Depression and alcohol misuse among older adults: exploring mechanisms and policy impacts using agent-based modelling

Ivana Stankov, Yong Yang, Brent A. Langellier, Jonathan Purtle, Katherine L. Nelson, Ana V. Diez Roux

Research output: Contribution to journalArticlepeer-review


Purpose: To: (1) explore how multi-level factors impact the longitudinal prevalence of depression and alcohol misuse among urban older adults (≥ 65 years), and (2) simulate the impact of alcohol taxation policies and targeted interventions that increase social connectedness among excessive drinkers, socially isolated and depressed older adults; both alone and in combination. Methods: An agent-based model was developed to explore the temporal co-evolution of depression and alcohol misuse prevalence among older adults nested in a spatial network. The model was based on Los Angeles and calibrated longitudinally using data from the Multi-Ethnic Study of Atherosclerosis. Results: Interventions with a social component targeting depressed and socially isolated older adults appeared more effective in curbing depression prevalence than those focused on excessive drinkers. Targeting had similar impacts on alcohol misuse, though the effects were marginal compared to those on depression. Alcohol taxation alone had little impact on either depression or alcohol misuse trajectories. Conclusions: Interventions that improve social connectedness may reduce the prevalence of depression among older adults. Targeting considerations could play an important role in determining the success of such efforts.

Original languageEnglish (US)
Pages (from-to)1243-1253
Number of pages11
JournalSocial psychiatry and psychiatric epidemiology
Issue number10
StatePublished - Oct 1 2019


  • Agent-based model
  • Chronic disease
  • Complex systems
  • Health policy
  • Mental health

ASJC Scopus subject areas

  • Epidemiology
  • Health(social science)
  • Social Psychology
  • Psychiatry and Mental health


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