[Natural outcome and risk-prediction model of late-life depression]

To investigate the prevalence and natural outcome of late-life depression in the community and to analyze the risk-prediction models.

A community in Hang Zhou was selected as a trial. A total of 1 275 persons aged 60 or more in this community were screened by PHQ-9 questionnaire; SCID was used for interviewer to diagnostic interview the people whose PHQ-9 was more than 10 points, 50 % of those whose PHQ-9 was from 5 to 9 points and 5 % of those whose PHQ-9 was less than 5 points, then all those who accepted diagnostically interview were interviewed by PHQ-9 every 3 months in one year, and were diagnostic interviewed by SCID in the last month. Logistic regression analysis was used to explore depressive risk factors in 12 months.

There were 141 (11.1%) persons whose PHQ-9 score was more than 10 points, 298 (23.4%) whose PHQ-9 score were 5-9 points, and 836 (65.5%) whose PHQ-9 score were 0 to 4 points in the preliminary survey, 93 were major depressive disorder (MDD). The prevalence of late-life depression was 7.3%. Compared with the PHQ-9 score in one year, 17.6% of those with no depressive symptoms emerged depression; 50% of those who had depressive symptoms declined, 9% developed to significant depressive symptoms, and 41% did not change; 12% of those with significant depressive symptoms were found no depression, 24% reduced, and 64% still had depression. The significant predictors were the accumulation of disease, social support, educational level, daily capacity and baseline of depression.

The prevalence of late-life depression was high. The rates of recognition, diagnosis and treatment were low. The natural outcome after a year did not relieve apparently. Specialist-community health partnership management model is one of the important ways to prevent and treat late-life depression.