Loneliness is associated with poor prognosis in late-life depression: Longitudinal analysis of the Netherlands study of depression in older persons

Abstract Background Although depression and loneliness are common among older adults, the role of loneliness on the prognosis of late-life depression has not yet been determined. Therefore, we examined the association between loneliness and the course of depression. Methods We conducted a 2-year fol...

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Bibliographic Details
Published in:	Journal of affective disorders Vol. 185; pp. 1 - 7
Main Authors:	Holvast, Floor, Burger, Huibert, de Waal, Margot M.W, van Marwijk, Harm W.J, Comijs, Hannie C, Verhaak, Peter F.M
Format:	Journal Article
Language:	English
Published:	Netherlands Elsevier B.V 01-10-2015
Subjects:	Aged Cohort Studies Depression Depressive Disorder - epidemiology Depressive Disorder - psychology Female Follow-Up Studies Geriatric Assessment - methods Geriatric Assessment - statistics & numerical data Humans Loneliness Loneliness - psychology Longitudinal Studies Male Middle Aged Netherlands - epidemiology Older age/aged Prognosis Psychiatry Social relations Netherlands Loneliness Social relations Depression Prognosis Older age/aged
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Summary:	Abstract Background Although depression and loneliness are common among older adults, the role of loneliness on the prognosis of late-life depression has not yet been determined. Therefore, we examined the association between loneliness and the course of depression. Methods We conducted a 2-year follow-up study of a cohort from the Netherlands Study of Depression in Older Persons (NESDO). This included Dutch adults aged 60–90 years with a diagnosis of major depression, dysthymia, or minor depression according to the criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. We performed regression analyses to determine associations between loneliness at baseline and both severity and remission of depression at follow-up. We controlled for potential confounders and performed multiple imputations to account for missing data. Results Of the 285 respondents, 48% were still depressed after 2 years. Loneliness was independently associated with more severe depressive symptoms at follow-up (beta 0.61; 95% CI 0.12–1.11). Very severe loneliness was negatively associated with remission after 2 years compared with no loneliness (OR 0.25; 95% CI 0.08–0.80). Limitations Despite using multiple imputation, the large proportion of missing values probably reduces the study’s precision. Generalizability to the general population may be limited by the overrepresentation of ambulatory patients with possibly more persistent forms of depression. Conclusion In this cohort, the prognosis of late-life depression was adversely affected by loneliness. Health care providers should seek to evaluate the degree of loneliness to obtain a more reliable assessment of the prognosis of late-life depression.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0165-0327 1573-2517
DOI:	10.1016/j.jad.2015.06.036