The 'Discontinuity Hypothesis' of Depression in Later Life: Clinical and Research Implications

This narrative review challenges the assumption that depressed mood exists on a continuum with depressive disorders, proposing instead that in older adults, depressed mood may be an aging-related consequence of physical illness in people resilient to actual depressive disorders. The authors argue that differences in course, poor screening predictive value, and inconsistent dose-response relationships support reconceptualizing depression in later life, with implications for pharmacological treatment efficacy.