The Indirect Costs of Late-Life Depression in the United States: A Literature Review and Perspective

Abstract

Late-life depression is a leading cause of disability in older adults and is associated with significant economic burden. This article draws from the existing literature and publicly available databases to describe the relative importance of the indirect costs associated with late-life depression. The authors found that unpaid caregiver costs represent the largest component of the indirect costs of late-life depression, with the highest level of economic burden attributed to the majority of care recipients who have fewer depressive symptoms. Other indirect costs, such as productivity losses related to early retirement, reduced ability to fulfill work and family functions and diminished financial success were mostly under-appreciated in the literature. Also, mortality cost estimates provided little clarity, employing variable methodologies and revealing mixed results. With respect to late-life suicide studies, studies approximated both economic costs and savings. More rigorous efforts to evaluate the indirect costs of late-life depression would afford a better understanding of the social and economic toll of this disorder and could influence the allocation of resources for research and treatment.

Evaluation of a Health Education Intervention to Improve Parental Knowledge and Attitudes About Chronic Stress and Depression Among Head Start Families

“…Chronic stress is highly prevalent among Americans, impacting one in two adults in the United States (US) (Halonen et al, 2020), and is thought to be one of the root causes of mental health problems, including depression (Stefanaki et al, 2018). The high prevalence of chronic stress and depression has important social, economic, and health implications for affected individuals and their families (Bermudez-Millan et al, 2016; Dalton et al, 2016; Snow & Abrams, 2016). Untreated depression can lead to lower educational attainment, unemployment, high work absenteeism and disability, increased risk of substance abuse and teen pregnancy, and high mental and medical care costs.…”

Mindfulness-based cognitive therapy vs. a health enhancement program for the treatment of late-life depression: Study protocol for a multi-site randomized controlled trial

“…Since MBCT is delivered in groups and could potentially be adapted into an online intervention, it is scalable in a variety of settings, including primary care. Additionally, future research could examine the cost-effectiveness of MBCT compared to individual psychotherapy or pharmacology for LLD, potentially lowering the direct health-care costs related to LLD (Snow and Abrams, 2016 ). Elucidating the neural mechanisms of MBCT will pave the road to optimized combination treatment approaches (e.g., with antidepressants or brain stimulation targeting complementary brain circuits).…”

“We are the sun for our community:” Partnering with community health workers/promotores to adapt, deliver and evaluate a home-based collaborative care model to improve equity in access to quality depression care for older U.S. Latino adults who are underserved

“…Older persons with depression use more health care (3)(4)(5) and enter nursing homes earlier (6). These institutionalizations can be devastating as most older persons prefer aging in place, and costs of health and social care continue to rise without improvement in health outcomes (7)(8)(9). Despite depression's impact on people, society, and systems, and the existence of effective depression care models, there is a depression treatment gap around the world.…”

“…Older persons with depression use more health care ( 3 – 5 ) and enter nursing homes earlier ( 6 ). These institutionalizations can be devastating as most older persons prefer aging in place, and costs of health and social care continue to rise without improvement in health outcomes ( 7 – 9 ).…”