Global, regional, and national burden for major depressive disorders and dysthymia in adults aged 55 years and older, 1990–2021

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Depression is one of the major causes of mental illness worldwide. The purpose of this study is to describe the disease burden caused by depression among the elderly in the Global Burden of Disease Study (GBD) 2021. We used GBD 2021 study methodology to evaluate the incidence estimates and the disability-adjusted life years (DALYs) for depressive disorders, which include major depressive disorder (MDD) and dysthymia. For MDD, the incidence has been gradually increasing since 2011 (annual percent change [APC] = 0.62). Regarding dysthymia, the middle-high Socio-demographic Index (SDI) regions have shown an increasing trend in incidence since 2015 (APC = 0.25). The incidence rate of depression has the largest increase in regions with medium SDI (average annual percent change [AAPC] = 0.5). The incidence of depression among the elderly in high SDI areas begins to trend towards younger elderly individuals. The incidence for women in each age group after 55 is higher than that for men, but in areas with a middle or lower SDI, the difference decreases as age increases. Between 1990 and 2021, the depression burden among the elderly showed an upward trend. In low SDI regions, incidence among the elderly remained high. In middle SDI regions, the burden increased substantially and in high SDI regions, it shifted towards younger elderly individuals. Compared to men, women carried a greater depression burden. • Health inequality persisted, and low-income areas bore a greater disease burden. • Middle SDI regions experienced the largest increase in both incidence and DALY rates of depression. • Females had a higher burden of depression than males, but in low-middle SDI regions, this disparity gradually diminished with increasing age. • The burden of depression in high SDI regions shifted to younger elderly individuals.

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