Depression in later life: A closer look at the gender gap

Sex-related differences in the associations between wishing to die, grip strength, and physical activity: An analysis in European middle-aged and older adults

BACKGROUND

The desire to die among older adults has been reported in several European countries. This study aimed to investigate the associations between grip strength (GS) and the frequency of weekly moderate physical activity (MPA) with wish to die (WTD) in European middle-aged and older adults.

METHODS

A cross-sectional analysis was conducted with 39,377 participants (22,313 women) from 27 European countries, aged ≥50 years, responding to wave 8 of the SHARE project. GS was assessed for both hands by a dynamometer, WTD was obtained by asking: 'In the last month, have you felt that you would rather be dead?' from the 12-item EURO-D scale, and the weekly frequency of moderate physical activity (MPA) was self-reported.

RESULTS

Greater GS (per 1 unit) was associated with a 26 % to 55 % lower chances of WTD among men. Among women, a 1 kg increase in GS was associated with a 40 % to 70 % lower chance of WTD. MPA once a week or more than once a week (compared to MPA less than once a week) was associated with a 57 % and 58 % lower chance of WTD among men. Among women, MPA once a week or more than once a week (compared to MPA less than once a week) was associated with 44 % and 48 % lower odds of WTD.

CONCLUSION

GS was inversely associated with WTD, particularly in women. Engaging in MPA once a week showed a greater association with less WTD for both sexes than MPA more than once a week, particularly in men.

Sex-Specific Inflammatory Profiles Affect Neuropsychiatric Issues in COVID-19 Survivors

Post-COVID syndrome has unveiled intricate connections between inflammation, depressive psychopathology, and cognitive impairment. This study investigates these relationships in 101 COVID-19 survivors, focusing on sex-specific variations. Utilizing path modelling techniques, we analyzed the interplay of a one-month 48-biomarker inflammatory panel, with three-months of depressive symptoms and cognitive performance. The findings indicate that cognitive impairment is influenced by both inflammation and depression in the overall cohort. However, prominent sex-specific differences emerged. In females, a lingering imbalance between pro- and anti-inflammatory responses-likely reflecting the long-lasting immune alterations triggered by COVID-19-significantly affects cognitive functioning and shows a marginal, though not statistically significant, association with depressive symptoms. This suggests that a mixed inflammatory profile may contribute to these outcomes. Conversely, in males, inflammation was inversely associated with depression severity, with protective effects from regulatory mediators (IL-2, IL-4, IL-6, IL-15, LIF, TNF-α, β-NGF) against depression. In males, cognitive impairment appeared to be driven mainly by depressive symptoms, with minimal influence from inflammatory markers. These results highlight distinct sex-specific pathways in immune and inflammatory responses post-COVID-19, potentially shaped by endocrine mechanisms. The findings suggest that persistent inflammation may foster long-term neuropsychiatric sequelae, possibly through its effects on the brain, and underscore the need for sex-tailored therapeutic strategies to address the lasting impact of COVID-19.

Differential cross-lagged relations of frailty predicting later depression in older women versus men

This study aimed to investigate autoregressive and lagged associations over 2 years between frailty, depression and quality of life, and to examine sex differences in these longitudinal associations among European men and women aged ≥50 years. The analyses included 10,077 individuals (5589 women) from 12 European countries. Women attested to a higher frailty and depression score and lower quality of life than men. For both sexes, frailty and depression correlated positively cross-sectionally and longitudinally (2 years later), while quality of life correlated negatively with frailty and depression cross-sectionally and longitudinally. With regard to lagged associations, for both men and women, frailty proved to be a predictor of depression 2 years later. In turn, depression did not predict frailty and quality of life 2 years later in women, but it did among men.

The role of meaning in life in the association between loneliness and depression: a mediation study among older adults from 26 European countries

Loneliness and depression are serious public mental health problems. Meaning in life (MIL) is associated with reduced loneliness and depression. This study aimed to: (1) investigate associations between loneliness, MIL, and depression, differentiated by sex in individuals aged ≥ 50 years, residing in 26 European countries and Israel, and (2) to examine in men and women separately whether MIL mediated the relationship between loneliness and depression. We included 41,372 individuals (23,789 women) who responded to wave 8 of the SHARE project. The variables analyzed were loneliness (UCLA), depression (EURO-D scale), and MIL (CASP-19). The analytical procedures included regression analysis and exploratory mediation analysis. Among men and women, the odds of loneliness increasing depression were 3.6 and 3.3 times higher, respectively. Among men, feeling MIL sometimes or often had odds for reducing depression by 0.53 and 0.21, respectively. In women, feeling MIL sometimes or frequently reduced the odds of depression by 0.37 and 0.19, respectively. Regardless of sex, mediation analyses showed a positive association between loneliness and depression, while MIL was negatively associated with loneliness and depression. MIL partially mediated the association between LON and depression in male and female models by approximately 83.2% and 80.7%, respectively. No differences were found between men's and women's mediation models. Regardless of sex, high levels of MIL seem to be effective in benefiting the mental health of Europeans aged 50 and over. MIL proved to be a significant mediator of the relationship between loneliness and depression, while loneliness and depression strengthened each other.

Psychosocial profiles and blood pressure control: results from the multi-ethnic study of atherosclerosis (MESA)

Growing research shows psychosocial factors are associated with blood pressure (BP) control among individuals with hypertension. To date, little research has examined multiple psychosocial factors simultaneously to identify distinguishing profiles among individuals with hypertension. The association of psychosocial profiles and BP control remains unknown. To characterize the psychosocial profiles of individuals with hypertension and assess whether they are associated with BP control over 14 years. We included 2,665 MESA participants with prevalent hypertension in 2002-2004. Nine psychosocial variables representing individual, interpersonal, and neighborhood factors were included. BP control was achieved if systolic blood pressure (SBP)  < 140 mmHg and diastolic blood pressure (DBP) < 9090 mmHg. Latent profile analysis (LPA) revealed an optimal model of three psychosocial profile groups (AIC 121,229; entropy = .88) "Healthy", "Psychosocially Distressed" and "Discriminated Against". Overall, there were no significant differences in systolic and diastolic BP control combined, across the profiles. Participants in the "Discriminated Against" profile group were significantly less likely [OR= 0.60; 95% CI: 0.43, 0.84] to have their DBP < 9090 mmHg as compared to the "Healthy" profile, but this was attenuated with full covariate adjustment. Discrete psychosocial profiles exist among individuals with hypertension but were not associated with BP control after full covariate adjustment.

Prevalence and risk factors of depression among elderly people in nursing homes from 2012 to 2022: a systematic review and meta-analysis

OBJECTIVES

To determine a pooled prevalence of depression and its influencing factors among nursing home residents.

METHOD

PsycINFO, PubMed, Embase, and Web of Science were searched for studies investigating the prevalence and risk factors of late-life depression among nursing home residents between January 2012 and November 2022. Two reviewers independently completed the literature screening, data extraction and quality assessment. A random-effects model was utilized to pool the prevalence of depression and summarize the influencing factors.

