Antidepressant use among older people has increased in two decades

The proportion of people aged over 65 on antidepressants has more than doubled in two decades.

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Depression is a common mental disorder, characterized by persistent sadness and a loss of interest in activities that you usually enjoy, accompanied by an inability to carry out daily activities, for at least two weeks.

Depression is the leading cause of ill health and disability worldwide. More than 300 million people are now living with depression. Older people may be less likely than other age groups to go to their GP with symptoms of depression.

Until now, little was known about how the relationship between the prevalence of depression and antidepressant use among older people has changed over time.

Now a study by the University of Cambridge and the University of East Anglia (UEA) suggests that the proportion of people aged over 65 on antidepressants has more than doubled in two decades.

The study is based on the Cognitive Function and Ageing Studies, conducted at two-time points – between 1991 and 1993, and between 2008 and 2011.

The Cognitive Function and Ageing Studies (CFAS) are populace based investigations of people aged 65 with the ability to look at changes in the health needs of older people across generations dependent on random sampling and diagnostic strategies held consistent after some time.

During the study, scientists interviewed more than 15,000 over 65s in England and Wales to see whether the prevalence of depression and antidepressant use is changing. They found that the proportion of older people receiving anti-depressant medication more than doubled over two decades – from 4.2 percent in the early nineties to 10.7 percent 20 years later. This was regardless of the evaluated prevalence of depression among over 65s, falling to 6.8 percent contrasted with 7.9 percent during the 1990s.

Depression and antidepressant use were more common in women than men at both time points. The proportion of over 65s living in care homes declined, but the prevalence of depression in care homes remained unchanged – affecting around one in ten residents.

Lead investigator Prof Carol Brayne, Director of the Cambridge Institute of Public Health, said: “Our research has previously shown a major age-for-age drop in dementia occurrence across generations. This new work reveals that depression has not shown the same reduction even in the presence of dramatically increased prescribing, itself not without concern given potential adverse effects we have also shown that are associated with polypharmacy.”

Prof Arthur said: “Depression affects one in 15 people aged over 65, and its impact is felt by the individual, their families, and friends.”

“The increase in antidepressant use could be due to improved recognition and treatment of depression, overprescribing, or use of antidepressants for other conditions. Whatever the explanation, substantial increases in prescribing has not reduced the prevalence of depression in the over-65 population. The causes of depression in older people, the factors that perpetuate it, and the best ways to manage it remain poorly understood and merit more attention.”

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