PsycNetwork, Leuphana University of Lüneburg, Rotenbleicher Weg 67, 21335 Lüneburg, Germany.
J Affect Disord. 2012 Dec 15;142(1-3):172-9. doi: 10.1016/j.jad.2012.05.010. Epub 2012 Aug 30.
In the past years, many studies have examined the prevalence of late-life depression. However, incidence studies, especially those including the oldest age groups, remained rare. The objective of this article is therefore to provide a systematic review on incidence of depressive disorders in latest life.
A systematic search of the literature published between 1985 and 2011 was conducted using MEDLINE, Web of Science, PsycInfo and Cochrane databases. Inclusion criteria were: incidence specified for persons aged≥70 years at baseline, population-based sample or primary care sample. Incidence rates or risks were extracted or calculated.
We found 20 studies reporting incidence according to categorical (n=14) or dimensional diagnoses (n=6). The incidence of depressive disorders varied considerably. Major Depression (MD) was found to occur less often than Minor Depression (MinD), whereas clinically relevant depressive symptoms are at least as frequent as MinD. The incidence rate of MD was 0.2-14.1/100 person-years, and incidence of clinically relevant depressive symptoms was 6.8/100 person-years. Female incidence was mostly higher than male. Associations between age and incidence revealed to be rather inconsistent between studies.
Methodological diversity of the studies concerning diagnostics, data collection methods, incidence definitions and sampling make the results difficult to interprete.
This review is the first to have focused on incidence studies on depression in latest life. The frequent occurrence of clinically relevant depressive symptoms will have to be considered in future health care planning. Physical health and psychosocial influences appear to be key variables in depression prevention.
在过去的几年中，许多研究都调查了老年期抑郁症的患病率。然而，发病研究，特别是包括最年长年龄组的研究仍然很少。本文的目的是对晚年抑郁障碍的发病情况进行系统回顾。
使用 MEDLINE、Web of Science、PsycInfo 和 Cochrane 数据库，对 1985 年至 2011 年期间发表的文献进行了系统搜索。纳入标准为：在基线时年龄≥70 岁的人群中明确报告了发病率、人群为基础的样本或初级保健样本。提取或计算发病率或风险。
我们发现了 20 项研究，这些研究根据分类诊断（n=14）或维度诊断（n=6）报告了发病率。抑郁障碍的发病率差异很大。重度抑郁症（MD）的发生率低于轻度抑郁症（MinD），而临床相关的抑郁症状至少与 MinD 一样常见。MD 的发病率为 0.2-14.1/100 人年，而临床相关抑郁症状的发病率为 6.8/100 人年。女性的发病率大多高于男性。年龄与发病率之间的关联在研究之间也不一致。
研究在诊断、数据收集方法、发病定义和抽样方面的方法多样性使得结果难以解释。
这是第一篇专门针对晚年抑郁发病研究的综述。未来的医疗保健规划必须考虑到临床相关抑郁症状的频繁发生。身体健康和心理社会影响似乎是预防抑郁的关键变量。
