Preventing depression in older adults

Late-life depression (LLD) is a devastating disease, complicating medical illnesses and their management. In addition to treating LLD, prevention of the disorder should be a priority, as identifying and modifying risk factors can pave the way for more effective intervention efforts. This article contrasts the Institute of Medicine's classification of prevention (universal, selective, indicated) with classic public health definitions (primary, secondary, tertiary) and describes how these terms are applied to LLD. The authors focus on three areas for prevention of LLD: 1) enabling access to effective treatment; 2) preventing the development of depression in high-risk individuals; and 3) treating mood disorders to complete remission to prevent recurrence. Medical, psychosocial, and genetic risk factors are described, as is work from the author's own laboratory in the area of LLD prevention.