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Late life depression: a comparison of risk factors and symptoms according to age of onset in community dwelling older adults
- Authors:
- GALLAGHER Damien, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 25(10), October 2010, pp.981-987.
- Publisher:
- Wiley
Late onset depression is often associated with acquired organic pathology, with patients less likely to report a family history of depression. The majority of previous studies have been in hospital populations. This study addressed this question in a sample of community dwelling older adults. Participants included 89 subjects with GMS-AGECAT depression who were identified from a sample of 1,231 community dwelling adults aged 65 and over. Subjects were analysed across a range of aetiological and phenomenological variables according to age of onset of first depressive episode. Findings indicated that subjects with late onset depression were significantly less likely to report a family history of depression, were less likely to report previous hospitalisation for depression and had greater cognitive impairment. Late onset subjects were also less likely to report feelings of guilt or thoughts that life was not worth living in the previous month. While patients with late onset depression differed from early onset patients according to certain aetiological risk factors, there was not a distinctive profile of depressive symptomatology which might be considered clinically useful – findings consistent with previous hospital-based studies.
Depression and parkinsonism in older Europeans: results from the EURODEP concerted action
- Authors:
- BRAAM Arjan, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 25(7), July 2010, pp.679-687.
- Publisher:
- Wiley
The prevalence rate of depression among patients with Parkinson's disease has been estimated at 25%, although figures range between 7-76%. Some depressive symptoms can be understood as symptoms of parkinsonism. This study aimed to describe the strength of the association between parkinsonism and depression among community dwelling older Europeans, and to examine whether symptoms of depression differ between those with and without parkinsonism. The study used data from the EURODEP collaboration. Nine study centres from 8 western European countries provided data on depression, depressive symptoms, parkinsonism, functional disability and dementia diagnosis. Data were complete for 16,313 respondents, aged 65 and older; 306 (1.9%) reported or had signs of parkinsonism. The rate of depression was about twice as high among respondents with parkinsonism, also among those without functional disability. Overlap symptoms between parkinsonism and depression, were represented by motivation and concentration problems, appetite problems and especially the symptom of fatigue. However, principal component analysis showed that these overlap symptoms loaded on different factors of the EURO-D scale. The article concludes that depression is highly common in community dwelling older people with parkinsonism, even among those without functional disability. Although fatigue did not strongly relate to motivational symptoms, both types of overlap symptoms possibly trigger a final common pathway towards a full depressive syndrome.
Correlates and prevalence of depression in Chinese residents of nursing homes in Hong Kong and implications for services and intervention policies
- Authors:
- YEUNG Jerf W. K., CHING Kwok-Lai Yuk, CHUNG Annie
- Journal article citation:
- Ljetopis Socijalnog Rada, 17(3), 2010, pp.445-460.
- Publisher:
- University of Zagreb
- Place of publication:
- Zagreb
In 2006, 12% of the total population of Hong Kong was aged 65 or above; in 2031 the total number of elderly people is expected to reach 25% of the population there. Noting that depression is one of the most common mental health problems occurring among older people, this study investigated the prevalence of depression. It used questionnaires to gather information from a sample of 187 older people living in 2 nursing homes in the Kwun Tong district of Hong Kong. The results showed that 17.6% of the participants reported a manifest level of depression according to the Geriatric Depression Scale. The researchers found that personal financial strain and physical functioning impairment were significantly predictive of depression. However, strong support networks in the residential setting and high self-esteem were factors which reduced the likelihood of developing depression. The authors discuss the findings and their implications for services and intervention policies.
Depressive symptoms are associated with hospitalization, but not with mortality in the elderly: a population-based study
- Authors:
- LAUDISIO Alice, et al
- Journal article citation:
- Aging and Mental Health, 14(8), November 2010, pp.955-961.