RESULTS

This meta-analysis included 48 studies involving 28,501 participants. The pooled prevalence of depressive mood and major depressive disorder was 53% and 27%, respectively. The rate of depressive mood is higher in lower-middle-income countries (60.0%), compared with high- (53.0%) and upper-middle-income countries (44.0%). The rate of depressive mood (35.0%) is higher among females than male (19.0%). Depression was influenced by factors, including male (OR = 0.28), insufficient income (OR = 3.53), comorbidities (OR = 2.66), pain (OR = 2.67; r = 0.31), functional disability (r = 0.33), loneliness (r = 0.43), number of chronic health problems (r = 0.18), social support (r = -0.28), activities of daily living (r = -0.43), subjective health (r = -0.28), autonomy (r = -0.41), environment (r = -0.50) and physical (r = -0.57) and psychological health (r = -0.65).

CONCLUSION

The prevalence of depressive mood is high among nursing home residents, especially in lower-middle-income countries. It is influenced by factors including gender, income, social support, daily activities, environment, physical and psychological health and autonomy. Understanding those factors can provide evidence-based recommendations for improved awareness, prevention and better management of late-life depression.

The Mediating Role of Physical Activity and Self-Rated Health in the Association Between Depression and Quality of Life in Older Europeans: An Analysis Differentiated by Sex

Objectives: This study investigates the mediating role of moderate physical activity (MPA), vigorous physical activity (VPA), and self-rated health (SRH) in the association between depression and quality of life (QoL) in a large sample of Europeans aged 50 and over, differentiated by sex. Methods: Data from the 2017 Survey of Health, Ageing and Retirement in Europe were analyzed, including 11,986 individuals (6843 women) aged 50 and older. All information was collected through face-to-face interviews: sociodemographic data, SRH, physical activity levels, depression (EURO-D scale), and QoL (CASP-12). Results: Comparatively, women reported a higher prevalence of depression, a lower perception of QoL, and slightly lower levels of SRH, MPA, and VPA. Parallel mediation models revealed, for both sexes, that an increase in VPA levels was more effective in benefiting SRH; and MPA proved to be a better promoter of QoL. When comparing sexes, only the path depression → VPA → QoL showed a significant difference (p < 0.001). Conclusions: These results provide valuable insights for developing physical activity interventions capable of improving mental health and promoting QoL in older European adults.

Exploring Self-Care, Anxiety, Depression, and the Gender Gap in the Software Engineering Pipeline

Software engineers may experience burnout, which is often caused by the anxieties and stresses of the workplace. Understanding the well-being and resilience practices of software engineers and evaluating their knowledge of mental health is one factor to understand our current, diverse, multi-generational workplaces. Here, we present preliminary results of a study examining the self-care practices of software engineers, a general overview of the state of mental health of software engineers, and correlations between expressions of mental health and demographic factors. Among 224 respondents, positive correlations between imposter syndrome and happiness, anxiety, and depression were identified. We also identified negative correlations between mental health literacy and imposter syndrome, happiness, anxiety, and depression. Well-being had a positive correlation with self-efficacy, as well as with happiness. We also present the Gender Gap in mental health and our findings in relation to that construct. Our findings suggest increasing mental health support services.

Serotonin in depression and Alzheimer's disease: Focus on SSRI's beneficial effects

Depression is a complex and pervasive mental health disorder affecting millions globally. Serotonin, a critical neurotransmitter, plays a central role in the pathophysiology of depression. This review explores serotonin's multifaceted role in depression, focusing on its synthesis, bioavailability, receptor interactions, and the impact of various factors, including diet, stress, and gender differences. This review aims to provide a comprehensive understanding of serotonin's role in depression by examining its synthesis and structure, its bioavailability and dietary influences, and its interactions with stress and immune responses. Additionally, it investigates the influence of age, socioeconomic status, and gender on depression, and integrates findings from animal research to elucidate serotonin's impact on mood disorders and cognitive decline. A literature review was conducted using PubMed, Google Scholar, and Embase databases. Key focus areas included serotonin synthesis and receptor interactions, dietary effects on serotonin bioavailability, and the relationship between serotonin, immune responses, and stress. Gender differences, age-related factors, and socioeconomic influences on depression were also examined. Studies were thematically categorized and analyzed to provide a cohesive overview. Our review highlights that serotonin synthesis involves a complex enzymatic process, with recent structural studies revealing intricate receptor interactions. Dietary factors significantly impact serotonin levels, with interventions potentially modulating mood disorders. Stress and immune responses are linked to serotonin dynamics, with chronic stress exacerbating mood disorders and influencing cognitive decline. Animal studies underscore serotonin's role in mood regulation and cognitive function, while human research reveals how age, gender, and socioeconomic factors affect depression. The findings emphasize the need for a multidimensional approach to understanding and treating depression. Various factors, including diet, stress, and immune responses, influence serotonin's role in mood disorders. The review suggests potential therapeutic pathways involving dietary interventions and stress management. Furthermore, gender-specific considerations and the impact of age and socioeconomic status on depression outcomes highlight the need for tailored treatment strategies.

Sex differences in the inflammation-depression link: A systematic review and meta-analysis

Major Depressive Disorder (MDD) is a heterogeneous disorder that affects twice as many women than men. Precluding advances in more tailored and efficacious treatments for depression is the lack of reliable biomarkers. While depression is linked to elevations in inflammatory immune system functioning, this relationship is not evident among all individuals with depression and may vary based on symptom subtypes and/or sex. This systematic review and meta-analysis examined whether inflammatory immune peripheral markers of depression are sex-specific. PRISMA guidelines were followed for the systematic review, and a comprehensive search strategy that identified studies from PubMed and PsycInfo was applied. Studies were included if they reported C-reactive protein (CRP), interleukin (IL)-6, tumor necrosis factor (TNF)-α and/or IL-1β for males and/or females among depressed and healthy adults. We identified 23 studies that satisfied these inclusion criteria. Random-effects meta-analysis models were fit, and measures of association were summarized between levels of circulating markers of inflammation in depressed and healthy males and females. Sex-based analyses revealed elevated levels of CRP among females with depression (Cohen's d = 0.19) relative to their healthy counterparts (p = 0.02), an effect not apparent among males (Cohen's d = -0.01). Similarly, levels of IL-6 were increased among females with depression compared to healthy controls (Cohen's d = 0.51; p = 0.04), but once again this was not found among males (Cohen's d = 0.16). While TNF-α levels were elevated among individuals with depression compared to controls (p = 0.01), no statistically significant sex differences were found. The meta-analysis for IL-1β resulted in only three articles, and thus, results are presented in the supplemental section. This meta-analysis advances our understanding of the unique involvement of inflammatory biomarkers in depression among men and women, which may help inform more tailored sex-specific treatment approaches in the future.

Outcome differences between males and females undergoing deep brain stimulation for treatment-resistant depression: systematic review and individual patient data meta-analysis

BACKGROUND

Treatment-resistant depression (TRD) occurs more commonly in women. Deep brain stimulation (DBS) is an emerging treatment for TRD, and its efficacy continues to be explored. However, differences in treatment outcomes between males and females have yet to be explored in formal analysis.

METHODS

A PRISMA-compliant systematic review of DBS for TRD studies was conducted. Patient-level data were independently extracted by two authors. Treatment response was defined as a 50 % or greater reduction in depression score. Percent change in depression scores by gender were evaluated using random-effects analyses.

RESULTS

Of 737 records, 19 studies (129 patients) met inclusion criteria. The mean reduction in depression score for females was 57.7 % (95 % CI, 64.33 %-51.13 %), whereas for males it was 35.2 % (95 % CI, 45.12 %-25.23 %) (p < 0.0001). Females were more likely to respond to DBS for TRD when compared to males (OR = 2.44, 95 % CI 1.06, 1.95). These differences varied in significance when stratified by DBS anatomical target, age, and timeframe for responder classification.

