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Jiménez AL, Cruz-Gonzalez M, Forsyth Calhoun T, Cohen L, Alegría M. Late life anxiety and depression symptoms, and suicidal behaviors in racial/ethnic minority older adults in community-based organizations and community clinics in the U.S. CULTURAL DIVERSITY & ETHNIC MINORITY PSYCHOLOGY 2024; 30:22-34. [PMID: 35113605 PMCID: PMC9519187 DOI: 10.1037/cdp0000524] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
OBJECTIVE Late life anxiety and depression represent a significant source of disability, with racial/ethnic minority older adults in the U.S. showing marked disparities in healthy aging. Community-based organizations (CBOs) and community clinics serve these populations for preventive care, yet few identify their mental health service needs. We examine the association between race/ethnicity and risk of mild-to-severe symptoms of anxiety and depression, and suicidal behaviors in minority older adults. METHOD Data come from the multisite randomized controlled trial Building Community Capacity for Disability Prevention for Minority Elders, which screened 1,057 adults (45.5% Asian, 26.8% Latinx, 15.0% non-Latinx Black, 8.5% non-Latinx White, and 4.2% American Indian) aged 60 + years at CBOs and clinics in Massachusetts, New York, Florida, and Puerto Rico. Screened participants completed the Generalized Anxiety Disorder-7 (GAD-7) for anxiety symptoms, the Geriatric Depression Scale-15 (GDS-15) for depression symptoms, and the Paykel Suicide Risk Questionnaire for suicidal behaviors. RESULTS 28.1% of older adults reported mild-to-severe anxiety symptoms, 30.1% reported mild-to-severe depression symptoms, and 4.3% reported at least one suicidal behavior. Compared to non-Latinx Whites, Latinxs had higher odds of mild-to-severe anxiety and depression symptoms and one or more suicidal behaviors, and Asians had higher odds of mild-to-severe depression symptoms only. CONCLUSIONS There is an urgent need to improve outreach for screening and preventive mental health care for minority older adults. Expanding outreach and community-based capacity to identify and treat minority older adults with mental health conditions represents an opportunity to prevent disability. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
- Aida L. Jiménez
- Department of Psychology, University of Puerto Rico, San
Juan, Puerto Rico
| | - Mario Cruz-Gonzalez
- Disparities Research Unit, Department of Medicine,
Massachusetts General Hospital
| | | | - Lauren Cohen
- Disparities Research Unit, Department of Medicine,
Massachusetts General Hospital
| | - Margarita Alegría
- Disparities Research Unit, Department of Medicine,
Massachusetts General Hospital
- Departments of Medicine and Psychiatry, Harvard Medical
School
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2
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Libon DJ, Matusz EF, Cosentino S, Price CC, Swenson R, Vermeulen M, Ginsberg TB, Okoli-Umeweni AO, Powell L, Nagele R, Tobyne S, Gomes-Osman JR, Pascual-Leone A. Using digital assessment technology to detect neuropsychological problems in primary care settings. Front Psychol 2023; 14:1280593. [PMID: 38046126 PMCID: PMC10693332 DOI: 10.3389/fpsyg.2023.1280593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 10/23/2023] [Indexed: 12/05/2023] Open
Abstract
Introduction Screening for neurocognitive impairment and psychological distress in ambulatory primary and specialty care medical settings is an increasing necessity. The Core Cognitive Evaluation™ (CCE) is administered/scored using an iPad, requires approximately 8 min, assesses 3- word free recall and clock drawing to command and copy, asks questions about lifestyle and health, and queries for psychological distress. This information is linked with patients' self- reported concerns about memory and their cardiovascular risks. Methods A total of 199 ambulatory patients were screened with the CCE as part of their routine medical care. The CCE provides several summary indices, and scores on 44 individual digital clock variables across command and copy tests conditions. Results Subjective memory concerns were endorsed by 41% of participants. Approximately 31% of participants reported psychological distress involving loneliness, anxiety, or depression. Patients with self-reported memory concerns scored lower on a combined delay 3- word/ clock drawing index (p < 0.016), the total summary clock drawing command/ copy score (p < 0.050), and clock drawing to command Drawing Efficiency (p < 0.036) and Simple and Complex Motor (p < 0.029) indices. Patients treated for diabetes and atherosclerotic cardiovascular disease (ASCVD) scored lower on selected CCE outcome measures (p < 0.035). Factor analyses suggest that approximately 10 underlying variables can explain digital clock drawing performance. Discussion The CCE is a powerful neurocognitive assessment tool that is sensitive to patient's subjective concerns about possible decline in memory, mood symptoms, possible cognitive impairment, and cardiovascular risk. iPad administration ensures total reliability for test administration and scoring. The CCE is easily deployable in outpatient ambulatory primary care settings.
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Affiliation(s)
- David J. Libon
- School of Osteopathic Medicine, New Jersey Institute for Successful Aging, Rowan University, Stratford, NJ, United States
- Department of Psychology, Rowan University, Glassboro, NJ, United States
| | - Emily Frances Matusz
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States
| | - Stephanie Cosentino
- Cognitive Neuroscience Division, Department of Neurology, Taub Institute and Sergievsky Center, Columbia University Medical Center, New York, NY, United States
| | - Catherine C. Price
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States
| | - Rod Swenson
- School of Medicine and Health Sciences, University of North Dakota, Grand Forks, ND, United States
| | - Meagan Vermeulen
- Department of Family Practice, School of Osteopathic Medicine, Rowan University, Stratford, NJ, United States
| | - Terrie Beth Ginsberg
- School of Osteopathic Medicine, New Jersey Institute for Successful Aging, Rowan University, Stratford, NJ, United States
| | - Adaora Obiageli Okoli-Umeweni
- School of Osteopathic Medicine, New Jersey Institute for Successful Aging, Rowan University, Stratford, NJ, United States
| | - Leonard Powell
- School of Osteopathic Medicine, New Jersey Institute for Successful Aging, Rowan University, Stratford, NJ, United States
| | - Robert Nagele
- School of Osteopathic Medicine, New Jersey Institute for Successful Aging, Rowan University, Stratford, NJ, United States
| | | | | | - Alvaro Pascual-Leone
- Linus Health, Boston, MA, United States
- Sidney Wolk Center for Memory Health, and Eleanor and Herbert Bearak Memory Wellness for Life Program, Hinda and Arthur Marcus Institute for Aging Research and Deanna, Hebrew SeniorLife, Boston, MA, United States
- Department of Neurology and Harvard Medical School, Boston, MA, United States
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3
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Abstract
Late-life depression is common but underrecognized and undertreated leading to significant morbidity and mortality, including from suicide. The presence of comorbidities necessitates screening followed by a careful history in order to make the diagnosis of depression. Because older adults tend to take longer to respond to treatment and have higher relapse rates than younger patients, they benefit most from persistent, attentive therapy. Although both pharmacotherapy and psychosocial treatments, or a combination of the two, are considered as the first-line therapy for late-life depression, most data support a combined, biopsychosocial treatment approach provided by an interdisciplinary team.
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Affiliation(s)
- Elizabeth Gundersen
- University of Colorado School of Medicine, Mail Stop B178 Academic Office One, 12631 E. 17th Avenue, Aurora, CO 80045, USA.
