Global, regional, and national burden of geriatric depressive disorders in people aged 60 years and older: an analysis of the Global Burden of Disease Study 2021.

Abstract

Background: Late-life depression (LLD) stands as a prevalent mental health issue among older adults, frequently intertwined with cardiovascular and cerebrovascular diseases as well as cognitive decline. The occurrence of LLD in the older adults, who often present with multiple aging-related conditions, frequently results in this disorder being overlooked. However, the astronomical treatment costs and the considerable societal burden associated with LLD necessitate urgent and sustained attention.

Materials and methods: Utilizing data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2021 (GBD 2021), we extracted incidence rates and disability-adjusted life years (DALYs) of LLD in individuals aged 60 and older. The extracted data underwent rigorous evaluation through the application of age-period-cohort models, the health inequality concentration index, and frontier analysis.

Results: From 1990 to 2021, a global increase was observed in both the age-standardized incidence rate (ASIR) and DALY rate of LLD. Specifically, the ASIR ascended by 0.01 per 100,000 annually, while the DALY rate rose by 0.03 per 100,000 each year. Notably, a statistically significant inverse relationship was identified between ASIR and the Socio-demographic Index (SDI) (p < 0.001). Additionally, a notable linear correlation was discerned between age-standardized death rate (ASDR) and SDI, albeit without a discernible downward trend (p < 0.001). According to the SDI, the Estimated average percentage change (EAPC) of five SDI districts showed no increase or decrease. Globally, the incidence of LLD showed an upward trend in the high SDI, middle SDI, and low-middle SDI regions, a downward trend in the high-middle SDI region, and no significant increase or decrease in the low SDI region. In the age-period-cohort analysis, we found that the incidence of LLD increased with age in high and middle SDI regions compared with low SDI regions, and the results were the opposite in low SDI regions, with significant regional characteristics. The period effect analysis revealed that irrespective of gender, the trends in incidence and DALY rates remained relatively unchanged globally from 1992 to 2021. As SDI levels rose, the SDI-adjusted disparities in incidence and DALY rates tended to stabilize. A comparative analysis of data from 1990 to 2021 highlighted a relative decline in health inequalities.

Conclusion: This comprehensive assessment of the disease burden of LLD among the global population aged 60 and older underscores significant accomplishments while simultaneously emphasizing areas requiring ongoing vigilance. In the context of relentless population growth and aging, the favorable downturns in incidence and DALY rates reflect tangible advancements in managing LLD.