LIMITATIONS

Studies included were open-label trials with small sample sizes.

CONCLUSIONS

Our findings suggest that females with TRD respond at higher rates to DBS treatment than males. Further research is needed to elucidate the implications of these results, which may include connectomic sexual dimorphism, depression phenotype variations, or unrecognized symptom reporting differences. Methodological standardization of outcome scales, granular demographic data, and individual subject outcomes would allow for more robust comparisons between trials.

Sex differences in the symptom network structure of depression: Findings from a nationwide sample of the Spanish adult population

BACKGROUND

Sex differences in the prevalence and clinical features of depression have been widely described. However, some authors argue that categorical diagnostic systems do not adequately capture the complexity of depression. The aim of this study was to examine sex differences in the symptom network structure of depressive symptoms among individuals with a major depressive episode.

METHODS

The study sample consisted of 510 participants (age 62.17 ± 14.43, 71.96 % women) from a nationwide study of the Spanish non-institutionalised adult population (Edad con Salud). To estimate the presence of a 12-month major depressive episode according to DSM-IV criteria, participants were administered an adapted version of the Composite International Diagnostic Interview (CIDI 3.0). A network analysis was carried out to determine possible interrelationships between different depressive symptoms by sex.

RESULTS

Men and women showed a similar overall structure and network strength. However, sex-specific variations emerged in relation to individual symptom associations and symptom centrality. Specifically, for individual symptom associations "loss of confidence" and "suicide attempts" were more strongly related in women, and "suicidal ideation" and "impaired thinking" in men. For symptom centrality, "anxiety" played a central role in men's symptomatology, whereas "hopelessness", "loss of confidence", "distress" and "slowness of movement" were the most central symptoms in the women's group.

LIMITATIONS

Reliance on cross-sectional data precludes us from determining the direction and temporality of the association between different symptoms.

CONCLUSIONS

This study suggests that specific symptoms should be prioritised in the prevention, diagnosis assessment and treatment of depressed patients based on sex.

Gender Differences in Depressive Symptoms Following Child Death in Later Life

OBJECTIVES

This study examined short- and long-term psychological adjustment to parental bereavement in later life for mothers and fathers.

METHODS

Using 9 waves of data from the United States (1998-2014 Health and Retirement Study), I estimated trajectories of mothers' and fathers' depressive symptoms surrounding child death in later life, highlighting gender differences in adjustment. Moderation analyses were performed to uncover heterogeneous trajectories across parental characteristics.

RESULTS

Mothers were more likely to experience child death and reported higher depressive symptoms prior to parental bereavement than fathers. Mothers and fathers who lost a child reported an increase in depressive symptoms that diminished over time. The short-term elevation in depressive symptoms was marginally greater for mothers than fathers, but depressive symptoms declined at a faster rate for mothers than fathers in the years following the death. These counterbalancing changes resulted in mothers and fathers returning to their respective prebereavement levels of depressive symptoms between 2 and 4 years postbereavement. Parental age moderated trajectories distinctly by gender, and the presence of surviving children buffered the impact of child death on depressive symptoms for mothers but not fathers.

DISCUSSION

Mothers more often experience child death in later life and their adjustment process differs from that of fathers, underscoring the salience of gender in shaping how older parents respond to the death of a child. Older parents and mothers without surviving children are vulnerable to prolonged elevations in depressive symptoms following the death of a child in later life.

Daily Stress Processes as Potential Intervention Targets to Reduce Gender Differences and Improve Mental Health Outcomes in Mid- and Later Life

The current study examines daily stress processes as risk factors for comprised mental health in midlife and later life, specifically for gender differences in depression risk. Using data from the Midlife in the United States (MIDUS) study and the National Study of Daily Experiences (NSDE), we examine (1) gender differences in depression; (2) the prospective effects of differential exposure and affective responses on 10-year depression status; (3) gender differences in daily stress-depression links. Furthermore, we explore whether the protective factor of help-seeking behavior moderates the effects of daily stress on depression. Participants included 1289 (mage = 55; SD = 12; range = 34-83; 56% female) individuals who completed the second waves of MIDUS and the 8-day NSDE daily diary protocol and participated in the third wave of MIDUS approximately 10 years later. Respondents completed assessments of depression and their seeking assistance from a psychiatrist, mental health professional, counselor, or religious leader. Covariate-adjusted logistic regression analyses revealed increased odds of depression among women compared to men, but no significant gender difference after taking daily stress into account. Higher levels of stressor exposure, negative affect, and affective reactivity were associated with increased odds of depression for both men and women. Compared to those who did not engage in help-seeking behavior, those who did had significantly greater odds of depression, and there were asymmetric patterns of daily stress effects across groups. These findings highlight differential exposure, negative affect, and affective responses to daily stress as potentially accessible intervention targets for reducing stress in daily life and mitigating longer-term depression risk during mid- and later life.

Prevalence and factors associated with anxiety and depression among community-dwelling older adults in Hunan, China: a cross-sectional study

BACKGROUND

Older adults' psychological health is a public health issue that cannot be ignored, especially when these psychological health problems and related factors change across different social backgrounds because of rapid changes in traditions and family structures and the epidemic responses after the outbreak of COVID-19 in China. The aim of our study is to determine the prevalence of anxiety and depression and their associated factors among community-dwelling older adults in China.

METHODS

A cross-sectional study was conducted from March to May 2021 with 1173 participants aged 65 years or above from three communities in Hunan Province, China who were selected using convenience sampling. A structured questionnaire including sociodemographic characteristics, clinical characteristics, the Social Support Rating Scale (SSRS), the 7-Item Generalized Anxiety Disorder scale (GAD-7), and the Patient Health Questionnaire-9 Item (PHQ-9) was used to collect relevant demographic and clinical data and to measure social support status, anxiety symptoms, and depressive symptoms, respectively. Bivariate analyses were conducted to explore the difference in anxiety and depression based on samples' different characteristics. The multivariable logistic regression analysis was performed to test for significant predictors of anxiety and depression.

RESULTS

The prevalence of anxiety and depression were 32.74% and 37.34%, respectively. Multivariable logistic regression analysis revealed that being female, being unemployed before retirement age, lacking physical activity, having physical pain, and having three or more comorbidities were significant predictors for anxiety. Subjective social support and support utilization were significant protective factors. Regarding depression, religion, lacking physical activity, having physical pain, having three or more comorbidities were found to be significant predictors. Support utilization was a significant protective factor.

CONCLUSIONS

The study group showed a high prevalence of anxiety and depression. Gender, employment status, physical activity, physical pain, comorbidities, and social support were associated with psychological health problems of older adults. These findings suggest that governments should focus on the psychological health problems of older adults by raising community awareness of issues related to older adults' psychological health. They should also screen for anxiety and depression among high-risk groups and encourage individuals to seek supportive counseling.

