A Wayne State University School of Medicine assistant professor has secured a National Institute of Mental Health grant to investigate the prevalence, risks and burden of disease associated with late-life depression among the national population and among major ethnic groups in the United States.

Hector Gonzalez, Ph.D., will use the $1.2 million three-year grant to fund the Epidemiology of Late-Life Depression and Ethnicity Research Study, or ELLDERS, to provide updated estimates on the distribution of major depression and the functional status of affected older adults in the U.S. The results, Dr. Gonzalez predicts, will offer insights about the opportunities for late-life depression prevention in an aging and increasingly diverse population – and one that is growing rapidly.

“Depression is a leading cause of disability in the United States and will continue to ascend in importance as the population continues to grow older over the coming decades,” said Dr. Gonzalez, a clinical neuropsychologist and assistant professor in the Department of Family Medicine and Public Health Sciences. He has a joint appointment with the Institute of Gerontology. “For older adults, national prevalence estimates of ‘true’ depressive disorders meeting established diagnostic criteria date back to pioneer psychiatric epidemiologic work in the 1980s.”

Demographically, Dr. Gonzalez pointed out, much has changed over the past 20 years in public health. Middle-aged baby boomers are entering retirement age, and Latinos, “largely ignored until the turn of the millennium,” are now the largest ethnic minority in the country. New technologies have advanced the understanding and treatment of depression over the last 20 to 30 years, yet most Americans suffering depression continue to go untreated or undertreated, especially disadvantaged ethnic and racial minorities, he said.

Medicine needs updated national estimates of depressive disorders in older adults to shape current and projected evidence-based allocations of appropriate mental health resources for an aging population.

While ELLDERS will study the nation’s whole population because of the dated psychiatric epidemiological information, ethnic and racial minority groups will also be targeted because they were largely ignored 30 years ago, leaving even less information currently available.

“While those early studies were pioneering, they lacked the large samples needed to understand depression in ethnically diverse populations. We expect to revise our current understanding of the epidemiology of depression and what will appear in textbooks,” Dr. Gonzalez explained. “Considering depression is a leading cause of disability worldwide, we believe our work has very important public health implications for the nation and for large and growing segments of the population.

“In addition, minority health has never been ignored by major stockholders, namely ethnic minorities. It’s a glaring part of the reality of daily living. It’s just taken a long time for others to realize the health of the nation depends on all of us,” he added.

The research will compare the epidemiology of depression between ethnic groups.

“Treatments are only good if you can get them to the right people. Thus far, we are seeing very low rates of treatments for ethnic minorities, lower than what has been previously reported,” Dr. Gonzalez said. “While that may be largely explained by differences in access to health care access, we are seeing some interesting differences in which types of treatment different ethnic groups are willing to stick with. Given that there are many different and effective depression treatments available, knowing who prefers what type of treatment can be helpful in reducing the stark inequalities in care we are seeing.”