One-year prognosis of depressive illness in the elderly population in Japan

A 1-year prospective study of 43 elderly depressed residents (13 men and 30 women) in Nagai City in Japan is described. An initial survey was carried out in 1993 to find depressed residents. The subjects of the survey were 2056 residents of 65 years of age and older. The Japanese version of the Geriatric Depression Scale (GDS) was employed as a screening tool in the first phase of the survey. In the second phase, screened subjects and control subjects were interviewed by psychiatrists using the Structured Interview for DSM-III-R (SCID). The diagnosis of depression was made by the psychiatrists on the basis of the results of the SCID. Forty-three persons were judged to be depressed. At follow-up, 10 were still depressed and 15 were well. Four were demented. Fourteen dropped out due to death, hospitalization, absence from home or refusal. The results showed that approximately half of the elderly depressed persons seemed to recover by the time of the 1-year follow-up. One-year prognosis of dysthymia was the worst. Some types of depression seemed to be a precursor for dementia. The concern is with how the findings may be used as an aid in understanding and planning community mental health services strategies. The results indicate that it is very important to pay close attention to patients with depressive illness who do not meet the criteria for major depression.