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Tohidi Nafe M, Movahedi A, Djazayery A. Comparison of Dutch healthy eating and healthy eating indexes and anthropometry in patients with major depression with health subjects: a case-control study. Front Nutr 2024; 11:1370562. [PMID: 38769989 PMCID: PMC11102997 DOI: 10.3389/fnut.2024.1370562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Accepted: 04/08/2024] [Indexed: 05/22/2024] Open
Abstract
Background Diseases and disorders related to mental health are spreading like other chronic diseases all around the world. Considering the role of food in the prevention and treatment of these disorders, including major depression, investigating the relationship between different food patterns and this disorder is of particular importance. The aim of this study was to compare Dutch healthy eating and healthy eating indexes and anthropometry in patients with major depression with healthy individuals. Methods In this case-control study, the final analysis was performed on 67 men and 111 women with an age range of 20-30 years. Height (cm), weight (kg), food frequency questionnaire (FFQ), physical activity (MET-min/week), demographic and PHQ-9 questionnaires were taken from all participants. In the following, all the food ingredients and their components were extracted and used to calculate HEI-2015 and DHD. Statistical analysis was performed using SPSS software with independent t-test, logistic regression and chi-square. Results It was found that people with major depression in this study were mostly women and occupied. The average HEI-2015 in healthy people and those with major depression was 58 and 54.3, respectively. Also, the average DHD in these people was 60.5 and 55, respectively. HEI-2015 and DHD had a significant negative correlation with depression score (r = -0.16, p-value = 0.03) (r = -0.19, p-value = 0.01). Also, in the logistic regression model, before and even after adjusting confounders, HEI-2015 and DHD had a reduced odds ratio in people suffering from major depression. The two groups did not differ significantly in terms of the average factors of height, weight and body mass index (BMI). Conclusion It seems that HEI2015 and DHD have a significant relationship in reducing major depression. However, due to the small number of studies in this regard, especially in the field of DHD, the need for more studies seems necessary.
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Affiliation(s)
- Melika Tohidi Nafe
- Department of Nutrition, Science and Research Branch, Islamic Azad University, Tehran, Iran
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Tamm AR, Jobst ML, Geyer M, Hahad O, Buderus V, Schmidt A, Prochaska JH, Wild PS, Treede H, Münzel T, von Bardeleben RS. Quality of life in patients with transcatheter aortic valve implantation: an analysis from the INTERVENT project. Front Cardiovasc Med 2023; 10:1181771. [PMID: 37435055 PMCID: PMC10330696 DOI: 10.3389/fcvm.2023.1181771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 06/05/2023] [Indexed: 07/13/2023] Open
Abstract
Background Transcatheter aortic valve implantation (TAVI) is a standard treatment for patients with aortic valve stenosis due to its very low mortality and complication rates. However, survival and physical integrity are not the only important factors. Quality of life (QoL) improvement is a crucial part in the evaluation of therapy success. Methods Patients with TAVI were questioned about their QoL before, one month and one year after the intervention as part of the INTERVENT registry trial at Mainz University Medical Center. Three different questionnaires were included in the data collection (Katz ADL, EQ-5D-5l, PHQ-D). Results We included 285 TAVI patients in the analysis (mean age 79.8 years, 59.4% male, mean EuroSCORE II 3.8%). 30-day mortality was 3.6%, complications of any kind occurred in 18.9% of the patients. Main finding was a significant increase in the general state of health measured on the visual analog scale by an average of 4.53 (± 23.58) points (BL to 1-month follow-up, p = 0.009) and by 5.19 (± 23.64) points (BL to 12-month follow-up, p = 0.016). There was also an improvement of depression symptoms, which was reflected in a decrease in the total value of the PHQ-D by 1.67 (± 4.75) points (BL to 12-month follow-up, p = 0.001). The evaluation of the EQ-5D-5l showed a significant improvement in mobility after one month (M = -0.41 (± 1.31), p < 0.001. Regarding the independence of the patients, no significant difference could be found. Apart from that, patients with risk factors, comorbidities or complications also benefited from the intervention despite their poor starting position. Conclusion We could show an early benefit of QoL in TAVI patients with significant improvement in the subjective state of health and a decrease in symptoms of depression. These findings were consistent over 1 year of follow up.
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Affiliation(s)
- Alexander R. Tamm
- Department of Cardiology, Cardiology I, University Medical Center Mainz, Mainz, Germany
| | - Marina L. Jobst
- Department of Cardiology, Cardiology I, University Medical Center Mainz, Mainz, Germany
| | - Martin Geyer
- Department of Cardiology, Cardiology I, University Medical Center Mainz, Mainz, Germany
| | - Omar Hahad
- Department of Cardiology, Cardiology I, University Medical Center Mainz, Mainz, Germany
| | - Victoria Buderus
- Department of Cardiology, Cardiology I, University Medical Center Mainz, Mainz, Germany
| | - Alexander Schmidt
- Department of Cardiology, Preventive Cardiology and Preventive Medicine, University Medical Center Mainz, Mainz, Germany
| | - Jürgen H. Prochaska
- Department of Cardiology, Preventive Cardiology and Preventive Medicine, University Medical Center Mainz, Mainz, Germany
| | - Philipp S. Wild
- Department of Cardiology, Preventive Cardiology and Preventive Medicine, University Medical Center Mainz, Mainz, Germany
| | - Hendrik Treede
- Department of Cardio-Thoracic and Vascular Surgery, University Medical Center Mainz, Mainz, Germany
| | - Thomas Münzel
- Department of Cardiology, Cardiology I, University Medical Center Mainz, Mainz, Germany
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Been S, Byeon H. Predicting Depression in Older Adults after the COVID-19 Pandemic Using ICF Model. Healthcare (Basel) 2023; 11:1181. [PMID: 37108014 PMCID: PMC10138015 DOI: 10.3390/healthcare11081181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 04/12/2023] [Accepted: 04/19/2023] [Indexed: 04/29/2023] Open
Abstract
This study aimed to test a predictive model for depression in older adults in the community after the COVID-19 pandemic and identify influencing factors using the International Classification of Functioning, Disability, and Health (ICF). The subjects of this study were 9920 older adults in South Korean local communities. The analysis results of path analysis and bootstrapping analysis revealed that subjective health status, instrumental activities of daily living (IADL), number of chronic diseases, social support satisfaction, household economic level, informal support, and participation in social groups were factors directly influencing depression, while formal support, age, gender, education level, employment status, and participation in social groups were factors indirectly affecting it. It will be needed to prepare measures to prevent depression in older adults during an infectious disease pandemic, such as the COVID-19 pandemic, based on the results of this study.
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Affiliation(s)
| | - Haewon Byeon
- Department of Digital Anti-Aging Healthcare, Graduate School (BK21), Inje University, Gimhae 50834, Republic of Korea
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Yorikawa F, Ishikawa J, Tamura Y, Murao Y, Toba A, Harada K, Araki A. Determinants of depressive symptoms in older outpatients with cardiometabolic diseases in a Japanese frailty clinic: Importance of bidirectional association between depression and frailty. PLoS One 2023; 18:e0281465. [PMID: 36780484 PMCID: PMC9925076 DOI: 10.1371/journal.pone.0281465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 01/24/2023] [Indexed: 02/15/2023] Open
Abstract
INTRODUCTION Frailty and depression may play important roles in the management of older patients with cardiometabolic diseases. We explored the determinants of depressive symptoms and their association with frailty among patients with cardiometabolic diseases (hypertension, diabetes, and atrial fibrillation) in a cross-sectional study. METHODS A total of 633 outpatients aged 65 years or older with cardiometabolic disease and suspected symptoms of frailty participated in this study. Depressive symptoms, physical activity, and social network were assessed using the Geriatric Depression Scale (GDS)-15, International Physical Activity Questionnaire, and Lubben Social Network Scale-6 (LSNS-6), respectively. Frailty was evaluated using the Kihon Checklist (KCL) based on the Comprehensive Geriatric Assessment (CGA), the modified Cardiovascular Health Study (mCHS), and the Clinical Frailty Scale (CFS). Binomial logistic regression analysis was used to examine the determinants of depressive symptoms and their association with frailty. RESULTS Depressive symptoms with GDS-15 scores ≥ 5 were present in 43.6% of the patients. In logistic regression, after adjusting for covariates, the determinants of depressive symptoms in all patients were lack of social network, low years of education, and frailty. In contrast, in logistic regression with frailty as the dependent variable, depressive symptoms were independently associated KCL-defined frailty (OR = 6.28, 95% CI: 4.13-9.55) and mCHS-defined frailty (OR = 2.66, 95% CI: 1.70-4.17), but not with CFS. Similarly, significant associations between depression and frailty were observed in patients with hypertension, diabetes, or atrial fibrillation. CONCLUSIONS Lack of social networks, low education, and frailty based on the KCL and mCHS were important determinants of depressive symptoms in all patients. The relatively strong associations between depressive symptoms and frailty based on CGA in patients with hypertension, diabetes, or atrial fibrillation suggest that the assessment of depressive symptoms is of great importance in clinical practice in those patients at high risk of frailty.
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Affiliation(s)
- Fumino Yorikawa
- Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Center for Comprehensive Care and Research for Prefrailty, Tokyo, Japan
| | - Joji Ishikawa
- Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Center for Comprehensive Care and Research for Prefrailty, Tokyo, Japan
- Department of Cardiology, Tokyo Metropolitan Geriatric Hospital, Tokyo, Japan
- * E-mail:
| | - Yoshiaki Tamura
- Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Center for Comprehensive Care and Research for Prefrailty, Tokyo, Japan
- Department of Diabetes, Metabolism and Endocrinology, Tokyo Metropolitan Geriatric Hospital, Tokyo, Japan
| | - Yuji Murao
- Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Center for Comprehensive Care and Research for Prefrailty, Tokyo, Japan
| | - Ayumi Toba
- Department of Cardiology, Tokyo Metropolitan Geriatric Hospital, Tokyo, Japan
| | - Kazumasa Harada
- Department of Cardiology, Tokyo Metropolitan Geriatric Hospital, Tokyo, Japan
| | - Atsushi Araki
- Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Center for Comprehensive Care and Research for Prefrailty, Tokyo, Japan
- Department of Diabetes, Metabolism and Endocrinology, Tokyo Metropolitan Geriatric Hospital, Tokyo, Japan
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Karolczak K, Kostanek J, Soltysik B, Konieczna L, Baczek T, Kostka T, Watala C. Relationships between Plasma Concentrations of Testosterone and Dihydrotestosterone and Geriatric Depression Scale Scores in Men and Women Aged 60-65 Years-A Multivariate Approach with the Use of Quade's Test. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12507. [PMID: 36231806 PMCID: PMC9566053 DOI: 10.3390/ijerph191912507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 09/26/2022] [Accepted: 09/27/2022] [Indexed: 06/16/2023]
Abstract
The potential role of testosterone and dihydrotestosterone in the pathogenesis of depression in older subjects is poorly recognized and understood. The current study examines the symptoms of depression in males and females at the age of 60-65 using a short version (15 questions) of the Geriatric Depression Scale (GDS) questionnaire. Blood plasma levels of androgens were estimated by LC/MS/MS. Total GDS score calculated for males were not found to be significantly associated with plasma levels of testosterone or dihydrotestosterone. Older men with higher plasma testosteronemia were more likely to report being in good spirits most of the time, but more willing to stay at home than undertake outside activities. The men with higher plasma levels of dihydrotestosterone also perceived themselves as being in good spirits most of the time. Older men with higher testosterone were more likely to report having more problems with their memory than others. No significant associations were found between plasma levels of androgens and GDS scores in older women; however, some tendencies suggest that testosterone and dihydrotestosterone may act as antidepressants in older women.
