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Loneliness and quality of life in older adults: the mediating role of depression
- Authors:
- AHADI Batool, HASSANI Bentolhoda
- Journal article citation:
- Ageing International, 46(3), 2021, pp.337-350.
- Publisher:
- Springer
- Place of publication:
- New York
This study's objective was to investigate the mediating role of depression in the relationship between loneliness and older adults' quality of life. Promoting the quality of life in individuals is one of the main issues that is consistently emphasized by the World Health Organization. The importance of this issue doubles, especially in older ages. Many elders face new challenges in this period and do not have access to their supportive resources as correctly as the past. Service providers for older people usually concentrate on providing physical facilities for them; however, psychological factors, with the same proportion, might affect the promotion or subsidence of older adults' quality of life. Two hundred and sixty-three participants (M = 68.99 years, SD = 7; 43% females) completed self-reported measures of loneliness, depressive symptoms, and quality of life. The researchers used Structural equation modeling (SEM) to analyze data. Older adults people who had a higher sense of loneliness and depression reported lower quality of life. The results also showed that depression had a partial mediator role in the relationship between loneliness and life quality. With the expansion of previous studies that showed a significant relationship between loneliness, depression, and quality of life, this study revealed that loneliness in the older adults directly and indirectly (through the incidence of depressive symptoms) lowered the quality of life. (Edited publisher abstract)
The impact of caregiver's depressive symptoms on trajectories of cognitive function in older adults with functional limitations
- Authors:
- JIANG Nan, SUN Qian, LOU Vivian W.Q.
- Journal article citation:
- International Journal of Geriatric Psychiatry, 36(8), 2021, pp.1284-1294.
- Publisher:
- Wiley
Objectives: Family caregivers are important to older adults' health, but few studies have examined how caregivers' mental health is associated with older adults' cognitive function. This study examined the trajectories of cognitive function of older adults and whether caregivers' depressive symptoms shape the pattern of cognitive function trajectories. Methods: This 6-year longitudinal sample consisted 1188 older adults aged ≥75 years with deficits in activities of daily living (ADL) and their family caregivers in Shanghai, China (Rounds 1–3). Cognitive function trajectories were identified based on an enhanced group-based trajectory modeling that accounted for nonrandom attrition. Multinomial logistic regression tested the association between caregivers' depressive symptoms and older adults' cognitive function trajectory. Results: Three trajectory groups were identified: a “newly onset” group (50.4%) had an increased risk of being cognitive impaired during the 6-year period; a “never” group (46.2%) remained cognitive active; and a “chronic” group was largely persistently cognitive impaired (3.4%). Caregivers' depressive symptoms increased the relative risk of having the “onset” or “chronic” versus “never” trajectory. Among the four dimensions of depressive symptoms, only somatic complaints were associated with a higher risk of the “newly onset” trajectory in 6 years. Conclusion: The progression of cognitive function among older adults with deficits in ADL followed three distinct trajectories during a 6-year period. Addressing the mental health of caregivers may prevent or delay progression of cognitive impairment among older adults. (Edited publisher abstract)
Social support and depressive symptoms among trauma-impacted older adults
- Authors:
- CHO Seungjong, BULGER Morgan
- Journal article citation:
- Journal of Evidence-Based Social Work, 18(4), 2021, pp.371-378.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Purpose: The present study investigates the association between social support and depressive symptomatology among older adults who have been impacted by trauma. Previous studies have not sufficiently explored this topic to date. Method: The current study analyzed public-use data from the 2012 Health and Retirement Study (N = 4,195), focusing specifically on community-dwelling older adults (> 50). They had at least one traumatic event in their lifetime. Results: This study found that higher levels of social support were significantly associated with lower levels of depressive symptoms after controlling for life satisfaction, age, gender, race, ethnicity, and education. Discussion and Conclusion: The recent emergence of trauma-informed research has consistently emphasized the importance of social interaction for mental health. The current study shows that social support can reduce depressive symptoms of those who have experienced trauma. (Edited publisher abstract)
Are older adults also at higher psychological risk from COVID-19?
- Authors:
- GARCIA-PORTILLA Paz, et al
- Journal article citation:
- Aging and Mental Health, 25(7), 2021, pp.1297-1304.