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4
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Lohman MC, Mezuk B, Fairchild AJ, Resciniti NV, Merchant AT. The role of frailty in the association between depression and fall risk among older adults. Aging Ment Health 2022; 26:1805-1812. [PMID: 35993919 PMCID: PMC9395731 DOI: 10.1080/13607863.2021.1950616] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES Although there is a recognized association between depression and greater fall risk among older adults, the mechanisms explaining this association are unclear. This study evaluated the role of frailty, a common geriatric syndrome, in determining greater risk of falls among older adults with depression. METHOD We used longitudinal data from three biennial waves of the Health and Retirement Study (HRS; 2010-2014). The sample included community-dwelling survey respondents age ≥ 65 who participated in objective physiological measures. Major Depression (MD) was measured using Composite International Diagnostic Interview for depression short form. Frailty was measured using criteria outlined in the frailty phenotype model. Causal mediation analysis was used to differentiate the direct effect of depression and indirect effect mediated by frailty on falls, fall injuries, and multiple falls. RESULTS Major depression was associated with significantly greater odds of experiencing a fall (OR: 1.91; 95% CI: 1.31, 2.77), fall injury (OR: 1.86; 95% CI: 1.17, 2.95), and multiple falls (OR: 2.26; 95% CI: 1.52, 3.37) over a two-year period. Frailty was a significant mediator of the effects of depression on falls and multiple falls, accounting for approximately 18.9% and 21.3% of the total effects, respectively. We found no evidence of depression-frailty interaction. Sensitivity analyses showed that results were robust to unmeasured confounding and alternative operationalizations of depression. CONCLUSION Frailty explains a significant proportion of increased likelihood of falls among older adults with depression. Treatment and management of frailty symptoms may be an important components of fall prevention among older adults with depression.
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Affiliation(s)
- Matthew C. Lohman
- Department of Epidemiology and Biostatistics, University of South Carolina, Arnold School of Public Health, Columbia, SC
| | - Briana Mezuk
- Center for Social Epidemiology and Population Health, Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI
| | | | - Nicholas V. Resciniti
- Department of Epidemiology and Biostatistics, University of South Carolina, Arnold School of Public Health, Columbia, SC
| | - Anwar T. Merchant
- Department of Epidemiology and Biostatistics, University of South Carolina, Arnold School of Public Health, Columbia, SC
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Abstract
The onset of the COVID-19 pandemic in early 2020 had a significant impact on the delivery of behavioral health services, with significant short-term and long-range consequences. Intertwined with the delivery of services has been the financial ramifications of the pandemic. The rapid response by governmental agencies to shore up financial support for clinical services, and the swift shift to virtual care provided relief for a broad array of practice settings; however, it did not mitigate the full impact of the pandemic. Effective state, national, and international leadership, communication, and coordination are critical to improve the global response to any pandemic.
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Tai Y, Obayashi K, Yamagami Y, Kurumatani N, Saeki K. Association Between Passive Body Heating by Hot Water Bathing Before Bedtime and Depressive Symptoms Among Community-Dwelling Older Adults. Am J Geriatr Psychiatry 2022; 30:161-170. [PMID: 34275727 DOI: 10.1016/j.jagp.2021.06.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 06/09/2021] [Accepted: 06/17/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Passive body heating can have an antidepressant effect by activating warm-sensitive neural pathways associated with affective functions. Interventional studies showed that patients with depression had reduced depressive symptoms after passive body heating. However, the effect of hot water bathing at home on depressive symptoms in the general population remains unclear. Thus, we evaluated the association between objectively measured hot water bathing and depressive symptoms among older adults. DESIGN Cross-sectional analysis. SETTING A baseline survey of community-based cohort study in Japan. PARTICIPANTS Community-dwelling older volunteers (n = 1,103; mean age: 72.0 years). MEASUREMENTS The authors evaluated bathing conditions and distal skin temperature for 2 consecutive days. Depressive symptoms were defined as the 15-item Geriatric Depression Scale score of ≥6. RESULTS Logistic regression showed that the no bathing group (adjusted odds ratio [OR] 2.60, 95% confidence interval [CI] 1.36-4.95, χ² = 8.40, degrees of freedom [df] = 1) and the either-day bathing group (adjusted OR 1.68, 95% CI 1.11-2.56, χ² = 5.89, df = 1) had higher odds of depressive symptoms than the both-day bathing group independent of potential confounders including age, sex, body mass index, alcohol intake, income, living alone, hypnotic use, diabetes, and physical activity. Shorter interval from bathing to bedtime was significantly associated with lower odds of depressive symptoms and higher nighttime distal skin temperature after adjusting for water temperature and duration. CONCLUSION A higher frequency of hot water bathing and shorter interval from bathing to bedtime were associated with lower odds of depressive symptoms.
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Affiliation(s)
- Yoshiaki Tai
- Department of Epidemiology, Nara Medical University School of Medicine, Kashihara, Nara, Japan.
| | - Kenji Obayashi
- Department of Epidemiology, Nara Medical University School of Medicine, Kashihara, Nara, Japan
| | - Yuki Yamagami
- Department of Epidemiology, Nara Medical University School of Medicine, Kashihara, Nara, Japan
| | - Norio Kurumatani
- Department of Epidemiology, Nara Medical University School of Medicine, Kashihara, Nara, Japan
| | - Keigo Saeki
- Department of Epidemiology, Nara Medical University School of Medicine, Kashihara, Nara, Japan
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7
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Dozier ME, Wetherell JL, Amir N, Weersing VR, Taylor CT, Ayers CR. The Association between Age and Experienced Emotions in Hoarding Disorder. Clin Gerontol 2021; 44:562-566. [PMID: 32175823 PMCID: PMC7492365 DOI: 10.1080/07317115.2020.1742833] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Objectives: Hoarding disorder (HD) is conceptualized as a fear-based disorder and exposure to sorting/discarding possessions is a core part of treatment. However, there has been no investigation of age-related differences in emotional reaction to sorting. The objective of this study was to explore the association between age and affective response during a sorting task.Methods: Forty-nine adults with HD completed a standardized sorting task. Participants reported their current emotion before and after the sorting task and reported their subjective distress throughout the task.Results: Older participants reported significantly lower distress ratings. Only 43% of participants reported fear prior to the task and 22% reported fear after the task. The probability of reporting fear before and after the task decreased significantly with age.Conclusions: Fear may not be the emotion experienced when discarding items, particularly for older adults with HD. Future work should focus on mechanisms of action in HD treatment.Clinical Implications: Clinicians should not assume fear or anxiety to be the primary emotional response in older adults with HD when engaged in an exposure to sorting/discarding. Older hoarding patients with a more fear-oriented aversion to sorting possessions may require a treatment emphasis on increasing the percentage of items discarded.
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Affiliation(s)
- Mary E Dozier
- Department of Psychology, Mississippi State University, Starkville, Mississippi, USA.,Research Service, VA San Diego Healthcare System, San Diego, California, USA.,San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA
| | - Julie Loebach Wetherell
- Research Service, VA San Diego Healthcare System, San Diego, California, USA.,Mental Health Care Line, VA San Diego Healthcare System, San Diego, California, USA.,Department of Psychiatry, University of California, San Diego School of Medicine, San Diego, CA
| | - Nader Amir
- Department of Psychology, San Diego State University, San Diego, California, USA
| | - V Robin Weersing
- Department of Psychology, San Diego State University, San Diego, California, USA
| | - Charles T Taylor
- Department of Psychiatry, University of California, San Diego School of Medicine, San Diego, CA
| | - Catherine R Ayers
- Research Service, VA San Diego Healthcare System, San Diego, California, USA.,Mental Health Care Line, VA San Diego Healthcare System, San Diego, California, USA.,Department of Psychiatry, University of California, San Diego School of Medicine, San Diego, CA
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8
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Transtornos de Ansiedade em Idosos. PAJAR - PAN AMERICAN JOURNAL OF AGING RESEARCH 2021. [DOI: 10.15448/2357-9641.2021.1.40528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Objetivos: descrever a prevalência de transtornos de ansiedade e avaliar o perfil e os fatores associados em uma amostra de idosos atendidos no ambulatório de psiquiatria geriátrica de um hospital de Porto Alegre, Brasil.Métodos: trata-se de um estudo transversal que avaliou 69 idosos com diagnóstico de transtornos de ansiedade, atendidos no ambulatório de psiquiatria geriátrica, no período de 2014 a 2019.Resultados: a prevalência de transtornos de ansiedade foi de 21,9% e a média de idade 73,4±8,7 anos. Houve predomínio de indivíduos do sexo feminino (81,2%), com 5 a 8 anos de estudo (33,8%), casados (47,7%) e residentes de Porto Alegre (65,2%). Em relação a variáveis clínicas, a maior frequência dos idosos não apresentaram histórico familiar de doença ou de internação psiquiátrica. Do total, 92,6% relataram ter alguma comorbidade clínica, sendo a mais frequente as doenças cardiovasculares (69,8%). Os principais psicofármacos utilizados foram os antidepressivos (66,7%) e os benzodiazepínicos (44,9%).Conclusões: os transtornos de ansiedade são frequentes entre os idosos. Dessa forma, são necessários mais estudos na população geriátrica e padronizações das ferramentas de avaliação.