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Affiliation(s)
- Kamil Karolczak
- Department of Haemostatic Disorders, Medical University of Lodz, ul. Mazowiecka 6/8, 92-215 Lodz, Poland
| | - Joanna Kostanek
- Department of Haemostatic Disorders, Medical University of Lodz, ul. Mazowiecka 6/8, 92-215 Lodz, Poland
| | - Bartlomiej Soltysik
- Department of Geriatrics, Healthy Aging Research Center (HARC), Medical University of Lodz, pl. Hallera 1, 90-647 Lodz, Poland
| | - Lucyna Konieczna
- Department of Pharmaceutical Chemistry, Medical University of Gdańsk, ul. Hallera 107, 80-416 Gdańsk, Poland
| | - Tomasz Baczek
- Department of Pharmaceutical Chemistry, Medical University of Gdańsk, ul. Hallera 107, 80-416 Gdańsk, Poland
| | - Tomasz Kostka
- Department of Geriatrics, Healthy Aging Research Center (HARC), Medical University of Lodz, pl. Hallera 1, 90-647 Lodz, Poland
| | - Cezary Watala
- Department of Haemostatic Disorders, Medical University of Lodz, ul. Mazowiecka 6/8, 92-215 Lodz, Poland
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Zenebe Y, Akele B, W/Selassie M, Necho M. Prevalence and determinants of depression among old age: a systematic review and meta-analysis. Ann Gen Psychiatry 2021; 20:55. [PMID: 34922595 PMCID: PMC8684627 DOI: 10.1186/s12991-021-00375-x] [Citation(s) in RCA: 120] [Impact Index Per Article: 40.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 12/03/2021] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Depression is a leading cause of disability worldwide and is a major contributor to the overall global burden of disease. It is also one of the most common geriatric psychiatric disorders and a major risk factor for disability and mortality in elderly patients. Even though depression is a common mental health problem in the elderly population, it is undiagnosed in half of the cases. Several studies showed different and inconsistent prevalence rates in the world. Hence, this study aimed to fill the above gap by producing an average prevalence of depression and associated factors in old age. OBJECTIVE This study aims to conduct a systematic review and meta-analysis to provide a precise estimate of the prevalence of depression and its determinants among old age. METHOD A comprehensive search of PubMed, Scopus, Web of sciences, Google Scholar, and Psych-info from database inception to January 2020. Moreover, the reference list of selected articles was looked at manually to have further eligible articles. The random-effects model was employed during the analysis. Stata-11 was used to determine the average prevalence of depression among old age. A sub-group analysis and sensitivity analysis were also run. A graphical inspection of the funnel plots and Egger's publication bias plot test were checked for the occurrence of publication bias. RESULT A search of the electronic and manual system resulted in 1263 articles. Nevertheless, after the huge screening, 42 relevant studies were identified, including, for this meta-analysis, n = 57,486 elderly populations. The average expected prevalence of depression among old age was 31.74% (95% CI 27.90, 35.59). In the sub-group analysis, the pooled prevalence was higher among developing countries; 40.78% than developed countries; 17.05%), studies utilized Geriatrics Depression Scale-30(GDS-30); 40.60% than studies that used GMS; 18.85%, study instrument, and studies having a lower sample size (40.12%) than studies with the higher sample; 20.19%. CONCLUSION A high prevalence rate of depression among the old population in the world was unraveled. This study can be considered as an early warning and advised health professionals, health policymakers, and other pertinent stakeholders to take effective control measures and periodic care for the elderly population.
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Affiliation(s)
- Yosef Zenebe
- Department of Psychiatry, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.
| | - Baye Akele
- Department of Pharmacy, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Mulugeta W/Selassie
- Department of Pediatrics and Child Health Nursing, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Mogesie Necho
- Department of Psychiatry, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
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Sousa S, Paúl C, Teixeira L. Predictors of Major Depressive Disorder in Older People. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:11894. [PMID: 34831649 PMCID: PMC8624368 DOI: 10.3390/ijerph182211894] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 11/09/2021] [Accepted: 11/10/2021] [Indexed: 11/22/2022]
Abstract
Major depressive disorder (MDD) is one of the most common mental disorders in older people. There are several biological, psychological, and social factors associated with this disorder. This study aimed to describe the depressive state to identify the associated factors and potential predictors of MDD in a population of community-dwelling older people with probable MDD. The sample consisted of 378 participants with probable dementia, with 47.3% of them presenting MDD. The factors that were found to be associated with MDD were sex, living status, mobility, and nutritional status. Knowing the factors that can predict a condition such as MDD is extremely important, both for prevention and for the customization of interventions.
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Affiliation(s)
- Susana Sousa
- Institute of Biomedical Sciences Abel Salazar, University of Porto (ICBAS-UP), 4050-313 Porto, Portugal
- Center for Health Technology and Services Research (CINTESIS), 4200-450 Porto, Portugal
| | - Constança Paúl
- Institute of Biomedical Sciences Abel Salazar, University of Porto (ICBAS-UP), 4050-313 Porto, Portugal
- Center for Health Technology and Services Research (CINTESIS), 4200-450 Porto, Portugal
| | - Laetitia Teixeira
- Institute of Biomedical Sciences Abel Salazar, University of Porto (ICBAS-UP), 4050-313 Porto, Portugal
- Center for Health Technology and Services Research (CINTESIS), 4200-450 Porto, Portugal
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Mogle J, Hill NL, Bratlee-Whitaker E, Bhargava S. Within-Person Associations of Self-Reports of Memory Impairment and Depressive Symptoms in Older Adults: Moderation of Relationships Over Time by Personality. J Gerontol B Psychol Sci Soc Sci 2021; 77:300-311. [PMID: 33959767 DOI: 10.1093/geronb/gbab080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES The current study examined within-person associations of self-reports of impaired current memory functioning and perceived decline with depressive symptoms in older adults without cognitive impairment, and whether these associations were moderated by individuals' levels of neuroticism, conscientiousness, and extraversion. METHODS Samples were drawn from the Einstein Aging Study (EAS), Rush Memory and Aging Project (MAP), Minority Aging Research Study (MARS), Health and Retirement Study (HRS), and National Health and Aging Trends Study (NHATS), with over 8,000 participants (65+ years) included across datasets. In a series of coordinated analyses, multilevel linear models tested within-person relationships over periods of up to 22 years. RESULTS Across HRS and NHATS samples, self-reports of impaired current memory functioning covaried with depressive symptoms over time. This association was moderated by neuroticism, such that the association was stronger for individuals with higher levels of neuroticism. Across all samples, perceived memory decline covaried with depressive symptoms over time. This association was moderated by neuroticism in MAP/MARS, HRS, and NHATS, such that the association was stronger for individuals with higher levels of neuroticism. DISCUSSION Self-reports of impaired current memory functioning and perceived memory decline are important determinants of older adults' psychological well-being. In our results, at times when older adults perceive poorer memory functioning or decline, they also tend to report more depressive symptoms. Further, results from two larger datasets suggest that individuals' level of neuroticism may determine the extent to which self-reports of memory impairment and depressive symptoms covary over time.
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Affiliation(s)
- Jacqueline Mogle
- Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, University Park, PA
| | - Nikki L Hill
- College of Nursing, The Pennsylvania State University, University Park, PA
| | | | - Sakshi Bhargava
- College of Nursing, The Pennsylvania State University, University Park, PA
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Interaction between Subjective Memory Decline and Depression Symptom Intensity in Older People. Results of the Second Wave of Cognition of Older People, Education, Recreational Activities, Nutrition, Comorbidities, and Functional Capacity Studies (COPERNICUS). J Clin Med 2021; 10:jcm10071334. [PMID: 33804811 PMCID: PMC8038085 DOI: 10.3390/jcm10071334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 03/08/2021] [Accepted: 03/17/2021] [Indexed: 11/26/2022] Open
Abstract
Background: Prevalence of subjective memory impairment (SMC), with or without objective memory impairment, and the mediating role of depression symptom intensity was examined in older people. Methods: n = 205 subjects (60 years old and older) were examined and followed up at two years. Cognitive function was examined using the Montreal Cognitive Assessment (MoCA) Delayed Recall (DR) subtest. Geriatric Depression Scale (GDS) was used as a screening tool for depression. Statistical analysis was performed using linear mixed models. Results: A total of 144 subjects (70.24%) had SMC. MoCA Delayed Recall scores were not significantly changed in relation to time and SMC. Dynamics of SMC significantly influenced changes in GDS score (p = 0.008). Conclusions: SMC and objective memory impairment do not fully overlap each other. Subjects without SMC for longer than two years noted less intensity of depression symptoms in comparison to subgroup with SMC. However, occurrence of SMC in subjects who were previously free of SMC, was not related to increase in depression symptom intensity.
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Bomfim AJDL, Chagas NMDS, Leal LR, Pessoa RMDP, Ferreira BLC, Chagas MHN. Cognitive performance of older adults with a low level of education with and without depression. Dement Neuropsychol 2021; 15:121-127. [PMID: 33907605 PMCID: PMC8049573 DOI: 10.1590/1980-57642021dn15-010013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 12/29/2020] [Indexed: 11/21/2022] Open
Abstract
Major depression can develop in individuals aged 60 years or older and is commonly associated with cognitive decline in this population, especially the domains of working memory, attention, executive functions, and processing speed. Schooling is a protective factor with regard to cognitive decline. OBJECTIVE To compare the cognitive performance of community-dwelling older adults with a low level of schooling with and without major depression. METHODS A descriptive, analytical, cross-sectional study was conducted with 22 community-dwelling older adults with depression and 187 without depression. The following assessment tools were employed: Mini Mental Health Examination, Brief Cognitive Screening Battery, Consortium to Establish a Registry for Alzheimer's Disease (CERAD), Digit Span Test (forward and backward), and an object similarity test. RESULTS No statistically significant differences were found between the groups with and without depression on any of the tests. CONCLUSIONS This study demonstrated that there are no differences in the cognitive performance of older people with and without depression on neurocognitive tests commonly used in clinical practice. Future studies with different designs and methods as well as specific tests for older people with a low level of schooling could assist in the understanding of these relations and the mechanisms involved.
