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Open Access Research article

Risk factors for depressed mood amongst a community dwelling older age population in England: cross-sectional survey data from the PRO-AGE study

Jane P Biddulph1*, Steve Iliffe2, Kalpa Kharicha2, Danielle Harari3, Cameron Swift4, Gerhard Gillmann5 and Andreas E Stuck6

Author Affiliations

1 Research Department of Epidemiology and Public Health, UCL, 1-19 Torrington Place, London WC1E 6BT, UK

2 Research Department of Primary Care and Population Health, UCL, London, UK

3 Department of Ageing and Health, St. Thomas’ Hospital, London, UK

4 Clinical Age Research Unit, Kings College London, London, UK

5 Department of Social and Preventive Medicine, University of Bern, Bern, Switzerland

6 Department of Geriatrics, Inselspital and University of Bern Hospital, Bern, Switzerland

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BMC Geriatrics 2014, 14:5  doi:10.1186/1471-2318-14-5

Published: 23 January 2014

Abstract

Background

The Quality and Outcomes Framework in the United Kingdom (UK) National Health Service previously highlighted case finding of depression amongst patients with diabetes or coronary heart disease. However, depression in older people remains under-recognized. Comprehensive data for analyses of the association of depression in older age with other health and functional measures, and demographic factors from community populations within England, are lacking.

Methods

Secondary analyses of cross-sectional baseline survey data from the England arm of a randomised controlled trial of health risk appraisal for older people in Europe; PRO-AGE study. Data from 1085 community-dwelling non-disabled people aged 65 years or more from three group practices in suburban London contributed to this study. Depressed mood was ascertained from the 5-item Mental Health Inventory Screening test. Exploratory multivariable logistic regression was used to identify the strongest associations of depressed mood with a previous diagnosis of a specified physical/mental health condition, health and functional measures, and demographic factors.

Results

Depressed mood occurred in 14% (155/1085) of participants. A previous diagnoses of depression (OR 3.39; P < 0.001) and poor vision as determined from a Visual Function Questionnaire (OR 2.37; P = 0.001) were amongst the strongest factors associated with depressed mood that were independent of functional impairment, other co-morbidities, and demographic factors. A subgroup analyses on those without a previous diagnosis of depression also indicated that within this group, poor vision (OR 2.51; P = 0.002) was amongst the strongest independent factors associated with depressed mood.

Conclusions

Previous case-finding strategies in primary care focussed on heart disease and diabetes but health-related conditions other than coronary heart disease and diabetes are also associated with an increased risk for depression. Complex issues of multi-morbidity occur within aging populations. ‘Risk’ factors that appeared stronger than those, such as, diabetes and coronary heart disease that until recently prompted for screening in the UK due to the QOF, were identified, and independent of other morbidities associated with depressed mood. From the health and functional factors investigated, amongst the strongest factors associated with depressed mood was poor vision. Consideration to case finding for depressed mood among older people with visual impairment might be justified.

Keywords:
Case finding; Depression; Older people; Ageing; Vision loss