Depressive symptom clusters among the elderly: a longitudinal study of course and its correlates

Abstract

Background The longitudinal course of depressive symptoms among the elderly was examined over a one-month follow-up period. The aim of the study was to identify clusters of change as well as their correlates, including demographic variables and coping strategies (brooding, reflection, co-rumination, and positive reappraisal). Participants and procedure Two hundred and seventy-seven seniors (age 77.39 ±9.20 years, 67.50% women) were assessed twice within one month with the 11-item version of the Centre for Epidemiological Studies Depression Scale. Demographic and clinical characteristics were measured at baseline together with coping strategies. Selected items from Ruminative Response Styles (brooding, reflection), the Co-Rumination Questionnaire (co-rumination), and mini-COPE (positive reframing) were used. Results On the basis of a two-step cluster analysis, four clusters of depression course were recognized: low stable (n = 53), medium stable (n = 101), high increasing (n = 69), and very high stable (n = 54). Multinomial logistic regression analyses showed that higher number of diseases, higher brooding and lower positive reappraisal were associated with increased likelihood of belonging to the higher symptom groups. No significant gender effect was noted. Conclusions A non-clinical sample of older people appeared to be heterogeneous regarding symptoms of depression and its course. However, only 19.00% of participants reported a low level of depression. Strategies of coping with health concerns may play a significant role here, as brooding and positive reappraisal significantly differentiate between clusters of low stable and high stable symptoms, even after control for a proxy of objective health status.