- Publisher:
- Taylor and Francis
This article examines whether older people with depression might request more healthcare services. The aim of the study was to evaluate the association of depressive symptoms with hospitalisation and mortality rates in an unselected community-dwelling older population. The study assessed the association of the 30-items Geriatric Depression Scale (GDS) score with 1-year hospitalisation and mortality in all 344 subjects aged 75 and over living in Tuscania, Italy. This population had been enrolled in a national study of the genetic determinants of health status. All participants were visited by the study researchers at baseline and after a 1-year follow-up. Analyses were conducted using continuous, as well as categorical GDS score levels. The results showed that, after adjusting for potential confounders, depressive symptoms were associated in Cox regression modelling with hospitalisation but not with mortality. Increasing GDS score levels were associated with increasing risk of hospitalisation. Up to 39% of hospitalisations might be attributed to depression. The article concludes that depressive symptoms are not associated with increased mortality rates in general older populations. However, depressive symptoms represent a potentially reversible determinant of increased hospitalisation rates in these subjects, independent of the presence and severity of other medical conditions.
High incidence of clinically relevant depressive symptoms in vulnerable persons of 75 years or older living in the community
- Authors:
- DOZEMAN Els, et al
- Journal article citation:
- Aging and Mental Health, 14(7), September 2010, pp.828-833.
- Publisher:
- Taylor and Francis
Incidence rates of depressive symptoms and their predictors were examined in a vulnerable elderly population. In a community-based cohort, 651 vulnerable elderly people aged 75 and over were identified by means of the COOP-WONCA charts (Dartmouth Coop Functional Health Assessment Charts/World Organisation of Family Doctors). To study the incidence of clinically relevant symptoms of depression and their predictors, 266 people with no symptoms were selected and measured again for clinical relevant symptoms of depression at 6 and 18 months. Logistic regression analyses were applied to determine risk indicators. The results showed that after 18 months 48% of the elderly people had developed clinically relevant symptoms of depression. No specific risk factors were identified within this population. The article concludes that the incidence of depressive symptoms identified in the study were considerably higher than those previously found in elderly populations living in the community. A vulnerable health status is associated with a high risk of depressive symptoms.
Effectiveness of integrative and instrumental reminiscence therapies on depression symptoms reduction in institutionalized older adults: an empirical study
- Authors:
- KARIMI H., et al
- Journal article citation:
- Aging and Mental Health, 14(7), September 2010, pp.881-887.
- Publisher:
- Taylor and Francis
Reminiscence therapy is a psychological intervention which is specifically designed to address issues of particular relevance to older adults, such as depression. Integrative reminiscence is a process that promotes acceptance of self and others, conflict resolution and reconciliation, a sense of meaning and self-worth, and the integration of the present and past. Instrumental reminiscence involves remembering past plans and goal-directed activities, recalling how one dealt with past problems, and drawing from past experience to solve the present problems. The aim of this study was to examine the therapeutic effectiveness of these two types of reminiscence interventions for the treatment of depression in institutionalised older adults dwelling in a nursing home. These interventions were implemented in a short-term (6 sessions) group format and compared to an active social discussion control group. The participants were 29 residents of Kahrizak Nursing Home in Iran with depressive symptoms varying from mild to severe who were randomly assigned to 1 of the 3 groups. Analysis of changes from pre-test to post-test revealed that integrative reminiscence therapy led to statistically significant reduction in symptoms of depression in contrast with the control group. Although instrumental reminiscence therapy also reduced depressive symptoms, this improvement was not statistically significant. The study provides support for the effectiveness of integrative reminiscence therapy as an intervention for depressed older adults living in residential care settings.
The relationship between depression and loneliness among homebound older persons: does spirituality moderate this relationship?
- Authors:
- HAN Jina, RICHARDSON Virginia E.
- Journal article citation:
- Journal of Religion and Spirituality in Social Work, 29(3), July 2010, pp.218-236.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Forty housebound older adults, aged 60 to 87 years, who lived alone in urban areas in the south eastern United States completed questionnaires to examine the association between loneliness and depression in this population and whether spirituality moderates this association. Of the participants 55% were White and 45% African Americans. The findings showed that loneliness and depression were significantly related but that spirituality did not significantly moderate this association. However, the positive relationship between loneliness and depression was weaker among older persons who reported higher scores on the spirituality measure suggesting that spirituality might act as a buffer between loneliness and depression. Implications of the findings for social work practice are discussed. The authors suggest that further research is needed in this area. They comment that spirituality might prevent loneliness from turning into depression; it may also alleviate depression and therefore invigorate a depressed older person to initiate social interactions, decreasing loneliness.
