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Depression in older adults: a meta-synthesis
- Authors:
- CORCORAN Jacqueline, et al
- Journal article citation:
- Journal of Gerontological Social Work, 56(6), 2013, pp.509-534.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
This qualitative meta-synthesis seeks to synthesize the qualitative studies that have been conducted on depression in older adults. The search included the databases Ageline, CINAHL, Dissertation Abstracts, Dissertations and Theses, PubMed/Medline, Psych Info, Social Services, and Social Work. Studies included up to January 2010. Thirteen studies met inclusion criteria, and four major themes were extracted: experiences, causes, recovery, and barriers to treatment. These themes are detailed and their implications for practice are explored. (Edited publisher abstract)
A systematic review and meta-analysis of group psychotherapy for sub-clinical depression in older adults
- Authors:
- KRISHNA Murali, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 28(9), 2013, pp.881-888.
- Publisher:
- Wiley
A systematic review of randomised controlled trials of group psychotherapy in older adults with sub-threshold depression was conducted to present the best available evidence in relation to its effect on depressive symptomatology and the prevention of major depression. Searches were conduced on electronic databases and random effects model was used for meta-analysis. Four clinical trials met the full inclusion criteria. Group cognitive behavioural therapy (CBT) is an effective intervention for reducing depressive symptoms in older adults with sub-threshold depression in comparison to waiting list. Computerised CBT is at least as effective as group CBT in reducing depressive symptoms. The benefit of group CBT at follow-up is not maintained. Group psychotherapy does not appear to reduce the risk of depressive disorder during follow-up. There are fewer drop outs from group psychotherapy when compared with control conditions. The methodological quality of the studies and their reporting are sub-optimal. Group psychological interventions in older adults with sub-threshold depression have a significant effect on depressive symptomatology, which is not maintained at follow-up. Group psychotherapy (Edited publisher abstract)
Relationship between depression and risk of malnutrition among community-dwelling young-old and old-old elderly people
- Authors:
- YOSHIMURA Kazuya, et al
- Journal article citation:
- Aging and Mental Health, 17(4), 2013, pp.456-460.
- Publisher:
- Taylor and Francis
A cross-sectional design was implemented to explores the association between nutritional status and depression among healthy community-dwelling young-old (aged 65–74) and old-old elderly (aged 75 and older). A total of 274 community-dwelling older individuals (142 young-old; 132 old-old) were assessed using the Geriatric Depression Scale (GDS), Mini-Nutritional Assessment Short-Form (MNA-SF) and Life-Space Assessment. Logistic regression analysis was used to determine if depression was independently associated with risk of malnutrition, stratified by age (young-old vs. old-old). In the logistic regression model for young-old, being at risk of malnutrition Was strongly associated with depression. In contrast, in the old-old group, the model was not statistically significant. This study reveals that not only the factors correlated with but also the symptoms of depression may vary among different age stratifications of the elderly. (Edited publisher abstract)
Effect of exercise on depression severity in older people: systematic review and meta-analysis of randomised controlled trials
- Authors:
- BRIDLE Christopher, et al
- Journal article citation:
- British Journal of Psychiatry, 201(3), September 2012, pp.180-185.
- Publisher:
- Cambridge University Press
There is uncertainty concerning the effect of exercise on depression among older people with clinically significant symptoms of depression. The primary aim of this meta analysis was to estimate the effect of exercise on depression severity in this group of patients. A secondary objective was to examine any variation between pre-specified subgroups stratified by depression eligibility criteria. Nine randomised controlled trials, including 667 patients, met the inclusion criteria and seven were used in the analyses. Medium term, 3-12 months, of mixed exercise was associated with significantly lower depression severity (standardised mean difference –0.34), irrespective of whether participant eligibility was determined by clinical diagnosis or symptom checklist. The authors conclude that, for older people who present with clinically meaningful symptoms of depression, prescribing structured exercise tailored to individual ability will reduce depression severity.
A community treatment intervention AdVancing Active Treatment in the Elderly (ACTIVATE): a pilot study
- Authors:
- SIREY Jo Anne, et al
- Journal article citation:
- Journal of Gerontological Social Work, 55(5), July 2012, pp.382-391.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Depression in older adults is a growing global health concern. Although a growing population of older adults receive treatment for depression, such as being prescribed antidepressant medication, many do not respond fully to this treatment. The AdVancing Active Treatment in the Elderly (ACTIVATE) intervention is targeted at this group of older adults who are in treatment but remain symptomatic. ACTIVATE is a brief, personalised, psychosocial intervention designed to help an older person with depressive symptoms intensify their depression treatment. This paper reports on a feasibility pilot study of ACTIVATE among 43 community-dwelling older people who were receiving home-meal service and in depression treatment, but still symptomatic. ACTIVATE sessions were conducted in the home by trained social workers. The sessions included an assessment to identify barriers to intensifying treatment followed by the development of an action plan. Many (66.6%) participants took a step to change their treatment; the rate (88.2%) was higher among individuals with major depression. ACTIVATE may be a useful social work intervention to improve depression care.
Depression and frailty in later life: a synthetic review
- Authors:
- MEZUK Briana, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 27(9), September 2012, pp.879-892.
