Depression in Japanese community-dwelling elderly--prevalence and association with ADL and QOL

This cross-sectional study examined the prevalence of screening-based depression and compared the scores of activities of daily living (ADL) and quality of life (QOL) between community-dwelling elderly subjects with and without depression in Japan. Elderly subjects aged 65 or older living in four rural towns participated in 2000 or 2001 (n = 5363, female 58.3%, mean (S.D.) age 74.6 (7.0) years). Depressive symptoms were assessed using a 15-item Geriatric Depression Scale (GDS-15) and ADL, higher functions, and medical and social histories were assessed by self-report questionnaires. For assessing subjective QOL, a 100 mm visual analogue scale was used. One thousand seven hundred ninety-eight participants (33.5%, range, 32.3-34.6%) had suggestive depression using cutoff 5/6 of GDS-15. Subjects with depression revealed significantly lower scores for ADL and QOL than those without depression. Prevalence of screening-based depression was similar in the four different rural Japanese towns. However, the reported prevalence of depression varies enormously in different country. Primary physicians and caregivers should pay more attention to depression in the community-dwelling elderly population, especially below the threshold of major depression as minor depression or dysthymia.