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9
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Lohman MC, Fairchild AJ, Merchant AT. Antidepressant Use Partially Mediates the Association Between Depression and Risk of Falls and Fall Injuries Among Older Adults. J Gerontol A Biol Sci Med Sci 2021; 76:e171-e178. [PMID: 33017840 DOI: 10.1093/gerona/glaa253] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The association between depression and fall risk in older adults is recognized, yet the mechanisms underlying this association are unclear. This study estimated the mediating role of antidepressant use in the association between depression and falls and fall injuries. METHODS Longitudinal data from the Health and Retirement Study (2004-2006) were linked with medication data from the Prescription Drug Study (2005). The sample included community-dwelling adults aged ≥65 with data on depression and medication use (n = 3565). Depression was measured using 2 independent survey tools: Composite International Diagnostic Interview for depression short form and an 8-item version of the Center for Epidemiological Studies-Depression scale. We used causal mediation analysis to estimate and compare the direct and indirect (mediated by antidepressant use) effects of depression on falls and fall injuries. RESULTS Individuals with major depressive disorder were significantly more likely to experience a fall (OR: 1.92; 95% CI: 1.41, 2.62) and a fall injury (OR: 1.67; 95% CI: 1.09, 2.55) over 2 years. Indirect effect estimates showed that antidepressant medication use accounted for approximately 19% and 18% of the association between major depressive disorder and falls and fall injuries, respectively. Results were similar when using an alternative depression measure and when considering only selective serotonin reuptake inhibitor antidepressants. CONCLUSIONS Antidepressant use explains a significant proportion, but not a majority, of the association between depression and greater fall risk. Treatment benefits of antidepressants should be considered with, and may outweigh, concerns about increased risk of falls associated with antidepressant use.
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Affiliation(s)
- Matthew C Lohman
- Department of Epidemiology and Biostatistics, University of South Carolina, Arnold School of Public Health, Columbia
| | | | - Anwar T Merchant
- Department of Epidemiology and Biostatistics, University of South Carolina, Arnold School of Public Health, Columbia
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10
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Hoertel N, Rotenberg L, Schuster JP, Blanco C, Lavaud P, Hanon C, Hozer F, Teruel E, Manetti A, Costemale-Lacoste JF, Seigneurie AS, Limosin F. Generalizability of pharmacologic and psychotherapy trial results for late-life unipolar depression. Aging Ment Health 2021; 25:367-377. [PMID: 31726850 DOI: 10.1080/13607863.2019.1691146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVES Despite evidence of low representativeness of clinical trial results for depression in adults, the generalizability of clinical trial results for late-life depression is unknown. This study sought to quantify the representativeness of pharmacologic and psychotherapy clinical trial results for late-life unipolar depression. METHOD Data were derived from the 2004-2005 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), a nationally representative sample of 34,653 adults from the United States population. To assess the generalizability of clinical trial results for late-life depression, we applied a standard set of eligibility criteria representative of pharmacologic and psychotherapy clinical trials to all individuals aged 65 years and older in NESARC with a DSM-IV diagnosis of MDE and no lifetime history of mania/hypomania (n = 273) and in a subsample of individuals seeking help for depression (n = 78). RESULTS More than four of ten respondents and about two of ten respondents would have been excluded by at least one exclusion criterion in a typical pharmacologic and psychotherapy efficacy trial, respectively. Similar results (i.e.41.1% and 25.9%, respectively) were found in the subsample of individuals seeking help for depression. Excess percentage of exclusion in typical pharmacologic studies was accounted for by the criterion "significant medical condition". We also found that populations typically included in pharmacologic and psychotherapy clinical trials for late-life unipolar depression may substantially differ. CONCLUSION Psychotherapy trial results may be representative of most patients with late-life unipolar depression in routine clinical practice. By contrast, pharmacologic clinical trials may not be readily generalizable to community samples.
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Affiliation(s)
- Nicolas Hoertel
- Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Corentin-Celton, Service de Psychiatrie, Issy-les-Moulineaux, France.,Université Paris Descartes, PRES Sorbonne Paris Cité, Paris, France.,Centre Psychiatrie et Neurosciences, Inserm Umr 894, Paris, France.,Université de Paris, Université Paris Descartes, Paris, France
| | - Léa Rotenberg
- Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Corentin-Celton, Service de Psychiatrie, Issy-les-Moulineaux, France
| | - Jean-Pierre Schuster
- Service of Old Age Psychiatry, Department of Psychiatry, Lausanne University Hospital, Prilly, Switzerland
| | - Carlos Blanco
- Division of Epidemiology, Services, and Prevention Research, National Institute on Drug Abuse, Bethesda, MD, USA
| | - Pierre Lavaud
- Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Corentin-Celton, Service de Psychiatrie, Issy-les-Moulineaux, France
| | - Cécile Hanon
- Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Corentin-Celton, Service de Psychiatrie, Issy-les-Moulineaux, France
| | - Franz Hozer
- Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Corentin-Celton, Service de Psychiatrie, Issy-les-Moulineaux, France
| | - Elisabeth Teruel
- Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Corentin-Celton, Service de Psychiatrie, Issy-les-Moulineaux, France
| | - Aude Manetti
- Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Corentin-Celton, Service de Psychiatrie, Issy-les-Moulineaux, France
| | | | - Anne-Sophie Seigneurie
- Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Corentin-Celton, Service de Psychiatrie, Issy-les-Moulineaux, France
| | - Frédéric Limosin
- Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Corentin-Celton, Service de Psychiatrie, Issy-les-Moulineaux, France.,Université Paris Descartes, PRES Sorbonne Paris Cité, Paris, France.,Centre Psychiatrie et Neurosciences, Inserm Umr 894, Paris, France.,Université de Paris, Université Paris Descartes, Paris, France
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11
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Elder Abuse in the Out-of-Hospital and Emergency Department Settings: A Scoping Review. Ann Emerg Med 2020; 75:181-191. [PMID: 31959308 DOI: 10.1016/j.annemergmed.2019.12.011] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 12/05/2019] [Accepted: 12/06/2019] [Indexed: 11/22/2022]
Abstract
This scoping review aimed to synthesize the available evidence on the epidemiology, patient- and caregiver-associated factors, clinical characteristics, screening tools, prevention, interventions, and perspectives of health care professionals in regard to elder abuse in the out-of-hospital or emergency department (ED) setting. Literature search was performed with MEDLINE, EMBASE, the Cumulative Index of Nursing and Allied Health, PsycINFO, and the Cochrane Library. Studies were eligible if they were observational or experimental and reported on elder abuse in the out-of-hospital or ED setting. A qualitative approach, performed independently by 2 reviewers, was used to synthesize and report the findings. A total of 413 citations were retrieved, from which 55 studies published between 1988 and 2019 were included. The prevalence of elder abuse reported during the ED visit was lower than reported in the community. The most commonly detected type of elder abuse was neglect, and then physical abuse. The following factors were more common in identified cases of elder abuse: female sex, cognitive impairment, functional disability, frailty, social isolation, and lower socioeconomic status. Psychiatric and substance use disorders were more common among victims and their caregivers. Screening tools have been proposed, but multicenter validation and influence of screening on patient-important outcomes were lacking. Health care professionals reported being poorly trained and acknowledged numerous barriers when caring for potential victims. There is insufficient knowledge, limited training, and a poorly organized system in place for elder abuse in the out-of-hospital and ED settings. Studies on the processes and effects of screening and interventions are required to improve care of this vulnerable population.