- Publisher:
- Taylor and Francis
Objective: Given the lack of information on the psychological impact of COVID-19 on people aged ≥60, we aimed to describe their psychological responses to this pandemic and lockdown situation and compare them with those under 60 years of age. Methods: Secondary analysis of a larger online cross-sectional study designed to determine the psychological impact of the COVID-19 pandemic and lockdown across Spain. We analyzed a total of 1690 respondents aged ≥60 years and compared them with 13,363 respondents under 60 years of age. We employed the Depression, Anxiety, and Stress Scale and the Impact of Event Scale to evaluate psychological responses. Results: In all, 52.6% of women and 34.3% of men were found to be probable cases of any emotional distress (p < 0.001). In both sexes, the most common psychological response was avoidance behavior (34.7% and 23.8%, respectively), followed by depression (28.5 and 14.2%). Older women and men were considered probable cases of any emotional distress less often than younger ones (women: 52.6% vs. 72.3%, p < 0.001; men: 34.3% vs. 50.6%, p < 0.001). Finally, the results of the binary logistic regression showed that only depressive and stress responses are psychological factors associated with age group [age ≥ 60 years, O.R. = 0.617 (95% CI = 0.501 − 0.759) and 0.437 (95% CI = 0.334 − 0.573), respectively]. Conclusion: Contrary to our hypothesis and despite the high percentage of emotional distress we found in older adults, especially women, they are actually at lower risk of developing depressive and stress consequences from COVID-19 and lockdown than those under 60 years of age. That said, we believe our results highlight the need for expert guidance in this age group, especially older women living alone. (Edited publisher abstract)
Towards an active and happy retirement? Changes in leisure activity and depressive symptoms during the retirement transition
- Authors:
- HENNING Georg, et al
- Journal article citation:
- Aging and Mental Health, 25(4), 2021, pp.621-631.
- Publisher:
- Taylor and Francis
Objectives: Retirement is a major life transition in the second half of life, and it can be associated with changes in leisure activity engagement. Although theories of retirement adjustment have emphasized the need to find meaningful activities in retirement, little is known about the nature of changes in leisure activity during the retirement transition and their association with mental health. Methods: Based on four annual waves of the ‘Health, Aging and Retirement Transitions in Sweden’ study, we investigated the longitudinal association of leisure activity engagement and depressive symptoms using bivariate dual change score models. We distinguished intellectual, social, and physical activity engagement. Results: We found increases in all three domains of activity engagement after retirement. Although level and change of activity and depressive symptoms were negatively associated, the coupling parameters were not significant, thus the direction of effects remains unclear. Conclusion: The results highlight the need to consider the role of lifestyle changes for retirement adjustment and mental health. (Edited publisher abstract)
Effects of transient and chronic loneliness on major depression in older adults: a longitudinal study
- Authors:
- MARTIN-MARIA Natalia, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 36(1), 2021, pp.76-85.
- Publisher:
- Wiley
Objectives: The number of older adults is rapidly rising globally. Loneliness is a common problem that can deteriorate health. The aims of this work were to identify different types of loneliness (transient and chronic) and to assess their association with depression over time. Methods: A nationally representative sample from the Spanish population comprising 1190 individuals aged 50+ years was interviewed on three evaluations over a 7‐year period. The UCLA Loneliness Scale was used to measure loneliness. While chronic loneliness was defined as the presence of loneliness across all three waves, transient loneliness expressed the presence of loneliness in one wave only. A 12‐month major depressive episode was assessed at each interview. After confirming the cross‐sectional relationship, a multilevel mixed‐effects model was used to examine the association between loneliness and depression. Results: Almost a quarter of individuals felt lonely and one out of 10 presented depression at baseline. Of the sample, 22.78% showed transient loneliness, while 6.72% presented the chronic type. People experiencing chronic loneliness were at a higher risk of presenting major depression (OR = 6.11; 95% CI = 2.62, 14.22) than those presenting transient loneliness (OR = 2.22; 95% CI = 1.19, 4.14). This association varied over time and was stronger at the first follow‐up than at the second one. Conclusions: Focusing on loneliness prevention could reduce the risk of depression. Chronic loneliness is a public health problem that should be addressed through the full participation of the political, social, and medical sectors. (Edited publisher abstract)
Supporting frail older people with depression and anxiety: a qualitative study
- Authors:
- FROST Rachael, et al
- Journal article citation:
- Aging and Mental Health, 24(12), 2020, pp.1977-1984.
- Publisher:
- Taylor and Francis
Objectives: Depression and anxiety are common in later life, particularly when people are frail. This leads to reduced quality of life, faster decline in physical health and increased health/social care use. Available treatments are commonly not tailored to people with frailty. We explored frail older peoples’ experiences of depression and/or anxiety and how services could be adapted to their needs. Methods: Semi-structured interviews with 28 older people in the UK purposively sampled for practice location and severity of frailty and anxiety/depression. We asked about symptoms, interactions with physical health, help-seeking, treatments and what might help in future. We audio-recorded and transcribed interviews, using thematic analysis to inductively derive themes. Results: Frail older people had low expectations of their wellbeing at this point in life due to multiple physical health issues and so anxiety and mild depressive symptoms were normalised. There was a particular reluctance and uncertainty regarding help-seeking for anxiety. Treatments were considered appropriate where they aligned with coping skills developed over their lifetime, and facilitated independence and problem-solving skills. Most older people felt their knowledge of mental health was limited and relied upon information about and endorsement of therapies from an expert. This was usually their GP, but access was often problematic. Online methods of accessing information and therapies were not popular. (Edited publisher abstract)
Inclusion/exclusion criteria in late life depression antidepressant efficacy trials
- Authors:
- ZIMMERMAN Mark, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 32(9), 2017, pp.1009-1016.
