The primary outcome in this study was the 2-year course of major depressive disorder (MDD), which was assessed by use of four indicators: having a depression diagnosis (MDD or dysthymia) after 2 years, having a chronic symptom course (depressive symptoms present during 80% or more of the 2-year follow-up period), time to remission, and depression severity change
The authors conclude their findings suggest a growing need for age-tailored treatment of MDD. They note older people are treated under guidelines that are almost similar to those used for younger patients, but their study highlights that older people might need multidisciplinary and highly structured treatment, including closer monitoring of effects by use of collaborative care, because MDD in this life phase appears to be much more persistent than in other phases.
A commentary notes that antidepressants and collaborative care management are shown in RCTs to be efficacious in averting remission and improving response in older patients with chronic medical conditions, although suboptimal treatment under naturalistic settings might be present in the population evaluated in the current study. It calls for further research into options for targeted treatment alternatives.