The objective of this study was to describe changes in depression and its correlates, in community-dwelling elderly, over a 12-month period. Data come from a longitudinal ESA Study (Enquête sur la Santé des A？nés) of elderly persons (n = 2752). Depression was measured using the DSM-IV criteria. Polytomous logistic regression was used to assess relations, over time, between participant’s characteristics and depression. Among the 164 (5.9%) subjects, who were depressed at baseline, 19.5% were continuously ill cases and 80.4% had recovered, 12 months later. In polytomous regression, factors increasing the probability of the three depression states (persistence, recovery, and incidence) were daily hassles, stress intensity, and fair/poor self-rated mental health. Depression in old age is dynamic. Available prognostic factors can be taken into account to help direct treatment to elderly at highest risk of a poor prognosis. 1. Introduction Depression in later life is a major health problem because of its enormous impact on well-being and daily functioning. Depression has been shown to be associated with functional impairment, morbidity, and mortality [1–4] and with greater utilization of health services [4, 5]. Several studies have followed the trajectory of individuals diagnosed with depression, but in a clinical setting [6, 7], and the results show that recovery from depression varies widely between studies. A meta-analysis on the prognosis of depression at 24 months in elderly community and primary care populations estimated that only 33% of subjects were well, 33% were depressed, and 21% had died [8]. In a one-year followup, a Canadian study of 380 elderly medical inpatients with major, minor, or no depression [9] found that 13% had recovered, 14% partially recovered, and 73% remained depressed. In the adult population, the Netherlands Mental Health Survey [10] showed that 76% of participants recovered within 12 months and nearly 20% had not recovered at 24 months. These variations between studies, which could be attributable to different definitions of recovery and population differences, make comparison between studies difficult. However, there are few longitudinal population-based reports of depression trajectories in older adults. Concerning predictors over time of adult depression, previous research has focused primarily on the clinical features of the disease and revealed that some factors such as stressful life events combined with genetic vulnerability were strongly related to the occurrence of depression [11]. However, research is scarce about
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