- Publisher:
- Wiley
Objective: The generalisability of antidepressant efficacy trials (AETs) has been questioned. No studies have examined the inclusion/exclusion criteria used in placebo-controlled studies of late life depression and compared them to the criteria used in non-late life AETs. Method: The authors conducted a comprehensive literature review of placebo-controlled AETs published from January, 1995 through December, 2014. They compared the inclusion/exclusion criteria used in the 18 studies of late life depression to those used in non-late life depression. Results: There were nine inclusion/exclusion criteria that were used in more than half of the late life depression AETs: minimum severity on a symptom severity scale (100.0%), significant suicidal ideation (77.8%), psychotic features during the current episode of depression or history of a psychotic disorder (94.4%), history of bipolar disorder (77.8%), diagnosis of alcohol or drug abuse or dependence (83.3%), presence of a comorbid nondepressive, nonsubstance use Axis I disorder (55.6%), episode duration too short (66.7%), and an insufficient score on a cognitive screen (88.3%) or the presence of a cognitive disorder (55.6%). There were some differences between the late life and non-late life depression studies—use of a screening measure of cognitive functioning, presence of a cognitive disorder such as dementia, and the minimum depression severity cutoff score required at baseline. Conclusions: The inclusion/exclusion criteria in AETs of late life depression were generally similar to the criteria used in non-late life depression (Edited publisher abstract)
Association between depression and resilience in older adults: a systematic review and meta-analysis
- Authors:
- AVILA Maria Priscila Wermelinger, LUCCHETTI Alessandra Lamas Granero, LUCCHETTI Giancarlo
- Journal article citation:
- International Journal of Geriatric Psychiatry, 32(3), 2017, pp.237-246.
- Publisher:
- Wiley
Objective: The objective of this study is to determine whether resilience is associated with depressive symptoms in geriatric populations. Method: A systematic review and meta-analysis were performed (up to March 2015) following the Preferred Reporting Items for Systematic Reviews and Meta-analysis recommendations on three databases (PubMed/Medline, Scopus, and Web of Science) with no language restrictions, using a Boolean expression. For inclusion in the study, articles had to assess the older population (60 years or older), assess both depressive and resilience symptoms, and investigate the association between these two variables. Articles not employing validated resilience and depression scales or assessing populations younger than 60 years were excluded. The quality of the selected studies was assessed using the Quality Assessment Tool for Quantitative Studies. Results: A total of 1094 articles were retrieved from the three databases, 367 of which were duplicates and therefore excluded, giving 727 articles for analysis. Of these articles, seven met the eligibility criteria. All of the included articles were observational and cross-sectional, found an inverse relationship between depression and resilience, and were conducted in three countries: the USA, China, and Belgium. A moderate inverse correlation was found on the meta-analysis (r = −0.35, 95% confidence interval: −0.41 to −0.28). Conclusion: Few studies were found on this subject in the older population. An association between greater resilience and less depressive symptomatology was identified, albeit based on cross-sectional studies. These results highlight the need for further studies in the area and the importance of fostering the use of interventions to promote resilience in older adults as a means of preventing and managing depressive symptoms in this population. (Publisher abstract)
Prospective associations between sedentary behaviour and incident depressive symptoms in older people: a 15-month longitudinal cohort study
- Authors:
- TSUTSUMIMOTO Kota, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 32(2), 2017, pp.193-200.
- Publisher:
- Wiley
Objective: This study aimed to investigate whether sitting time, as a form of sedentary behaviour, is related to incident depressive symptoms in older people. Methods: This study included 3503 participants (mean age 71.7 years, 50.1% female) from the ‘Obu Study of Health Promotion for the Elderly' cohort study. At baseline and then 15 months later, the participants reported their status of depressive symptoms using the 15-item Geriatric Depression Scale. During the baseline assessment, the participants were also asked about their sedentary behaviour on weekdays over the past 7 days and, from there, categorised into three groups (<240, 240–480, ≥480 min/day). Demographic data and the other health behaviours were also assessed at the baseline. Results: Cross-sectional analysis revealed that 437 participants (12.0%) had depressive symptoms. In a prospective analysis, the logistic regression model revealed that the odds ratio for depressive symptom incidence was higher in participants who, at baseline, spent 480 min or more per day sitting, and in those who spent 240-480 min in comparison with those who spent less than 240 min. Conclusions: Sedentary behaviour significantly affects the risk of incident depressive symptoms. Further research is needed to develop an intervention strategy to manage depressive symptoms, as the second most common cause of burden of disease among older adults. (Edited publisher abstract)