The Risk of Major Depressive Disorder Due to Cataracts among the Korean Elderly Population: Results from the Korea National Health and Nutrition Examination Survey (KNHANES) in 2016 and 2018

Cataracts and major depressive disorder (MDD) both have high prevalence, representing for major health burdens globally. In this study, we examined the risk of MDD due to cataracts. Data from the 2016 to 2018 Korea National Health and Nutrition Examination Survey (KNHANES) were used, including 4122 participants. Logistic regression analysis was performed to evaluate the odds ratio for MDD in association with cataracts. Controlled variables were age, gender, smoking, dyslipidemia and mobility. Subgroup analysis was performed with stratification by gender. The results reveal that cataracts are significantly correlated with MDD. Elderly people with cataracts were found to be more likely to develop MDD compared to those without cataracts (adjusted odds ratio: 1.654; 95% CI = 1.197-2.286). In subgroup analysis, men (adjusted odds ratio: 2.631; 95% CI = 1.247-5.551) were found to be more likely to develop MDD than women (adjusted odds ratio: 1.510; 95% CI = 1.061-2.150). Cataracts may be a risk factor for MDD in the elderly, especially among the male population.

[Structural brain changes in patients with temporal lobe epilepsy and comorbid depression]

OBJECTIVE

To assess the morphological features of the brain structures in patients with temporal lobe epilepsy and comorbid depression.

MATERIAL AND METHODS

From 1 January 2017 to 31 December 2020, we studied 80 patients with temporal lobe epilepsy (aged 18-60 years, 38 of whom had comorbid depression) and 48 healthy subjects of comparable age. Magnetic resonance imaging (MRI) of the brain was performed using the epilepsy protocol in a scanner with a magnetic field strength of 1.5 T. Focal temporal lobe epilepsy was diagnosed by neurologists (epileptologists) specialising in epilepsy according to the International League Against Epilepsy (ILAE) classification of epilepsy. Psychiatrists assessed the presence and severity of depressive disorders by clinical interview and by participants' scores on the Beck Depression Inventory (BDI-II). MRI data were processed using FreeSurfer 6.0 software to determine volumes of subcortical structures and thicknesses of cortical structures. At the group level, analysis of covariance with Holm-Bonferroni correction was used as the statistical method.

RESULTS

Morphometric analysis revealed a significant decrease in the volume of the thalamus bilaterally and the brain stem and an increase in the volume of the choroid plexus in the left hemisphere, as well as a significant decrease in the thickness of the entorhinal cortex, temporal pole and isthmus of the cingulate gyrus in the left hemisphere and middle temporal gyrus and inferior temporal gyrus in the right hemisphere in patients with epilepsy compared to healthy controls. No association was found between the presence of depression and significant structural changes on MRI.

CONCLUSION

The data obtained suggest an effect of temporal lobe epilepsy, but not comorbid depression, on the morphology of brain structures.

Sex differences in quality of life and depressive symptoms among middle-aged and elderly Europeans: results from the SHARE survey

OBJECTIVES

We examine sex differences in quality of life (QoL) and depressive symptoms across age and European regions.

METHODS

We performed a large cross-sectional study based on 64,552 women and 53,647 men aged 50+ who participated in the Survey of Health, Ageing and Retirement in Europe (SHARE) from 2004-2020. Linear and logistic regression models were used to examine associations with QoL (CASP-12) and depressive symptoms (EURO-D).

RESULTS

Women reported slightly lower QoL (coefficient -0.78, 95% CI -0.92; -0.65) and more depressive symptoms (odds ratio (OR) 2.23, 95% CI 2.13; 2.34) than men. Sex differences in QoL increased with advancing age, whereas sex differences in depressive symptoms were stable across age groups. No overall sex difference in QoL was found in Northern Europe, but women had lower QoL than men in Western (coefficient -0.49, 95% CI -0.69; -0.29), Southern (coefficient -1.35, 95% CI -1.61; -1.09) and Eastern (coefficient -0.72, 95% CI -1.05; -0.39) Europe. However, sex differences varied within the specific CASP-12 items, with women having overall lower control and autonomy, but more self-realisation, than men. Women reported more depressive symptoms than men in all regions, with the largest overall sex difference in Southern Europe (OR 2.62, 95% CI 2.40; 2.86). A female disadvantage was found for most of the EURO-D items, with the largest sex differences for 'tearfulness', 'depression' and 'sleep'.

CONCLUSION

Middle-aged and elderly European women report lower QoL and more depressive symptoms than European men, lending support for the male-female health survival paradox.

Associations among depression, demographic variables, and language impairments in chronic post-stroke aphasia

INTRODUCTION

Depression may influence treatment participation and outcomes of people with post-stroke aphasia, yet its prevalence and associated characteristics in aphasia are poorly understood. Using retrospective data from an overarching experimental study, we examined depressive symptoms and their relationship to demographic and language characteristics in people with chronic aphasia. As a secondary objective, we compared prevalence of depressive symptoms among the overarching study's included and excluded participants.

METHODS

We examined retrospective data from 121 individuals with chronic aphasia including depression scale scores, demographic information (sex, age, time post onset of stroke, education, race/ethnicity, and Veteran status), and scores on assessments of general and modality-specific language impairments.

RESULTS

Approximately 50% of participants reported symptoms indicative of depressive disorders: 23% indicative of major depression and 27% indicative of mild depression. Sex (males) and comparatively younger age emerged as statistically significant variables associated with depressive symptoms; naming ability was minimally associated with depressive symptoms. Time post onset of stroke, education level, race/ethnicity, Veteran status, and aphasia severity were not significantly associated with depressive symptoms. Depression-scale scores were significantly higher for individuals excluded from the overarching study compared to those who were included.

CONCLUSIONS

The rate of depressive disorders in this sample was higher than rates of depression reported in the general stroke literature. Participant sex, age, and naming ability emerged as factors associated with depressive symptoms, though these links appear complex, especially given variable reports from prior research. Importantly, depressive symptoms do not appear to diminish over time for individuals with chronic aphasia. Given these results and the relatively limited documentation of depression in aphasia literature, depression remains a pressing concern for aphasia research and routine clinical care.

Microglia Involves in the Immune Inflammatory Response of Poststroke Depression: A Review of Evidence

Poststroke depression (PSD) does not exist before and occurs after the stroke. PSD can appear shortly after the onset of stroke or be observed in the weeks and months after the acute or subacute phase of stroke. The pathogenesis of PSD is unclear, resulting in poor treatment effects. With research advancement, immunoactive cells in the central nervous system, particularly microglia, play a role in the occurrence and development of PSD. Microglia affects the homeostasis of the central nervous system through various factors, leading to the occurrence of depression. The research progress of microglia in PSD has been summarized to review the evidence regarding the pathogenesis and treatment target of PSD in the future.

Predicting the gender difference in depressive symptoms in older adults

Objectives: The gender difference in depressive symptoms in older adults is well-established, with women exhibiting approximately twice as many depressive symptoms as men across the life span. However, almost no studies have explored why we see this pattern in older adults.Method: In this study, moderation, mediation and reverse mediation analyses were used to learn how gender differences in psychosocial and health variables contribute to the gender difference in depressive symptoms in 60-74 year old participants in the baseline sample of the ORANJ BOWL study (n = 3008).Results: Moderation analyses show that functional ability, health, social support, and living alone interact with gender to predict depressive symptoms. Mediation analyses demonstrate that gender differences in financial comfort, social support, health, functional ability and living alone help explain the gender difference in depression. Reverse mediation analyses show that depressive symptoms also predict the gender difference in psychosocial and health variables.Conclusion: While the moderation analyses show multiple points of entry for clinical implications, they do not provide clarity that explains the gender difference in depressive symptoms. Mediation analyses highlight the roles of functional ability, financial comfort, health and living alone in explaining the gender difference. Reverse mediation analyses suggest a negative feedback loop between depressive symptoms and the predictor variables, with gender differences in functional ability, financial comfort, health and living alone at least partially explained by gender differences in depression. The findings highlight opportunities for targeted depression screening and to identify the gender inequities that need attention in order to reduce disadvantages for women.

