The Impact of Depressive Symptoms on Healthcare Costs in Late Life: Longitudinal Findings From the AgeMooDe Study

Abstract

Objective: To examine whether depressive symptoms affect healthcare costs in old age longitudinally.

Design: Multicenter prospective observational cohort study (two waves with n_t1 = 1,195 and n_t2 = 951) in Germany.

Setting: Community.

Participants: Participants aged 75 years and older recruited via general practitioners.

Measurements: Depressive symptoms were assessed by the Geriatric Depression Scale (GDS). The health-related resource use was measured retrospectively from a societal perspective based on a questionnaire, covering outpatient services, inpatient treatment, pharmaceuticals, as well as formal and informal nursing care. Hybrid regression models were used to determine the between- and within-effect of depressive symptoms on healthcare costs, adjusting for important covariates.

Results: Six-month total cost increased from €3,090 (t1) to €3,748 (t2). The hybrid random effects models showed that individuals with more depressive symptoms had higher healthcare costs compared with individuals with less depressive symptoms (between-effect). Moreover, an intra-individual increase in depressive symptoms increased healthcare costs by €539.60 (within-effect) per symptom on GDS.

Conclusions: Our findings emphasize the economic importance of depressive symptoms in old age. Appropriate interventions to treat depressive symptoms in old age might also be a promising strategy to reduce healthcare costs.

Keywords: Depression; depressive symptoms; economic burden; healthcare costs; old age.