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12
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Trastornos del Ánimo y Demencia. Aspectos clínicos y estudios complementarios en el diagnóstico diferencial. REVISTA MÉDICA CLÍNICA LAS CONDES 2020. [DOI: 10.1016/j.rmclc.2020.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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13
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Qazi JJ, Wilson JH, Payne SC, Mattos JL. Association Between Smell, Taste, and Depression in Nationally Representative Sample of Older Adults in the United States. Am J Rhinol Allergy 2020; 34:369-374. [PMID: 31896279 DOI: 10.1177/1945892419897217] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectives To characterize the association between quantitative olfactory dysfunction (OD) and gustatory dysfunction and depression in older adults. Methods The 2013–2014 National Health and Nutrition Examination Survey (NHANES) data were used to investigate the relationship between smell and taste dysfunction and depression. Adults aged 65 years and older were included in the analysis. For smell status, subjects were divided into hyposmia, anosmia, and OD (hyposmia + anosmia) using the Pocket Smell Test. For taste status, subjects were evaluated using quinine, 1M NaCl, and 0.32M NaCl solutions. Indicator variables were made for subjects with both smell and taste dysfunction to determine whether a combination of symptoms could predict depression. Depression status was evaluated by the 9-item Patient Health Questionnaire using accepted cutoff values. Relevant demographic, socioeconomic, and comorbid factors were included in multivariate logistic regression models, which accounted for the complex survey design of NHANES. Results A total of 931 subjects aged 65 years or older were included in the weighted analysis. Anosmia significantly predicted depressive symptoms in multivariate analysis (odds ratio [OR] = 2.484, P = .032) but not univariate. In univariate analysis, hyposmia + anosmia (OR = 2.193, P = .006) and hyposmia (OR = 2.512, P < .001) significantly predicted depression. Significance was lost in multivariate analysis. Conclusions Smell dysfunction is an independent predictor of depressive symptoms in a representative sample of older adults in the United States after adjusting for relevant demographic factors and comorbidities.
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Affiliation(s)
- Jamiluddin J Qazi
- School of Medicine, University of Virginia, Charlottesville, Virginia
| | - James H Wilson
- School of Medicine, University of Virginia, Charlottesville, Virginia
| | - Spencer C Payne
- School of Medicine, University of Virginia, Charlottesville, Virginia.,Department of Otolaryngology-Head and Neck Surgery, University of Virginia, Charlottesville, Virginia
| | - Jose L Mattos
- School of Medicine, University of Virginia, Charlottesville, Virginia.,Department of Otolaryngology-Head and Neck Surgery, University of Virginia, Charlottesville, Virginia
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14
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Bickford D, Morin RT, Nelson JC, Mackin RS. Determinants of Suicide-related Ideation in Late Life Depression: Associations with Perceived Stress. Clin Gerontol 2020; 43:37-45. [PMID: 31514586 PMCID: PMC6923534 DOI: 10.1080/07317115.2019.1666442] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Objectives: Perceived stress is emerging as a potential contributing factor in suicide-related ideation in older adults. We hypothesized higher levels of perceived stress would be associated with increased self-reported suicidal ideation independent of depressive symptom severity.Methods: This study used data from community-dwelling older adults aged ≥65 with a current diagnosis of major depression. Eligible participants completed measures of depression symptom severity (Hamilton Depression Rating Scale-17 item), current suicidal ideation (Geriatric Suicide Ideation Scale), and perceived stress (Perceived Stress Scale).Results: Participants were 225 older adults with a mean age of 71.4 (SD = 5.6). Sixty-five percent of the sample was female. Fifteen percent of the variance in suicidal ideation was accounted for by lower education (p = .03), male sex (p = .03) and higher current perceived stress (p < .001). Specifically, stress accounted for 12% of the variance.Conclusions: Perceived stress is an important avenue to increase identification of individuals with a higher risk of suicide-related ideation among older adults with a current diagnosis of major depression.Clinical Implications: Screening for perceived stress may allow for improved screening and prevention of suicidal activity in depressed older adults.
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Affiliation(s)
- David Bickford
- Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Ruth T Morin
- Department of Psychiatry, University of California, San Francisco, California, USA.,Department of Veterans Affairs Medical Center, Center for Imaging of Neurodegenerative Diseases, San Francisco, California, USA
| | - James Craig Nelson
- Department of Psychiatry, University of California, San Francisco, California, USA
| | - Robert Scott Mackin
- Department of Psychiatry, University of California, San Francisco, California, USA.,Department of Veterans Affairs Medical Center, Center for Imaging of Neurodegenerative Diseases, San Francisco, California, USA
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Borson S, Korpak A, Carbajal‐Madrid P, Likar D, Brown GA, Batra R. Reducing Barriers to Mental Health Care: Bringing Evidence‐Based Psychotherapy Home. J Am Geriatr Soc 2019; 67:2174-2179. [DOI: 10.1111/jgs.16088] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 06/24/2019] [Accepted: 06/26/2019] [Indexed: 12/12/2022]
Affiliation(s)
- Soo Borson
- Department of Psychiatry and Behavioral Science, School of Medicine, University of Washington Seattle Washington
| | - Anna Korpak
- Department of Psychiatry and Behavioral Science, School of Medicine, University of Washington Seattle Washington
| | | | - Denise Likar
- Independence at Home, SCAN Health Plan Long Beach California
| | | | - Romilla Batra
- Independence at Home, SCAN Health Plan Long Beach California
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16
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An MH, Park SS, You SC, Park RW, Park B, Woo HK, Kim HK, Son SJ. Depressive Symptom Network Associated With Comorbid Anxiety in Late-Life Depression. Front Psychiatry 2019; 10:856. [PMID: 31824354 PMCID: PMC6880658 DOI: 10.3389/fpsyt.2019.00856] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 10/31/2019] [Indexed: 11/13/2022] Open
Abstract
Background: Depression and anxiety are the most common comorbid psychiatric disorders in the elderly. Psychiatrists have been reporting worsened depression symptoms and prognosis by comorbid anxiety symptoms. However, it is still unclear how anxiety affects the course of depression in the elderly. The aims of this study are (1) to identify the symptom network in late-life depression (LLD), and (2) to examine the role of anxiety in LLD with a network perspective. Methods: The study analyzed 776 community-based participants who were clinically diagnosed with depression and enrolled in Suwon Geriatric Mental Health Center. Network analysis was used to investigate the relationships between the symptoms of the Montgomery-Åsberg Depression Rating Scale (MADRS). The depression sample was divided into groups of low and high anxiety according to the Beck Anxiety Index. Propensity score matching (PSM) was used to minimize the effects of depression severity on the network. Network comparison test (NCT) were carried out to compare the global connectivity, global strength, and specific edge strength between the two subgroups. Results: Reported sadness, pessimistic thinking, and suicidal ideation are the core symptoms of LLD in terms of node strength. The MADRS sum score [mean (SD) 28.10 (9.19) vs 20.08 (7.11); P < .01] was much higher in the high anxiety group. The NCT before PSM showed the high anxiety group had significantly higher global strength (P < .01). However, the NCT after PSM did not reveal any statistical significance both in global structure (P = .46) and global strength (P = .26). A comparison between centrality indices showed a higher node strength of vegetative symptoms in the high anxiety group and this also remained after PSM. Conclusion: Based on the statistical analysis, anxiety worsens the severity of depression in the elderly. However, NCT after PSM revealed comorbid anxiety does not change the global structure and strength of the depression symptom network. Therefore, anxiety may affect LLD in a way of worsening the severity, rather than changing psychopathology. Additionally, the study revealed the centrality of vegetative symptoms was low in LLD but increased substantially in patients with comorbid anxiety.