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Affiliation(s)
- Ana Julia de Lima Bomfim
- Department of Neurosciences and Behavioral Sciences,
Universidade de São Paulo – Ribeirão Preto, SP, Brazil
- Research Group on Mental Health, Cognition and Aging,
Universidade Federal de São Carlos – São Carlos, SP, Brazil
| | | | - Lívio Rodrigues Leal
- Department of Neurosciences and Behavioral Sciences,
Universidade de São Paulo – Ribeirão Preto, SP, Brazil
- Research Group on Mental Health, Cognition and Aging,
Universidade Federal de São Carlos – São Carlos, SP, Brazil
| | - Rebeca Mendes de Paula Pessoa
- Department of Neurosciences and Behavioral Sciences,
Universidade de São Paulo – Ribeirão Preto, SP, Brazil
- Research Group on Mental Health, Cognition and Aging,
Universidade Federal de São Carlos – São Carlos, SP, Brazil
| | - Bianca Letícia Cavalmoretti Ferreira
- Department of Neurosciences and Behavioral Sciences,
Universidade de São Paulo – Ribeirão Preto, SP, Brazil
- Research Group on Mental Health, Cognition and Aging,
Universidade Federal de São Carlos – São Carlos, SP, Brazil
| | - Marcos Hortes Nisihara Chagas
- Department of Neurosciences and Behavioral Sciences,
Universidade de São Paulo – Ribeirão Preto, SP, Brazil
- Research Group on Mental Health, Cognition and Aging,
Universidade Federal de São Carlos – São Carlos, SP, Brazil
- Bairral Institute of Psychiatry – Itapira, SP, Brazil
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11
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Willi J, Süss H, Grub J, Ehlert U. Prior depression affects the experience of the perimenopause - findings from the Swiss Perimenopause Study. J Affect Disord 2020; 277:603-611. [PMID: 32905912 DOI: 10.1016/j.jad.2020.08.062] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 07/07/2020] [Accepted: 08/24/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND There is a prevalence peak of depression in the perimenopause, with this reproductive phase being considered a window of vulnerability due to major biopsychosocial changes. Depression has been associated with physical and psychosocial impairment. Prior depression has been shown to be a risk factor for the development of several somatic and mental diseases. We assume that women with prior depression will exhibit increased burdensome symptoms in the perimenopause compared to women without prior depression. METHODS A total of 135 perimenopausal women aged 40-56 years participated in the longitudinal Swiss Perimenopause Study. For the purpose of this investigation, a cross-sectional design was chosen. A wide range of validated psychosocial questionnaires were used to compare women with and without prior depression regarding their experience of the perimenopause. Findings were statistically adjusted for multiple testing. RESULTS Women with prior depression showed significantly more depressive symptoms (U = 1215.5, p < .01), more menopausal symptoms (U = 1395.0, p < .01), and more sleep disturbances (U = 1583.5, p < .05) than women without prior depression. Moreover, women with a history of depression reported lower subjective mental health (U = 1573.0, p < 05) and felt more isolated (U = 1524.0, p < .05) than those without prior depression. LIMITATIONS Self-report data may affect the results. Furthermore, due to the cross-sectional design, causality cannot be inferred. CONCLUSIONS Prior depression affects women's experience of the perimenopause. Women with prior depression exhibit significantly more negative health outcomes in the perimenopause than those without prior depression.
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Affiliation(s)
- Jasmine Willi
- Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland; University Research Priority Program Dynamics of Healthy Aging, University of Zurich, Zurich, Switzerland
| | - Hannah Süss
- Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland; University Research Priority Program Dynamics of Healthy Aging, University of Zurich, Zurich, Switzerland
| | - Jessica Grub
- Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland; University Research Priority Program Dynamics of Healthy Aging, University of Zurich, Zurich, Switzerland
| | - Ulrike Ehlert
- Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland; University Research Priority Program Dynamics of Healthy Aging, University of Zurich, Zurich, Switzerland.
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12
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Willi J, Ehlert U. Symptoms assessed in studies on perimenopausal depression: A narrative review. SEXUAL & REPRODUCTIVE HEALTHCARE 2020; 26:100559. [PMID: 33010665 DOI: 10.1016/j.srhc.2020.100559] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 09/07/2020] [Accepted: 09/22/2020] [Indexed: 12/19/2022]
Abstract
The menopausal transition constitutes a phase of major biopsychosocial changes associated with an elevated risk for the development of depression. Perimenopausal depression is highly prevalent and usually characterized by core symptoms of a major depressive disorder combined with menopausal complaints such as vasomotor symptoms or other physical complaints. However, a distinct definition of the condition is lacking. The aim of this review is to portray the symptoms assessed in studies on perimenopausal depression in order to provide relevant information on the current understanding of this condition. A literature search was conducted using the databases PubMed, Cochrane Library, and PsycINFO. A total of 37 studies were included. Various assessment tools have been used to measure symptoms related to perimenopausal depression. Fifteen symptoms were identified. Depressed mood was assessed across all studies. Low energy or sleep disturbances, as acknowledged symptoms of a major depressive disorder, were surveyed in most studies. However, the assessment of menopausal complaints was rather heterogeneous. While vasomotor symptoms were often measured, other menopausal symptoms such as mood swings or pain were investigated less frequently. Sexual problems were only rarely assessed. Studies on perimenopausal depression regularly include the assessment of core symptoms of a major depressive disorder, but the assessment of menopausal complaints is inconsistent. While certain symptoms are commonly measured, others are not assessed. Such inconsistencies underline an ambiguous understanding of perimenopausal depression, which in turn affects the evaluation and treatment of the condition. Thus, the use of the existing guidelines on perimenopausal depression is recommended.
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Affiliation(s)
- Jasmine Willi
- Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland; University Research Priority Program Dynamics of Healthy Aging Research Priority Program, University of Zurich, Zurich, Switzerland
| | - Ulrike Ehlert
- Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland; University Research Priority Program Dynamics of Healthy Aging Research Priority Program, University of Zurich, Zurich, Switzerland.
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Kim H, Cho J, Isehunwa O, Noh J, Noh Y, Oh SS, Koh SB, Kim C. Marriage as a social tie in the relation of depressive symptoms attributable to air pollution exposure among the elderly. J Affect Disord 2020; 272:125-131. [PMID: 32379603 DOI: 10.1016/j.jad.2020.04.059] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 03/19/2020] [Accepted: 04/27/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Air pollution is a risk factor for depression or depressive symptoms. However, few studies have examined an effect modifier as a protective factor against depressive symptoms associated with air pollution, including social support. Notably, less is known about a married relationship in the association between exposure to air pollution and depressive symptoms among the elderly. METHODS This study included 2122 marrieds and 607 non-marrieds, recruited in 2014-2017 from different regions of South Korea. Depressive symptoms were measured by the Korean version of the Geriatric Depression Scale Short Form (SGDS-K). After adjustment for potential confounders using propensity score of being assigned to the marrieds, we examined the extent of whether the effects of exposure to air pollutants (PM10, PM2.5, and NO2) on depressive symptoms were different between marrieds and non-marrieds. Subgroup analyses by gender and residence area were also performed. RESULTS Marrieds than non-marrieds were less likely to have depressive symptoms and had smaller SGDS-K associated with increased exposure to PM10 and PM2.5 concentrations, respectively. After stratification of subjects by gender and residence area, the interaction term appeared to be significant among men and the non-metropolitan group, indicating the protective effect of married relationships on depressive symptoms attributable to air pollution exposure in them. LIMITATIONS Although we adjusted the propensity score, our findings might be confounded by the contextual effect associated with married relationships. CONCLUSIONS A married relationship, as a social tie, may attenuate the effect of exposure to air pollution on depressive symptoms among the elderly. Nonetheless, additional research is worthwhile to explore the extent of other social relationships in the association between air pollution exposure and depressive symptoms.
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Affiliation(s)
- Hyunmin Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; Division of Health Systems Management and Policy, The University of Memphis School of Public Health, Memphis, TN 38152, United States
| | - Jaelim Cho
- Institute of Human Complexity and Systems Science, Yonsei University, Incheon, Republic of Korea; School of Medicine, Auckland University, Auckland, New Zealand; Institute for Environmental Research, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Oluwaseyi Isehunwa
- Division of Health Systems Management and Policy, The University of Memphis School of Public Health, Memphis, TN 38152, United States; Harvard/MGH Center on Genomics, Vulnerable Populations, and Health Disparities, Boston, MA, United States
| | - Juhwan Noh
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; Institute of Human Complexity and Systems Science, Yonsei University, Incheon, Republic of Korea
| | - Young Noh
- Department of Neurology, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Sung Soo Oh
- Department of Occupational and Environmental Medicine, Wonju Severance Christian Hospital, Wonju College of Medicine, Yonsei University, Wonju, Republic of Korea
| | - Sang-Baek Koh
- Department of Preventive Medicine, Wonju Severance Christian Hospital, Wonju College of Medicine, Yonsei University, Wonju, Republic of Korea
| | - Changsoo Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; Institute of Human Complexity and Systems Science, Yonsei University, Incheon, Republic of Korea; Institute for Environmental Research, Yonsei University College of Medicine, Seoul, Republic of Korea.
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Mogle J, Hill NL, Bhargava S, Bell TR, Bhang I. Memory complaints and depressive symptoms over time: a construct-level replication analysis. BMC Geriatr 2020; 20:57. [PMID: 32114980 PMCID: PMC7050122 DOI: 10.1186/s12877-020-1451-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 01/28/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Memory complaints and depressive symptoms are frequently associated in older adults and both serve as potential indicators of future cognitive decline. However, the temporal ordering of the development of these two symptoms remains unclear. The goal of the current study was to examine concurrent and temporal relationships between memory complaints and depressive symptoms in older adults. METHODS Data were drawn from two longitudinal, nationally representative datasets and included cognitively intact older adults aged 65 and over. The datasets in the current study were from the National Health and Aging Trends Study (NHATS) and the Health and Retirement Study (HRS). Using an integrative analytic framework, we tested bidirectional temporal relationships between memory complaints (memory ratings and perceived memory decline) and depressive symptoms over 6 to 9 years of data in over 5000 older adults across these two samples. RESULTS Across both datasets, perceived memory decline predicted future depressive symptoms whereas memory ratings did not. Additionally, results showed that at times when depressive symptoms tended to be higher, memory complaints were also higher, but depressive symptoms did not predict future memory complaints. One finding that was inconsistent across datasets was memory ratings predicting depressive symptoms. After accounting for covariates, this relationship was only significant in one dataset. CONCLUSIONS Cognitively intact older adults who report memory decline may be at risk for developing depressive symptoms in the future. Furthermore, our findings highlight the importance of using immediate replication of results across datasets to determine the generalizability of conclusions.
