Elsevier

Clinical Psychology Review

Volume 17, Issue 8, December 1997, Pages 847-879
Clinical Psychology Review

Aging and depression: Vulnerability and stress across adulthood

https://doi.org/10.1016/S0272-7358(97)00053-6Get rights and content

Abstract

This paper reviews research on the relationship between age and depression in adulthood, with a focus on depression in late life. Age differences in prevalence rates of major depression and depressive symptomatology raise questions about presentation and measurement of depression across adulthood, and suggest a changing salience of risk factors for depression from young adulthood through old age as well as to cohort differences in risk for depression. Applying a developmental perspective on biological change, psychological adaptation, and stress processes throughout adulthood shows that risk for depression onset in young adults is typified more through psychological vulnerability and stress, as well as genetic factors, while risk for depression in older adults typified more through comorbid medical and neurological disorder. Implications for research and clinical practice are discussed. This review of the relationship of age to depression shows that the study of psychopathology and adult development can inform each other.

References (212)

  • C.M. Aldwin

    Does age affect the stress and coping process? Implications of age differences in perceived control

    Journal of Gerontology

    (1991)
  • C.M. Aldwin

    Aging, coping and efficacy: Theoretical framework for examining coping in life-span developmental context

  • C.M. Aldwin

    Stress, coping and development

    (1994)
  • C. Aldwin et al.

    Stress and coping in older men: Findings from the Normative Aging Study

    The Gerontologist

    (1993)
  • R. Allen-Burge et al.

    Sex differences in the sensitivity of two self-report depression scales in older depressed inpatients

    Psychology and Aging

    (1994)
  • A. Allen et al.

    Mood disorders

  • American Psychiatric Association
  • American Psychiatric Association
  • T.C. Antonucci

    Social supports and social relationships

  • T.C. Antonucci et al.

    Social support, interpersonal efficacy, and health: A life course perspective

  • C.B. Ballinger

    Psychiatric aspects of the menopause

    British Journal of Psychiatry

    (1990)
  • P.A. Barnett et al.

    Psychosocial functioning and depression: Distinguishing among antecedents, concomitants and consequences

    Psychological Bulletin

    (1988)
  • A.T. Beck

    Depression: Clinical, experimental and theoretical aspects

    (1967)
  • L.F. Berkman et al.

    Depressive symptoms in relation to physical health and functioning in the elderly

    American Journal of Epidemiology

    (1986)
  • J.M. Berry et al.

    Age and sex differences in somatic complaints associated with depression

    Journal of Gerontology

    (1984)
  • D.G. Blazer

    Epidemiology of late-life depression

  • D. Blazer et al.

    The association of age and depression among the elderly: An epidemiologic exploration

    Journal of Gerontology

    (1991)
  • D. Blazer et al.

    The phenomenology of late life depression

  • D. Blazer et al.

    The epidemiology of depression in an elderly community population

    Gerontologist

    (1987)
  • D. Blazer et al.

    Epidemiology of dysphoria and depression in an elderly population

    American journal of Psychiatry

    (1980)
  • M.D. Blumenthal

    Measuring depressive symptomatology in a general population

    Archives of General Psychiatry

    (1975)
  • M.D. Blumenthal

    Depressive illness in old age: Getting behind the mask

    Geriatrics

    (1980)
  • K. Bolla-Wilson et al.

    Absence of depression in elderly adults

    Journal of Gerontology

    (1989)
  • J. Brandtstadter et al.

    Adaptive resources of the aging self: Outlines of an emergent perspective

    International Journal of Behavioral Development

    (1993)
  • K.C. Burke et al.

    Age at onset of selected mental disorders in five community populations

    Archives of General Psychiatry

    (1990)
  • E.D. Caine et al.

    Clinical and etiological heterogeneity of mood disorders in elderly patients

  • C.M. Callahan et al.

    Longitudinal study of depression and health services use among elderly primary care patients

    Journal of the American Geriatrics Society

    (1994)
  • S.S. Carney et al.

    Suicide over 60: The San Diego Study

    Journal of the American Geriatrics Society

    (1994)
  • L. Carstensen

    Social and emotional patterns in adulthood: Support for socioemotional selectivity theory

    Psychology and Aging

    (1993)
  • K.A. Christie et al.

    Epidemiologic evidence for early onset of mental disorders and higher risk of drug abuse in young adults

    American Journal of Psychiatry

    (1988)
  • S. Cohen et al.

