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Screening for depression in older adults on an acute medical ward: the validity of NICE guidance in using two questions
- Authors:
- ESIWE Collins, et al
- Journal article citation:
- Age and Ageing, 44(5), 2015, pp.771-775.
- Publisher:
- Oxford University Press
Background: Depression is common in older people in general hospital settings and associated with poor outcomes. This study aimed to evaluate the validity of two screening questions recommended by the UK National Institute for Health and Clinical Excellence (NICE). Methods: One hundred and eighteen patients aged over 65 years, admitted to acute medical wards at a teaching hospital, were interviewed in a standardised manner using relevant sections of the Present State Examination—Schedules for Clinical Assessment in Neuropsychiatry to identify depression according to ICD-10 criteria. Subsequently, participants completed the two depression screening questions and the 15-item version of the Geriatric Depression Scale (GDS-15). Results: A threshold of one or more positive responses to the two NICE depression screening questions gave a sensitivity of 100%, specificity of 71%, positive predictive value (PPV) of 49% and negative predictive value (NPV) of 100%. The GDS-15 optimal cut-off was 6/7 with a sensitivity of 80%, specificity of 86%, PPV of 62% and NPV of 94%. A two-stage screening process utilising the NICE two questions followed by the GDS-15 with these cut-offs gave a sensitivity of 80%, specificity of 91%, PPV of 71% and NPV of 94%. Conclusion: The two depression questions perform well as an initial screening process for non-cognitively impaired older people in the acute medical setting. A positive response to either question would indicate that further assessment is required by a clinician competent in diagnosing depression in this population, or the possible use of a more detailed instrument such as the GDS-15 to reduce the number of false-positive cases. (Publisher abstract)
Physical exercise for late-life major depression
- Authors:
- MURRI M. Belvederi, et al
- Journal article citation:
- British Journal of Psychiatry, 207(3), 2015, pp.235-242.
- Publisher:
- Cambridge University Press
Aims: Interventions including physical exercise may help improve the outcomes of late-life major depression, but few studies are available. This study aimed to investigate whether augmenting sertraline therapy with physical exercise leads to better outcomes of late-life major depression. Method: Primary care patients (465 years) with major depression were randomised to 24 weeks of higher-intensity, progressive aerobic exercise plus sertraline (S+PAE), lower-intensity, non-progressive exercise plus sertraline (S+NPE) and sertraline alone. The primary outcome was remission (a score of ≤10 on the Hamilton Rating Scale for Depression). Results: A total of 121 patients were included. At study end, 45% of participants in the sertraline group, 73% of those in the S+NPE group and 81% of those in the S+PAE group achieved remission (P = 0.001). A shorter time to remission was observed in the S+PAE group than in the sertraline-only group. Conclusions: Physical exercise may be a safe and effective augmentation to antidepressant therapy in late-life major depression. (Publisher abstract)
The relationship between depression and frailty syndrome: a systematic review
- Authors:
- BUIGUES Cristina, et al
- Journal article citation:
- Aging and Mental Health, 19(9), 2015, pp.762-772.
- Publisher:
- Taylor and Francis
Objectives: Frailty is a geriatric syndrome characterised by the clinical presentation of identifiable physical alterations such as loss of muscle mass and strength, energy and exercise tolerance, and decreased physiological reserve. Frailty and depressive symptoms are common issues facing older adults and may be associated. It is not clear if the depression facilitates the appearance of frailty syndrome or vice versa or these two coexist independently in the same individuals. Method: Searches were conducted in several databases (Embase, PubMed, CINAHL, Scopus, and PsycINFO) for papers published between November 2003 to February 2014 about frailty syndrome and depression in people aged 65 and older. The reference lists of from the articles retrieved were also pearled in order to identify any which may have been missed in the initial search. Two independent reviewers extracted descriptive information on the prevalence and co-occurrence of frailty and depression in older individuals and of frailty criteria among depressed patients. Results: Depression and frailty occur in a significant proportion of frail older individuals. Common pathophysiological alterations and biomarkers in the two syndromes have been recently described. Conclusion: Studies on the causal relationship between the two syndromes are clearly necessary in the future. (Edited publisher abstract)
Moderating effect of communication difficulty on the relationship between depression and pain: a study on community-dwelling older adults in Hong Kong
- Authors:
- CHAN Wallace Chi Ho, KWAN Chi Wai, CHI Iris
- Journal article citation:
- Aging and Mental Health, 19(9), 2015, pp.829-834.
