Direct costs associated with depressive symptoms in late life – A 4.5-year prospective study

Introduction: Depression in old age is common. Only few studies examined the association of depressive symptoms and direct costs in the elderly in a cross-sectional way. This study aims to investigate health service use and direct costs over 4.5 years considering different courses of depressive symptomatology Methods: 305 primary care patients aged 75+ were assessed face-to-face regarding depressive symptoms (Geriatric Depression Scale), and service use and costs at baseline and 4.5 years later. Resource utilisation was monetarily valued using 2004/2005 prices. Results: Mean annual direct costs of depressive individuals were almost one third higher than of non-depressive, and highest for individuals with chronic depressive symptoms. Most relevant cost driver were costs for inpatient care, pharmaceuticals and home care. Costs for home care increased at most in individuals with chronic depressive symptoms. Predictors of direct costs after 4.5 years were number of medications, age, gender and depressive symptoms at baseline. Discussion: Presence and persistence of depressive symptoms in old age cause a substantial increase in direct costs even after adjustment for somatic comorbidity. Further research and clinical efforts to establish secondary prevention strategies are challenged to preserve quality of life of sufferers and reduce economic burden.

costs - depression - depressive symptoms - economic burden - service use