Home confinement and mental health problems during the Covid-19 pandemic among the population aged 50 and older: A gender perspective

Home confinement during the Covid-19 pandemic is usually associated with worsening mental health. In the case of older adults, although they have been identified as a vulnerable group in terms of mental health, the results of studies on the relationship between home confinement and mental health are not consistent and few studies have adopted a gender perspective. Using data from the SHARE Corona Survey (2020), we aimed to analyse the role of gender on the relationship between home confinement and increased depression in individuals aged 50 and over living in Europe and Israel. Our study shows that, although women reported increased depression/sadness during the Covid-19 pandemic more often than men, it was the latter who experienced the greatest increase.

Depression Risk Factors for Knowledge Workers in the Post-Capitalist Society of Taiwan

This study aimed to examine the depression risk factors for knowledge workers aged 20–64 in the post-capitalist society of Taiwan. Interview data from 2014 and 2019 were adopted for quantitative analysis of the depression risk by demographic and individual characteristics. The results showed that the depression risks of knowledge workers were not affected by demographic variables in a single period. From 2014 to 2019, the prevalence of high depression risk in knowledge workers aged 20–64 years increased over time. The more attention is paid to gender equality in society, the less the change in the gender depression index gap may be seen. Positive psychological state and family relationships are both depression risk factors and depression protective factors. Being male, married, religious, and aged 45–49 years old were found to be critical risk factors. Variables of individual characteristics could effectively predict depression risk.

The impact of socioeconomic status, general health and oral health on Health-Related Quality of Life, Oral Health-Related Quality of Life and mental health among Polish older adults

BACKGROUND

The study aims to evaluate the impact of socioeconomic status, general health and oral health parameters on Health-Related Quality of Life (HRQoL), Oral Health-Related Quality of Life (OHRQoL) and mental health in elderly urban residents of South-Western Poland.

METHODS

The 500 residents of Wroclaw, aged 65 and older provided demographic and personal information as well as their medical history. A patient's oral condition were determined based on the clinical oral examination.Quality of Life was assessed using Euro-Quality of Life (EQ-5D), Oral Health Impact Profile-14 (OHIP-14) and Patient Health Questionnaire (PHQ-9).The association between exposure (socioeconomic status, general health and oral health) and outcome (HRQoL, OHRQoL and mental health variables) were analyzed with the use of four models: P - Poisson model, NB-Negative Binomial model, ZIP - Zero Inflated Poisson model, ZINB - Zero Inflated Negative Binomial model.

RESULTS

The best model turned out to be the ZINB model, in which a negative binomial distribution in the count equation is assumed. In this model, only 13 independent variables had a significant effect on HRQoL, OHRQoL, and mental health. HRQoL assessed with the EQ-5D is significantly influenced by: living conditions 0.133 (95% CI: 0.001, 0.267, p = 0.049), income -0.348 (95%CI: -0.466, -0.230, p < 0.001), diabetes mellitus 0.437 (95%CI: 0.250, 0.624, p < 0.001), myocardial infarction 0.454 (95% CI: 0.151, 0.757, p = 0.003), stroke 0.543 (95%CI: 0.094, 0.992, p = 0.018) and renal disease 0.466 (95% CI: 0.206, 0.726, p < 0.001). Factors negatively affecting OHRQOL are: the need for oral treatment 0.278 (95%CI: 0.104, 0.452, p = 0.002), the number of missing teeth 0.053 (95%CI: 0.039, 0.067, p < 0.001) and gender 0.271 (95%CI: 0.015, 0.527, p = 0.038) and age -0.025 (95%CI: -0.042, -0.008, p = 0.003). An important factor influencing the level of depression assessed by the PHQ-9 questionnaire may be the material condition -0.225 (95%CI: -0.349, -0.101, p < 0.001). It should be emphasized that living with other people may be a factor that significantly increases the probability of avoiding the occurrence of depression symptoms.

CONCLUSION

The study concerning elderly residents of the macroregion in Poland found the impact of socioeconomic, general health and oral health parameters on Health-Related Quality of Life, Oral Health-Related Quality of Life and mental health. Research on the quality of life of the elderly at the local level allowed to assess the factors linked to quality of life of older adults.

Age and sex trends in depressive symptoms across middle and older adulthood: Comparison of the Canadian Longitudinal Study on Aging to American and European cohorts

BACKGROUND

The literature suggests depressive symptoms differ in a non-linear fashion across adulthood and are more commonly reported in women as compared to men. Whether these trends are observed across countries in population-based cohorts is unclear.

METHODS

Cross-sectional observational study of approximately 138,000 women and men between the ages of 45 and 95 from three population-based cohorts representing Canadian, European, and American populations. Age, gender, educational attainment and annual income were assessed in each cohort. Depressive symptoms were assessed by the Center for Epidemiological Studies Depression Scale in the US and Canadian cohorts, and by the EURO-D in the European cohort.

RESULTS

Across all three cohorts, non-linear age trends and gender differences were observed in the report of depressive symptoms, independent from educational attainment and annual income effects. The non-linear age trends reflected a negative association between depressive symptoms and age during midlife and then a positive association in late life. Females reported greater depressive symptoms than males; however, an interaction between gender and age was also observed in the Canadian and European cohorts. Among Canadians, the gender differences were largest after age 70, whereas among Europeans, gender differences where largest among those approximately aged 60.

LIMITATIONS

Limitations include: 1) the cross-sectional nature of the study, resulting in age differences potentially reflecting cohort effects rather than a developmental process; and 2) the use of different depressive symptoms measures across cohorts.

CONCLUSIONS

Characterization of depressive symptoms over mid and late adulthood in women and men provides insights into potential focal points for intervention and allocation of resources.

Acculturation and Depressive Symptoms Among Dominicans in New York City

Little is known about the association between acculturation and mental health among Dominican populations in the United States. Data came from a community survey of Dominican residents of New York City (n = 2744). Associations between two indicators of acculturation, proportion of life spent in the U.S. and interview language (English/Spanish), with lifetime depressive symptoms (Patient Health Questionnaire-9 score ≥ 5) were examined using logistic regression overall and by gender. In adjusted models, respondents with English-language interview and above-median proportion of life spent in the U.S. had 77% higher odds (95% CI 1.28, 2.44) of lifetime depressive symptoms than those with Spanish-language interview and below-median proportion of life spent in the U.S. There was some evidence of elevated odds of depressive symptoms among men with English-language interview and below-median proportion of life spent in the U.S. Additional research is needed to elucidate gender-specific impacts of acculturation on mental health in this population.

Factors Associated with Depression and Anxiety in Adults ≥60 Years Old during the COVID-19 Pandemic: A Systematic Review

COVID-19 represents a threat to public health and the mental health of the aged population. Prevalence and risk factors of depression and anxiety have been reported in previous reviews in other populations; however, a systematic review on the factors associated with depression and anxiety in older adults is not currently present in the literature. We searched PubMed, Embase, Scopus, ProQuest Psychology Database, Science Direct, Cochrane Library and SciELO databases (23 February 2021). The results were obtained by entering a combination of MeSH or Emtree terms with keywords related to COVID-19, elderly, depression and anxiety in the databases. A total of 11 studies were included in the systematic review. Female gender, loneliness, poor sleep quality and poor motor function were identified as factors associated with both depression and anxiety. Aspects related to having a stable and high monthly income represent protective factors for both depression and anxiety, and exercising was described as protective for depression. This study synthesised information and analysed the main factors associated with depression and anxiety in the older population during the COVID-19 pandemic. However, the cross-sectional design of most of the included studies does not allow a causal relationship between the factors analysed and depression or anxiety.