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Affiliation(s)
- Jacqueline Mogle
- College of Health and Human Development, Pennsylvania State University, 320D Biobehavioral Health Building, University Park, Pennsylvania, PA 16802 USA
| | - Nikki L. Hill
- College of Nursing, Pennsylvania State University, 201 Nursing Sciences Building, University Park, Pennsylvania, PA 16802 USA
| | - Sakshi Bhargava
- College of Nursing, Pennsylvania State University, 201 Nursing Sciences Building, University Park, Pennsylvania, PA 16802 USA
| | - Tyler Reed Bell
- College of Nursing, Pennsylvania State University, 201 Nursing Sciences Building, University Park, Pennsylvania, PA 16802 USA
| | - Iris Bhang
- College of Nursing, Pennsylvania State University, 201 Nursing Sciences Building, University Park, Pennsylvania, PA 16802 USA
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15
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Epigenome-wide association study of depression symptomatology in elderly monozygotic twins. Transl Psychiatry 2019; 9:214. [PMID: 31477683 PMCID: PMC6718679 DOI: 10.1038/s41398-019-0548-9] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Revised: 02/15/2019] [Accepted: 06/20/2019] [Indexed: 12/11/2022] Open
Abstract
Depression is a severe and debilitating mental disorder diagnosed by evaluation of affective, cognitive and physical depression symptoms. Severity of these symptoms strongly impacts individual's quality of life and is influenced by a combination of genetic and environmental factors. One of the molecular mechanisms allowing for an interplay between these factors is DNA methylation, an epigenetic modification playing a pivotal role in regulation of brain functioning across lifespan. The aim of this study was to investigate if there are DNA methylation signatures associated with depression symptomatology in order to identify molecular mechanisms contributing to pathophysiology of depression. We performed an epigenome-wide association study (EWAS) of continuous depression symptomatology score measured in a cohort of 724 monozygotic Danish twins (346 males, 378 females). Through EWAS analyses adjusted for sex, age, flow-cytometry based blood cell composition, and twin relatedness structure in the data we identified depression symptomatology score to be associated with blood DNA methylation levels in promoter regions of neuropsin (KLK8, p-value = 4.7 × 10-7) and DAZ associated protein 2 (DAZAP2, p-value = 3.13 × 10-8) genes. Other top associated probes were located in gene bodies of MAD1L1 (p-value = 5.16 × 10-6), SLC29A2 (p-value = 6.15 × 10-6) and AKT1 (p-value = 4.47 × 10-6), all genes associated before with development of depression. Additionally, the following three measures (a) DNAmAge (calculated with Horvath and Hannum epigenetic clock estimators) adjusted for chronological age, (b) difference between DNAmAge and chronological age, and (c) DNAmAge acceleration were not associated with depression symptomatology score in our cohort. In conclusion, our data suggests that depression symptomatology score is associated with DNA methylation levels of genes implicated in response to stress, depressive-like behaviors, and recurrent depression in patients, but not with global DNA methylation changes across the genome.
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Senra H, Macedo AF, Nunes N, Balaskas K, Aslam T, Costa E. Psychological and Psychosocial Interventions for Depression and Anxiety in Patients With Age-Related Macular Degeneration: A Systematic Review. Am J Geriatr Psychiatry 2019; 27:755-773. [PMID: 31005495 DOI: 10.1016/j.jagp.2019.03.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 03/01/2019] [Accepted: 03/01/2019] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To review the current literature on psychosocial and psychological interventions to prevent and treat depression and anxiety in patients with age-related macular degeneration (AMD). METHODS The authors conducted a systematic review of literature evaluating psychosocial and psychological interventions for depression and anxiety in patients with AMD. Primary searches of PubMed, Cochrane library, EMBASE, Global Health, Web of Science, EBSCO, and Science Direct were conducted to include all articles published up to April 21, 2018. RESULTS Of a total of 398 citations retrieved, the authors selected 12 eligible studies published between 2002 and 2016. The authors found nine randomized controlled trials (RCT), and three non-randomized intervention (NRI) studies. RCT studies suggested that interventions using group self-management techniques and individual behavioral activation plus low vision rehabilitation can be effective to treat and prevent depression in patients with AMD, and one study suggested that a stepped-care intervention using cognitive-behavioral techniques can be effective to manage anxiety and depression over time. NRI studies highlighted a positive effect of self-help and emotion-focused interventions to reduce depression. CONCLUSION Clinical practice with patients with AMD can rely on some tailored cognitive-behavioral therapeutic protocols to improve patients' mental health, but further clinical trials will generate the necessary evidence-based knowledge to improve those therapeutic techniques and offer additional tailored interventions for patients with AMD.
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Affiliation(s)
- Hugo Senra
- Institute of Psychiatry, Psychology and Neuroscience (HS), King's College London, London
| | - António Filipe Macedo
- Department of Medicine and Optometry, Linnaeus University, Kalmar, Sweden; Low Vision and Visual Rehabilitation Lab, Department and Center of Physics - Optometry and Vision Science, University of Minho, Braga, Portugal
| | - Nuno Nunes
- Centre of Psychology, Faculty of Psychology and Educational Sciences (NN, EC), University of Porto, Porto, Portugal
| | - Konstantinos Balaskas
- NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
| | - Tariq Aslam
- Division of Pharmacy and Optometry (TA), School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK; Manchester Royal Eye Hospital (TA), Central Manchester Foundation Trust, Manchester, UK
| | - Emilia Costa
- Centre of Psychology, Faculty of Psychology and Educational Sciences (NN, EC), University of Porto, Porto, Portugal
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Féki I, Turki M, Zitoun I, Sellami R, Baati I, Masmoudi J. [Depression and coping strategies in the elderly with type 2 diabetes]. L'ENCEPHALE 2019; 45:320-326. [PMID: 30885441 DOI: 10.1016/j.encep.2019.01.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 01/15/2019] [Accepted: 01/22/2019] [Indexed: 11/25/2022]
Abstract
INTRODUCTION AND OBJECTIVES Elderly patients with diabetes have been shown to have more diabetes-related complications, and they are more likely to develop somatic and psychiatric comorbidities including cognitive dysfunction and depression. Several studies have shown a close association between diabetes and depression. This comorbidity may lead to functional disability and quality of life deterioration. Thus, the elderly will face various constraints through the coping strategies. In this context, we conducted our study to assess the prevalence of depressive symptoms in elderly patients with diabetes as well as its associated factors, and to investigate their coping strategies. METHODS We conducted a cross-sectional, descriptive and analytic study among 50 elderly patients (age≥65 years) being followed for type 2 diabetes at the outpatient department for chronic diseases of the Regional Hospital of Aguereb, Sfax, Tunisia. We used the "Activity of Daily Living" to assess the dependence level, the "Geriatric Depression Scale" to screen for depressive symptoms, and the "Brief Coping with Problems Experienced" to investigate the coping strategies. RESULTS The mean age of patients was 73.3 years, with a sex-ratio (M/F) of 0.62. Smoking and alcohol consumption were reported respectively in 20% and 4% of participants. The mean duration of diabetes was 7.7 years. Diabetes complications were noted in 70% of participants. Somatic comorbidities were noted in 94% of cases (hypertension 84%; dyslipidemia 34%). Psychiatric histories were reported in 18% of patients who suffered from anxio-depressive symptoms. No patient among those with mental disorder histories benefited from any psychiatric management prior to the study. Three patients (6%) had previously presented suicidal ideations but none of them had attempted suicide. The mean "Activity of Daily Living" score was 4.9 points. Patients were autonomous in 28%, and dependent in 4% of cases. The mean "Geriatric Depression Scale" score was 9.8 points. According to this scale, the prevalence of depressive symptoms was 34%. They were correlated with: smoking (P=0.04), psychiatric histories (P=0.031), absence of leisure activity (P=0.035), "Activity of Daily Living" score (P=0.028), long duration of diabetes (P=0.04) and the presence of suicidal ideation (P=0.013). According to the « Brief Coping with Problems Experienced », the problem-focused coping strategies were the most frequently used (44%), followed by emotion-focused (38%) and passive strategies (18%). Participants with depressive symptoms are significantly more likely to adopt emotion-focused coping strategies (P=0.01). CONCLUSION Our study highlighted a high prevalence of depressive symptoms among elderly patients with diabetes. This relationship seems to be bi-directional and may increase somatic complications and alter the quality of life, and then darken the prognosis. Thus, besides pharmacological treatment, regular depression screening and psychological support are essential to ensure a better control of diabetes and to improve well-being.
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Affiliation(s)
- I Féki
- Service de psychiatrie « A », CHU Hédi Chaker, 3029 Sfax, Tunisie
| | - M Turki
- Service de psychiatrie « A », CHU Hédi Chaker, 3029 Sfax, Tunisie.
| | - I Zitoun
- Service de psychiatrie « A », CHU Hédi Chaker, 3029 Sfax, Tunisie
| | - R Sellami
- Service de psychiatrie « A », CHU Hédi Chaker, 3029 Sfax, Tunisie
| | - I Baati
- Service de psychiatrie « A », CHU Hédi Chaker, 3029 Sfax, Tunisie
| | - J Masmoudi
- Service de psychiatrie « A », CHU Hédi Chaker, 3029 Sfax, Tunisie
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18
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Cho S, Park S, Takahashi S, Yoshiuchi K, Shephard RJ, Aoyagi Y. Changes in and Interactions between Physical and Mental Health in Older Japanese: The Nakanojo Study. Gerontology 2018; 65:340-352. [PMID: 30566936 DOI: 10.1159/000494383] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 10/10/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND An age-related decrease in functional capacity is consistently reported, but it is not consistently related to a worsening of health-related quality of life (HRQOL) or psychological adjustment. A poor functional capacity and HRQOL have been associated with anxiety or depression, but the possible causal nature and direction of the relationship remain to be explored using long-term longitudinal data. OBJECTIVE The purpose of this study was to examine age-related changes in functional capacity, HRQOL, and scores on the Hospital Anxiety and Depression Scale (HADS), and possible causal interrelationships between these variables. METHODS Study participants were 5,124 Japanese aged ≥65 years. After the baseline study (2003), annual follow-up observations continued for 10 years. Generalized linear mixed models examined age-related changes in Barthel index (BI), Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC), HRQOL, and HADS. Cross-lagged effects models tested possible causal interrelationships. RESULTS With age, functional capacity and HRQOL scores showed similar declines in both sexes. Changes in mental health, anxiety, and depression developed more slowly than decreases in physical health (BI, TMIG-IC, and physical functioning scores). Cross-lagged effects models demonstrated that functional capacity had positive effects on psychological adjustment, and that psychological adjustment had positive effects on functional capacity 5 years later. Interactions between functional capacity and psychological adjustment showed no sex differences. A decline in functional capacity negatively affected psychological adjustment, but reduced psychological adjustment had no significant impact on functional capacity 5 and 10 years later. Moreover, functional capacity and poor psychological adjustment showed no interactions in either sex. CONCLUSION Functional capacity and mood state are interrelated. Greater function could sustain vitality and mental health, possibly reducing anxiety and depression.
