Late-life Depression

     Late Life depression or recurrent major depressive disorder, is a mental health condition where repeated episodes of depression happen across a person’s lifespan. Life long depression happens in cycles that can last anywhere from a week to years. The risk of repeated episodes are high even after a person may feel better for a period of time. Each episode increases the risk of future episodes that creates a cycle that can be difficult to come out of, even with effective treatment. For most individuals, depression mainly appears in adolescence or early adulthood and it could be triggered by major life stressors or trauma. 

Dr. Ajilore and his team are researching which clinical, cognitive, and social factors could be involved in relapse in older adults who have been diagnosed with late-life depression. The study “Reconsidering Remission in Recurrent Late-life Depression: Clinical Presentation and Phenotypic Predictors of Relapse Following Successful Antidepressant Treatment” researches how often a group of participants who were diagnosed with late-life depression had a relapse over a period of two years. Participants were being checked on every two months by conducting interviews or testing. Dr. Ajilore’s hypothesis was that in older adults with late-life depression who are at risk of relapse over a two-year period could be associated with life stress, social support, and other depression symptoms even during remission periods. He also compared the individuals with late-life depression to healthy controls by measuring their constant depressive symptoms, medical history, social scene, and memory. The results show that 44% of participants with late-life depression have a relapse within two years. Individuals with late-life depression have higher residual depressive symptoms, they have more medical issues such as obesity, disability, or pain, they have low social aspects in their lives, and that they are less likely to perform well cognitively. 

George S. Alexopoulos is researching a similar aspect of late-life depression by finding out the mechanisms of late life depression. In his article, “Mechanisms and Treatment of late-life depression” he too mentions that medical illness is a factor of risk of late-life depression. He claims that stress responses can lead to depression because of the dysfunction that is happening in control networks. He compares how different responses to stress and the predisposing factors both lead to diagnosing late life depression by looking at it mechanistically. Even though they are separate hypotheses, at times they can overlap and create a different mechanism. 

In conclusion, both of these articles express the different factors that go into diagnosing late-life depression. These studies show that late-life depression is not easily diagnosable or treatable, but it can help us understand how and which factors could contribute to it. 

References: 

Alexopoulos, G.S. Mechanisms and treatment of late-life depression. Transl Psychiatry 9, 188 (2019). https://doi.org/10.1038/s41398-019-0514-6

Taylor WD et al (2024). Reconsidering remission in recurrent late-life depression: clinical presentation and phenotypic predictors of relapse following successful antidepressant treatment. Psychological Medicine 54, 4896–4907. https:// doi.org/10.1017/S0033291724003246