Therapy Management of Metabolic Disorder Comorbidity With Depression

Depression is a common disease that seriously endangers the physical and mental health of human beings, and it often coexists with other metabolic disorders such as diabetes and cancer. There have been endless reports on the mechanism, prevention, and cure of comorbidity because of its high incidence and poor prognosis and the increased burden on the family and society. There may be a specific comorbid basis and causal relationship between depression and metabolic diseases. Depression in patients with metabolic disorders can be effectively alleviated through psychotherapy and medication. The timely and effective treatment of depression can significantly improve the quality of life of patients with metabolic disorders, reduce their psychological burden, and promote the effective treatment of metabolic diseases. This study reorganized the research progress on the management of metabolic disorder comorbidity with depression.

Well-being during COVID-19 pandemic: A comparison of individuals with minoritized sexual and gender identities and cis-heterosexual individuals

BACKGROUND

Preliminary empirical data indicates a substantial impact of the COVID-19 pandemic on well-being and mental health. Individuals with minoritized sexual and gender identities are at a higher risk of experiencing such negative changes in their well-being. The objective of this study was to compare levels of well-being among cis-heterosexual individuals and individuals with minoritized sexual and gender identities during the COVID-19 pandemic.

METHODS

Using data obtained in a cross-sectional online survey between April 20 to July 20, 2020 (N = 2332), we compared levels of well-being (WHO-5) across subgroups (cis-individuals with minoritized sexual identities, individuals with minoritized gender identities and cis-heterosexual individuals) applying univariate (two-sample t-test) and multivariate analysis (multivariate linear regression).

RESULTS

Results indicate overall lower levels of well-being as well as lower levels of well-being in minoritized sexual or gender identities compared to cis-heterosexual individuals. Further, multivariate analyses revealed that living in urban communities as well as being in a relationship were positively associated with higher levels of well-being. Furthermore, a moderation analysis showed that being in a relationship reduces the difference between groups in terms of well-being.

CONCLUSION

Access to mental healthcare for individuals with minoritized sexual and gender identities as well as access to gender-affirming resources should be strengthened during COVID-19 pandemic. Healthcare services with low barriers of access such as telehealth and online peer support groups should be made available, especially for vulnerable groups.

The double burden of poverty and marital loss on the mental health of older Australian women; a longitudinal regression analysis using 17 annual waves of the HILDA cohort

PURPOSE

Compared to men, older women have poorer mental health and are more vulnerable to poverty, especially when living alone. However, few studies have examined how gender, marital status and poverty are inter-related and are associated with mental health. This study examines the gendered associations between relative poverty, marital status and mental health in older Australians.

METHODS

Drawing on 17 waves of the HILDA Survey, fixed-effects longitudinal regression analysis was utilised to examine the association between: (1) relative poverty (< 50% median household income) and mental health (MHI-5); (2) marital status and poverty, in a cohort of Australians aged 65 + years. We then examined effect modification of the association between relative poverty and mental health by marital status.

RESULTS

Within-person associations, stratified by gender, showed that women in relative poverty reported poorer mental health than when not in relative poverty, however no association was observed for men. Being divorced/separated was associated with increased odds of relative poverty for women, but not men. Widowhood was strongly associated with relative poverty in women, and also among men, albeit a smaller estimate was observed for men. There was no evidence of effect modification of the relationship between relative poverty and mental health by marital status for either men or women.

CONCLUSION

This study provides evidence that relative poverty is a major determinant of mental health in older Australian women. Addressing gender inequities in lifetime savings, as well as in division of acquired wealth post marital loss, may help reduce these disparities.

Similarities and Differences of Mental Health in Women and Men: A Systematic Review of Findings in Three Large German Cohorts

In Germany, large, population-based cohort studies have been implemented in order to identify risk and protective factors for maintaining health across the life span. The purpose of this systematic review is to analyse findings from three large ongoing cohorts and to identify sex-specific prevalence rates, risk and protective factors for mental health. Published studies from the Cooperative Health Research in the Region Augsburg (KORA), the Study of Health in Pomerania (SHIP) and the Gutenberg Health Study (GHS)), representing the southern, north-eastern and middle parts of Germany, were identified through searches of the databases PubMed and Web of Science. A total of 52 articles was identified from the start of each cohort until June 2019. Articles reporting prevalence rates of mental health [N = 22], explanatory factors for mental health [N = 25], or both [N = 5] were identified. Consistent across cohorts, higher prevalence rates of internalizing disorders were found for women and more externalizing disorders for men. Risk and protective factors for mental health included social factors, lifestyle, physical health, body mass index (BMI), diabetes, genetic and biological factors. In all areas, differences and similarities were found between women and men. The most evident were the sex-specific risk profiles for depression with mostly external risk factors for men and internal risk factors for women. Gender was not assessed directly, therefore we examined whether socioeconomic and family-related factors reflecting gender roles or institutionalized gender could be used as a proxy for gender. Overall, this systematic review shows differences and similarities in prevalence rates and determinants of mental health indicators between women and men. They underline the importance of focussing on sex specific approaches in mental health research and in the development of prevention measures. Current research on mental health still lacks focus on gender aspects. Therefore, an increased focus on sex and gender in mental health research is of great importance.

Gendered experiences of widowhood and depression across Europe: The role of loneliness and financial resources from a longitudinal perspective

OBJECTIVE

This study analyses the gendered experiences of widowhood and its relation to depressive symptoms in four European regions. A special focus lies on the question whether loneliness and reduced financial contribute to the detrimental effect of widowhood on mental health.

METHODS

Using waves 5,6 and 7 of the Survey of Health. Ageing and Retirement in Europe (SHARE), this study estimates fixed-effects linear regression models for the effect of widowhood on depressive symptoms with and without adjustment for potential mediating factors.

RESULTS

There were no gender differences in the mental health consequences of widowhood irrespective of the regional context. Whereas loneliness was a major pathway through which widowhood exerts its negative consequences on mental health, reduced financial resources did not play a substiantial role. Moreover, the magnitude of the widowhood effect on depressive symptoms differed between European regions with stronger increases in Southern Europe. These regional differences were attenuated when accounting for inequalities in financial resources and loneliness.

DISCUSSION

The findings support Attachment Theory, which postulates that it's mainly the loss of such an emotionally strong tie as one's spouse that leads to psychological distress following widowhood. Moreover, one can conclude that some contexts in Europe provide conditions that buffer the negative effect of widowhood on mental health at least to some extent.

Risk factors for depressive symptoms among older Chinese adults: A meta-analysis

BACKGROUND

The study aims to explore the risk factors for depressive symptoms among older Chinese adults.

METHODS

PubMed, PsycINFO, Cochrane Library, EMbase, Google Scholar, Chinese National Knowledge Infrastructure (CNKI), Chinese BioMedical Literature Database, and Wanfang data were searched for potentially relevant articles published before September 1^st, 2019. Stata/IC 15 was used to perform a meta-analysis and subgroup analysis to compute the pooled odds ratio.

