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Journal article

Depression in relation to purpose in life among a very old population: a five-year follow-up study

Authors:
HEDBERG Pia, et al
Journal article citation:
Aging and Mental Health, 14(6), August 2010, pp.757-763.
Publisher:
Taylor and Francis

This study investigated whether purpose in life, when adjusted for different background characteristics, can prevent very old people from developing depression. An initial cross-sectional study included 189 participants aged 85-103 years living in northern Sweden. A five year follow-up study was also conducted. In the original study 40 participants of the 189 were depressed and those with depression had significantly lower purpose in life scores. In the follow-up study, 21 of the 78 people assessed were diagnosed as depressed. The researchers found no association between purpose in life and the risk of developing depression after five years, and concluded that a high degree of purpose in life could not prevent the development of depression during a five-year period among very old men and women.

Journal article

Suicide in the oldest old: an observational study and cluster analysis

Authors:
SINYOR Mark, et al
Journal article citation:
International Journal of Geriatric Psychiatry, 31(1), 2016, pp.33-40.
Publisher:
Wiley-Blackwell

Objectives: The older population are at a high risk for suicide. This study sought to learn more about the characteristics of suicide in the oldest-old and to use a cluster analysis to determine if oldest-old suicide victims assort into clinically meaningful subgroups. Methods: Data were collected from a coroner's chart review of suicide victims in Toronto from 1998 to 2011. The study compared two age groups (65-79 year olds, n = 335, and 80+ year olds, n = 191) and then conducted a hierarchical agglomerative cluster analysis using Ward's method to identify distinct clusters in the 80+ group. Results: The younger and older age groups differed according to marital status, living circumstances and pattern of stressors. The cluster analysis identified three distinct clusters in the 80+ group. Cluster 1 was the largest (n = 124) and included people who were either married or widowed who had significantly more depression and somewhat more medical health stressors. In contrast, cluster 2 (n = 50) comprised people who were almost all single and living alone with significantly less identified depression and slightly fewer medical health stressors. All members of cluster 3 (n = 17) lived in a retirement residence or nursing home, and this group had the highest rates of depression, dementia, other mental illness and past suicide attempts. Conclusions: This is the first study to use the cluster analysis technique to identify meaningful subgroups among suicide victims in the oldest-old. The results reveal different patterns of suicide in the older population that may be relevant for clinical care. (Edited publisher abstract)

Journal article

Normal aging or depression? A qualitative study on the differences between subsyndromal depression and depression in very old people

Authors:
LUDVIGSSON Mikael, et al
Journal article citation:
Gerontologist, 55(5), 2015, pp.760-769.
Publisher:
Gerontological Society of America

Purpose of the Study: The aim of this study was to make a qualitative comparison of experiences of being in very old people with subsyndromal depression (SSD), in relation to the experiences of very old people with syndromal depression or nondepression. Through investigation and deeper understanding of the interface between depressive disease and normal aging, clinicians might give more accurate prevention or treatment to those very old persons who need such help. Design and Methods: Semistructured qualitative interviews were conducted for 27 individuals of 87–88 years of age, who were categorized in the 3 strata of nondepressive, SSD, and syndromal depression. Transcripts were analysed using qualitative content analysis within each stratum and later with a comparison between the strata. Results: The content analysis resulted in 4 themes in people with SSD, as defined by a self-report depression screening instrument, giving a comprehensive picture of SSD in very old people, and also showed qualitative differences between the SSD, syndromal depression, and nondepressive groups. A main finding was that SSD differs qualitatively from syndromal depression but not clearly from nondepression. Implications: The results might indicate that SSD in very old people is not related to pathology but to normal aging, even though the condition correlates with negative health parameters. Overlooking certain psychosocial aspects of living in the very old may pose a risk of both underdiagnosis and overdiagnosis in the spectrum of depressive disorders. (Edited publisher abstract)

Digital Media Full text available online for free

Older people talk about how frailty can lead to loneliness and isolation

Author:
AGE UK
Publisher:
Age UK
Publication year:
2014
Pagination:
8 minutes 41 seconds
Place of publication:
London

As part of Age UK's research into frailty in later life, older people talk about how frailty can lead to loneliness and isolation and the strategies they use to cope with loneliness. (Edited publisher abstract)

Journal article

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)

Book

Living with ageing and dying: palliative care and end of life care for older people

Editors:
GOTT Merryn, INGLETON Christine, (eds.)
Publisher:
Oxford University Press
Publication year:
2011
Pagination:
304p.
Place of publication:
Oxford

This book identifies ways of improving the end of life experiences of older people by taking an interdisciplinary and international approach. It brings together contributions from leading international experts from different disciplinary backgrounds. Ageing populations mean that end of life care for older people needs to be given greater priority. In particular, there is a perceived need to improve the experiences of older people at the end of life; those that have been identified as the 'disadvantaged dying'. Most current models of care are underpinned by the ideals of specialist palliative care services which were developed to meet the needs of predominantly 'young old' people, and evidence suggests these may not be adequate for the older group. The contributions provide a synergy between the currently disparate literature of gerontology and palliative care. Some authors take a theoretical focus, others a very practical approach rooted in clinical and research experience. The issues covered are diverse and related to a wide range of geographical settings. The book is aimed at both academics and practitioners (doctors and nurses) in palliative care, geriatrics, and gerontology but is also expected to be of interest to social workers, policy makers and anyone with an interest in older people in relation to public health.

