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Ageism as a risk factor for chronic disease
- Author:
- ALLEN Julie Ober
- Journal article citation:
- Gerontologist, 56(4), 2016, pp.610-614.
- Publisher:
- Oxford University Press
Ageism is one of the most socially condoned and institutionalised forms of prejudice in the United States. Older adults are discriminated against in employment, health care, and other domains. Exposure to unfavourable stereotypes adversely affects the attitudes, cognitions, and behaviour of older adults. Recurrent experiences with negative stereotypes combined with discrimination may make ageism a chronic stressor in the lives of older adults. The way stress influences physical health is gaining increasing support. The weathering hypothesis (Geronimus, A. T. (1992). The weathering hypothesis and the health of African-American women and infants: evidence and speculations. Ethnicity and Disease, 2, 207–221) posits that the cumulative effects of chronic objective and subjective stressors and high-effort coping cause deterioration of the body, premature ageing, and associated health problems such as chronic diseases. Researchers have found empirical support for the weathering hypothesis as well as its theorised contribution to racial and ethnic health disparities. Although ageism is not experienced over the entire life course, as racism typically is, repeated exposure to chronic stressors associated with age stereotypes and discrimination may increase the risk of chronic disease, mortality, and other adverse health outcomes. I conclude with implications for practice in the helping professions and recommendations for future research. Ageism warrants greater recognition, social condemnation, and scientific study as a possible social determinant of chronic disease. (Edited publisher abstract)
Prevalence of depression symptoms and related risk factors for depressive symptoms among Elderly persons living in a rural Japanese community: a cross-sectional study
- Authors:
- KANEKO Yoshihiro, et al
- Journal article citation:
- Community Mental Health Journal, 43(6), December 2007, pp.583-590.
- Publisher:
- Springer
To clarify the prevalence of depression in a rural community in Japan and to evaluate the social and familial risk factors for depression, with the goal of suicide prevention, a questionnaire survey was conducted on a total of 2,763 elderly persons. The determined prevalence of depressive symptoms (Zung’s self-rated depression scale score of 50 points or more) was 10.4%. Logistic regression analysis showed associations between depressive symptoms and age, absence of a friendly companion, irritation with one’s family, frequent loneliness, the opinion that stress has a large impact on one’s life, suicide ideation, and poor subjective physical and mental health.
Informal caregiving and its impact on health: a reappraisal from population-based studies
- Authors:
- ROTH David L., FREDMAN Lisa, HALEY William E.
- Journal article citation:
- Gerontologist, 55(2), 2015, pp.309-319.
- Publisher:
- Oxford University Press
This article aims to re-examine some of the existing evidence on the health effects of caregiving, focusing in particular on one commonly cited claim that family caregiving is associated with an increased risk for mortality. The authors discuss important methodological concerns on the definition of caregiving, the composition of different caregiving subgroups, the sampling of caregivers, and the sampling and recruitment of appropriate noncaregiving comparison groups. A landmark study by Schulz and Beach reported higher mortality rates for strained spouse caregivers. However, five subsequent population-based studies found reduced mortality and extended longevity for caregivers as a whole compared with noncaregiving controls. Most caregivers also report benefits from caregiving, and many report little or no caregiving-related strain. The article stresses the importance of achieving more balanced and updated portrayal of the health effects of caregiving is needed to encourage more persons to take on caregiving roles, and to better target evidence-based services to the subgroup of caregivers who are highly strained or otherwise at risk. Recommendations are discussed for research that will better integrate and clarify both the negative and potential positive health effects of informal caregiving. (Edited publisher abstract)
Earlier stress exposure and subsequent major depression in aging women
- Authors:
- KASEN Stephanie, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 25(1), January 2010, pp.91-99.
- Publisher:
- Wiley
Asserting that despite evidence that stress exposure earlier in the life course may have long-term consequences for psychopathology most models of vulnerability for later life depression are limited to current stressors or retrospective reports of stress history, the authors of this study employed longitudinal data from a community sample of 565 women from New York counties assessed over three decades to examine whether major depressive disorder at average age 60 is associated with childhood adversity and both negative life events and chronic marital stress over adulthood. The results showed that greater childhood adversity, earlier high levels of negative life events and marital stress, and an increasing trajectory of marital stress over time all elevated the odds of major depressive disorder at average age 60, independent of all stressors and other salient risk factors. The authors conclude that the findings support the enduring effects of earlier stress burden on major depressive disorder in women into old age and have important clinical implications for identification and treatment of those at risk for depression.
On becoming depressed or anxious in late life: similar vulnerability factors but different effects of stressful life events
- Authors:
- de BEURS Edwin, et al
- Journal article citation:
- British Journal of Psychiatry, 179, November 2001, pp.426-431.
- Publisher:
- Cambridge University Press
This research aimed to delineate risk factors for the decline of mental health in older persons, compares risk profiles for developing symptoms of pure depression, pure anxiety and both anxiety and depression in a prospective design. Self-report data on depression and anxiety were collected from community-dwelling older respondents on two occasions, 3 years apart. After 3 years 9% of the subjects had scored beyond the thresholds for symptoms. Vulnerability for depression and anxiety was quite similar, but life events differed: onset of depression was predicted by death of a partner or other relatives; onset of anxiety was best predicted by having a partner who developed a major illness. No support for moderator effects between vulnerability factors and stress was found; the effects were purely additive. Concludes that depression and anxiety have many risk factors in common, but specific risk factors also were found, especially in subjects developing both depression and anxiety.