PTSD in older bereaved people
- Author:
- O'CONNOR Maja
- Journal article citation:
- Aging and Mental Health, 14(6), August 2010, pp.670-678.
- Publisher:
- Taylor and Francis
The prevalence of post traumatic stress disorder (PTSD) and depression in recently bereaved older people and whether the loss of a spouse in old age can lead to PTSD was investigated. 276 bereaved older people (mean age 73 years) from the county of Aarhus in Denmark, contacted two months after bereavement, agreed to participate. The results from this group were compared with a control group of 276 married older people. Prevalence of PTSD and depression was measured through a self-report questionnaire. The results indicated that older bereaved people in the sample were four times more likely to have PTSD than those who were still married. The author concludes that this demonstrates that late life bereavement is a traumatic experience for some, and discusses the results and their implications.
Depression in Dutch homes for the elderly: under-diagnosis in demented residents?
- Authors:
- BALLER Menke, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 25(7), July 2010, pp.712-718.
- Publisher:
- Wiley
Although community-based studies have reported an increased incidence of depression among demented persons compared with non-demented persons, it is not clear whether this relationship also exists among institutionalised elderly persons. The aim of this study was to compare the prevalence of diagnosed depressive disorders and mood symptoms between demented and non-demented residents living in homes for the elderly. The study was done on 787 residents, 313 demented and 463 non-demented, with a mean age of 84 years in 16 homes for the elderly in the Netherlands. A cross-sectional analysis was performed of routine outcome measurements collected by trained nurse assistants using the Resident Assessment Instrument (RAI) between January 2007 and April 2008. The nurse assistants recorded all known medical diagnoses including dementia and depression, as well as a structured observation of the presence or absence of 11 mood symptoms over the last 3 days. The results showed that 24.6% of participants were diagnosed with a depressive disorder, with no statistically significant difference between demented and non-demented persons. Mood symptoms were more prevalent in demented residents. Among residents with mood symptoms, demented residents were less likely to be diagnosed with a depressive disorder than non-demented residents. The article concludes that the prevalence of diagnosed depressive disorders was comparable between demented and non-demented residents. However, demented residents suffered more from mood symptoms and may be at risk of under-diagnosis of depression.
Depression, cognitive reserve and memory performance in older adults
- Authors:
- MURPHY Mike, O’LEARY Eleanor
- Journal article citation:
- International Journal of Geriatric Psychiatry, 25(7), July 2010, pp.665-671.
- Publisher:
- Wiley
This study examined the relationship between education and leisure, as markers of cognitive reserve, depressive symptoms and memory performance in a sample of cognitively normal Irish older adults. It was hypothesised that greater education level and leisure activity and lower depressive symptoms would emerge as predictors of superior recall performance. The sample consisted of 99 community-dwelling volunteers (65 female, 34 male) living in the area of Cork city, Ireland. All participants were aged between 60 and 83 years, were deemed cognitively normal on the basis of Mini-Mental State Examination scores, and were not taking antidepressant or anxiolytic medications. A cross-sectional survey was employed, involving a face-to-face meeting with each of the participants. The results showed that, controlling for age and gender, depressive symptoms were associated with poorer immediate recall performance, while greater than 12 years of education was positively associated with delayed recall and savings. Leisure did not emerge as being associated with any of the dimensions of memory assessed. The article concludes that depressive symptoms emerged as associated with immediate recall. This may indicate a need for intervention in cases of subclinical depression with associated memory complaints. The association between education level and both delayed recall and savings provides support for the cognitive reserve hypothesis, and may suggest useful non-pharmacological approaches to memory deficits in later life.