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Affiliation(s)
- Min Ho An
- Ajou University School of Medicine, Suwon, South Korea
| | | | - Seng Chan You
- Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, South Korea
| | - Rae Woong Park
- Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, South Korea
| | - Bumhee Park
- Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, South Korea
| | | | - Han Ki Kim
- Ajou University School of Medicine, Suwon, South Korea
| | - Sang Joon Son
- Department of Psychiatry, Ajou University School of Medicine, Suwon, South Korea
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17
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Hoshino E, Ohde S, Rahman M, Takahashi O, Fukui T, Deshpande GA. Variation in somatic symptoms by patient health questionnaire-9 depression scores in a representative Japanese sample. BMC Public Health 2018; 18:1406. [PMID: 30587173 PMCID: PMC6307287 DOI: 10.1186/s12889-018-6327-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 12/14/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study aims to evaluate variation in somatic symptoms by age using patient health questionnaire-9 (PHQ) depression scores, which may be helpful in identifying depression. METHODS The study evaluated a nationally representative cross-sectional sample of community-dwelling adults in Japan in 2013. We utilized the PHQ to identify risk for depression, with PHQ ≥ 10 defining at least moderate depression. Bivariate and factor analyses were used to capture underlying patterns in self-reported symptoms over a 30 day period; aged-stratified multivariate logistic regression was performed to further explore associations between age, symptoms, and depression. RESULTS Of 3753 respondents, 296 (8, 95% CI 7.0-8.8) reported a PHQ ≥ 10; 42% of these were male and mean age was 51.7 years old (SD = 18.6). Multivariate analysis showed that presence of fatigue and malaise (OR = 1.7, 95% CI 1.3-2.4) was significantly associated with PHQ ≥ 10. After stratification by age, PHQ ≥ 10 was associated with gastrointestinal complaints among 18-39 year olds (OR = 1.7, 95% CI 1.0-2.9); fatigue and malaise (OR = 1.8, 95% CI 1.1-3.1) among 40-64 year olds; and fatigue and malaise (OR = 1.8, 95% CI 1.1-3.0) as well as extremity pain (OR = 1.7, 95% CI 1.0-2.8) in over 65 year olds. CONCLUSION Age-related somatic symptom correlates of PHQ ≥ 10 differ across the lifespan. Predominantly gastrointestinal symptoms in younger patients, and generalized fatigue, malaise, and musculoskeletal pain in older groups were observed. In order for screening physicians to proactively identify depression, awareness of age-related somatic symptoms is warranted.
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Affiliation(s)
- Eri Hoshino
- Graduate School of Public Health, Center for Clinical Academia, 5th Floor, St. Luke's International University, Tsukiji 3-6-2, Chuou-ku, Tokyo, 104-0045, Japan.
| | - Sachiko Ohde
- Graduate School of Public Health, Center for Clinical Academia, 5th Floor, St. Luke's International University, Tsukiji 3-6-2, Chuou-ku, Tokyo, 104-0045, Japan
| | - Mahbubur Rahman
- Graduate School of Public Health, Center for Clinical Academia, 5th Floor, St. Luke's International University, Tsukiji 3-6-2, Chuou-ku, Tokyo, 104-0045, Japan
| | - Osamu Takahashi
- Graduate School of Public Health, Center for Clinical Academia, 5th Floor, St. Luke's International University, Tsukiji 3-6-2, Chuou-ku, Tokyo, 104-0045, Japan.,St. Luke's International Hospital, Tokyo, Japan
| | | | - Gautam A Deshpande
- Graduate School of Public Health, Center for Clinical Academia, 5th Floor, St. Luke's International University, Tsukiji 3-6-2, Chuou-ku, Tokyo, 104-0045, Japan.,St. Luke's International Hospital, Tokyo, Japan
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Masse-Sibille C, Djamila B, Julie G, Emmanuel H, Pierre V, Gilles C. Predictors of Response and Remission to Antidepressants in Geriatric Depression: A Systematic Review. J Geriatr Psychiatry Neurol 2018; 31:283-302. [PMID: 30477416 DOI: 10.1177/0891988718807099] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Geriatric depression is a heterogeneous disorder that increases morbidity and mortality in a population that is already vulnerable. Predicting response and remission to antidepressants could help clinicians to optimize the management of antidepressants and reduce the consequences of depression. METHOD The aim of this article is to present results of a systematic review of the literature on predictive factors related to antidepressant response and remission in older adults with depression. MAIN FINDINGS We identified sociodemographic, clinical, neuropsychological, neuroimaging, and genetic factors that could be potential predictors of outcomes. Inconsistent findings and methodological differences among studies, however, limit the generalizability and application of these predictors in clinical practice. The results of our review confirm that geriatric depression includes many subgroups of patients with particular endophenotypes that may influence the course of depression. CONCLUSION Further studies are needed to characterize depression subgroups in order to better understand the pathophysiology of late life depression and to find specific predictors for each group of patients.
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Affiliation(s)
- Caroline Masse-Sibille
- 1 Department of Clinical Psychiatry, University Hospital of Besançon, Besançon, France.,2 University of Bourgogne Franche-Comté, Besançon, France
| | - Bennabi Djamila
- 1 Department of Clinical Psychiatry, University Hospital of Besançon, Besançon, France.,2 University of Bourgogne Franche-Comté, Besançon, France.,3 University Hospital of Besançon, Besançon, France.,4 FondaMental Foundation, Créteil, France
| | - Giustiniani Julie
- 1 Department of Clinical Psychiatry, University Hospital of Besançon, Besançon, France.,2 University of Bourgogne Franche-Comté, Besançon, France
| | - Haffen Emmanuel
- 1 Department of Clinical Psychiatry, University Hospital of Besançon, Besançon, France.,2 University of Bourgogne Franche-Comté, Besançon, France.,3 University Hospital of Besançon, Besançon, France.,4 FondaMental Foundation, Créteil, France
| | - Vandel Pierre
- 1 Department of Clinical Psychiatry, University Hospital of Besançon, Besançon, France.,2 University of Bourgogne Franche-Comté, Besançon, France.,5 Memory Center of Research and Resources (MCRR), University Hospital of Besançon, Besançon, France
| | - Chopard Gilles
- 1 Department of Clinical Psychiatry, University Hospital of Besançon, Besançon, France.,2 University of Bourgogne Franche-Comté, Besançon, France.,4 FondaMental Foundation, Créteil, France.,6 Department of Neurology, University Hospital of Besançon, Besançon, France
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Farioli Vecchioli S, Sacchetti S, Nicolis di Robilant V, Cutuli D. The Role of Physical Exercise and Omega-3 Fatty Acids in Depressive Illness in the Elderly. Curr Neuropharmacol 2018; 16:308-326. [PMID: 28901279 PMCID: PMC5843982 DOI: 10.2174/1570159x15666170912113852] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2017] [Revised: 06/20/2017] [Accepted: 07/30/2017] [Indexed: 02/07/2023] Open
Abstract
Background: In adulthood, depression is the most common type of mental illness and will be the second leading cause of disease by 2020. Major depression dramatically affects the function of the central nervous system and degrades the quality of life, especially in old age. Several mechanisms underlie the pathophysiology of depressive illness, since it has a multifactorial etiology. Human and an-imal studies have demonstrated that depression is mainly associated with imbalances in neurotransmitters and neurotrophins, hypothalamic-pituitary-adrenal axis alterations, brain volume changes, neurogenesis dysfunction, and dysregulation of in-flammatory pathways. Also the gut microbiota may influence mental health outcomes. Although depression is not a consequence of normal aging, depressive disorders are common in later life, even if often undi-agnosed or mis-diagnosed in old age. When untreated, depression reduces life expectancy, worsens medical illnesses, en-hances health care costs and is the primary cause of suicide among older people. To date, the underpinnings of depression in the elderly are still to be understood, and the pharmacological treatment is the most commonly used therapy. Objective: Since a sedentary lifestyle and poor eating habits have recently emerged as crucial contributors to the genesis and course of depression, in the present review, we have focused on the effects of physical activity and omega-3 fatty acids on depressive illness in the elderly. Results: A growing literature indicates that both exercise and dietary interventions can promote mental health throughout one’s lifespan. Conclusion: There thus emerges the awareness that an active lifestyle and a balanced diet may constitute valid low-cost pre-vention strategies to counteract depressive illness in the elderly.
