Predictors of depression in older adults with multiple sclerosis

Chatterjee, Tanaya (2018) Predictors of depression in older adults with multiple sclerosis. Doctoral (PhD) thesis, Memorial University of Newfoundland.

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Abstract

Canada’s growing population of older people with MS (PwMS) has warranted a closer look into factors associated with depression that may interfere with healthy aging. At the same time, researchers, clinicians, and medical professionals treating PwMS with mood disorders have spoken about the difficulty they face when having to determine a diagnosis of depression in this population. This difficulty arises because both MS and depression share various psychological and neurological symptoms (e.g., fatigue, pain, sleep difficulties, psychomotor retardation, and cognitive difficulties). It is also found that these overlapped symptoms vary when completing a self-report measure of depression, versus when medically diagnosed by a psychiatrist. As such, we aim to investigate the personal and disease-related factors that are associated with self-reported depressive symptoms and medically diagnosed depression (i.e. depression diagnosed by a medical professional). Following this, we aim to determine the risk factors for depression in older PwMS. This study used secondary data collected from the original study, the Canadian survey of health, lifestyle, and aging with multiple sclerosis. Data of the original study was collected from 743 Canadians (> 55 years of age and living with MS for >20 years). In this present study, presence of self-reported depressive symptoms was defined as a score of ≥ 8 on the depression component of the Hospital Anxiety and Depression Scale (HADS-D). Presence of medically diagnosed depression was determined by the item that asked participants if they have received a diagnosis of depression by their medical professional. Logistic regression was used to identify variables that predicted depression. Self-reported depressive symptoms were found in 30.5% of the population, while medically diagnosed depression was found in 25.7%. 11.7% of PwMS had both self-identified depressive symptoms and were diagnosed with depression by their medical professional. Low social support, high perceived disability, and additional comorbid physical conditions were independent predictors of depression in older PwMS in our cohort. Depression is prevalent in older PwMS. Clinicians should be cognizant of the overlap of symptoms between MS and depression and should employ possible ways to minimize over-diagnosing or underdiagnosing depression in this population. Identifying risk factors for depression is imperative because at-risk individuals may be thoroughly assessed for depression and will be able to receive treatment more promptly.

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