The interaction between physical illness and depression in late life

The main goal of my dissertation is to study the interaction between physical disease burden and depression in late life, with particular emphasis on the clinical complexity and longitudinal course of both conditions. We have tried to answer this research question within it The Swedish National Study on Aging and Care in Kungsholmen (SNAC-K)a population-based cohort of older adults who have been regularly followed for more than two decades.

Important results

First, we showed that depressive symptoms are strongly interconnected in old age, with specific symptoms such as decreased appetite, cognitive difficulties, and suicidal ideation linking physical illness to other depressive symptoms.

In subsequent studies, we examined bidirectional relationships and obtained several results. For example, individuals with major and subsyndromal depression experience an accelerated accumulation of somatic pathology over time. At the symptomatic level, the greater burden of cognitive symptoms of depression, such as concentration difficulties and memory problems, has been found to be a sign of the rapid accumulation of somatic pathology.

Conversely, a greater burden of physical disease, both in terms of the number of diseases and their composition (eg, cardiometabolic burden), was associated with a greater risk of depression.

Finally, we examined the natural course of late-life depression and observed that physical illness burden predicts progression and recovery across different depressive symptom states.

How can this new knowledge contribute to improving human health?

The findings could contribute to improving care for older adults by providing an increased understanding of how depression and physical health relate to each other in old age.

Careful consideration of the clinical presentation, longitudinal course that characterizes depression, and the burden of physical illness may contribute to person-centered care, improved risk stratification, and the design of tailored interventions to address the complex health needs of older individuals.

What are your future plans?

I would like to continue as a postdoctoral researcher in geriatric psychiatry, although I do not rule out the possibility of returning to some clinical activities.