RESULTS

The retrieve strategy yielded 11 studies that met the inclusion criteria. The total sample size was 31528 across seven districts, including Mainland China, Hong Kong, and Taiwan. Patients with depression were included in the sample size. Fourteen risk factors were extracted for at least having two or more relative studies. The combined odds ratio ranged from 0.70 to 4.75. Female, poor self-perceived financial condition, single, average and poor self-perceived health status, diabetes, adverse life events, poor social support, two or more numbers of cardiovascular diseases, and functional disability are risk factors of depressive symptoms among older Chinese adults. Fair or good social support is a protective factor.

LIMITATIONS

These findings may be somewhat limited by (i) quality of studies included, (ii) a finite number of studies met inclusion criteria.

CONCLUSIONS

Despite the methodological limitations of the studies and this meta-analysis, average or poor self-perceived health status, functional disability, poor social support, poor self-perceived financial condition, negative life events, and diabetes appear to be significant risk factors for depressive symptoms among the aged population in China. Social support can mitigate depressive symptoms.

Comorbid depression associated with non-routine discharge following craniotomy for low-grade gliomas and benign tumors - a nationwide readmission database analysis

PURPOSE

Prior studies have demonstrated elevated rates of depression in patients with malignant brain tumor; however, the prevalence and effect on surgical outcomes in patients with low-grade gliomas (LGG) and benign brain tumors (BBT) remain unknown. Readmission and non-routine discharge, which includes discharge to skilled nursing, rehabilitative, and other inpatient facilities, are well-established quality of care indicators. We sought to analyze the association between comorbid depression and non-routine discharge, readmission, and other post-operative inpatient outcomes in patients with LGG and BBT.

METHODS

The Nationwide Readmissions Database from 2010 to 2014 was retrospectively queried to select for surgically treated patients with LGG and BBT. Multivariable logistic regression models adjusting for patient and hospital characteristics were used to determine the effects of comorbid depression on post-operative outcomes. Interaction of gender and depression on non-routine disposition was analyzed.

RESULTS

We identified 31,654 craniotomies for resection of BBT and LGG (2010-2014). The majority of patients (64.1%) were female. The rate of depression comorbid with BBT and LGG was 11.9%. Depression was associated with non-routine discharge after surgery (OR 1.19, p 0.0002*), but was not associated with increased morbidity, mortality, or readmission at 30 or 90 days. The rate of comorbid depression was higher among female than male patients (14.0 vs. 8.0%). Depression in males was associated with a 38% increased likelihood of non-routine disposition (p = 0.0002*), while depression in females was associated with a 13% increased likelihood of non-routine disposition (p = 0.03*).

CONCLUSION

Depression is prevalent in patients with LGG and BBT and is associated with increased risk of non-routine discharge following surgical intervention. The increased likelihood of non-routine disposition is greater for males than that for females. Awareness of the risk factors for depression may aid in early screening and intervention and improve overall patient outcomes.

Visualizing Inequality in Health and Socioeconomic Wellbeing in the EU: Findings from the SHARE Survey

The main objective of this paper is to visualize profiles of older Europeans to better understand differing levels of dependency across Europe. Data comes from wave 6 of the Survey of Health, Ageing and Retirement in Europe (SHARE), carried out in 18 countries and representing over 124 million aged individuals in Europe. Using the information of around 30 mixed-type variables, we design four composite indices of wellbeing for each respondent: self-perception of health, physical health and nutrition, mental agility, and level of dependency. Next, by implementing the k-prototypes clustering algorithm, profiles are created by combining those indices with a collection of socio-economic and demographic variables about the respondents. Five profiles are established that segment the dataset into the least to the most individuals at risk of health and socio-economic wellbeing. The methodology we propose is wide enough to be extended to other surveys or disciplines.

Depression in women and men, cumulative disadvantage and gender inequality in 29 European countries

Macro-sociological theories stress the contribution of gender inequality to this gender gap in depression, while cumulative advantage/disadvantage theory (CAD) reminds us that mental health inequalities accumulate over the life course. We explore the complementarity of both perspectives in a variety of European countries using data of the European Social Survey (2006 2012, 2014, N of countries = 29; N of men = 53,680 and N of women = 63,103) and using an 8-item version of the CES-D. Results confirm that the relevance of gender stratification for the mental health of women and men in Europe depends on age. The gender gap is nearly absent amongst adults in their twenties in the most gender equal countries, while an impressive gender gap is present amongst older adults in gender unequal countries, in accordance with CAD theory. These effects occur on top of the mental health consequences of taking up work and family roles at various life stages. The convergence of the results predicted by gender stratification and cumulative disadvantage theories strengthen the case for the link between gender, disadvantage and depression.

The impact of laughter yoga on depression and anxiety among retired women: a randomized controlled clinical trial

Recently, laughter yoga (LY) has been introduced for managing depression and anxiety. This study aimed to investigate the impact of LY on depression and anxiety among retired women in city of Bojnurd, Iran, 2018. Sixty-six retired women were randomly assigned to intervention and control groups. Intervention group received LY twice weekly for 8 weeks; control group had their routine daily activities. Depression and anxiety levels were measured at study initiation, week 4, and week 8 in both groups. Results showed significant difference in the pattern of depression (p <.001) and anxiety (p <.001) scores within and between groups. LY could be an effective intervention in reducing depression and anxiety among retired women.

Sex difference in prevalence of depression after stroke

OBJECTIVE

This study investigated the sex difference in prevalence of depression at 90 days after first-ever stroke.

METHODS

Patients with first-ever stroke (n = 786) were identified from the population-based Brain Attack Surveillance in Corpus Christi project (2011-2016). Poststroke depressive symptoms were assessed by the 8-item Patient Health Questionnaire, and prestroke depression status (history and medication use) was self-reported. Logistic regression was used to examine the association between sex and depression after stroke, and effect modification by prestroke depression status, accounting for missing data.

RESULTS

Women were more likely to have a history of and be on medication for depression at the time of stroke than men (p < 0.001). Prevalence of depression at 90 days was 28.2% for men (95% confidence interval [CI], 23.7%-32.8%) and 32.7% for women (95% CI, 27.8%-37.5%). The age-adjusted odds ratio (OR) of depression after stroke comparing women and men was 1.34 (95% CI, 0.97-1.85), and fully attenuated after adjustment for sociodemographic, stroke, and prestroke characteristics. Effect modification by prestroke depression status was present (p = 0.038). Among participants on medication for depression at the time of stroke, women were significantly less likely to have depression at 90 days compared with men (OR, 0.39; 95% CI, 0.16-0.96), whereas significant sex differences were not noted among those with and without a depression history.

CONCLUSION

The sex difference in prevalence of depression at 90 days after first-ever stroke was not significant overall, but varied by prestroke depression status. Interventions to address and prevent poststroke depression are needed, particularly among those with prestroke depression but not undergoing treatment for depression at stroke onset.

A survey-wide association study to identify youth-specific correlates of major depressive episodes

BACKGROUND

Major depressive disorder is a common disease with high mortality and morbidity worldwide. Though peak onset is during late adolescence, the prevalence of major depressive disorder remains high throughout adulthood. Leveraging an association study design, this study screened a large number of variables in the 2017 National Survey on Drug Use and Health to characterize differences between adult and youth depression across a wide array of phenotypic measurements.

