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Effect of Long-term Supplementation With Marine Omega-3 Fatty Acids vs Placebo on Risk of Depression—Reply
In Reply In their comments about our study, Dr Liang and colleagues state that its relevance is restricted to preventing geriatric depression and that observed rates of depression were low compared with data estimating the average prevalence of depression in old age as 31.74% Testing preventive effects of omega-3 fatty acids for late-life depression was indeed the priority of our study. However, although the mean baseline age was 67 years, we included participants aged 50 years or older, so it did not focus exclusively on geriatric depression. As previously noted, depression rates in our study were comparable with age- and sex-specific incidence and recurrence in rigorous prior work among community-dwelling older adults. Moreover, incidence, rather than prevalence, is the relevant rate here. Also, Liang and colleagues do not distinguish between current vs lifetime prevalence or major vs minor depression. The estimated 31.74% prevalence rate of depression is considerably higher than prior prevalence estimates of late-life major depression (7%) and depressive disorders (17%). This discrepancy may also reflect varied or less stringent symptom questionnaire cut points for diagnosis of depression compared with diagnostic interviews, which were used in the source studies for the meta-analysis.
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