Manto: Depression Risk Calculator

The Manto Depression Risk Calculator can estimate a person’s risk of developing depression over the next two years. Answer a few questions about current depressive symptoms and several other aspects of life and you will receive an estimate of your individual risk score. All information collected by the test is anonymous and cannot be traced back to any individual.

How Was Manto Developed?

The Manto Depression Risk Calculator was developed for adults aged 55 years and older who wish to know their chance of developing depression in the next two years. The calculator is based on the Manto study, which uses data from 39,439 individuals included in the European SHARE dataset. The Manto model shows good predictive ability (AUC 0.81; 95 % CI 0.79 – 0.82; Sensitivity 84.3 %; Specificity 58.4 %).

Online risk-prediction calculators are not diagnostic tools. If your risk score is high, share the result with a healthcare professional and remember that depression can be both prevented and successfully treated. The authors at the University of Ferrara accept no responsibility for any loss or risk arising, directly or indirectly, from use of this calculator.

The Manto Depression Risk Calculator is based on the study:

Belvederi Murri M, Cattelani L, Chesani F, Palumbo P, Triolo F, Alexopoulos GS.
Risk Prediction Models for Depression in Community-Dwelling Older Adults.
Am J Geriatr Psychiatry. 2022 Sep;30(9):949-960.
doi: 10.1016/j.jagp.2022.05.017.
PMID: 35821215
Publisher’s website: https://www.ajgponline.org/article/S1064-7481(22)00435-3/fulltext
Download the study: Study, Supplementary Data

Manto

In Greek mythology, Manto was a prophetess, daughter of the blind seer Tiresias. She fled Thebes and founded the Italian city of Mantua, creating its lake with her tears.

Depression and Its Consequences

Around 15 % of people experience depression at some point in their lives. Depression has many forms, but it usually includes sadness and/or an inability to feel pleasure together with other symptoms such as hopelessness, appetite changes, disturbed sleep and reduced concentration (1). Depression is the leading cause of disability worldwide. In older adults, depression often leads to negative consequences: cognitive decline accelerates and the risk of dementia increases, while physical health may deteriorate faster (2). Compared with non-depressed individuals, those with depression tend to die prematurely, irrespective of physical illness (3, 4).

You May Be at Risk of Developing Depression

Anyone can become depressed under difficult circumstances. Risk factors for depression in people aged over 55 include female gender, bereavement, sleep disorders, activity limitations and a prior history of depression (5). Medical illnesses, pain and physical disability also increase the risk.

How Manto Works

The Manto Depression Risk Calculator helps individuals and healthcare professionals estimate the likelihood that a person will develop depression within the next two years. Simply answer a few questions about depressive symptoms and certain other aspects of life and you will receive an estimate of your individual risk score. The calculator should be used by adults aged 55 or older who do not have dementia or severe cognitive impairment. The two-year risk can be calculated reliably even if the respondent is already depressed at the time of use.

How Is the Manto Depression Risk Calculator Used?

The Manto Depression Risk Calculator generates a risk score using the information you provide about conditions that increase the likelihood of depression (risk factors). The score is a percentage indicating your chance of developing depression within the next two years. The calculator is based on the recent Manto study that uses data from the large European SHARE dataset (6) and has good predictive performance (AUC 0.81; 95 % CI 0.79 – 0.82; Sensitivity 84.3 %; Specificity 58.4 %). It was developed by researchers at the University of Ferrara, the University of Bologna, the Karolinska Institute and Weill Cornell Medical College, and follows recent guidelines on detecting depression in older adults (7).

The Calculator Says I’m at High Risk: What Should I Do?

If your risk score is high, don’t panic. Depression can be successfully treated and prevented. Treatment and preventive measures include psychological, pharmacological and behavioural strategies, or a combination of these (8-10). Physical exercise can also improve or prevent depression (11). Several risk factors can be modified (e.g. treating sleep disorders or pain, engaging in enjoyable activities). If you think you may be depressed, consult a healthcare professional.

Study Authors

Martino Belvederi Murri University of Ferrara
Luca Cattelani University of Bologna, Tampere University and University of Eastern Finland
Federico Chesani University of Bologna
Pierpaolo Palumbo University of Bologna
Federico Triolo Karolinska Institutet
George S. Alexopoulos Weill Cornell Medical College

References

  1. Otte C, Gold SM, Penninx BW, Pariante CM, Etkin A, Fava M, et al. Major depressive disorder. Nat Rev Dis Prim. 2016;2:1-20.
  2. Byers AL, Yaffe K. Depression and risk of developing dementia. Nat Rev Neurol. 2011;7(6):323-31.
  3. Cuijpers P, Vogelzangs N, Twisk J, Kleiboer A, Li J, Penninx BW. Excess mortality in depression. Am J Psychiatry. 2014;171(4):453-62.
  4. Gold SM, Köhler-Forsberg O, Moss-Morris R, Mehnert A, Miranda JJ, Bullinger M, et al. Comorbid depression in medical diseases. Nat Rev Dis Prim. 2020;6(1):1-23.
  5. Cole MG, Dendukuri N. Risk factors for depression among elderly community subjects: a systematic review. Am J Psychiatry. 2003;160(6):1147-56.
  6. Börsch-Supan A, Brandt M, Hunkler C, Kneip T, Korbmacher J, Malter F, et al. SHARE data resource profile. Int J Epidemiol. 2013;42(4):992-1001.
  7. Smith M, Haedtke C, Shibley D. Late-life depression detection. J Gerontol Nurs. 2015;41(2):18-25.
  8. van Zoonen K, Buntrock C, Ebert DD, Smit F, Reynolds CF III, Beekman ATF, et al. Preventing the onset of major depressive disorder: meta-analytic review. Int J Epidemiol. 2014;43(2):318-29.
  9. Alexopoulos GS. Mechanisms and treatment of late-life depression. Transl Psychiatry. 2019;9(1):1-11.
  10. Kok RM, Reynolds CF III. Management of depression in older adults: a review. JAMA. 2017;317(20):2114-22.
  11. Belvederi Murri M, Amore M, Menchetti M, Toni G, Neviani F, Cerri M, et al. Physical exercise for late-life major depression. Br J Psychiatry. 2015;207(3):235-42.