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Affiliation(s)
- Stefano Farioli Vecchioli
- Institute of Cell Biology and Neurobiology, CNR/Fondazione Santa Lucia, Via del Fosso di Fiorano 64, 00143, Rome, Italy
| | - Stefano Sacchetti
- Laboratory of Experimental and Behavioral Neurophysiology, Fondazione Santa Lucia, Via del Fosso di Fiorano 64, 00143, Rome, Italy.,Department of Psychology, University Sapienza of Rome, Via dei Marsi 78, 00185, Rome, Italy
| | - V Nicolis di Robilant
- Institute of Cell Biology and Neurobiology, CNR/Fondazione Santa Lucia, Via del Fosso di Fiorano 64, 00143, Rome, Italy
| | - Debora Cutuli
- Laboratory of Experimental and Behavioral Neurophysiology, Fondazione Santa Lucia, Via del Fosso di Fiorano 64, 00143, Rome, Italy.,Department of Psychology, University Sapienza of Rome, Via dei Marsi 78, 00185, Rome, Italy
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20
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Walsh SE, LaJoie AS. Influence of Built Environment Quality and Social Capital on Mental Health of Residents of Assisted Living Communities in Louisville, Kentucky. Gerontol Geriatr Med 2018; 4:2333721418795900. [PMID: 30159360 PMCID: PMC6109847 DOI: 10.1177/2333721418795900] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 07/30/2018] [Accepted: 07/30/2018] [Indexed: 11/17/2022] Open
Abstract
Objectives: Prior research has shown social capital and built environment quality are associated with overall health status and the incidence of mental illness. This study explores the relationship between social capital, built environment, and quality of life specifically for assisted living residents, currently a gap in the literature. Method: A total of 76 assisted living residents were interviewed for the study using researcher-administered questionnaires. In addition, site audits were conducted to quantitatively evaluate the built environment surrounding 12 assisted living communities in the Louisville Metro region. Results: There was a moderate, positive correlation between social capital and mental health, r = .473, p < .001. Built environment quality for the neighborhood immediately surrounding the assisted living community was not significantly correlated with quality of life for assisted living residents. Other population characteristics, including demographic characteristics, self-rated health status, and instrumental activities of daily living were not significantly predictive of mental health scores. Conclusion: This study demonstrates that social capital is associated with happiness and self-rated quality of life. Specifically, increased social capital is associated with increased mental well-being for older adults residing in assisted living communities, with social capital explaining about 20% of the variation in quality of life scores.
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21
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Crick K, Al Sayah F, Ohinmaa A, Johnson JA. Responsiveness of the anxiety/depression dimension of the 3- and 5-level versions of the EQ-5D in assessing mental health. Qual Life Res 2018. [DOI: 10.1007/s11136-018-1828-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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22
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WANG J, LI W, YUE L, HONG B, AN N, LI G, XIAO S. The Study of White Matter Hyperintensity (WMH) and Factors Related to Geriatric Late-Onset Depression. SHANGHAI ARCHIVES OF PSYCHIATRY 2018; 30:12-19. [PMID: 29719354 PMCID: PMC5925594 DOI: 10.11919/j.issn.1002-0829.217038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Geriatric depression is one of the most common and harmful mental illnesses seen in the elderly. However, there are few studies focusing on the relationship between late-onset depression (LOD) and social and psychological factors, as well as brain structure. AIMS To explore factors related to late-onset depression (LOD) in elderly patients. METHODS 24 first onset LOD patients over 60 years old (meeting ICD-10 diagnostic criteria for depression) and 23 non-depressed elders were selected for inclusion into this study. Scale assessments, including Fazelasscale for white matter hyperintensity (WMH) high signal level and the MTA-scale for medial temporal lobe atrophy levels, were combined with general demography and sociology data to find factors related to LOD. RESULTS There was no significant difference in age (t=0.419, p=0.678), gender (X2=1.705, p=0.244), or years of education (t=1.478, p=0.146) between the two groups. However, statistical differences were shown on scores on the WMH, (X2=7.817, p=0.008), periventricular white matter hyperintensity (PWMH)(Fisher exact test: p=0.031), having or not having religious beliefs (Fisher exact test: p=0.265) and family harmony (yes or no) (Fisher exact test: p=0.253) between the LOD group and control group. The results of linear regression analysis showed that the total score for WMH, religious beliefs (with or without) and family harmony (yes or no) were associated with depressive symptomology. CONCLUSION Scores on the WMH, religious beliefs and family harmony are all potentially related to LOD in elderly patients.
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Affiliation(s)
| | | | | | | | | | - Guanjun LI
- Alzheimer’s Disease and Related Disorders Center of the Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shifu XIAO
- Alzheimer’s Disease and Related Disorders Center of the Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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23
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Atlas A, Kerse N, Rolleston A, Teh R, Bacon C. Falls and depression in octogenarians - life and living in advanced age: a cohort study in New Zealand. J Prim Health Care 2017. [DOI: 10.1071/hc17012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
ABSTRACT
INTRODUCTION
Falls and injury have the most devastating consequences for very old people. Depression may be a significant cause and consequence of falls.
AIM
To examine the association between falls and depression in octogenarians.
METHODS
LiLACS NZ (Life and Living in Advanced Age: A Cohort Study in New Zealand), cohort study data of Māori (aged 80–90 years, 11-year age band) and non-Māori (aged 85 years, 1-year age band) followed for 3 years was used to describe the incidence and prevalence of falls and depression. Falls by self-report were accumulated over 3 years. Geriatric depression score (GDS) was ascertained at baseline.
RESULTS
Over 3 years, fewer Māori (47%) than non-Māori (57%) fell; 19% of non-Māori and 20% of Māori scored 5+ (depressed) on the GDS. For non-Māori and Māori, people with depression were more likely to fall than Māori not diagnosed with depression (OR 2.72, CI 1.65–4.48 for non-Māori and OR 2.01, CI 1.25–3.25 for Māori). This remained significant, adjusted for age and sex. Depression was a significant predictor of hospitalisations from falls for Māori (OR 5.59, CI 2.4–12.72, adjusted for age and sex) and non-Māori (OR 4.21, 2.3–7.44, adjusted for sex).
