Distinct latent symptom profiles in late-onset depressive symptoms in community-dwelling older adults

Abstract

Objectives

To examine the symptom profiles of late-onset depressive symptoms in a sample of older adults.

Method

The sample included 1,192 participants from the National Alzheimer’s Coordinating Center Data Set. Participants were ≥65 years old, community-dwelling, and without cognitive impairment or a prior history of depression. Depressive symptoms were assessed using the Geriatric Depression Scale, 15-item (GDS-15). Latent class analysis (LCA) was used to identify and group participants based on profiles of depressive symptoms.

Results

LCA revealed three distinct symptom profiles: (1) an Anhedonia/Amotivation profile with a higher probability of endorsing a combination of low positive emotion and amotivation (6%), (2) an Amotivation/Withdrawal profile with a high probability of endorsing only amotivational depressive symptoms (35%), and (3) an asymptomatic profile with no probability of endorsing any depressive symptoms (59%). Amotivational depressive symptoms were observed across both symptomatic profiles, while depressed mood (e.g. sadness) did not predominantly characterize any profile in this sample. There were also significant differences among symptom profiles in terms of demographic and clinical characteristics.

Conclusions

Findings highlight the importance of understanding depression at the symptom pattern level. A profile-based diagnostic approach may help improve the recognition of depressive symptoms in older adults.

Keywords:

• Late-onset depression
• symptom profile
• older adult
• depressive symptoms
• latent class analysis

Disclosure statement

The authors declare no conflict of interest.

Additional information

Funding

Z.T was funded by the Health Resources and Service Administration (D40HP33346). V.D is funded by the National Institutes of Health (AG054046-04). The NACC database is funded by a National Institute on Aging/National Institutes of Health grant U01 AG016976. NACC data are contributed by the NIA-funded ADCs: P30 AG019610 (PI Eric Reiman, M.D.), P30 AG013846 (PI Neil Kowall, M.D.), P50 AG008702 (PI Scott Small, M.D.), P50 AG025688 (PI Allan Levey, M.D., Ph.D.), P50 AG047266 (PI Todd Golde, M.D., Ph.D.), P30 AG010133 (PI Andrew Saykin, Psy.D.), P50 AG005146 (PI Marilyn Albert, Ph.D.), P50 AG005134 (PI Bradley Hyman, M.D., Ph.D.), P50 AG016574 (PI Ronald Petersen, M.D., Ph.D.), P50 AG005138 (PI Mary Sano, Ph.D.), P30 AG008051 (PI Thomas Wisniewski, M.D.), P30 AG013854 (PI M. Marsel Mesulam, M.D.), P30 AG008017 (PI Jeffrey Kaye, M.D.), P30 AG010161 (PI David Bennett, M. D.), P50 AG047366 (PI Victor Henderson, M.D., M. S.), P30 AG010129 (PI Charles DeCarli, M.D.), P50 AG016573 (PI Frank LaFerla, Ph.D.), P50 AG005131 (PI James Brewer, M.D., Ph.D.), P50 AG023501 (PI Bruce Miller, M.D.), P30 AG035982 (PI Russell Swer-dlow, M.D.), P30 AG028383 (PI Linda Van Eldik, Ph. D.), P30 AG053760 (PI Henry Paulson, M.D., Ph.D.), P30 AG010124 (PI John Trojanowski, M.D., Ph.D.), P50 AG005133 (PI Oscar Lopez, M.D.), P50 AG005142 (PI Helena Chui, M.D.), P30 AG012300 (PI Roger Rosenberg, M.D.), P30 AG049638 (PI Suzanne Craft, Ph.D.), P50 AG005136 (PI Thomas Grabowski, M.D.), P50 AG033514 (PI Sanjay Asthana, M.D., F.R. C.P.), P50 AG005681 (PI John Morris, M.D.), and P50 AG047270 (PI Stephen Strittmatter, M.D., Ph.D.).