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Affiliation(s)
- Sunyoung Cho
- Exercise Sciences Research Group, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Sungjin Park
- Exercise Sciences Research Group, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Shin Takahashi
- Exercise Sciences Research Group, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Kazuhiro Yoshiuchi
- Department of Stress Sciences and Psychosomatic Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Roy J Shephard
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada
| | - Yukitoshi Aoyagi
- Exercise Sciences Research Group, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan,
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Subjective memory complaints and future depression in primary care patients: A four-year follow-up study. Gen Hosp Psychiatry 2018; 55:4-9. [PMID: 30176576 DOI: 10.1016/j.genhosppsych.2018.08.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 08/19/2018] [Accepted: 08/20/2018] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To investigate the predictive value of subjective memory complaints (SMCs) for having a hospital-based diagnosis of a single depressive episode over a four-year follow-up period. METHODS A prospective register-based cohort study in general practice. All 17 practices in Inner city Copenhagen participated in the study. They had 40,865 registered patients, 2934 aged 65 years or older. Information on SMCs and socio-demographics was collected during two months at enrolment in primary care. Diagnoses of single depressive episodes were retrieved from the Danish Psychiatric Central Research Register. Cox proportional hazard regression models were used to examine risk factors for a hospital-based diagnosis of a single depressive episode. RESULTS 758 patients aged 65 years or older consulted their GP in October and November 2002. According to our definition, 177 (23%) had SMCs at enrolment, 12 (6.9%) of whom received a diagnosis of a single depressive episode within the follow-up period. In three multivariate models, SMCs were significantly associated with single depressive episodes. In the fully controlled model SMCs had a hazard ratio (HR) of 2.59 for receiving a subsequent depression diagnosis. CONCLUSIONS In an older general practice population, SMCs are associated with increased risk of receiving a hospital-based diagnosis of a single depressive episode.
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Lin WC, Hu LY, Tsai SJ, Yang AC, Shen CC. Depression and the risk of vascular dementia: a population-based retrospective cohort study. Int J Geriatr Psychiatry 2017; 32:556-563. [PMID: 27161941 DOI: 10.1002/gps.4493] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Revised: 03/22/2016] [Accepted: 03/23/2016] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To examine the association between the risks of depression and vascular dementia (VaD) based on Taiwan's National Health Insurance Research Database. METHODS This retrospective longitudinal matched-cohort study used National Health Insurance Research Database data from 49,955 participants (9,991 with new onset depression, 39,964 controls). A Cox regression analysis was performed on the whole sample and the subgroup of patients with depression. We further excluded patients who developed VaD within 3 or 5 years after enrollment to evaluate depression as an independent risk factor for or a prodrome of VaD. RESULTS During the 10-year follow-up period, the incidence rate ratio of VaD between patients with depression and controls was 4.24 [95% confidence interval (CI) 2.90-6.21, P < 0.001]. After adjustment for covariates, the hazard ratio (HR) of VaD in patients with depression was 3.10 (95% CI 2.13-4.52, P < 0.001). In the whole sample, risk factors for VaD besides depression were aged ≥60 years (HR = 20.08), hypertension (HR = 1.70), diabetes (HR = 1.61), coronary artery disease (HR = 2.26), head injury (HR = 2.20), and cerebrovascular disease (HR = 3.02). In patients with depression, aged ≥60 years (HR = 32.16), coronary artery disease (HR = 2.82), head injury (HR = 2.06), and cerebrovascular disease (HR = 2.37) remained risk factors for VaD. After excluding those who developed VaD within 3 or 5 years, HRs remained high (3.28, 95% CI 2.03-5.31, P < 0.001; 2.12, 95% CI 1.05-4.25, P = 0.035, respectively). CONCLUSIONS Our findings suggest that depression is an independent risk factor for subsequent VaD. Older age, cerebrovascular disease, head injury, and coronary artery disease might increase the risk of VaD among patients with depression.
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Affiliation(s)
- Wei-Chen Lin
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan.,Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
| | - Li-Yu Hu
- Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.,Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Shih-Jen Tsai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Albert C Yang
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Cheng-Che Shen
- Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Psychiatry, Chiayi Branch, Taichung Veterans General Hospital, Chiayi, Taiwan.,Department of Information Management, National Chung-Cheng University, Chiayi, Taiwan
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Taymur İ, Özdel K, Aypak C, Duyan V, Türedi Ö, Güngör BB, Selvi Y. Evaluation of the Relationship between Major Depressive Disorder and Bereavement Symptoms in Elderly Patients Who Present Either to Psychiatry or Family Medicine. Noro Psikiyatr Ars 2017; 53:108-114. [PMID: 28360781 DOI: 10.5152/npa.2015.10095] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Accepted: 03/21/2015] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION We aimed to determine the level of bereavement and depression symptoms among elderly patients who experience the loss of a significant other and the relationship between depressive symptoms and bereavement symptoms. METHODS The study sample consisted of elderly adults who lost a significant other at least 6 months prior to the submission time. Participants were recruited from patients who presented to either the psychiatry or family medicine outpatient unit of a Training and Research Hospital. Cognitive functions were assessed using Standardized Mini Mental Examinations for Educated and Uneducated People (SMME/SMME-U). Participants were excluded from the study if their SMME or SMME-U scores were lower than 23 points. To assess the severity of depressive and bereavement symptoms, the Geriatric Depression Scale (GDS) and Core Bereavement Items (CBI) scales were used, respectively. RESULTS Overall, 33 out of 67 individuals (49.2%) who presented to the psychiatry unit and 7 out of the 43 individuals (16.3%) who presented to the family medicine unit were diagnosed with major depressive disorder (MDD). CBI scale score means were higher in the MDD groups than in the non-depressive groups (p=0.012 and p=0.001, respectively). CBI scores were significantly correlated to acute (p=0.047) and chronic stress (p=0.007) in the psychiatry group and to chronic stress in the family medicine group (p=0.001). CONCLUSION Probing loss experiences and reactions to them can be important to understand depression, to evaluate its symptoms, and to help manage the relevant symptoms. Considering the significant contributions of bereavement to depressive symptom severity in elders, interventions specific to bereavement symptoms should not be ignored.
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Affiliation(s)
- İbrahim Taymur
- Clinic of Psychiatry, Şevket Yılmaz Training and Research Hospital, Bursa, Turkey
| | - Kadir Özdel
- Clinic of Psychiatry, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Cenk Aypak
- Clinic of Family Practice, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Veli Duyan
- Ankara University Scholl of Health Sciences, Social Service Specialist, Ankara, Turkey
| | - Özlem Türedi
- Clinic of Family Practice, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Buket Belkız Güngör
- Clinic of Psychiatry, Şevket Yılmaz Training and Research Hospital, Bursa, Turkey
| | - Yavuz Selvi
- Department of Psychiatry, Selçuk University School of Medicine, Konya, Turkey
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Angelini V, Klijs B, Smidt N, Mierau JO. Associations between Childhood Parental Mental Health Difficulties and Depressive Symptoms in Late Adulthood: The Influence of Life-Course Socioeconomic, Health and Lifestyle Factors. PLoS One 2016; 11:e0167703. [PMID: 27936078 PMCID: PMC5147958 DOI: 10.1371/journal.pone.0167703] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Accepted: 11/19/2016] [Indexed: 11/19/2022] Open
Abstract
Background Depression among older adults (i.e., the 50+) is a major health concern. The objective of this study is to investigate whether growing up with a parent suffering from mental health problems is associated with depressive symptoms in late-adulthood and how this association is influenced by life-course socio-economic, health and lifestyle factors in childhood and late adulthood. Methods We used life-history data from the SHARE survey, consisting of 21,127 participants living in 13 European countries. Symptoms of depression were assessed using the EURO-D scale. Parental mental health was assessed by asking respondents to report whether any of their parents had mental health problems during the respondents’ childhood. Logistic regression models were used to assess the association between parental mental health status and depression. Variables on childhood and late-life socio-economic, health and lifestyle factors were sequentially added to the model to assess the extent to which this association is influenced by life-course circumstances. Results Individuals who were exposed during childhood to a parent with mental health problems suffered from depressive symptoms more often in late adulthood than those who were not (OR 1.76, 95% CI: 1.43–2.17). Adjustment for life-course socio-economic, health and lifestyle factors in childhood and late adulthood diminished this association to an OR of 1.54 (95% CI: 1.24–1.90) and OR of 1.45 (95% CI: 1.16–1.82), respectively. Conclusion Our results indicate a substantial association between parental mental health problems in childhood and depression in late adulthood and that this association is partly explained by childhood as well as late adulthood socio-economic, health and lifestyle factors.
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Affiliation(s)
- Viola Angelini
- Department of Economics, Econometrics and Finance, University of Groningen, Groningen, the Netherlands
- * E-mail:
| | - Bart Klijs
- Statistics Netherlands, The Hague, the Netherlands
| | - Nynke Smidt
- Department of Epidemiology, Department of Geriatrics, University Medical Centre Groningen, Groningen, the Netherlands
- Department of Geriatrics, University Medical Centre Groningen, Groningen, the Netherlands
| | - Jochen O. Mierau
- Department of Economics, Econometrics and Finance, University of Groningen, Groningen, the Netherlands
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Hill NL, Mogle J, Wion R, Munoz E, DePasquale N, Yevchak AM, Parisi JM. Subjective Cognitive Impairment and Affective Symptoms: A Systematic Review. THE GERONTOLOGIST 2016; 56:e109-e127. [PMID: 27342440 DOI: 10.1093/geront/gnw091] [Citation(s) in RCA: 159] [Impact Index Per Article: 19.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Accepted: 04/15/2016] [Indexed: 11/13/2022] Open
Abstract
PURPOSE OF STUDY Subjective cognitive impairment (SCI) has been argued to reflect affective symptoms (i.e., depression and anxiety) rather than actual cognitive issues. Although a number of studies exist that look at the associations between SCI and affective symptoms, no review is available to aggregate this disparate literature. We addressed this gap by conducting a systematic review to better understand the relationships among SCI and affective symptoms among older adults in both community and clinical settings. DESIGN AND METHODS We reviewed available literature per the criteria of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Weight of evidence (WoE) ratings and narrative synthesis were completed for 58 articles. RESULTS A majority of studies focused on community-based samples (n = 40). Approximately half (53%) of the articles reviewed met high WoE criteria for the current review. Cross-sectional findings consistently identified a positive relationship among SCI and affective symptoms. Findings from available longitudinal studies (n = 9) were mixed but suggested a possible reciprocal relationship among SCI and depression. The relationship between SCI and anxiety appeared to be driven by fears over loss of function. Following consultation with health professionals, the association between SCI and anxiety was diminished or eliminated. IMPLICATIONS Although SCI is consistently related to affective symptoms in older adults cross-sectionally, more longitudinal work is needed to understand their temporal relationship. Improved measurement of SCI would support a deeper understanding of the impact of SCI on psychological well-being.