CONCLUSION
Depression and falls are common and co-exist in octogenarians. GPs thinking about falls should also think about depression and vice versa.
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Efficacy and tolerability of antidepressants in people aged 65 years or older with major depressive disorder - A systematic review and a meta-analysis. J Affect Disord 2016; 205:1-12. [PMID: 27389296 DOI: 10.1016/j.jad.2016.06.013] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Revised: 05/31/2016] [Accepted: 06/03/2016] [Indexed: 01/07/2023]
Abstract
BACKGROUND There has been a steady increase in the prescription of antidepressants for the elderly. This study comprises a systematic review of randomized, placebo-controlled trials of antidepressants for treatment of depressive disorder in people aged 65 years or more. METHODS PubMed, EMBASE, Cochrane Library, CINAL, and PsycINFO were searched until May 2016. Where appropriate, the results were synthesized in meta-analyses. RESULTS Twelve trials met the inclusion criteria. For patients with major depressive disorder, selective serotonin re-uptake inhibitors (SSRI) were not superior to placebo in achieving remission (OR: 0.79, 95% CI: 0.61-1.03) or response (OR=0.86, 95% CI: 0.51-1.10) after 8 weeks of treatment (three trials). However, maintenance treatment with SSRIs was superior to placebo in preventing relapse (OR: 0.22, 95% CI: 0.13-0.36; NNT=5, 95% CI: 3-6; two trials). Duloxetine was superior to placebo in achieving remission (OR: 1.78, 95% CI: 1.20-2.65; NNT=9, 95% CI: 6-20; three trials) and response (OR: 1.83, 95% CI: 1.96-4.08; two trials) in recurrent major depression after 8 weeks, but increased the risk of adverse events that can be problematic in the elderly. LIMITATIONS The quality of evidence was generally low or moderate, emphasizing the uncertainty of the results. Study populations only partly covered the heterogeneous population of elderly with depressed mood, limiting the generalizability. CONCLUSION The results underscore the importance of close monitoring of the effects of antidepressants in treatment of elderly patients with a depressive disorder. Methods for early detection of non-responders and effective treatment options for this group are needed.
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Burhenn PS, McCarthy AL, Begue A, Nightingale G, Cheng K, Kenis C. Geriatric assessment in daily oncology practice for nurses and allied health care professionals: Opinion paper of the Nursing and Allied Health Interest Group of the International Society of Geriatric Oncology (SIOG). J Geriatr Oncol 2016; 7:315-24. [DOI: 10.1016/j.jgo.2016.02.006] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 01/19/2016] [Accepted: 02/10/2016] [Indexed: 12/14/2022]
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Cano Gutiérrez C, Arciniegas Rubio A, Germán Borda M, Samper-Ternent R, Gil Laverde F, Londoño Trujillo D. Perception of health-related quality of life using the EURO-QOL in older adults in Bogotá, Colombia. Eur Geriatr Med 2016. [DOI: 10.1016/j.eurger.2016.01.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Wang C, Gao S, Hendrie HC, Kesterson J, Campbell NL, Shekhar A, Callahan CM. Antidepressant Use in the Elderly Is Associated With an Increased Risk of Dementia. Alzheimer Dis Assoc Disord 2016; 30:99-104. [PMID: 26295747 PMCID: PMC4760914 DOI: 10.1097/wad.0000000000000103] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
A retrospective cohort study was conducted including 3688 patients age 60 years or older without dementia enrolled in a depression screening study in primary care clinics. Information on antidepressant use and incident dementia during follow-up was retrieved from electronic medical records. The Cox proportional hazard models were used to compare the risk for incident dementia among 5 participant groups: selective serotonin re-uptake inhibitors (SSRI) only, non-SSRI only (non-SSRI), mixed group of SSRI and non-SSRI, not on antidepressants but depressed, and not on antidepressants and not depressed. SSRI and non-SSRI users had significantly higher dementia risk than the nondepressed nonusers (hazard ratio [HR]=1.83, P=0.0025 for SSRI users and HR=1.50, P=0.004 for non-SSRI users). In addition, SSRIs users had significantly higher dementia risk than non-users with severe depression (HR=2.26, P=0.0005). Future research is needed to confirm our results in other populations and to explore potential mechanism underlying the observed association.
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Affiliation(s)
- Chenkun Wang
- Department of Biostatistics, Indiana University School of Medicine. Indianapolis, IN
- Richard M. Fairbank School of Public Health, Indiana University, Indianapolis, IN
| | - Sujuan Gao
- Department of Biostatistics, Indiana University School of Medicine. Indianapolis, IN
- Richard M. Fairbank School of Public Health, Indiana University, Indianapolis, IN
- Indiana University Center for Aging Research. Indianapolis, IN
| | - Hugh C. Hendrie
- Department of Psychiatry, Indiana University School of Medicine. Indianapolis, IN
- Regenstrief Institute, Inc. Indianapolis, IN
- Indiana University Center for Aging Research. Indianapolis, IN
| | | | - Noll L. Campbell
- Regenstrief Institute, Inc. Indianapolis, IN
- Indiana University Center for Aging Research. Indianapolis, IN
- Department of Pharmacy Practice, Purdue University School of Pharmacy, West Lafayette, IN
| | - Anantha Shekhar
- Department of Psychiatry, Indiana University School of Medicine. Indianapolis, IN
| | - Christopher M. Callahan
- Regenstrief Institute, Inc. Indianapolis, IN
- Indiana University Center for Aging Research. Indianapolis, IN
- Department of Medicine, Indiana University School of Medicine. Indianapolis, IN
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Cossmann JC, Scherbaum N, Bonnet U. Substance Addiction in Old Age. GEROPSYCH-THE JOURNAL OF GERONTOPSYCHOLOGY AND GERIATRIC PSYCHIATRY 2016. [DOI: 10.1024/1662-9647/a000140] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Abstract. There is a lack of studies using a structured face-to-face interview focusing on the full spectrum of substance addictions according to ICD or DSM classification systems in older patients. We therefore examined a cohort of 400 randomly selected, at least 65-year-old inpatients of a general hospital concerning addictive disorders using a well-tested structured clinical interview (DSM-IV-TR-based SKID-I). Nearly one third of this cohort was substance dependent: The 12-month prevalence rate for nicotine was 10.3% and for alcohol dependence 3%, with 24.4% and 66.7%, respectively, being severely dependent. These rates were similar to those found in the general German population of persons under 65 year of age. A fifth of the cohort was (mostly mildly) dependent on prescription drugs, remarkably including nonopioid analgesics. One case with a previous dependence on gabapentin was identified. Identification and management of addiction disorders should be considered as part of the basic geriatric assessment.