METHODS

All dichotomous variables were manually identified from the survey for association screening. Association between each dichotomous variable and past-year major depressive episode (MDE) occurrence was calculated as an odds ratio for adults (≥18 years) and youth (12-17 years), and tested for significance with Fischer's exact test. Logarithm of the calculated odds ratios were plotted and fitted to a linear model to assess correlation between adult and youth risk factors.

RESULTS

Many of the screened variables showed similar association between past-year depressive episode occurrence in youth and adults; Lin's concordance correlation coefficient between adult and youth associations was 0.91 (95% CI 0.89-0.92). Differentially associated variables were identified, tracking: female sex, alcohol use, cigarette use, marijuana use, Medicaid/CHIP coverage, cognitive changes due to a mental, physical or emotional condition, and respondents' identification of a single depressive event as the worst experienced.

CONCLUSIONS

While some youth-specific correlates of major depressive episodes were identified through screening, including some novel associations, most examined variables showed similar association with youth and adult depression. Further study of results is warranted, especially concerning the finding of increased association between marijuana use and depressive episodes in youth.

The gender health gap in Europe's ageing societies: universal findings across countries and age groups?

We provide a systematic country and age group comparison of the gender gap in several generic health indicators and more specific morbidity outcomes. Using data from the Survey of Health, Ageing and Retirement (SHARE), we examined the gender gap in the prevalence of poor self-rated health, chronic health conditions, activity limitations, multimorbidity, pain, heart attacks, diabetes, and depression in three age groups (50–64, 65–79, and 80+) based on linear probability models with and without adjustment for covariates. While women were typically disadvantaged regarding poor self-rated health, chronic health conditions, activity limitations, multimorbidity, pain, and depression, men had a higher prevalence of heart attacks and diabetes. However, the gender gap’s magnitude and sometimes even its direction varied considerably with some age trends apparent. Regarding some health indicators, the gender gap tended to be higher in Southern and Eastern Europe than in Western and Northern Europe. All in all, the presence of a gender health gap cannot be regarded as a universal finding as the gap tended to widen, narrow or even reverse with age depending on the indicator and country.

Gender-specific associations between activities of daily living disability and depressive symptoms among older adults in China: Evidence from the China Health and Retirement Longitudinal Study

PURPOSE

To evaluate the associations between BADL/IADL disability and depressive symptoms from the perspective of gender among older adults in China.

METHODS

This cross-sectional study used the data from the second wave of the China Health and Retirement Longitudinal Study (CHARLS). The sample included 3463 older adults aged 60 years and older across China. Multivariable logistic regression models were conducted.

RESULTS

Among 3463 older adults, 1240 (35.8%) were classified as depressed, the prevalence of BADL and IADL disabilities were 756 (21.8%) and 1194 (34.5%), respectively. After controlling for covariates, BADL/IADL disability was significantly associated with an increased risk of depression prevalence both in men and women among older adults. Compared with IADL independent, IADL disability was about two times more likely to develop depressive symptoms in men (OR = 2.165, 95% CI = 1.661-2.822), which was much higher than that in women (OR = 1.748, 95% CI = 1.415-2.160). In contrast, the odds of being depressed for women with BADL disability (OR = 1.824, 95% CI = 1.447-2.299) were much higher than the odds for men with BADL disability (OR = 1.791, 95% CI = 1.348-2.379).

CONCLUSIONS

Older adults with BADL/IADL disability were more likely to have depressive symptoms both for men and women. However, the associations between depressive symptoms and BADL/IADL disability were different in gender. Our results suggest that differential institutional care service and appropriate strategies for improvement in mental health are required.

Do gender differences in housework performance and informal adult caregiving explain the gender gap in depressive symptoms of older adults?

We assess whether gender differences in domestic time-use, including informal adult caregiving and housework, explain the gender gap in depression among older adults. Using data from the Panel Study of Income Dynamics, we model depressive symptoms as a function of informal adult caregiving and housework. The analytic sample includes 539 men and 782 women. Findings suggest informal adult caregiving is associated with increased depressive symptoms for women (p < .05) and men (p < .05). Time spent on housework is associated with decreased depressive symptoms for women and female caregivers (p < .01). Women may experience elevated depressive symptoms relative to men despite their domestic time-use.

Gender, mental health and ageing

This article presents a broad narrative review of the epidemiological evidence on how and why the mental health of older adults varies by gender. We draw upon international research literatures spanning gerontology and population mental health, as well as major reports from global health agencies. Compared with older men, older women are more likely to experience common mental disorders such as depression and anxiety, although the gender gap is smaller than it is at younger ages. In contrast, the mortality-related impacts of poor mental health, including suicide, are more severe for older men. These gendered patterns vary by country and other social contexts. Factors proposed to account for these findings include cultural and social norms, differentiation of gender roles, disadvantage and (dis)empowerment across the life course, and the coping styles of older men. However, little research has explicitly tested these explanations. Research to date has overwhelmingly focused on identifying differences in the mental health of older men and women. Notably, most studies have been restricted to binary comparisons, lacking the data to disentangle sex and gender dynamics, and few studies have examined the mental health of minority gendered adults in later life. Finally, there remains a need for high-quality population-based research into the mental health of those aged over 80 that includes coverage of people living in residential aged care settings.

Partner's depression and quality of life among older Europeans

We aim to study among European older adults (after age 50) if partner's mental health influences the individual's well-being. A sample of married or with registered partnership couples that live together, from the latest wave of the Survey of Health, Ageing and Retirement in Europe (SHARE) is considered. More specifically, we use logistic regressions to determine the impact that partner's mental health has on an individual well-being. Besides, personal health and socio-demographic characteristics are also analysed. Differences by gender have been also considered. We shed new light on the factors determining well-being. The empirical findings show that there are important spillover effects from individual's mental health to the well-being of their partners within households (OR = 1.51; 95% C.I 1.43, 1.59). Our results show utility and empathy between couples, regardless of being a man or a woman. Further, once controlled by the individual traditional factors (age, education or labour status), the interdependence of the closest environment is shown. These findings play a very important role in explaining the public policies that consider the social perspective of well-being in general, as well as mental health policies in particular.

Gender differences in post-stroke depression: A longitudinal analysis of prevalence, persistence and predictive value of known risk factors

Post-stroke depression (PSD) is the most frequent psychiatric condition after stroke with a prevalence of approximately 33%. In the general population, depression is consistently reported to be more frequent in women than in men. Evidence about gender differences in PSD remains inconclusive and it is unknown if established risk factors exert gender-specific influence. The authors examined gender differences in PSD prevalence, persistence and influence of established risk factors using χ ²- and Welch's t-tests and continuous-time structural equation modelling (CT-SEM). Patients (N = 301) from the longitudinal Berlin-PSD-study were assessed six weeks (baseline), and up to four times during the first 2.5 years post-stroke using DSM-5 depression criteria and the Geriatric Depression Scale (GDS). Established risk factors were assessed at baseline. Women showed higher PSD prevalence and severity at baseline (p < .01) but not thereafter (p ≥ .43). CT-SEM analysis revealed that known risk factors predicted depression, yet predictive value and persistence did not differ between genders. Our results showed that established PSD risk factors influence both genders to a similar extent and that in contrast to depression in the general population, gender differences in PSD prevalence and severity disappeared within six months post-stroke. Thus, for reasons yet to be deciphered, gender differences in PSD appear to be time-dependent after stroke.