Late Life Depression: A Narrative Review

Abstract

The recent literature (last five years) on late life depression is predominantly focused on risk factors/predictors of late life depression along with studies on effects, buffers, and interventions. Late life depression has typically been self-reported or diagnosed starting at age 60. The prevalence rates for late life depression were highly variable in this literature, ranging from a low of 7% in Italy to a high of 37% in Chile, a variability that may relate to the year or type of data collection and/or cross-cultural variation. Negative effects have included loneliness, suicidal ideation, cognitive decline, frailty, functional limitations, low heart rate variability, biological aging (short telomere length and white matter lesions) and earlier mortality. Risk factors have included loneliness, aging anxiety, life stressors (marital discord and job strain), physical problems (activities of daily living), physical health (elevated blood pressure), physical weakness (handgrip, frailty, falls and disability) and unhealthy intake (poor diet, excessive alcohol and vitamin D deficiency). Buffers/protective factors have included positive views on aging, resilience, practicing religion, a Mediterranean diet, and remaining active. Interventions have included cognitive training, mindfulness, physical activity and ketamines. Multiple underlying mechanisms have been suggested including dysfunctional connectivity between different networks in the brain. Although the data highlight the severity of late