The diagnosis of depression in the elderly

The reported prevalence of depressive symptomatology among the elderly ranges from 5 to 65 percent in hospital and community populations. Depression is considered the most common emotional disorder of advanced age. One of the chief diagnostic problems has been the lack of differentiation between disorders manifested by dysphoric or depressive symptoms. Recent work on operational criteris, as exemplified in the Third Edition of the American Psychiatric Association's Diagnostic and Statistical Manual (DSM-III) provides a basis from which the diagnosis of depression can be made and subgroups of elderly depressed subjects can be delineated. A community survey involving a stratified random sample of 997 persons aged 65 or older living in Durham County was completed in 1972. An 18-item subscale eliciting depressive symptomatology was abstracted from the survey questionnaire and submitted to factor analysis, tests of reliability, and association with clinical diagnosis. The instrument proved to be a useful means of identifying persons with depressive symptomatology, as outlined in DSM-III. It also can be used for epidemiologic studies of depression in the elderly.