Depression diagnoses


Contact: Almar Kok

Depressive disorders are common in older adults; the prevalence of major depression disorders among older adults (>65 years) ranges from 1-5% (Fiske et al., 2009).  Depression can have serious consequences for the quality of life and health care costs. In many the cases depression disorders have an early onset, and have a chronic or remittent course into later life. However, also a large number of persons has their first onset of depression in later life. Comorbidity of depression with physical diseases and cognitive impairment is high in the elderly. To study the course of (subthreshold) depression and to unravel the mechanisms that underlie these comorbidities LASA included a screenings list for depression (CES-D) and a diagnostic interview in those scoring high on the screener.

Measurement instruments in LASA
Depression diagnoses are obtained according to a two stage procedure. At baseline, all persons with a CES-D>16 and a similarly sized random sample of the non-depressed (CES-D < 16) were approached to participate in the diagnostic interview, which was part of the medical interview (Beekman et 1997). At each follow-up measurement, all persons with a CES-D>16 at the current and previous measurement are included for the diagnostic interview. Later, the screening procedure changed, and persons were also included when having a HADS-A score>8 (anxiety screening).

In wave B through 3B, the Diagnostic Interview Schedule (DIS, Robins et al. 1981; Dingemans et al 1985) was used, which was based on DSM III criteria. From wave I onwards, the CIDI (Composite International Diagnostic Interview) was used to assess disorders according to DSM IV criteria. The DIS and the CIDI are designed for epidemiological research and have been widely used among the elderly. Interviewers were fully trained by certified staff, using the official Dutch translation.

At the D and E measurement, the self-rating inventory for posttraumatic stress disorder was also examined to screen for Posttraumatic Stress Disorder (PTSD) (SRIP; Hovens et al. 2000).

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Variable information
LASA*d10 files contain the raw items of the DIS, negative life events during childhood, information about treatment and family history of mental disorders.

LASA*d11 files contain the depression diagnoses per timeframe.

Availability of information per wave 1











MB* I J*

DIS, depression










- - -
CIDI, depression, DSM-IV - - - - - - - - - - Me Me

1  More information about the LASA data collection waves is available here.

* 2B=baseline second cohort;
   3B=baseline third cohort;
   MB=migrants: baseline first cohort;
   J=under construction

Me=data collected in medical interview

Previous use in LASA
Studies have been performed on the prevalence of depressive disorders (Beekman et al. 1995a), it’s comorbidity with anxiety disorders (Beekman et al. 2000) and its risk factors (Braam et al. 1997, Beekman et al. 2000; Steunenberg et al. 2010).

Other studies focussed on the consequences of depressive disorders (Beekman et al. 1997) and course of depression (Beekman et al. 1995b) was examined. In addition, Penninx et al. (1999) studied minor and major depression and the risk of death. Sonnenberg et al. (2003, 2008) examined drug treatment and trends in antidepressant use in depressed older adults. Recently, Jeuring et al. examined the long-term outcome of subthreshold depression in later life, with one of the outcomes being major depression (in press).


  1. Beekman AT, Deeg DJ, van Tilburg T, Smit JH, Hooijer C, van Tilburg W. Major and minor depression in later life: a study of prevalence and risk factors. J Affect Disord. 1995a, 24;36(1-2):65-75.
  2. Beekman AT, Deeg DJ, Smit JH, van Tilburg W. Predicting the course of depression in the older population: results from a community-based study in The Netherlands. J Affect Disord. 1995b, 16;34(1):41-49.
  3. Beekman AT, Deeg DJ, Braam AW, Smit JH, Van Tilburg W. Consequences of major and minor depression in later life: a study of disability, well-being and service utilization. Psychol Med. 1997, 27(6):1397-1409.
  4. Beekman AT, de Beurs E, van Balkom AJ, Deeg DJ, van Dyck R, van Tilburg W.Anxiety and depression in later life: Co-occurrence and communality of risk factors. Am J Psychiatry. 2000, 157(1):89-95.
  5. Braam AW, Beekman AT, Deeg DJ, Smit JH, van Tilburg W. Religiosity as a protective or prognostic factor of depression in later life; results from a community survey in The Netherlands. Acta Psychiatr Scand. 1997, 96(3):199-205.
  6. Dingemans P, Van Engeland H, Dijkhuis JH & Bleeker JH. De ‘Diagnostic Interview Scale’(DIS). Tijdschrift voor Psychiatrie, 1985, 27 (5): 341-359.
  7. Fiske A, Loebach, Wetherell J, Gatz M. Depression in older adults. Annu Rev Clin Psychol 2009; 5:363- 389.
  8. Hovens, J.E., Bramsen, I., Van der Ploeg, H.M., 2000. Zelfinventarisatielijst Posttraumatische Stressstoornis ZIL Handleiding. Swets Test Publishers, Lisse.
  9. Jeuring HW, Huisman M, Comijs HC, Stek ML, Beekman ATF.The Long-Term Outcome of Subthreshold Depression in Later Life. Psychological Medicine, in press.
  10. Penninx BW, Geerlings SW, Deeg DJ, van Eijk JT, van Tilburg W, Beekman AT. Minor and major depression and the risk of death in older persons. Arch Gen Psychiatry. 1999, 56(10):889-895.
  11. Robins LN, Helzer JE, Croughan JL, Ratcliff KS. National Institute of Mental Health Diagnostic Interview Schedule: its history, characteristics and validity. Arch Gen Psychiatry 1981; 38(4): 381–389.
  12. Sonnenberg CM, Deeg DJ, Comijs HC, van Tilburg W, Beekman AT. Trends in antidepressant use in the older population: results from the LASA-study over a period of 10 years. J Affect Disord. 2008, 111(2-3):299-305.
  13. Sonnenberg CM, Beekman AT, Deeg DJ, Van Tilburg W. Drug treatment in depressed elderly in the Dutch community. Int J Geriatr Psychiatry. 2003, 18(2):99-104.
  14. Steunenberg B, Beekman AT, Deeg DJ, Kerkhof AJ. Personality predicts recurrence of late-life depression. J Affect Disord. 2010, 123(1-3):164-172.