Psychological status, life and social conditions: A study in a population of institutionalized elderly people

The relationship between social and life conditions on the one hand and the presence of depression on the other was analysed in a population of institutionalized elderly subjects. The influence of health status on psychological condition and the presence of endocrinological changes in hormones associated with chronic stress were investigated in depressed elderly people. One hundred and thirty-seven elderly people (mean age 82.4 ± 7.7) were studied and 60 of them underwent a thorough psychiatric examination. The overall prevalence of depression-not previously diagnosed in all but one patient was 76.6%; 23.3% were severely depressed. Neither gender nor the presence of organic disease differentiated the depressed from the non-depressed. The only two life and social variables associated with depression among the many items analysed were the length of institutionalization and the period of retirement. It was observed that a higher cortisol level in the severely depressed group showed a positive correlation between plasma (and urine) cortisol level and Hamilton Rating Scale for Depression (HRSD) score. A relationship between immunological impairment and depression in old age has been reported elsewhere; it is suggested that these findings could be partly mediated by the observed endocrinological changes.