University of Rochester Medical Center researchers have pinpointed the prime factors identifying which elderly persons are at the highest risk for developing major depression and are advocating for early detection and intervention to improve patient outcomes. Preventive treatments for people in the high-risk group hold promise for providing the greatest health benefit at the lowest cost, the researchers concluded. Led by Jeffrey M. Lyness, MD, professor of Psychiatry at the Medical Center, they reported their findings in the December issue of The American Journal of Psychiatry. “People with low-level depressive symptoms, who perceive that they have poor quality social support from other people and with a past history of depression, were at particularly high risk to develop new major depression within the one-to-four year time period of the study,” Dr. Lyness said. “This is good news, as we in the field are just learning how to prevent depression in particular high-risk groups. Future work will be able to test whether any of a variety of treatments—perhaps psychotherapy, perhaps medication, perhaps other things such as exercise—will help to prevent depression in persons suffering from the risks we identified in this study.” More than 600 people 65 years of age or older took part in the study, recruited from private practices and University-affiliated clinics in internal medicine, geriatrics and family medicine in Monroe County, NY. Only participants without an active diagnosis of major depression were included in the analyses. Annual follow-up in-person interviews were conducted for up to four years. Information obtained from telephone contacts and annual medical chart reviews supplemented the interviews. Thirty-three participants, or about 5.3 percent, developed an episode of major depression during the study period. In their analysis, the researchers concluded the “number needed to treat,” an epidemiological measure used in determining the effectiveness of a medical intervention, was five. This means the fully effective preventive treatment of five individuals presenting the indicators would prevent one new case of major depression.
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