Frequency and risk factors associated with depression in elderly visiting Primary Health Care (PHC) settings: Findings from the Cretan Aging Cohort

Maria Basta, Katerina Micheli, Panagiotis Simos, Ioannis Zaganas, Symeon Panagiotakis, Katerina Koutra, Christina Krasanaki, Christos Lionis, Alexandros Vgontzas

Research output: Contribution to journalArticlepeer-review

12 Scopus citations


Background: Depression is a frequent and serious disease often undiagnosed in elderly. We aimed to examine (1) the prevalence/correlates associated with depression and (2) the magnitude of depression underdiagnosis/related factors, in a large community-dwelling elderly population in Crete/Greece visiting Primary Health Care (PHC) settings. Methods: A sub-sample of 2428 non-demented individuals with Mini Mental State Examination (MMSE)>19 were recruited from a population-based cohort of 3140 elderly (>60 years). In phase I, all participants were assessed with a structured questionnaire including demographics, life-style, sleep, physical health and cognitive function. Diagnosis of depression was based on history/treatment of depression. In phase II, in a sub-sample of 293 participants, depression was diagnosed after a thorough extensive neuropsychiatric/neuropsychological evaluation. Results: In phase I, 10.8% reported a diagnosis/treatment of depression. In multivariate analysis, female gender, lack of physical activity, caregiver dependence and use of benzodiazepines were associated with depression. In phase II, depression was prevalent in 28.7% of our sample, whereas about 61% of those diagnosed with depression were undetected in phase I. Factors associated with non-detection of depression were sleep complaints/subjective short sleep, low MMSE and medical comorbidities. Two screening questions related to mood increased possibility to detect undiagnosed depression up to 90%. Limitations: Due to the cross-sectional design, causality between correlated factors cannot be examined. Conclusion: Prevalence of depression is high and largely underdiagnosed in elderly in Crete/Greece. Sleep and memory complaints appear to be surrogate markers of depression, whereas screening mood in PHC settings may significantly increase detection of depression in elders.

Original languageEnglish (US)
Article number100109
JournalJournal of Affective Disorders Reports
StatePublished - Apr 2021

All Science Journal Classification (ASJC) codes

  • Psychiatry and Mental health
  • Clinical Psychology


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