Clinician Article

Is depression in old age fatal only when people feel lonely?

  • Stek ML
  • Vinkers DJ
  • Gussekloo J
  • Beekman AT
  • van der Mast RC
  • Westendorp RG
Am J Psychiatry. 2005 Jan;162(1):178-80. doi: 10.1176/appi.ajp.162.1.178. (Original)
PMID: 15625218
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  • Psychiatry
    Relevance - 6/7
    Newsworthiness - 5/7
  • FM/GP/Mental Health
    Relevance - 5/7
    Newsworthiness - 5/7
  • Geriatrics
    Relevance - 4/7
    Newsworthiness - 4/7


OBJECTIVE: The impact of depression and perceived loneliness in the oldest old is largely unknown. The authors studied the relationship between the presence of depressive symptoms and all-cause mortality in old age, especially the potential distorting effect of perceived loneliness.

METHOD: Within a prospective population-based study of 85-year-olds, the 15-item Geriatric Depression Scale and the Loneliness Scale were annually applied in all 476 participants with a Mini-Mental State Examination score of 18 points or more.

RESULTS: Depression was present in 23% and associated with marital state, institutionalization, and perceived loneliness. When depression and perceived loneliness were assessed during follow-up, neither depression nor perceived loneliness had a significant effect on mortality. However, those who suffered from both depression and feelings of loneliness had a 2.1 times higher mortality risk.

CONCLUSIONS: The data suggest that the increased mortality risk attributable to depression in the presence of perceived loneliness may result from motivational depletion.

Clinical Comments

FM/GP/Mental Health

Depression being a possible killer is controversial enough without suggesting (from this relatively weak study) that you also need to be lonely.

FM/GP/Mental Health

Not terribly surprising results. However, some colleagues may need informing that depression and social isolation are associated with increased mortality.

FM/GP/Mental Health

Very interesting article. Intuitive and well conducted work with implications for interventions in the very elderly who are lonely as well as depressed.

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