    Stress, social support, and the buffering hypothesis

    Psychological Bulletin

    (1985)
  • C.A. Colarusso et al.

    Adult development: A new dimension in psychodynamic theory and practice

    (1981)
  • G.W. Comstock et al.

    Symptoms of depression in two communities

    Psychological Medicine

    (1976)
  • J.J. Conley

    Longitudinal consistency of adult personality: Self-reported psychological characteristics across 45 years

    Journal of Personality and Social Psychology

    (1984)
  • Y. Conwell

    Suicide in elderly patients

  • Y. Conwell et al.

    Relationships of age and Axis 1 diagnoses in victims of completed suicide: A psychological autopsy study

    American Journal of Psychiatry

    (1996)
  • Y. Conwell et al.

    Completed suicide at age 50 and over

    Journal of the American Geriatrics Society

    (1990)
  • P.T. Costa et al.

    Personality in adulthood: A six-year longitudinal study of self-reports and spouse ratings on the NEO Personality Inventory

    Journal of Personality and Social Psychology

    (1988)
  • P.T. Costa et al.

    Depression as an enduring disposition

  • Cited by (70)

    • Sex differences in nicotine dependency and depressive tendency among smokers

      2018, Psychiatry Research
      Citation Excerpt :

      However, they also mentioned the possibility that the association between these variables may become obvious with more severe depressive tendency of the participants (Psujek et al., 2004). People generally have an increased susceptibility to various diseases with aging and accordingly, the likelihood of depressive tendency increases (Karel, 1997; Huang et al., 2010; Kim et al., 2016). Participants in the present study were relatively older smokers with a relatively severe depressive tendency.

    • Predictors of first-episode unipolar major depression in individuals with and without sub-threshold depressive symptoms: A prospective, population-based study

      2015, Psychiatry Research
      Citation Excerpt :

      Much higher rates of conversion from sub- to full-threshold depression have been found in younger cohorts (Hill et al., 2014; Klein et al., 2009). In addition, given that this sample consists primarily of middle-aged adults, it seems plausible that the assessed age range represents a more firmly consolidated stage of development that is less prone to age-related fluctuations in mood relative to younger or older adults (Karel, 1997; Mirowsky, 2013). Further, the small effect sizes with respect to age in this sample stand in contrast to findings regarding sex, child abuse, family history, and anxiety, which demonstrate effects of a moderate to large magnitude in this sample of adults.

    • Psychological Protective Factors Across the Lifespan: Implications for Psychiatry

      2011, Psychiatric Clinics of North America
      Citation Excerpt :

      The factor structure of the CD-RISC was somewhat different, with greater prominence of more emotion-focused coping strategies (eg, tolerating negative affect) over problem-focused strategies. The investigators theorized that that the shift toward emotion-focused coping may be caused by the changing nature of stressors in the latter half of life; older adults are more likely to face chronic uncontrollable stressors (eg, medical problems) than acute stressors that require active problem solving (eg, losing a job).29 Optimism is among the better-studied positive psychological traits30 and is generally defined by the tendency to hold positive expectations of the future.

    • Cognitive style and depressive symptoms in elderly people - Extending the empirical evidence for the cognitive vulnerability-stress hypothesis

      2010, Behaviour Research and Therapy
      Citation Excerpt :

      For these reasons, the prevention, identification and treatment of depression in older people is an important topic in an increasingly aged population. Intrinsic factors including poor physical health, bereavement and prior depression are important risk factors for depression in elderly people (e.g. Blazer & Hybels, 2005; Cole & Dendukuri, 2003; Karel, 1997; Vink, Aartsem, & Schoevers, 2008). With regard to external life events, there is evidence that a) the onset of depression is often associated with stressful live events and b) older people tend to experience more critical life events which are out of their control than do other age groups (e.g. Aldwin, 1992; Karel, 1997).

    • Aging, brain disease, and reserve: Implications for delirium

      2010, American Journal of Geriatric Psychiatry
      Citation Excerpt :

      Moreover, education may cause measurement bias in the assessment of neuropsychological performance.75,76 SES and cultural background may confound the meaning of educational attainment74 or contribute to psychopathology through mechanisms not consistent with cognitive reserve theory.77,78 Recognizing limitations of SES indicators, some investigators have turned to measures of literacy or reading level to capture academic achievement.79,80

    View all citing articles on Scopus
    View full text