Book Full text available online for free

Home care in London

Author:
BRADLEY Laura
Publisher:
Institute for Public Policy Research
Publication year:
2011
Pagination:
40p.
Place of publication:
London

Like the rest of the UK, London’s over-80 population is increasing; the Greater London Authority estimates it will rise by 40% over the next 30 years. Public services must adapt to the challenge that this poses. Home-based care has the potential to reduce the pressure on more costly public services such as hospital beds and care home places, and can enable older people to remain in their homes for longer. This paper explores the issue of home-based social care in London. It aims to provide policymakers and commissioners with a clearer idea of what makes for good quality home-based care, the challenges that exist for delivering it, and how the increasing demand can be met. Research undertaken for this paper involved analysis of secondary information as well as 50 semi-structured interviews conducted with service providers, carers and service users. The paper starts by outlining the current context for home-based care in the UK, looking at where it fits within the overall approach to social care and the current financial environment. It then covers home-based care in London by giving an analysis of the home care market and some characteristics unique to London. Three key tests are provided that ensure home care is of good quality, and it is considered whether home care in London is successfully meeting each of these tests. Recommendations to address the emerging issues are provided.

Journal article

Positive approaches to the fourth age

Authors:
BANO Ben, BENBOW Susan Mary
Journal article citation:
Quality in Ageing and Older Adults, 11(2), June 2010, pp.29-34.
Publisher:
Emerald

In this paper, the authors reflect on the outcomes of From the Cradle to Beyond the Grave, a multi-faith conference on the theme of positive approaches to the fourth age held in 2008, discussing participants views' on what makes life worth living at different stages and the spiritual needs in the fourth age. The article looks at transcendence and spiritual needs, and needs and roles in the context of Maslow's hierarchy of needs and the social role inventory, a tool that develops a profile of the roles a person is performing or might perform. The authors conclude that there is a developing consensus that services need to understand and meet the spiritual and transcendence needs of older people in the fourth age, and that the developing focus on social inclusion needs to ensure that people in the fourth age are considered and involved in national and local initiatives.

Journal article

Experiences of loneliness among the very old: the Umea 85+ project

Authors:
GRANEHEIM Ulla H., LUNDMAN Berit
Journal article citation:
Aging and Mental Health, 14(4), May 2010, pp.433-438.
Publisher:
Taylor and Francis

This study is part of the ongoing Umea 85+ project, which focuses on people aged 85 years and over to examine successful ageing as well as threats against successful ageing. The losses associated with becoming old include the loss of friends and family members, which may contribute to experiences of loneliness. This study aimed to elucidate experiences of loneliness among the very old who live alone. The participants were 23 women and 7 men, aged 85-103 years, who were interviewed about their experiences of loneliness. The text was subjected to qualitative content analysis. The descriptions of loneliness were twofold: on the one hand, living with losses and feeling abandoned represented the limitations imposed by loneliness; and on the other, living in confidence and feeling free represented the opportunities of loneliness. The findings indicate that experiences of loneliness among the very old are complex, and concern their relations in the past, the present, and the future. The article concludes that experiences of loneliness among the very old can be devastating or enriching, depending upon life circumstances and outlook on life and death.

Journal article

Aging without agency: theorizing the fourth age

Authors:
GILLEARD Chris, HIGGS P.
Journal article citation:
Aging and Mental Health, 14(2), March 2010, pp.121-128.
Publisher:
Taylor and Francis

This article looks at the ‘fourth age’ as a manifestation of the fragmentation of old age, attempting to give it a more cogent status within gerontology. It argues that the fourth age emerges from the institutionalisation of the infirmities of old age set against the appearance of a third-age culture that negates past representations of old age. The historical marginalisation of old age is outlined from early modern society to the contemporary concentration of infirmity within long-term care which makes of old age an undesirable social imaginary. As old age fades from the social world, the article likens this to the impact of a social or cultural ‘black hole’ distorting the gravitational field surrounding it, unobservable except for its traces. At this stage, choice, autonomy, self-expression, and pleasure collapse into a silent negativity. Within this perspective, the fourth age can be understood by examining not the experience itself but its impact on the discourses that surround and orientate themselves to it.

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