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Affiliation(s)
- Nikki L Hill
- College of Nursing, The Pennsylvania State University, University Park.
| | - Jacqueline Mogle
- College of Nursing, The Pennsylvania State University, University Park
| | - Rachel Wion
- College of Nursing, The Pennsylvania State University, University Park
| | - Elizabeth Munoz
- Department of Psychology, University of California, Riverside
| | - Nicole DePasquale
- Center for Healthy Aging and Department of Human Development & Family Studies, The Pennsylvania State University, University Park
| | - Andrea M Yevchak
- College of Nursing, The Pennsylvania State University, University Park
| | - Jeanine M Parisi
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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Ray KD, Mittelman MS. Music therapy: A nonpharmacological approach to the care of agitation and depressive symptoms for nursing home residents with dementia. DEMENTIA 2015; 16:689-710. [DOI: 10.1177/1471301215613779] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Depression, agitation, and wandering are common behaviors associated with dementia and frequently observed among nursing home residents. Even with pharmacological treatment, behaviors often persist, hindering quality of life for elders, their family, and paid caregivers. This study examined the use of music therapy for treatment of these symptoms among 132 people with moderate to severe dementia in nursing homes. Participants were evaluated for depressive symptoms, agitation, and wandering to determine their predominate behavior. There were two assessments, two weeks apart, prior to intervention, followed by a two-week intervention, and two follow-up assessments, also two weeks apart. A repeated measures ANOVA determined that after two weeks of music therapy, symptoms of depression and agitation were significantly reduced; there was no change for wandering. Multivariate analyses confirmed a relationship between music therapy and change in neuropsychiatric symptoms associated with dementia. Results suggest widespread use of music therapy in long-term care settings may be effective in reducing symptoms of depression and agitation.
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Thorlund K, Druyts E, Wu P, Balijepalli C, Keohane D, Mills E. Comparative efficacy and safety of selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors in older adults: a network meta-analysis. J Am Geriatr Soc 2015; 63:1002-9. [PMID: 25945410 DOI: 10.1111/jgs.13395] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To establish the comparative efficacy and safety of selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors in older adults using the network meta-analysis approach. DESIGN Systematic review and network meta-analysis. PARTICIPANTS Individuals aged 60 and older. MEASUREMENTS Data on partial response (defined as at least 50% reduction in depression score from baseline) and safety (dizziness, vertigo, syncope, falls, loss of consciousness) were extracted. A Bayesian network meta-analysis was performed on the efficacy and safety outcomes, and relative risks (RRs) with 95% credible intervals (CrIs) were produced. RESULTS Fifteen randomized controlled trials were eligible for inclusion in the analysis. Citalopram, escitalopram, paroxetine, duloxetine, venlafaxine, fluoxetine, and sertraline were represented. Reporting on partial response and dizziness was sufficient to conduct a network meta-analysis. Reporting on other outcomes was sparse. For partial response, sertraline (RR=1.28), paroxetine (RR=1.48), and duloxetine (RR=1.62) were significantly better than placebo. The remaining interventions yielded RRs lower than 1.20. For dizziness, duloxetine (RR=3.18) and venlafaxine (RR=2.94) were statistically significantly worse than placebo. Compared with placebo, sertraline had the lowest RR for dizziness (1.14) and fluoxetine the second lowest (1.31). Citalopram, escitalopram, and paroxetine all had RRs between 1.4 and 1.7. CONCLUSION There was clear evidence of the effectiveness of sertraline, paroxetine, and duloxetine. There also appears to be a hierarchy of safety associated with the different antidepressants, although there appears to be a dearth of reporting of safety outcomes.
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Affiliation(s)
- Kristian Thorlund
- Stanford Prevention Research Center, Stanford University, Stanford, California.,Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada.,Redwood Outcomes, Vancouver, British Columbia, Canada
| | - Eric Druyts
- Redwood Outcomes, Vancouver, British Columbia, Canada.,Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Ping Wu
- Redwood Outcomes, Vancouver, British Columbia, Canada
| | | | | | - Edward Mills
- Stanford Prevention Research Center, Stanford University, Stanford, California.,Redwood Outcomes, Vancouver, British Columbia, Canada
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Kuroda A, Tanaka T, Hirano H, Ohara Y, Kikutani T, Furuya H, Obuchi SP, Kawai H, Ishii S, Akishita M, Tsuji T, Iijima K. Eating Alone as Social Disengagement is Strongly Associated With Depressive Symptoms in Japanese Community-Dwelling Older Adults. J Am Med Dir Assoc 2015; 16:578-85. [PMID: 25687929 DOI: 10.1016/j.jamda.2015.01.078] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Accepted: 01/07/2015] [Indexed: 12/20/2022]
Abstract
OBJECTIVES Depression in later life poses a grave challenge for the aging countries. The reported key risk factors include social disengagement, but the lack of social companionship during mealtimes, namely eating alone, has not been examined extensively, especially in relation to living arrangement. Past studies on changes along geriatric trajectories in the association between social engagement and depression also remain inadequate. This study aims to examine the association between social engagement and depressive symptoms with a particular focus on eating alone and how the association changes along the aging and mental frailty trajectories. DESIGN A cross-sectional study. SETTING Kashiwa-city, Chiba-prefecture in Japan. PARTICIPANTS A total of 1856 community-dwelling older adults. MEASUREMENTS The 15-item Geriatric Depression Scale was used to measure depressive symptoms. The indicators used to assess social engagement included eating alone, living arrangement, reciprocity of social support, social participation, social stressors and social ties. RESULTS Social engagement was significantly associated with depressive symptoms. Those who live with their families yet eat alone were found to be at particular risk (odds ratio = 5.02, 95% confidence interval 2.5-9.9 for young-old; odds ratio = 2.41, 95% confidence interval 1.2-4.8 for old-old). Younger and less mentally frail populations showed stronger associations. CONCLUSIONS Eating alone was a key risk factor for depressive symptoms in community-dwelling older adults. The living arrangement in which they eat alone is important in identifying those with the greatest risk. Mental health management for older adults requires comprehensive assessment of their social relations that takes into account their companionship during mealtimes. Social preventive measures need to involve early interventions in order to augment their effectiveness against mental frailty.
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Affiliation(s)
- Aki Kuroda
- Institute of Gerontology, The University of Tokyo, Tokyo, Japan
| | - Tomoki Tanaka
- Institute of Gerontology, The University of Tokyo, Tokyo, Japan
| | | | - Yuki Ohara
- Department of Oral Health Care Education, Graduate School of Medical and Dental Sciences, The Tokyo Medical and Dental University, Tokyo, Japan
| | - Takeshi Kikutani
- Division of Clinical Oral Rehabilitation, The Nippon Dental University Graduate School of Life Dentistry at Tokyo, Tokyo, Japan
| | - Hiroyasu Furuya
- Division of Clinical Oral Rehabilitation, The Nippon Dental University Graduate School of Life Dentistry at Tokyo, Tokyo, Japan
| | | | - Hisashi Kawai
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Shinya Ishii
- Department of Geriatric Medicine, The University of Tokyo, Tokyo, Japan
| | - Masahiro Akishita
- Department of Geriatric Medicine, The University of Tokyo, Tokyo, Japan
| | - Tetsuo Tsuji
- Institute of Gerontology, The University of Tokyo, Tokyo, Japan
| | - Katsuya Iijima
- Institute of Gerontology, The University of Tokyo, Tokyo, Japan.
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Bennett S, Thomas AJ. Depression and dementia: cause, consequence or coincidence? Maturitas 2014; 79:184-90. [PMID: 24931304 DOI: 10.1016/j.maturitas.2014.05.009] [Citation(s) in RCA: 313] [Impact Index Per Article: 31.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2014] [Revised: 05/16/2014] [Accepted: 05/17/2014] [Indexed: 10/25/2022]
Abstract
The relationship between depression and dementia is complex and still not well understood. A number of different views exist regarding how the two conditions are linked as well as the underlying neurobiological mechanisms at work. This narrative review examined longitudinal and cross sectional studies in the existing literature and determined the evidence supporting depression being a risk factor, a prodrome, a consequence, or an independent comorbidity in dementia. Overall there is convincing evidence to support both the notion that early life depression can act as a risk factor for later life dementia, and that later life depression can be seen as a prodrome to dementia. There is also evidence to support both conditions showing similar neurobiological changes, particularly white matter disease, either indicating shared risk factors or a shared pattern of neuronal damage. These findings highlight the need to examine if effective treatment of depressive episodes has any effect in reducing the prevalence of dementia, as well as clinicians being vigilant for late life depression indicating the incipient development of dementia, and therefore carefully following up these individuals for future cognitive impairment.
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Affiliation(s)
- Sophia Bennett
- Institute for Ageing and Health, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne NE4 5PL, United Kingdom
| | - Alan J Thomas
- Institute for Ageing and Health, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne NE4 5PL, United Kingdom.
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Jee YJ, Lee YB. Factors Influencing Depression among Elderly Patients in Geriatric Hospitals. J Phys Ther Sci 2013; 25:1445-9. [PMID: 24396207 PMCID: PMC3881474 DOI: 10.1589/jpts.25.1445] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2013] [Accepted: 06/20/2013] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The purpose of this study was to investigate the prevalence of depression among elderly patients and identify the factors influencing depression in a geriatric hospital in Korea. [Subjects] A self-report questionnaire was administered to the patients in community geriatric hospitals. Participants were 195 elderly patients. [Methods] The instruments utilized in this study were the Geriatric Depression Scale Short Form Korea (GDSSF-K), an activity of daily living scale, a self-esteem scale, a social support scale, and a life satisfaction scale. Data were collected from April 20 to June 20, 2011. Data were analyzed using descriptive statistics, Pearson correlations, and multiple logistic regression analysis using SPSS 15.0 and Stata 11.0. [Results] The average GDSSF-K score of the participants was 8.94, indicating a moderate level of depression. About 78.4% of the elderly patients in this study were classified as predisposed toward depression. Significant predictors for depression included the patients' perceived health status and life satisfaction. [Conclusion] The results indicate that elderly patients face a high risk of developing depression and that efforts should be made to address it wherever possible. Regular depression screening will be beneficial for early detection of depression in patients at community geriatric hospitals.
