRC CFA Study. Psychological Medicine 37, 17871795.

LV Nilsson , G Persson (1984). Prevalence of mental disorders in an urban sample examined at 70, 75 and 79 years of age. Acta Psychiatrica Scandinavica 69, 519527.

S Palsson , I Skoog (1997). The epidemiology of affective disorders in the elderly: a review. International Clinical Psychopharmacology 12, 313.

SG Riedel-Heller , A Busse , MC Angermeyer (2006). The state of mental health in old-age across the ‘old’ European Union: a systematic review. Acta Psychiatrica Scandinavica 113, 388401.

K Ritchie , S Artero , I Beluche , ML Ancelin , A Mann , AM Dupuy , A Malafosse , JP Boulenger (2004). Prevalence of DSM-IV psychiatric disorder in the French elderly population. British Journal of Psychiatry 184, 147152.

I Skoog , L Nilsson , B Palmertz , LA Andreasson , A Svanborg (1993 b). A population-based study of dementia in 85-year-olds. New England Journal of Medicine 328, 153158.

DC Steffens , I Skoog , MC Norton , AD Hart , JT Tschanz , BL Plassman , BW Wyse , KA Welsh-Bohmer , JC Breitner (2000). Prevalence of depression and its treatment in an elderly population: the Cache County study. Archives of General Psychiatry 57, 601607.

J Wancata , A Börjesson-Hansson , S Ostling , K Sjögren , I Skoog (2007). Diagnostic criteria influence dementia prevalence. American Journal of Geriatric Psychiatry 15, 10341045.

MM Weissman , R Bland , PR Joyce , S Newman , JE Wells , HU Wittchen (1993). Sex differences in rates of depression: cross-national perspectives. Journal of Affective Disorders 29, 7784.

MM Weissman , P Wickramaratne , S Greenwald , HY Hsu , R Ouellette , LN Robins , JI Escobar , R Bland , S Newman , H Orn , G Canino , M Rubiostipec , HU Wittchen , CA Essau , C Faravelli , G Incerpi , BG Deglinnocenti , L Aiazzi , S Pallanti , JP Lepine , P Pariente , J Lellouch , E Karam , JE Wells , PR Joyce , M Oakleybrowne , JA Bushnell , HG Hwu , EK Yeh , LY Chang , GL Klerman , AC Leon , P Lavori , M Warshaw , W Maier , A Marx , D Lichtermann , J Minges , R Heun , J Hallmayer (1992). The changing rate of major depression. Cross-national comparisons. Journal of the American Medical Association 268, 30983105.

PJ Wickramaratne , MM Weissman , PJ Leaf , TR Holford (1989). Age, period and cohort effects on the risk of major depression: results from five United States communities. Journal of Clinical Epidemiology 42, 333343.

K Wilhelmson , P Allebeck , B Steen (2002). Improved health among 70-year olds: comparison of health indicators in three different birth cohorts. Aging Clinical and Experimental Research 14, 361370.

L Wilhelmsen , L Welin , K Svardsudd , H Wedel , H Eriksson , PO Hansson , A Rosengren (2008). Secular changes in cardiovascular risk factors and attack rate of myocardial infarction among men aged 50 in Gothenburg, Sweden: accurate prediction using risk models. Journal of Internal Medicine 263, 636643.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Psychological Medicine
  • ISSN: 0033-2917
  • EISSN: 1469-8978
  • URL: /core/journals/psychological-medicine
Please enter your name
Please enter a valid email address
Who would you like to send this to? *



Altmetric attention score

Full text views

Total number of HTML views: 8
Total number of PDF views: 61 *
Loading metrics...

Abstract views

Total abstract views: 322 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 17th October 2017. This data will be updated every 24 hours.