- Publisher:
- Taylor and Francis
Objectives: This study examined the relationship between depression and pain, and the moderating effect of communication difficulty on this relationship, among community-dwelling older adults in Hong Kong. Method: Logistic regression was used to analyse secondary data regarding 12,402 Chinese older adults applying for long-term care service in Hong Kong in 2012. Results: Approximately 30% of participants were depressed and 37% experienced communication difficulty. Depression was associated with increased pain. Communication difficulty was found to moderate the relationship between depression and pain. Pain scores increased more when individuals who experienced communication difficulty reported being depressed, compared to those who did not experience communication difficulty. Conclusion: The moderating effect of communication difficulty may be explained by the interaction between depression and communication difficulty. Participants who were depressed and concurrently experienced communication difficulty may be more likely to catastrophise their pain and may tend to report or experience more pain. Health care professionals need to be aware of the different effects of communication difficulty on the pain experiences of older adults. Psychosocial intervention may be provided to minimize older adults’ communication barriers to pain management. (Edited publisher abstract)
Cognitive behavioural therapy for older adults with depression: a review
- Authors:
- JAYASEKARA Rashika, et al
- Journal article citation:
- Journal of Mental Health, 24(3), 2015, pp.168-171.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
Aims: This review examines the current use of cognitive behavioural therapy (CBT) and its effect on older adults with depression. Method: A web-based literature search was performed to identify original research articles published from 2000 to 2013 using a three-step search strategy. Results: Evidence indicates that cognitive behavioural therapies are likely to be efficacious in older people when compared with treatment as usual. This is consistent with the findings of several systematic reviews and meta-analyses undertaken across a wider age range. Conclusions: Given that many older adults with depression are reluctant to accept antidepressant medication or unable to tolerate their side effects, CBT can be used as an option in treating depression in older adults. (Edited publisher abstract)
Perceptions of giving support and depressive symptoms in late life
- Authors:
- BANGERTER Lauren R., et al
- Journal article citation:
- Gerontologist, 55(5), 2015, pp.770-779.
- Publisher:
- Oxford University Press
Purpose: Research shows that parents benefit psychologically from generativity, giving and caring for the next generation, but older adults' perceptions on giving support to their children are rarely if ever explored in these studies. The current study examines the association between the support that ageing parents give to one of their middle-aged offspring, their perception of this support as rewarding or stressful, and their levels of depressive symptoms. Design and Methods: The sample draws from The Family Exchanges Study and consisted of 337 older parents (mean age: 76) who were drawn from a larger study of middle-aged adults (i.e., target participants). Older parents reported tangible and nontangible forms of support given to the target middle-aged child and the extent to which they viewed providing such support as stressful and/or rewarding. Results: Significant interactions were found between tangible support and feelings of reward and between nontangible support and feelings of stress in explaining parental depressive symptoms. Parents who found giving support to be highly rewarding had lower levels of depressive symptoms when giving high amounts of tangible support. Conversely, parents who view giving support to be highly stressful had higher levels of depressive symptoms when they gave low amounts of nontangible support. Implications: Findings suggest older parents’ perceptions of supporting their offspring may condition how generativity affects their mental health. (Edited publisher abstract)
Meaning in Life and depressive symptoms: a person-oriented approach in residential and community-dwelling older adults
- Authors:
- VAN DER HEYDEN Karen, DEZUTTER Jessie, BEYERS Wim
- Journal article citation:
- Aging and Mental Health, 19(12), 2015, pp.1063-1070.
