Outcome of hospital-treated depression at 4.5 years: An elderly and a younger adult cohort compared

Direct comparisons of the prognosis for treated depression in adult and elderly cohorts are few, but suggest higher morbidity and mortality in the elderly. To examine outcome in two such groups after 4.5 years and compare results with those reported elsewhere. Fifty-six adults (aged under 65) and 54 elderly people (over 65) with primary depression were assessed 4.5 years after receiving hospital treatment, and factors influencing the outcome were explored. Recovery rates were higher in the adults than in the elderly (42.8% v. 24%), largely due to higher rates of death (33%) and dementia (14.8%) in the latter group, who also suffered more serious health problems (62.9% v. 28.5%). Survival analysis showed no difference in the recovery time between cohorts, with over 90% recovered after 25 weeks. After deducting the natural deaths, melancholic illness proved a poor outcome predictor in the adults. The outlook for elderly depressed patients is poorer than for younger patients because of concurrent physical disease, a higher death rate and the development of dementia.