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Affiliation(s)
- Young Ju Jee
- Department of Nursing, College of Natural Science, Kyungnam University, Republic of Korea
| | - Yun Bok Lee
- Department of Nursing, College of Natural Science, Kyungnam University, Republic of Korea
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Nose M, Kodama C, Ikejima C, Mizukami K, Matsuzaki A, Tanaka S, Yoshimura A, Yasuno F, Asada T. ApoE4 is not associated with depression when mild cognitive impairment is considered. Int J Geriatr Psychiatry 2013; 28:155-63. [PMID: 22700491 DOI: 10.1002/gps.3803] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2011] [Accepted: 02/28/2012] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The aim of the study was to examine the relationship between apolipoprotein E4 allele (ApoE4) and depression among an older Japanese population. Mild cognitive impairment (MCI) was taken into consideration. METHODS This is a community-based cross-sectional study. We assessed the mood and cognitive function of Japanese community-dwelling individuals aged 65 years or older. In the first phase of the study, we evaluated the mood and cognitive function. In the second phase, face-to-face structured interviews were conducted. Individuals with dementia and other mental diseases were excluded on the basis of a consensus meeting of psychiatrists and neuropsychologists; 738 subjects with full data were included in the analyses. We subdivided depression into major depressive episode (MDE) and depressive symptoms cases (DSCs). DSC was defined as a score of 6 or more on the Geriatric Depression Scale but not having a diagnosis of MDE. The relationship between depression (MDE and DSC) and ApoE4 was examined by multivariate logistic regression. RESULTS The adjusted odds ratio (OR) of ApoE4 on DSC was not significant (OR = 0.82, 95%CI = 0.48-1.39, p < 0.46). Sex (OR = 2.53, 95%CI = 1.33-4.79, p < 0.01), MCI (1.95, 1.21-3.14, p < 0.01), years of education (0.87, 0.79-0.95, p < 0.01), and Nishimura's activities of daily living scores (0.75, 0.63-0.89, p < 0.01) significantly correlated with prevalence of DSC. There were no significant risk factors for MDE. CONCLUSION Apolipoprotein E4 allele contributed to neither DSC nor MDE. The association of MCI with ApoE4 and DSC suggested that MCI is a confounder for the association between ApoE4 and DSC.
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Affiliation(s)
- Mayumi Nose
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba City, Japan
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Hilderink P, Collard R, Rosmalen J, Oude Voshaar R. Prevalence of somatoform disorders and medically unexplained symptoms in old age populations in comparison with younger age groups: a systematic review. Ageing Res Rev 2013; 12:151-6. [PMID: 22575906 DOI: 10.1016/j.arr.2012.04.004] [Citation(s) in RCA: 82] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2012] [Revised: 04/09/2012] [Accepted: 04/23/2012] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To review current knowledge regarding the prevalence of somatization problems in later life by level of caseness (somatoform disorders and medically unexplained symptoms, MUS) and to compare these rates with those in middle-aged and younger age groups. METHOD A systematic search of the literature published from 1966 onwards was conducted in the Pubmed and EMBASE databases. RESULTS Overall 8 articles, describing a total of 7 cohorts, provided data of at least one prevalence rate for somatoform disorders or MUS for the middle-aged (50-65 years) or older age (≥65 years) group. Prevalence rates for somatoform disorders in the general population range from 11 to 21% in younger, 10 to 20% in the middle-aged, and 1.5 to 13% in the older age groups. Prevalence rates for MUS show wider ranges, of respectively 1.6-70%, 2.4-87%, and 4.6-18%, in the younger, middle, and older age groups, which could be explained by the use of different instruments as well as lack of consensus in defining MUS. CONCLUSION Somatoform disorders and MUS are common in later life, although the available data suggest that prevalence rates decline after the age of 65 years. More systematic research with special focus on the older population is needed to understand this age-related decline in prevalence rates.
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Cross K, Flores R, Butterfield J, Blackman M, Lee S. The Effect of Passive Listening versus Active Observation of Music and Dance Performances on Memory Recognition and Mild to Moderate Depression in Cognitively Impaired Older Adults. Psychol Rep 2012; 111:413-23. [DOI: 10.2466/10.02.13.pr0.111.5.413-423] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The study examined the effects of music therapy and dance/movement therapy on cognitively impaired and mild to moderately depressed older adults. Passive listening to music and active observation of dance accompanied by music were studied in relation to memory enhancement and relief of depressive symptoms in 100 elderly board and care residents. The Beck Depression Inventory and the Recognition Memory Test–Faces Inventory were administered to two groups (one group exposed to a live 30-min. session of musical dance observation, the other to 30 min. of pre-recorded music alone) before the intervention and measured again 3 and 10 days after the intervention. Scores improved for both groups on both measures following the interventions, but the group exposed to dance therapy had significantly lower Beck Depression scores that lasted longer. These findings suggest that active observation of Dance Movement Therapy could play a role in temporarily alleviating moderate depressive symptoms and some cognitive deficits in older adults.
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Affiliation(s)
| | | | | | | | - Stephanie Lee
- Department of Psychology, California State University Fullerton
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Ramsay CE, Reisinger Walker E, Ramsay R, Compton MT, Thompson N. An exploration of perceptions of possible depression prevention services for caregivers of elderly or chronically ill adults in rural Georgia. Community Ment Health J 2012; 48:167-78. [PMID: 21132461 DOI: 10.1007/s10597-010-9361-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2009] [Accepted: 11/15/2010] [Indexed: 11/26/2022]
Abstract
Caregiving for elderly or chronically ill adults can be stressful, contributing to a high rate of depression in caregivers. Rural caregivers are at particularly high risk due to reduced access to mental health care services. This study explored the acceptability among rural caregivers of introducing a program to prevent or alleviate depression. Focus groups with caregivers and community members were conducted in four rural counties of Georgia. Caregivers reported high levels of stress and depression and recommended the following interventions: support groups, respite care, a centralized source of information, training for caregivers and other community members, financial support, and a telephone hotline. There were more commonalities than differences across the locations, but some programmatic preferences and acceptability varied.
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Affiliation(s)
- Claire E Ramsay
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 49 Jesse Hill Jr. Drive S.E., Atlanta, GA 30303, USA.
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Piboon K, Subgranon R, Hengudomsub P, Wongnam P, Louise Callen B. A causal model of depression among older adults in Chon Buri Province, Thailand. Issues Ment Health Nurs 2012; 33:118-26. [PMID: 22273346 DOI: 10.3109/01612840.2011.630497] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The purposes of this study are to develop and empirically test a theoretical model that examines the relationships between a set of predictors and depression among older adults. A biopsychosocial model was tested with 317 community dwelling older adults residing in Chon Buri Province, Thailand. A face-to-face interview was used in a cross-sectional community-based survey. A hypothesized model of depression was tested by using path analysis. It was found that the modified model fitted the data and the predictors accounted for 60% of the variance in depression. Female gender, activities of daily living, loneliness, stressful life events, and emotional-focused coping had a positive direct effect on depression. Social support and problem-focused coping had a negative direct effect on depression. Additionally, perceived stress, stressful life events, loneliness, and income had a negative indirect effect on depression through social support. Female gender, activities of daily living, and perceived stress also had a positive indirect effect on depression through emotional-focused coping. Stressful life events, perceived stress, and income had a negative indirect effect on depression through problem-focused coping. These findings contribute to a better understanding of the variables that predict depression in older adults. Thus, health care providers should consider the effects of these contributing factors on depression in the older adult person and can devise a program to prevent and promote health in older adults alleviating depression.
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Affiliation(s)
- Kanchana Piboon
- Burapha University, Faculty of Nursing, Chon Buri, Thailand.
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Liang Y, Gong YH, Wen XP, Guan CP, Li MC, Yin P, Wang ZQ. Social determinants of health and depression: a preliminary investigation from rural China. PLoS One 2012; 7:e30553. [PMID: 22276213 PMCID: PMC3261904 DOI: 10.1371/journal.pone.0030553] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2011] [Accepted: 12/19/2011] [Indexed: 01/12/2023] Open
Abstract
Background In the last several years, research related to social determinants of health (SDH) has begun to resonate in the medical, behavioral, social and political sciences arena. The aim of the present study was to explore the relationship between SDH and depression, and to provide new evidences and clues for depression control and prevention. Methodology/Principal Findings This research was a cross-sectional survey executed door to door from October 2006 to April 2008, with a sample of 3,738 individuals aged 18 and older in rural China. The three variables of SDH were socioeconomic status (years of schooling and self-reported economic status of family), social cohesion and negative life events. Demographic variables and self-perceived physical health were taken as potential confounders. The cross-table analysis showed that variations in levels of depression were associated with variations in SDH, and logistic regression analysis confirmed the association even after adjusting for potential confounding variables. Conclusions Although there were some limitations, the current study provides initial evidence of the importance of SDH in depression. Findings indicate that social inequity and the role of policy action emphasized by SDH should be considered high priorities when addressing the issue of depression. In addition, cell-to-society and pill-to-policy approaches should be encouraged in the future.
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Affiliation(s)
- Yuan Liang
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yan-Hong Gong
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiao-Piao Wen
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chao-Ping Guan
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ming-Chuan Li
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ping Yin
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- * E-mail:
| | - Zhi-Qing Wang
- Department of Clinical Epidemiology, the Suicide Research and Training Center of World Health Organization & Beijing Suicide Research and Prevention Center, Beijing Hui Long Guan Hospital, Beijing, China
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Li N, Pang L, Chen G, Song X, Zhang J, Zheng X. Risk factors for depression in older adults in Beijing. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2011; 56:466-73. [PMID: 21878157 DOI: 10.1177/070674371105600804] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Depression is a common mental disorder in older adults. We examined the prevalence and risk factors for depression in older adults in the Beijing area. METHOD We used data from a cross-sectional survey conducted in July 2006 in Beijing. As part of the national survey for older Chinese adults, 2002 older adults were interviewed. The 15-item Geriatric Depression Scale was used to assess depression. Demographics as well as other personal information were also collected. RESULTS Among Beijing older adults, 13.01% were categorized as depressed. Prevalence rates of depression in rural and urban older adults were 26.63% and 10.79%, respectively. Poor economic status, high activities of daily living (ADL) score, poor physical health, impious offspring, and feeling old were important predictors of depression in older adults in Beijing. For the urban sample, poor economic status, poor physical health, high ADL score, and impious offspring were risk factors for depression. For the rural sample, depression was significantly associated with poor economic status and poor physical health. CONCLUSIONS Depression is a common mood disorder among older adults in the Beijing area. Filial piety is a unique predictor for depression in older Chinese adults, compared with findings in Western cultures.
