Depression symptoms in late life assessed during the EURO-D scale. Effect of age, gender and marital status in 14 European centres

Background. Data from surveys involving 21 724 subjects aged ≥ 65 years were analysed using a harmonised depression symptom scale, the EURO-D. Aims. To describe and compare the effects of age, gender and mental status on depressive symptoms across Europe. Method. We tested for the effects of centre, age, gender and marital status on EURO-D score. Between-centre variance was partitioned according to centre-characteristics: region, religion and survey instrument used. Results. EURO-D scores tended to increase with age, women scored higher than men, and widowed and separated subjects scored higher than others. The EURO-D scale could be reduced into two factors: affective suffering, responsible for the gender difference, and motivation, accounting for the positive association with age. Conclusions. Large between-centre differences in depression symptoms were not explained by demography or by the depression measure used in the survey. Consistent, small effects of age, gender and marital status were observed across Europe. Depression may be overdiagnosed in older persons because of an increase in lack of motivation that may be affectively neutral, and is possibly related to cognitive decline.