Outcomes for antidepressant trials in late-life depression

Most randomized controlled trials of antidepressant efficacy in older depressive patients use outcome measures similar to those applied in younger patients. Defining subjects as geriatric based on chronological age alone misses the opportunity to study relationships among efficacy, safety, and the range of impairments associated with aging. Assessment of outcomes related to the medical comorbidities and disabilities associated with late-life depression is needed to understand the broad range of treatment effects. Assessment of changes in subjective and objective measures of functioning can address relationships between clinical state and health-related quality of life. Sensitive measurement of the number and severity of comorbid medical illnesses can precisely characterize the study sample and assess the impact of efficacious treatment on medical illnesses. In long-term studies of heterogeneous geriatric samples, use of appropriate outcome measures can determine the effect of efficacious treatment on changes in health status and functional independence.