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Affiliation(s)
- Ning Li
- Institute of Population Research, Peking University, Peking, China
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Psychische Komorbidität bei Menschen mit chronischen Erkrankungen im höheren Lebensalter unter besonderer Berücksichtigung von Krebserkrankungen. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2010; 54:75-82. [DOI: 10.1007/s00103-010-1192-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Thielke SM, Diehr P, Unützer J. Prevalence, incidence, and persistence of major depressive symptoms in the Cardiovascular Health Study. Aging Ment Health 2010; 14:168-76. [PMID: 20336548 PMCID: PMC3622544 DOI: 10.1080/13607860903046537] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
PURPOSE To explore the association of major depressive symptoms with advancing age, sex, and self-rated health among older adults. DESIGN AND METHODS We analyzed 10 years of annual assessments in a longitudinal cohort of 5888 Medicare recipients in the Cardiovascular Health Study. Self-rated health was assessed with a single question, and subjects categorized as healthy or sick. Major depressive symptoms were assessed using the Center for Epidemiologic Studies Short Depression Scale, with subjects categorized as nondepressed (score < 10) or depressed (> or =10). Age-, sex-, and health-specific prevalence of depression and the probabilities of transition between depressed and nondepressed states were estimated. RESULTS The prevalence of a major depressive state was higher in women, and increased with advancing age. The probability of becoming depressed increased with advancing age among the healthy but not the sick. Women showed a greater probability than men of becoming depressed, regardless of health status. Major depressive symptoms persisted over one-year intervals in about 60% of the healthy and 75% of the sick, with little difference between men and women. IMPLICATIONS Clinically significant depressive symptoms occur commonly in older adults, especially women, increase with advancing age, are associated with poor self-rated health, and are largely intransigent. In order to limit the deleterious consequences of depression among older adults, increased attention to prevention, screening, and treatment is warranted. A self-rated health item could be used in clinical settings to refine the prognosis of late-life depression.
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Affiliation(s)
- Stephen M. Thielke
- Department of Psychiatry and Behavioral Sciences, University of Washington, 1660s Columbian way, S-182 GRECC, Seattle 98108, USA
,Corresponding author.
| | - Paula Diehr
- Department of Biostatistics, University of Washington, Seattle 98195, USA
| | - Jürgen Unützer
- Department of Psychiatry and Behavioral Sciences, University of Washington, 1660s Columbian way, S-182 GRECC, Seattle 98108, USA
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Pinho MX, Custódio O, Makdisse M. Incidência de depressão e fatores associados em idosos residentes na comunidade: revisão de literatura. REVISTA BRASILEIRA DE GERIATRIA E GERONTOLOGIA 2009. [DOI: 10.1590/1809-9823.2009120111] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo Depressão geriátrica ocorre com frequência, mesmo na população residente na comunidade. Vários fatores de risco associados estão descritos na literatura. O objetivo deste estudo é realizar uma revisão da literatura sobre a incidência de depressão geriátrica e os fatores de risco associados em idosos residentes na comunidade. Para este fim, realizou-se revisão bibliográfica da literatura sobre o tema, sendo efetuada consulta às bases de dados MEDLINE, PUBMED, LILACS e SCIELO, utilizando-se das palavras chaves "idoso", "fator de risco", "depressão" e "incidência". A incidência de depressão na população idosa residente na comunidade é de 13,23%, em média. Os preditores de depressão identificados foram: sexo feminino, idade avançada, condição marital, baixa escolaridade, condição socioeconômica desfavorável, condições de moradia, baixo suporte social, eventos estressores, depressão prévia, co-morbidades psiquiátricas, características de personalidade, distúrbios do sono, déficits cognitivos, condições de saúde adversas, limitação funcional e dor. Depressão ocorre com frequência na população idosa e constitui problema grave. A identificação dos fatores de risco associados com sua incidência pode ajudar os profissionais que atuam na área a diagnosticar e propor intervenções mais precoces e adequadas.
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Depressive symptoms among elderly inpatients of a Brazilian university hospital: prevalence and associated factors. Int Psychogeriatr 2008; 20:1028-40. [PMID: 18416877 DOI: 10.1017/s1041610208007278] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND This study aims to evaluate the prevalence of depressive symptoms and associated factors among elderly hospital inpatients. METHODS A cross-sectional study evaluated 189 participants using the Geriatric Depression Scale, the Mini-mental State Examination and the Katz and Lawton Index, to assess dependence regarding activities of daily living (ADL). RESULTS Most of the participants were women, aged between 60 and 92 years, with low levels of educational attainment and personal income, and non-qualified occupations. The prevalence of depressive symptoms was 56%, but only 3% had a psychiatric diagnosis registered in their medical records. Univariate analysis showed significant associations between depressive symptoms and low educational level and income, marital status, number of hospitalizations in the previous year, cognitive decline, dependence regarding basic and instrumental ADL, and death. After logistic regression, the only variables that remained significantly associated with depression were low educational level, dependence regarding basic ADL, and death. CONCLUSIONS Depressive symptoms were independently associated with low educational level and dependence regarding basic ADL. Hospitalized elderly people with depressive symptoms were more likely to die. It is essential to diagnose and treat depression properly in this population to minimize its negative impacts.
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Ganatra HA, Zafar SN, Qidwai W, Rozi S. Prevalence and predictors of depression among an elderly population of Pakistan. Aging Ment Health 2008; 12:349-56. [PMID: 18728948 DOI: 10.1080/13607860802121068] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To assess the magnitude and risk factors of the problem of depression in an elderly population of Pakistan. METHOD A cross-sectional study was conducted using a sample of 402 people aged 65 and above visiting the Community Health Center of the Aga Khan University, Karachi. Questionnaire based interviews were conducted for data collection and the 15-Item Geriatric Depression Scale was used to screen for depression. Univariate and multivariate logistic regression analyses were performed to identify factors associated with depression. RESULTS Of the 402 participants; 69.7% (95% CI=+/-4.5%) were men, 76.4% (95% CI=+/-4.2%) were currently married, 36.8% (95% CI=+/-5%) had received 11 or more years of education and 24.4% (95% CI=+/-4.2%) were employed. The mean age was 70.57 years (SD=+/-5.414 years). The prevalence of depression was found to be 22.9% (95% CI=+/-4.1%) and multiple logistic regression analysis indicated that higher number of daily medications (p-value=0.03), total number of health problems (p-value=0.002), financial problems (p-value<0.001), urinary incontinence (p-value=0.08) and inadequately fulfilled spiritual needs (p-value = 0.067) were significantly associated with depressive symptoms. CONCLUSION We have identified several risk factors for depression in the elderly which need to be taken into account by practicing family physicians and health care workers.
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Vink D, Aartsen MJ, Schoevers RA. Risk factors for anxiety and depression in the elderly: a review. J Affect Disord 2008; 106:29-44. [PMID: 17707515 DOI: 10.1016/j.jad.2007.06.005] [Citation(s) in RCA: 338] [Impact Index Per Article: 21.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2007] [Revised: 06/12/2007] [Accepted: 06/13/2007] [Indexed: 11/27/2022]
Abstract
BACKGROUND Although a number of studies have examined risk factors for anxiety and depression at a later age, there have been no systematic comparisons of risk profiles across studies. Knowledge on such risk profiles may further our understanding of both the etiology and early recognition of these highly prevalent disorders. This paper gives a comprehensive overview and compares risk factors associated with anxiety and depression in the elderly. METHODS The databases MEDLINE, PsycINFO and Sociological Abstracts were systematically searched, and relevant English-language articles from January 1995 to December 2005 were reviewed. Cross-sectional and longitudinal studies on risk factors in elderly from a community or primary care setting were included. The associations between risk factors and pure anxiety or depressive symptoms or disorders were summarized and compared. RESULTS The abstracted risk factors from studies on anxiety (N=17) and depression (N=71) were clustered into the categories biological, psychological and social. Although risk factors for anxiety and depression showed many similarities, some differences were found. Biological factors may be more important in predicting depression, and a differential effect of social factors on depression and anxiety was found. LIMITATION Due to a high heterogeneity between studies, no meta-analysis could be conducted. CONCLUSIONS There is considerable overlap between the risk profiles for anxiety and depression in the elderly, which suggests a dimensional approach on the interrelationship between anxiety and depression is more appropriate. To improve the recognition and preventive mental health programs, a clearer understanding of differentiating etiological factors will be needed.
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Affiliation(s)
- Dagmar Vink
- Knowledge Centre of Psychiatry in the Elderly, Oude Arnhemseweg 260, 3705 BK Zeist, The Netherlands.
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Ehrt U, Brønnick K, De Deyn PP, Emre M, Tekin S, Lane R, Aarsland D. Subthreshold depression in patients with Parkinson's disease and dementia--clinical and demographic correlates. Int J Geriatr Psychiatry 2007; 22:980-5. [PMID: 17393542 DOI: 10.1002/gps.1774] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND About 40% of the patients with Parkinson's disease (PD) have depressive symptoms, either major depression (MD) or subthreshold depression. Depression was found to be associated with age and age at onset of PD, female gender, more severe parkinsonism, in particular with left-sided and akinetic-rigid symptoms, more functional impairment and cognitive impairment.However, the findings are inconsistent and partly contradictory and most of the studies focused on major depression in PD without dementia. The aim of this study was to examine the relationship between subthreshold depression and other clinical features in 538 PD patients with dementia but without MD drawn from a randomized, placebo-controlled multicentre trial of rivastigmine in PD. RESULTS One hundred and sixteen patients (21%) had subthreshold depression. Depression was associated with a younger age and age at onset and female gender, but not with severity of parkinsonism, cognition or activities of daily living or laterality of motor symptoms. However, in male patients, an association between depression and left-sided parkinsonism was found. CONCLUSION In contrast to previous findings in PD patients with major depression but without dementia, we found no relationship between subthreshold depression and other clinical symptoms in patients with PDD.
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Affiliation(s)
- Uwe Ehrt
- Norwegian Centre for Movement Disorders, Stavanger University Hospital, Norway.
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Milisen K, Braes T, Fick DM, Foreman MD. Cognitive assessment and differentiating the 3 Ds (dementia, depression, delirium). Nurs Clin North Am 2006; 41:1-22, v. [PMID: 16492451 DOI: 10.1016/j.cnur.2005.09.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Differentiation between a diminished or altered cognitive functioning asa consequence of aging and one resulting from serious health problems is critical in the elderly. An unrecognized cognitive disorder or the worsening of the impairment may hamper the effectiveness and appropriateness of care and treatment; therefore, standardized assessment procedures and systematic monitoring of cognition and behavior are important aspects of the nursing care. of older adults. In this article, current notions for accurate and comprehensive cognitive assessment in older persons are delineated. Further, an overview of epidemiological screening and diagnostic dilemmas of dementia, depression, and deliriumare provided.
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Affiliation(s)
- Koen Milisen
- Centre for Health Services and Nursing Research, Katholieke Universiteit Leuven, Kapucijnenvoer 35/4, 3000 Leuven, Belgium.
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