Risk Factors of Kivela et al for Predicting Chronic Depression in the Elderly

 

Outcomes: Initially depressed patients were separated into 2 groups:

(1) chronically depressed (still depressed during follow-up visits)

(2) recovered (not depressed in follow-up visits)

 

Risk factors:

(1) diurnal variation in symptoms

(2) poor self-appreciation

(3) drinking beer

(4) severe disease during follow-up

(5) death of a family member during follow-up

(6) marital problems during follow-up

(7) taking care of a disabled spouse during follow-up

(8) worsening of health status during follow-up

Factor	Odds Ratio	95% CI
diurnal variation of symptoms	3.9	1.10 – 13.5
poor self-appreciation	4.6	1.08 – 19.3
drinking beer	11.7	1.49 – 91.1
severe disease during follow-up	5.3	1.46 – 19.3
death of a family member during follow-up	3.2	0.99 – 10.2
marital problems during follow-up	12.4	1.30 – 118
taking care of disabled spouse	15.2	1.16 – 200
worse health status during follow-up	4.6	1.07 – 19.8

from Table 2, page 190

 

where:

• Beer drinking was found to be a risk factor for chronicity, but drinking wine or spirits was not. I wonder if this may have been related to the population selected (a third did not finish required schooling and the previous occupation was "agriculture or other independent" for half).

• In the implementation I replaced drinking beer with being an alcoholic. This may be a stretch, since the volume of beer drunk per day was not given.

• Severe disease or worsening health status seem to be fairly similar concepts.

• Only 6% of the patients were in a nursing home, while 11% needed assistance to use stairs.

 

Additional risk factors referred to from previous studies:

(1) severe depressive symptoms

(2) history of previous depressive episodes (? history of chronic depression)

(3) long duration prior to treatment (? history of chronic depression)