Depression and serious depressive symptoms are common among the elderly. Few cases are detected, and even with treatment the prognosis is only modest. The results include personal suffering, decline in functioning, greater use of medical services, and higher health care costs. As a step toward preventing depression in the elderly, Cole and Dendukuri (p. 1147) systematically reviewed studies of factors associated with new cases of depression over a median of 24 months. Twenty studies of elderly subjects in the community covered 43 variables. Meta-analysis identified five characteristics significantly associated with the onset of depression: bereavement, sleep disturbance, disability, prior depression, and female gender. Specific techniques are available for managing the first three conditions. On a larger scale, the five factors together can help identify elderly people at high risk of depression and guide population-based interventions.