- Publisher:
- Taylor and Francis
In current society, an increasing population of older adults and a high prevalence of depressive symptoms in late life is noticeable. A possible protective resource is ‘Meaning in Life’. The objective of this study is to identify from a person-oriented view (a) Meaning in Life-profiles, based on Presence of Meaning and Search for Meaning dimensions, and (b) their associations with depressive symptoms. (Edited publisher abstract)
Life-space mobility and dimensions of depressive symptoms among community-dwelling older adults
- Authors:
- POLKU Hannele, et al
- Journal article citation:
- Aging and Mental Health, 19(9), 2015, pp.781-789.
- Publisher:
- Taylor and Francis
Objectives: To examine the association between life-space mobility and different dimensions of depressive symptoms among older community-dwelling people. Life-space mobility refers to the size of the spatial area in which a person moves in everyday life, including not only individuals’ ability to walk, but also other forms of mobility, such as using public transportation or driving a car. Methods: Cross-sectional analyses of baseline data of the ‘Life-Space Mobility in Old Age’ cohort study were carried out. The participants were community-dwelling women and men aged 75–90 years (N = 848). Data were gathered via structured interviews in participants’ home. Life-space mobility (the University of Alabama at Birmingham (UAB) Life-Space Assessment – questionnaire) and depressive symptoms (Centre for Epidemiological Studies Depression Scale, CES-D) were assessed. Other factors examined included sociodemographic factors, difficulties walking 500 m, number of chronic diseases and the sense of autonomy in participation outdoors (subscale of Impact on Participation and Autonomy questionnaire). Results: Poorer life-space mobility was associated with higher prevalence of different dimensions of depressive symptoms. The associations were partially mediated through walking difficulties, health and the sense of autonomy in participation outdoor activities. Conclusion: Poorer life-space mobility interrelates with higher probability for depressive symptoms, thus compromising older adults’ mental wellbeing. A focus on older adults’ life-space mobility may assist early identification of persons, who have elevated risk for depressive symptoms. The association between life-space mobility and depressive symptoms should be studied further utilising longitudinal study designs to examine temporality and potential causality. (Edited publisher abstract)
Health and wellbeing consequences of social isolation and loneliness in old age
- Authors:
- COURTIN Emilie, KNAPP Martin
- Publisher:
- NIHR School for Social Care Research
- Publication year:
- 2015
- Pagination:
- 3
- Place of publication:
- London
Summarises the findings of a scoping review which looked at literature on the impact of social isolation and loneliness on physical health, mental health and wellbeing in old age. Searches were conducted on nine databases, retrieving 11,736 articles, of which 128 were included in the scoping review. Almost all the studies reviewed found that isolation and loneliness has a detrimental effect on health. Depression and cardiovascular health were the most often researched outcomes, followed by well-being. Gaps in the evidence base were identified in both the use of health and social care by older people and on interventions to reduce loneliness and isolation. A lack of consistency in the definitions and measures of isolation and loneliness was also found, which limits the ability to compare findings between studies. (Edited publisher abstract)
Depression in older cat and dog owners: the Nord-Trøndelag Health Study (HUNT)-3
- Authors:
- ENMARKER Ingela, et al
- Journal article citation:
- Aging and Mental Health, 19(4), 2015, pp.347-352.
- Publisher:
- Taylor and Francis
Objective: Previous studies have shown that mental health among older people who live with animals could be improved, but contrary results exist as well. This study compared the self-rated depression symptoms of both female and male non-pet owners, cat owners, and dog owners. Method: Participants included 12,093 people between the ages of 65 and 101 in Norway. One thousand and eighty three participants owned cats and 814 participants owned dogs. Self-rated depression symptoms were measured using HADS-D, the scale of self-administered depression symptoms in HADS (Hospital Anxiety and Depression Scale). Results: The main results showed higher mean values on the HADS-D for cat owners than for both dog and non-pet owners. The latter group rated their depression symptoms the lowest. When dividing the ratings into low- and high-depression symptoms, the logistic regression analysis showed that it was more likely that males who owned cats perceived lower depression symptoms than females who owned cats. No interactions were recognised between pet ownership and subjective general health status, loneliness, or marital status. Conclusions: Results provide a window into the differences in health factors between older females and males who own cats and dogs in rural areas. Results from population studies like ours might increase the available knowledge base when using cats and dogs in clinical environments such as nursing homes. (Edited publisher abstract)