Depression Treatment Trajectories and Associated Social Determinants: A Three-Year Follow-Up Study in 66,540 Older Adults Undergoing First-Time Depression Treatment in Denmark

Kazi Ishtiak-Ahmed*, Christopher Rohde, Ole Köhler-Forsberg, Kaj Sparle Christensen, Christiane Gasse

*Corresponding author for this work

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperJournal articleResearchpeer-review

Abstract

OBJECTIVE: This study aimed to describe depression treatment patterns, identify unique trajectory groups using a group-based trajectory approach, and explore associated social determinants in older adults undergoing first-time depression treatment during a 3-year follow-up.

METHODS: This Danish register-based cohort study included all adults aged ≥ 65 who initiated depression treatment by redeeming first-time antidepressant prescriptions (no prescriptions in the last 10 years) between 2006 and 2015. The outcome of interest during the 2-year follow-up was depression treatment, assessed as antidepressant prescriptions redemptions and psychiatric hospital contacts for depression. Latent class growth analyses were applied to model treatment trajectories during 3 years. Multinomial logistic regression analyses were used to analyze adjusted associations between social determinates and trajectory group membership.

RESULTS: Among the 66,540 older adults (55.2% females, mean age: 77.3 years), we identified three distinct groups with unique patterns of depression treatment trajectories: 'brief-treatment' where individuals stopped depression treatment within 6 months (33.7%); 'gradual-withdrawal' (26.5%) where treatment was gradually stopped over 2 years; and 'persistent-treatment' where individuals continued depression treatment for the entire 3 years (39.8%). Females, single-person households, and residents of less-urbanized regions were associated with higher odds of membership in the 'persistent-treatment' group, while older age, widowhood or separation, and non-Danish ethnicities were associated with lower odds.

CONCLUSIONS: Three distinct patterns of depression treatment trajectories were identified in older adults, indicating differential clinical courses of depression-potentially influenced by social determinants, including sex, marital status, urban residence, and ethnicity. Early patient stratification and targeted interventions are crucial in depression care for older adults.

Original languageEnglish
Article numbere70006
JournalInternational Journal of Geriatric Psychiatry
Volume39
Issue11
ISSN0885-6230
DOIs
Publication statusPublished - Nov 2024

Keywords

  • Aged
  • Aged, 80 and over
  • Antidepressive Agents/therapeutic use
  • Cohort Studies
  • Denmark
  • Depressive Disorder/therapy
  • Female
  • Follow-Up Studies
  • Humans
  • Logistic Models
  • Male
  • Registries
  • Social Determinants of Health
  • register-based cohort study
  • psychiatric hospital contacts for depression
  • brief treatment
  • persistent treatment
  • antidepressant prescriptions

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