Gesundheitswesen 2014; 76 - A178
DOI: 10.1055/s-0034-1387028

The role of spousal loss in the development of depressive symptoms in the elderly – implications for diagnostic systems

C Sikorski 1, M Luppa 2, H Bickel 1, M Pentzek 1, S Weyerer 1, W Maier 1, B Wiese 3, M Scherer 1, H van den Bussche 4, H König 1, SG Riedel-Heller 5
  • 1Universität Leipzig
  • 2Universität Leipzig, Institut für Sozialmedizin, Arbeitsmedizin und Public Health, Leipzig
  • 3Medizinische Hochschule Hannover, Hannover
  • 4Universitätsklinikum Hamburg-Eppendorf, Hamburg
  • 5Universität Leipzig, Medizinische Fakultät, Leipzig

Background: For the revised version of the Diagnostic and Statistical Manual of Mental Disorders (DSM) the Mood Disorder Workgroup for DSM-V will entail the elimination of the bereavement exclusion criterion for the diagnosis of major depression.

Aim: To investigate the impact of bereavement on the indidence of depression and depressive symptoms in the elderly.

Method: Participants over 75 years from the longitudinal German Study on Ageing, Cognition, and Dementia in Primary Care Patients (AgeCoDe) that were still married at baseline were investigated (n = 1,193). Data from four follow-ups (time frame: 6 years) were investigated. The response rate at baseline was 50.3%. Three clinical endpoints were analyzed: depressive symptoms according to Geriatric Depression Scale (1) GDS ≥ 6; (2) GDS ≥ 10; and (3) Major Depression (MD). The effect of loss was investigated using random-effects regression models.

Results: Experiencing a loss of spouse was predictive of a higher incidence in GDS ≥ 6 (OR 4.52, 95% CI 2.6 – 7.9) and 10 (OR 5.59, 95% CI 1.8 – 17.0) even after adjusting for age, gender, impairment at baseline, and GDS score at baseline. Associations with MD were not significant (OR 1.77, 96% CI 0.9 – 3.5).

Conclusions: Older adults experiencing the loss of their spouse are more likely to display elevated levels of depressive symptoms, that may reach a concerning level of severity.