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Late-Life Depression: A Narrative Review on Risk Factors and Prevention
Chirag M Vyas1, Olivia I Okereke
1From Harvard Medical School; Department of Psychiatry, Massachusetts General Hospital, Boston, MA; Department of Epidemiology, Harvard T.H. Chan School of Public Health (Dr. Okereke); Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA (Dr. Okereke).
Learning Objectives:
After participating in this activity, learners should be better able to:• Identify risk factors for late-life depression• Evaluate strategies to prevent late-life depression ABSTRACT: Late-life depression (LLD) is one of the major sources of morbidity and mortality in the world. Because LLD is related to increased public health burden, excess health care costs and utilization, reduced quality of life, and increased mortality, prevention is a priority. Older adults differ from younger adults with respect to key features, such as their chronicity and lifetime burden of depression and their constellation of comorbidities and risk factors. LLD likely arises from a complex interplay of risk factors, including medical, physiologic, psychosocial, behavioral, and environmental factors. Thus, a comprehensive understanding of LLD risk factors is necessary to inform prevention strategies. In this narrative literature review, we address both the risk architecture of LLD and several potential strategies for prevention. Our description of LLD risk factors and prevention approaches is informed by the framework developed by the National Academy of Medicine (formerly, Institute of Medicine), which includes indicated, selective, and universal approaches to prevention.
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