ABSTRACT

D EPRESSION is perhaps the most frequent cause of emotional suffering in later life and significantly decreases quality of life in older adults (2-7). In recent years, the literature on late-life depression has exploded. Excellent North American epidemiological studies from the 1980s and early 1990s have been complemented by more recent reports from other countries (2,4,8-12). Many gaps in our understanding of the outcome of late-life depression have been filled (13-15). Intriguing findings have emerged regarding the etiology of late-onset depression (16-18). The number of studies documenting the evidence base for therapy has increased dramatically (19,20). In this review, I first address case definition, and then I review the current community-and clinic-based epidemiological studies. Next I address the outcome of late-life depression, including morbidity and mortality studies. Then I present the extant evidence regarding the etiology of depression in late life from a biopsychosocial perspective (6,21). Finally, I present evidence for the current therapies prescribed for depressed elders, ranging from medications to group therapy. Given the plethora of literature, important (though on my view not critical) studies have necessarily been omitted, yet the current review reflects the astounding advance of our database since I reviewed the subject in 1989 (22).