Predictors of recurrence in remitted late-life depression
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BACKGROUND: Late-life depression (LLD) is associated with a fragile antidepressant response and high recurrence risk. This study examined what measures predict recurrence in remitted LLD. METHODS: Individuals of age 60 years or older with a Diagnostic and Statistical Manual - IV (DSM-IV) diagnosis of major depressive disorder were enrolled in the neurocognitive outcomes of depression in the elderly study. Participants received manualized antidepressant treatment and were followed longitudinally for an average of 5 years. Study analyses included participants who remitted. Measures included demographic and clinical measures, medical comorbidity, disability, life stress, social support, and neuropsychological testing. A subset underwent structural magnetic resonance imaging (MRI). RESULTS: Of 241 remitted elders, approximately over 4 years, 137 (56.8%) experienced recurrence and 104 (43.2%) maintained remission. In the final model, greater recurrence risk was associated with female sex (hazard ratio [HR] = 1.536; confidence interval [CI] = 1.027-2.297), younger age of onset (HR = 0.990; CI = 0.981-0.999), higher perceived stress (HR = 1.121; CI = 1.022-1.229), disability (HR = 1.060; CI = 1.005-1.119), and less support with activities (HR = 0.885; CI = 0.812-0.963). Recurrence risk was also associated with higher Montgomery-Asberg Depression Rating Scale (MADRS) scores prior to censoring (HR = 1.081; CI = 1.033-1.131) and baseline symptoms of suicidal thoughts by MADRS (HR = 1.175; CI = 1.002-1.377) and sadness by Center for Epidemiologic Studies-Depression (HR = 1.302; CI, 1.080-1.569). Sex, age of onset, and suicidal thoughts were no longer associated with recurrence in a model incorporating report of multiple prior episodes (HR = 2.107; CI = 1.252-3.548). Neither neuropsychological test performance nor MRI measures of aging pathology were associated with recurrence. CONCLUSIONS: Over half of the depressed elders who remitted experienced recurrence, mostly within 2 years. Multiple clinical and environmental measures predict recurrence risk. Work is needed to develop instruments that stratify risk.
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Even with antidepressant treatment over half of remitted LLD patients experienced recurrence, mostly within 2 years.
“However, even with antidepressant treatment over half of remitted LLD patients experienced recurrence, mostly within 2 years141.”
From Mechanisms and treatment of late-life depression (2019) · cites this paper as [141]
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Self-citationRemission is insufficient: predictors and mechanistic models of recurrence in late-life depression
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Self-citationLongitudinal Changes in White Matter Hypointensities in Recurrent Late-Life Depression
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Maintenance Psychotherapies for Older Adults: A Scoping Review
González, M. L. S., Vásquez, E., & Alegria, M. M. (2023) · American Journal of Geriatric Psychiatry · doi:10.1016/j.jagp.2023.02.001 · Cited by 2 · see citing works
Treatment Approach and Modalities for Management of Depression in Older People
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Outcomes of Late-Life Depression (Clinical and Follow-Up Study)
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Homiack, D., Boyd, B. D., Zhang, A., Begnoche, J. P., Butters, M. A., Andreescu, C., Taylor, W. D., & Ajilore, O. (2025) · Biological Psychiatry Cognitive Neuroscience and Neuroimaging · doi:10.1016/j.bpsc.2025.08.013 · Cited by 1 · see citing works
Self-citationModerators of treatment response in late-life depression
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Best Practices in the Management of Major Depression for Older Adults in Primary Care
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Evidence for a Geroscience Approach to Late Life Depression: Bioenergetics and the Frail-Depressed
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Two steps forward, one step back
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Pharmacotherapy for late-life depression
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Chapter 9. Depressive Disorders
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Self-citationBrain Age Is Not a Significant Predictor of Relapse Risk in Late-Life Depression
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Self-citationTreatment-resistant depression in geriatrics
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Childhood Trauma, Recent Stressors, and Risk of Depression Relapse in Late‐Life Depression
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Self-citationNavigating the Complexities of Treatment-Resistant Depression in Late Life
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- Authors
- Deng, Y., McQuoid, D. R., Potter, G. G., Steffens, D. C., Albert, K., Riddle, M., Beyer, J. L., & Taylor, W. D.
- Affiliations
- Vanderbilt University Medical Center (US)
- Duke University (US)
- UConn Health (US)
- VA Tennessee Valley Healthcare System (US)
- Corresponding author
- Taylor, Warren D.
- Venue
- Depression and Anxiety
- Publisher
- Wiley
- Published
- 2018-05-10
- Volume
- 35
- Issue
- 7
- Pages
- 658-667
- ISSN
- 1091-4269 (ISSN-L)
- PMC
- PMC6035781
- OpenAlex
- W2802098170
- Cited by
- 65
- References
- 45
- Citations by year
- 2026: 9 · 2025: 7 · 2024: 6 · 2023: 7 · 2022: 7 · 2021: 12 · 2020: 6 · 2019: 10 · 2018: 1
- FWCI
- 4.68
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Depression and Anxiety (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (R01 MH102246, R01 MH054846, K24 MH110598)
- Topics
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- geriatric depression, depression recurrence, remitted depression, predictors of recurrence, antidepressant treatment, perceived stress, disability, social support, suicidal ideation, age of onset, sex differences, neuropsychological outcomes, brain aging, older adults, major depressive disorder, MRI biomarkers, neuropsychological performance, life events
- MeSH terms
- Activities of Daily Living, Aged, Antidepressive Agents, Brain, Major Depressive Disorder, Female, Humans, Longitudinal Studies, Magnetic Resonance Imaging, Male, Middle Aged, Neuropsychological Tests, Prognosis, Recurrence, Remission Induction, Sex Factors, Social Support, Stress, Psychological, Comorbidity, Proportional Hazards Models, Age of Onset, Suicidal Ideation
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