- Publisher:
- Wiley
Frailty is defined as a state or indication of being vulnerable to declining health in later life. Depression in later life is predictive of many of the same kinds of outcomes as frailty, including cognitive impairment, disability, fracture, and mortality. The aim of this review was to explore the conceptual and empirical interrelationships between depression and frailty among older adults. A literature search was conducted using PubMed for publications through to 2010. Reviewers assessed the eligibility of each report and abstracted information on study design, sample characteristics, and key findings. Of these abstracted articles, 39 met the inclusion criteria. The findings from both cross-sectional and cohort studies indicated that frailty, its components, and functional impairment are risk factors for depression. Although cross-sectional studies indicated a positive association between depression and frailty, findings from cohort studies were less consistent. The majority of studies included only women and non-Hispanic Whites. None used diagnostic measures of depression or considered antidepressant use in the design or analysis of the studies.
Depression: a modifiable factor in fearful older fallers transitioning to frailty?
- Authors:
- MHAOLÁIN Aine M. Ni, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 27(7), July 2012, pp.727-733.
- Publisher:
- Wiley
It is suggested that fear of falling, one of the most common fears among community-dwelling older people, is as serious a health problem as the falls themselves. It often leads to activity avoidance. The authors believe that understanding fear of falling may help to identify strategies to reduce concern in the vulnerable old. This cross sectional study evaluated the psychological factors associated with fear of falling in a group of fallers transitioning to frailty compared with robust or non-frail fallers. A total of 301 fallers (mean age 75 years) underwent assessment. Fear of falling was measured using the Modified Falls Efficacy Scale, and frailty using the Biological Syndrome Model. Psychological assessment included anxiety, depression, loneliness, personality factors and cognition. Frailer fallers had increased fear of falling compared to robust fallers. Age, female gender and lower cognitive scores were associated with greater fear of falling in the robust group. For frailer fallers, higher depression score was the only factor associated with fear of falling. The odds ratio of having case level depressive disorder if a frail faller was significantly higher than if robust. The authors conclude that fallers at a transitional level of frailty may be particularly vulnerable group psychologically and would benefit most from interventional strategies focussing on depressive symptoms.
Self-rated health as a moderator of the relation between functional impairment and depressive symptoms in older adults
- Authors:
- JAHN Danielle R., CUKROWICZ Kelly C.
- Journal article citation:
- Aging and Mental Health, 16(3), April 2012, pp.281-287.
- Publisher:
- Taylor and Francis
A variety of risk factors have been linked to depression. The purpose of this study was to examine the relation between functional impairment, self-rated health, and depressive symptoms. Previous research has indicated that self-rated health and functional impairment each contribute to depressive symptoms. This study sought to determine if self-rated health moderates the relation between functional impairment and depressive symptoms in a sample of older adults. A community sample of 106 adults aged 60 and above was recruited from primary care clinics; 98 of these participants had usable data. The participants completed self-report questionnaires that assessed depressive symptoms, functional impairment, and self-rated physical health. The finding showed that self-rated health moderated the relation between functional impairment and depressive symptoms. For participants with poor self-rated health, greater functional impairment was associated with greater depressive symptoms. The paper concludes that patient perceptions of health may be protective against depressive symptoms for those with functional impairment.
Phenomenology of depression in older compared with younger adults: meta-analysis
- Authors:
- HEGEMAN J. M., et al
- Journal article citation:
- British Journal of Psychiatry, 200(4), April 2012, pp.275-281.
- Publisher:
- Cambridge University Press
Late-life depression may present differently to early-life depression. Conceptual and methodological limitations and the inherent subjectivity of narrative reviews have made it difficult to draw firm conclusions. This study was designed to investigate the effect of age on the phenomenology of major depression. A systematic search was conducted in PubMed, Embase and PsycINFO for studies examining the relation between age and phenomenology of major depression according to RDC, DSM and ICD criteria. Inclusion criteria required age groups to be compared at the single-item level using the 17-, 21- or 24-item versions of the Hamilton Rating Scale. A meta-analysis was undertaken for each item of the 17-item scale. Eleven papers met the inclusion criteria. When compared with younger depressed adults, older adults demonstrated more agitation, hypochondriasis and general as well as gastrointestinal somatic symptoms, but less guilt and loss of sexual interest. The authors conclude that the experience of late-life depression differs only in part from that of early-life depression. Older people may have a more somatic presentation, whereas feelings of guilt and loss of sexual function may be more prevalent in younger people.
Depression and social networks in community dwelling elders: a descriptive study
- Author:
- WILBY Frances
- Journal article citation:
- Journal of Gerontological Social Work, 54(3), April 2011, pp.246-259.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Social isolation and inadequate social support have previously been identified as correlates of depression in older adults. This study aimed to describe the social networks of depressed older adults living in the community and to compare the social networks of depressed and nondepressed individuals. The study participants consisted of 91 respondents aged 65 and older who were randomly selected using the voter registry. About 27% (25) of the participants reported significant levels of depressive symptomology as measured by the Center for Epidemiological Studies-Depression Scale (CES-D). The participants completed semi-structured interviews that included questions about social contacts with family and others during the prior week. All the participants reported social contact with family and friends during this period. The findings showed that, in this sample, the depressed elders were not socially isolated. They were more likely to report contacts with friends than those who were not depressed, and equally likely to report involvement in volunteer activities. Their likelihood of seeking social support was also comparable. The results emphasise the importance of peer relationships and suggest that, in some groups of older adults, social isolation may not be a hallmark of depressive symptoms.