Interplay between somatic disease burden and depression in late life
Hi there Federico Triolo! You are soon to defend your thesis entitled "Depression and chronic diseases in old age: understanding their interplay for better health". What is the main focus?
The primary aim of my thesis is to investigate the interplay between somatic disease burden and depression in late life, with a particular focus on the clinical complexity and longitudinal course of both conditions. We tried to answer this research question within the Swedish National Study on Aging and Care in Kungsholmen (SNAC-K), a population-based cohort of older people who have been regularly followed up for over two decades.
First, we showed that depressive symptoms are highly interconnected in old age, with specific ones such as reduced appetite, cognitive difficulties, and suicidal thoughts bridging somatic diseases and other depressive symptoms.
In subsequent studies, we explored bidirectional associations and obtained several findings. For instance, individuals with major and subsyndromal depression experienced an accelerated accumulation of somatic diseases over time. At a symptom level, a higher burden of cognitive symptoms of depression such as concentration difficulties and memory complaints was found to be a marker of rapid somatic disease accumulation.
Conversely, a higher burden of somatic diseases, in terms of both disease count and composition (e.g., cardiometabolic burden), was linked to a higher risk of developing depression.
Lastly, we examined the natural course of late-life depression and observed that somatic disease burden predicts both progression and recovery across different depressive symptom states.
How can this knowledge contribute to the improvement of people's health?
The findings could help improve geriatric care by providing an improved understanding of how depression and somatic health are linked in older age.
A thorough consideration of the clinical presentation and longitudinal course that characterize depression and somatic disease burden may contribute to person-centered care provision, enhanced risk stratification, and the design of tailored interventions to address the complex health needs of older individuals.
What are your future plans?
My immediate plans include continuing research in geriatric psychiatry as a postdoctoral researcher, although I do not exclude the possibility to return to some clinical practice.