Intended for healthcare professionals


Depression in older adults

BMJ 2018; 363 doi: (Published 28 November 2018) Cite this as: BMJ 2018;363:k4922
  1. Philip Wilkinson, consultant psychiatrist, honorary senior clinical lecturer in psychiatry1,
  2. Catherine Ruane, former carer2,
  3. Katie Tempest, member of research user group3
  1. 1Oxford Health NHS Foundation Trust and Department of Psychiatry, University of Oxford, UK
  2. 2Leeds, UK
  3. 3Research Institute, Primary Care and Health Sciences, Keele University, Staffordshire, UK
  1. philip.wilkinson{at}

A neglected chronic disease as important as dementia

Around the world we are witnessing a continued upward trend in life expectancy with the proportion of people aged over 80 years growing fastest. Depressive disorders are common across the life course and depressive symptoms are present in up to a third of older adults. Depression in older people is associated with more functional and cognitive impairment than depression in younger adults1 and carries significant costs for the person, the family, and the NHS. Comorbid physical illness, poor social support, and bereavement are known to increase risk of developing depression.23

With increasing age, the course of depression worsens: in a recent large cohort study of adults aged 18 to 88 years, people aged 70 and above experienced greater symptom severity compared with younger adults and a greater likelihood of still having a diagnosis of depression after two years, even after adjusting for physical illness and antidepressant use.4 Persistent severe depression is also known to be linked to the onset of dementia.5

In …

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