Stratmann M W, König H-H, Hajek A
Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Int J Geriatr Psychiatry. 2025 Oct;40(10):e70160. doi: 10.1002/gps.70160.
Although late-life depression is common, there has previously not been a comprehensive review of chronic depression (CD) in older adults. This systematic review summarizes prevalence rates, potential risk factors, and consequences of CD in later life.
This preregistered review (PROSPERO: CRD42025649324) searched MEDLINE, Web of Science, CINAHL and PsycINFO from inception to February 2025. Observational studies reporting the prevalence of CD in older adults (mean age 60+) were included. Study quality was assessed using the Joanna Briggs Institutes Critical Appraisal Tool. Random-effects models were used to estimate pooled prevalence across subgroups and meta-regression analyses were used to explore sources of heterogeneity.
A total of 39 articles (38 studies) met the inclusion criteria; 20 articles (27 data points) were included in meta-analysis for point prevalence. Overall point prevalence was 4.02% [2.88%-5.35%], with estimates varying by assessment method: 2.30% [1.47%-3.31%] using DSM-IV/DSM-III-R, 7.12% [2.31%-14.22%] using DSM-III/ICD-10% and 5.52% [3.80%-7.54%] using rating scales. Prevalence varied also by region and was higher for women. Consistent risk factors included less physical activity and higher impairment in daily life. Evidence on consequences was sparse.
Approximately 4% of adults aged 60+ meet criteria for CD. Estimates vary substantially by method and region, and potential risk factors and outcomes remain poorly understood. Future studies should target underrepresented subgroups - such as the oldest old, the institutionalized and physically and cognitively impaired individuals-using both dimensional and categorical assessment. CD in late life appears often unrecognized, untreated and underresearched.
尽管晚年抑郁症很常见，但此前尚未对老年人慢性抑郁症（CD）进行全面综述。本系统综述总结了晚年CD的患病率、潜在风险因素和后果。
本预注册综述（PROSPERO：CRD42025649324）检索了从创刊至2025年2月的MEDLINE、Web of Science、CINAHL和PsycINFO。纳入报告老年人（平均年龄60岁以上）CD患病率的观察性研究。使用乔安娜·布里格斯研究所的批判性评价工具评估研究质量。采用随机效应模型估计各亚组的合并患病率，并进行meta回归分析以探讨异质性来源。
共有39篇文章（38项研究）符合纳入标准；20篇文章（27个数据点）纳入现患率的meta分析。总体现患率为4.02%[2.88%-5.35%]，估计值因评估方法而异：使用DSM-IV/DSM-III-R为2.30%[1.47%-3.31%]，使用DSM-III/ICD-10为7.12%[2.31%-14.22%]，使用评定量表为5.52%[3.80%-7.54%]。患病率也因地区而异，女性患病率更高。一致的风险因素包括身体活动较少和日常生活能力受损程度较高。关于后果的证据较少。
约4%的60岁以上成年人符合CD标准。估计值因方法和地区而异，潜在风险因素和结果仍知之甚少。未来研究应针对代表性不足的亚组——如高龄老人、机构养老者以及身体和认知功能受损者——采用维度和分类评估方法。晚年CD似乎常常未被识别、未得到治疗且研究不足。