Depression of older age
- Author:
- COPELAND J.R.M.
- Journal article citation:
- British Journal of Psychiatry, 174, April 1999, pp.304-306.
- Publisher:
- Cambridge University Press
This article introduces the first set of publications from the EURPDEP collaboration, presented in five accompanying papers this issue. The EURODEP Consortium is a Concerted Action Programme funded by the European Commission (EC) with the following objectives: to study the variation of the prevalence of depression in Europe among people aged 65 and over; to compare the clinical features and the mode of presentation of depression in each centre; and where possible to study the social support networks, adverse life events, daily life stresses and other risk factors and the reasons for failure to receive treatment in primary care.
Aspects of eldercare that place employees at risk
- Authors:
- GOTTLIEB Benjamin H., KELLOWAY E. Kevin, FRABONI Maryann
- Journal article citation:
- Gerontologist, 34(6), December 1994, pp.815-821.
- Publisher:
- Oxford University Press
Examines the contribution of seven different aspects of eldercare to the prediction of several work and personal outcomes among employees of eight organizations. Results revealed that assistance with at least one Activity of Daily Living, eldercare management activities, and the number of eldercare crises to which the employee responded, each placed respondents at risk of more family interference with work, more stress, and more personal and job costs.
Acculturative stress and depressive symptoms among Korean immigrant elders residing in non-Korean ethnic enclaves
- Author:
- RHEE Stephanie L.
- Journal article citation:
- Journal of Ethnic and Cultural Diversity in Social Work, 26(4), 2017, pp.347-365.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
This cross-sectional structured survey examined the relationships of personal factors, acculturative stress, and depressive symptoms among Korean immigrant elders (N = 108) residing in areas without any Korean ethnic enclave. Multiple regression and path analyses indicated that personal factors such as levels of acculturation and socioeconomic status might influence acculturative stress and depressive symptoms negatively; however, acculturative stress was the most significant risk factor for depressive symptoms. Culturally relevant programmes and services are important vehicles through which to enhance personal resources and reduce lingual and cultural barriers among Korean immigrant elders residing in non-Korean ethnic enclaves. (Publisher abstract)
Factors associated with suicidal thoughts in a large community study of older adults
- Authors:
- ALMEIDA Osvaldo P., et al
- Journal article citation:
- British Journal of Psychiatry, 201(6), December 2012, pp.466-472.
- Publisher:
- Cambridge University Press
While thoughts about death and self-harm in old age are commonly associated with the presence of depression, evidence is accumulating that other risk factors may also be important. This cross sectional study examined the independent association between suicidal ideation in later life and demographic, lifestyle, socioeconomic, psychiatric and medical factors. A community-derived sample of 21,290 adults aged 60–101 years was enrolled from Australian primary care practices. Participants endorsing any of the four items of the Depressive Symptom Inventory –Suicidality Subscale were deemed to be experiencing suicidal thoughts. The 2-week prevalence of suicidal ideation was 4.8%. Male gender, higher education, current smoking, living alone, poor social support, no religious practice, financial strain, childhood physical abuse, history of suicide in the family, past depression, current anxiety, depression or comorbid anxiety and depression, past suicide attempt, pain, poor self-perceived health and current use of antidepressants were independently associated with suicidal ideation. Poor social support was associated with a population attributable fraction of 38.0%, followed by history of depression (23.6%), concurrent anxiety and depression (19.7%), prevalent anxiety (15.1%), pain (13.7%) and no religious practice (11.4%). While prevalent and past mood disorders could be valid targets for interventions to reduce suicidal thoughts and behaviour, the data indicate that social disconnectedness and stress account for a larger proportion of cases than mood disorders.
Panic disorder in older adults: evidence from the national epidemiologic survey on alcohol and related conditions
- Author:
- CHOU Kee-Lee
- Journal article citation:
- International Journal of Geriatric Psychiatry, 25(8), August 2010, pp.822-832.
- Publisher:
- Wiley
Panic disorder is significantly associated with higher medical and psychiatric comorbidities, yet there is a lack of research in this area. This study investigated the association of panic disorder with childhood parental loss and recent stressful life events; the co-existence of panic disorder with major depressive disorder and alcohol dependence; and the impact of panic disorder on health-related quality of life. Data from 13,420 adults, aged 55 years and older, from the National Epidemiologic Survey on Alcohol and Related Conditions (2001–2002) was used. Panic disorder was assessed using the Alcohol Use Disorder and Associated Disabilities Interview Schedule. Findings indicated that the current and lifetime prevalence rates of panic disorder were 1.17 and 3.72%, respectively. Panic disorder was more common among low income groups, and those who had reported more recent stressful life events. Major depressive disorder was significantly related to lifetime panic disorder. Panic disorder was also related to a lower health-related quality of life and dual medical conditions. The authors conclude that the correlation between panic disorder and major depressive disorder raised further questions about the nature of panic disorder in the elderly. This study supports the idea that panic disorder has a strong impact on quality of life in old age.