ABSTRACT
INTRODUCTION The worldwide burden of major depression is considerable among the elderly population. Based on 2002 estimates, for those aged 60 and older, major depression accounts for 5.2% of all the years lived with disability (YLD). Of all YLD, major depression accounts for 6.1% among older females and 3.9% among older males. Only cataracts, Alzheimer disease, and other dementias, adult-onset hearing loss, cerebrovascular disease, age-related vision disorders, and osteoarthritis result in more YLDs for elderly individuals. In high-income countriesmajor depression is the fifth most common cause of YLD out of 136 other disorders, accounting for 4.7% of all YLDs (1). Although the amount of YLD accounted for by major depression in the elderly population is tremendously high, this is in contrast to younger adults where major depression is ranked either first or second. Among the elderly population, major depression was noted to result in 9.3 days of disability in the past four weeks, in which they were completely unable to carry out their usual activities or had to cut down. This was more than days of disability for anxiety disorders, substance use disorders, or personality disorders (2). At least half of those with major depression have impairment in work and social roles, and over two-thirds are unable to perform household functions (3). Clearly, the degree of disability associated with major depression makes it a major public health issue in geriatrics.
