Sadness in older persons: 13-year follow-up of a community sample in Baltimore, Maryland

Background. Our prior psychometric work suggested that older adults interviewed in 1981 in a community survey were less likely than younger adults to report dysphoria. We hypothesized that this would also be true of older adults interviewed 13 years later. Methods. This study is a population-based 13-year follow-up survey of community-dwelling adults living in East Baltimore in 1981. Subjects were the continuing participants of the Baltimore Epidemiologic Catchment Area Program. After excluding 269 adults who were 65 years of age and older at initial interview in 1981, 1651 adults remained (347 aged 65 years and older and 1304 who were 30-64 years-old at follow-up). We applied structural equations with a measurement model for dichotomous data (the MIMIC - multiple indicators, multiple causes - model) to compare symptoms between adults who were 65 years and older at follow-up with younger adults, in relation to the nine symptom groups comprising the diagnostic criteria for major depression, adjusting for several potentially influential characteristics (namely, gender, self-reported ethnicity, educational attainment, cognitive impairment, marital status and employment). Results. Older adults were less likely to endorse sadness as evidenced by a direct effect coefficient of -0.335 (95% Confidence Interval -0.643, -0.027). After adjusting for several potentially influential characteristics, the direct effect of age was substantially unchanged (-0.298 (95 % CI -0.602, 0.006)). Conclusions. Older adults in 1994, like older adults in 1981, were less likely to endorse sadness than younger persons. This finding suggests, but does not prove, that the observed age difference in reporting depression does not reflect a cohort effect.