Study sheds light on depression in community-dwelling older adults

(Press-News.org) January 8, 2025—Marked variation in the prevalence of depression was found in a multisite sample of community-dwelling older adults in the United States reports a study by Columbia University Mailman School of Public Health. Until now, few studies, have examined the frequency of depression in community-dwelling older adults in the U.S. The study is published in the Journal of American Geriatrics Society.

Of the 2,900 participants studied, 6.2 percent had depression. Older adults who had a negative history of depression or had annual household incomes of $50,000 or greater were at significantly decreased odds of depression. Volunteering was a factor in reducing the odds of depression – with at a 43 percent rate of decline.

“Our findings help strengthen the existing research on the epidemiology and prevention of depression in older adults,” said Yitao Xi, MPH, a recent graduate in Epidemiology from Columbia Mailman School and first author. “Specifically, it provides empirical data on the prevalence of depression among community-dwelling older adults in the U.S. and the potential role of volunteering in mitigating the risk of depression among older adults.”

Using data from the Longitudinal Research on Aging Drivers (LongROAD) study of 2,990 active drivers aged 65–79 years without significant cognitive impairment, the researchers examined the prevalence and correlates of depression in this multisite sample of community-dwelling adults who were enrolled and assessed between July 2015 and March 2017 from primary care clinics or healthcare systems across five study sites: Ann Arbor, MI; Baltimore, MD; Cooperstown, NY; Denver, CO; and San Diego, CA. The Patient-Reported Outcomes Measurement Information System (PROMIS®) depression scale was used to determine the depression status. Participants were also assessed from questionnaires, medical record abstraction, functional tests (e.g., grip strength), and a comprehensive review of current medications.

Among participants 7 percent were women; 8 percent were not married; 8 percent had a high school degree or less and 11 percent had annual household incomes lower than $50,000. Elevated prevalence rates of depression were found in those who: were 65–-69 years of age (8 percent), whereas those aged 70-74 years had significantly lower odds of depression.

“The 65-69 age group often faces significant life changes such as retirement or the onset of chronic diseases, which can contribute to depressive symptoms,” said Guohua Li, MD, DrPH, professor of Epidemiology at Columbia University, senior author and principal investigator of the LongROAD study. “This finding aligns with other reports indicating that ages 65 and older are often accompanied by factors such as increased physical health issues or chronic medical conditions including diabetes mellitus, anxiety, cognitive decline, and the loss of social networks -- which can exacerbate feelings of isolation and depressive symptoms. Alternately, those engaged in volunteering activities had a significantly lower prevalence of depression.” 

In addition to volunteering’s effect on reducing the odds of depression, the study also reaffirms the important role of marital status in the prevalence of depression. “It is well known that social relationships in general and marriage in particular can provide social support and buffer against mental health problems,” notes Li, who is also professor of Anesthesiology at Columbia College of Physicians & Surgeons.

The World Health Organization estimates there are over 1.4 billion individuals aged 60 and above. Accompanying this estimate are public health challenges, such as increasing prevalence of depression due to comorbid medical conditions and inadequate social support. Globally, depression among older adults is a serious concern.

“Our findings reaffirm the important role that sociodemographic and medical factors play in the prevalence of depression at the late phase of lifespan,” points out Li. “Our study underscores the need for policies that bolster financial security for older adults, and provides further evidence for the potential protective role of volunteering in mitigating the risk of depression.”

Dr. Soo Borson, journal editor, wrote: “The important study by Xi et al. deserves wide attention. In addition to reminding us that older people with chronic illness, prior depression, and sociodemographic disadvantage are more likely to be depressed, they find a potential protective effect of volunteering — even in people with a history of depression. Interestingly, their data show that the period around “‘normal”’ retirement age — the mid- to late-60'’s — is one of higher depression prevalence. In the early days of geriatrics in the United States, retirement was recognized as a developmental stage fraught with potential risks -- loss of purpose, personal value, and meaning, all experiences that reside in the penumbra of depression. Retirement is still a defining life event, but its timing has now spread widely across the age span. Xi and colleagues point us once again to the value of “‘work”’ in all its forms --especially the work of serving others long beyond the last paycheck.”

Co-authors are Thelma Mielenz, Columbia Mailman School; Howard F. Andrews, Columbia Mailman School and Vagelos College of Physicians & Surgeons; Linda L. Hill, University of California, San Diego; David Strogatz, Bassett Research Institute; Carolyn DiGuiseppi, University of Colorado School of Public Health; Marian Betz, University of Colorado School of Medicine and VA Eastern Colorado Geriatric Research Education and Clinical Center; Vanya Jones, Johns Hopkins University Bloomberg School of Public Health; David Eby and Lisa Molnar, University of Michigan Transportation Research Institute; and Barbara H. Lang, Vagelos College of Physicians & Surgeons.

The Longitudinal Research on Aging Drivers project was sponsored by the AAA Foundation for Traffic Safety.

Columbia University Mailman School of Public Health

Founded in 1922, the Columbia University Mailman School of Public Health pursues an agenda of research, education, and service to address the critical and complex public health issues affecting New Yorkers, the nation and the world. The Columbia Mailman School is the third largest recipient of NIH grants among schools of public health. Its nearly 300 multi-disciplinary faculty members work in more than 100 countries around the world, addressing such issues as preventing infectious and chronic diseases, environmental health, maternal and child health, health policy, climate change and health, and public health preparedness. It is a leader in public health education with more than 1,300 graduate students from 55 nations pursuing a variety of master’s and doctoral degree programs. The Columbia Mailman School is also home to numerous world-renowned research centers, including ICAP and the Center for Infection and Immunity. For more information, please visit www.mailman.columbia.edu.

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