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Affiliation(s)
- Johanna Cristina Cossmann
- , Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, Evangelisches Krankenhaus Castrop-Rauxel, Academic Training Hospital of the University of Duisburg-Essen, Germany
| | - Norbert Scherbaum
- , Department of Addictive Behavior and Addiction Medicine, LVR-Klinikum Essen, Hospital of the University of Duisburg-Essen, Germany
| | - Udo Bonnet
- , Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, Evangelisches Krankenhaus Castrop-Rauxel, Academic Training Hospital of the University of Duisburg-Essen, Germany
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Understanding Exercise Practices and Depression, Anxiety, and Stress in Senior Games Athletes. TOPICS IN GERIATRIC REHABILITATION 2016. [DOI: 10.1097/tgr.0000000000000092] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Investigating Factors that Bias the Reporting of Depression Symptomatology Among Older Australian Adults. Am J Geriatr Psychiatry 2015; 23:1046-55. [PMID: 25979203 DOI: 10.1016/j.jagp.2015.04.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Revised: 03/28/2015] [Accepted: 04/13/2015] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To investigate factors that may bias the reporting of major depression symptoms among older adults, specifically the presence of physical conditions, bereavement, episode onset, and episode length. METHODS A secondary data analysis of a nationally representative cross-sectional survey of community-dwelling older Australian adults aged 50-85 years who completed the depression module in the 2007 Australian National Survey of Mental Health and Wellbeing (N=629) was conducted. Depression symptomatology was assessed according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria using the World Mental Health Composite International Diagnostic Interview. RESULTS Multiple indicators multiple causes modeling indicated a unidimensional factor structure of depression. Two depressive symptoms displayed measurement noninvariance (i.e., nonequivalency): worthlessness/guilt and suicidality/thoughts of death. Specifically, older adults who were bereaved were significantly less likely to report worthlessness/guilt (OR: 0.29; 95% CI: 0.16-0.50) and more likely to report suicidality/thoughts of death (OR: 4.67; 95% CI: 2.84-7.68), compared with older adults who were not bereaved. Examination of latent mean differences revealed that older adults with physical conditions displayed significantly greater depression severity compared with older adults without physical conditions. CONCLUSION The presence of physical conditions and episode onset and length do not appear to differentially influence reporting of depression symptoms among older Australian adults, suggesting these factors do not bias prevalence estimates of depression. Reporting of worthlessness/guilt and suicidality/thoughts of death may be biased toward older adults who are bereaved; however, these did not influence overall depression severity.
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Abstract
BACKGROUND Mental disorders in the elderly are common, with a 12-month prevalence in the community ranging from 8.54% to 26.4%. Unfortunately, many mental disorders are unrecognized, untreated, and associated with poor health outcomes. The aim of this paper is to describe the prevalence of mental disorders in the elderly primary care (PC) population and its associated factors by age groups. METHODS Cross-sectional survey, conducted in 77 PC centers in Catalonia (Spain), 1,192 patients over 65 years old. The prevalence of mental disorders was assessed through face-to-face evaluations using the Structured Clinical Interview for DSM-IV Axis I Disorders, Research Version (SCID-I-RV) and the Mini International Neuropsychiatric Interview (MINI); chronic physical conditions were noted using a checklist; and disability through the Sheehan Disability Scales (SDS). RESULTS Nearly 20% of participants had a mental disorder in the previous 12 months. Anxiety disorders were the most frequent, (10.9%) (95% CI = 8.2-14.4), followed by mood disorders (7.4%) (95% CI = 5.7-9.5). Being female, greater perceived stress and having mental health/emotional problems as the main reason for consultation were associated with the presence of any mental disorder. There were no differences in prevalence across age groups. Somatic comorbidity was not associated with the presence of mental disorders. CONCLUSIONS Mental disorders are highly prevalent among the elderly in PC in Spain. Efforts are needed to develop strategies to reduce this prevalence and improve the well-being of the elderly. Based on our results, we thought it might be useful to assess perceived stress regularly in PC, focusing on people who consult for emotional distress, or that have greater perceived stress.
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Reynolds K, Pietrzak RH, El-Gabalawy R, Mackenzie CS, Sareen J. Prevalence of psychiatric disorders in U.S. older adults: findings from a nationally representative survey. World Psychiatry 2015; 14:74-81. [PMID: 25655161 PMCID: PMC4329900 DOI: 10.1002/wps.20193] [Citation(s) in RCA: 214] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Data on the prevalence of psychiatric disorders in late life are lacking. The present study addresses this gap in the literature by examining the prevalence of the broadest range of psychiatric disorders in late life to date; comparing prevalences across older adult age groups using the largest sample of adults aged 85+; and exploring gender differences in the prevalence of psychiatric disorders in late life. Using data from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions, we examined the prevalence of past-year mood, anxiety, and substance use disorders, and lifetime personality disorders in a nationally representative sample of 12,312 U.S. older adults. We stratified our analyses by gender and by older age groups: young-old (ages 55-64), middle-old (ages 65-74), old-old (ages 75-84), and oldest-old (ages 85+). The proportion of older adults who experienced any past-year anxiety disorder was 11.4%, while the prevalence of any past-year mood disorder was 6.8%. A total of 3.8% of older adults met criteria for any past-year substance use disorder, and 14.5% of older adults had one or more personality disorder. We observed a general pattern of decreasing rates of psychiatric disorders with increasing age. Women experienced higher rates of mood and anxiety disorders, while men had higher rates of substance use disorders and any personality disorder. Gender differences in rates of most psychiatric disorders decreased with increasing age. These data indicate that psychiatric disorders are prevalent among U.S. older adults, and support the importance of prevention, diagnosis, and treatment of psychiatric disorders in this population.
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Affiliation(s)
- Kristin Reynolds
- Department of Psychology, University of Manitoba190 Dysart Rd., Winnipeg, Manitoba, R3T 2N2 Canada
| | - Robert H Pietrzak
- Department of Psychiatry, Yale University School of MedicineNew Haven, CT, USA,United States Department of Veterans Affairs National Center for Posttraumatic Stress Disorder and Department of Psychiatry, Yale University School of MedicineNew Haven, CT, USA
| | - Renée El-Gabalawy
- Department of Psychology, University of Manitoba190 Dysart Rd., Winnipeg, Manitoba, R3T 2N2 Canada
| | - Corey S Mackenzie
- Department of Psychology, University of Manitoba190 Dysart Rd., Winnipeg, Manitoba, R3T 2N2 Canada
| | - Jitender Sareen
- Department of Psychiatry, University of ManitobaWinnipeg, Manitoba, Canada
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Andreas S, Lüdemann J, Härter M. Depressive Erkrankungen im höheren Lebensalter. PSYCHOTHERAPEUT 2015. [DOI: 10.1007/s00278-014-1101-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Manetti A, Hoertel N, Le Strat Y, Schuster JP, Lemogne C, Limosin F. Comorbidity of late-life depression in the United States: a population-based study. Am J Geriatr Psychiatry 2014; 22:1292-306. [PMID: 23988281 DOI: 10.1016/j.jagp.2013.05.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2012] [Revised: 04/29/2013] [Accepted: 05/02/2013] [Indexed: 11/15/2022]
Abstract
OBJECTIVES This study sought to determine the clinical and sociodemographic correlates and the treatment-seeking rate of major depressive disorder (MDD), diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, among older adults and its association with comorbid psychiatric disorders and perceived health status. METHODS Data were drawn from the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions, a large cross-sectional survey (N = 43,093) representative of the US population. RESULTS Compared with participants aged 65 years and older without a 12-month diagnosis of MDD, those with MDD were more likely to have lifetime and 12-month comorbid psychiatric disorders. Except for lifetime dysthymia, we found no significant interaction between rates of current somatic comorbidity, lifetime and 12-month psychiatric comorbidity, and age groups. Compared with younger participants with a 12-month MDD, they had an older age at onset, reported a similar number of lifetime major depressive episodes and perceived health status, and had lower mental health service utilization rates. CONCLUSIONS Current major depression in the elderly seems to be as disabling as in younger adults in terms of comorbid psychiatric disorders and impaired quality of life. Poorer prognosis of MDD in older adults might be explained by a lower perceived need of treatment, resulting in a lower rate of treatment-seeking behavior.
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Affiliation(s)
- Aude Manetti
- Assistance Publique-Hôpitaux de Paris, Service universitaire de Psychiatrie de l'adulte et du sujet âgé, Hôpitaux Universitaires Paris Ouest, Corentin Celton Hospital, Issy-les-Moulineaux, France.
| | - Nicolas Hoertel
- Assistance Publique-Hôpitaux de Paris, Service universitaire de Psychiatrie de l'adulte et du sujet âgé, Hôpitaux Universitaires Paris Ouest, Corentin Celton Hospital, Issy-les-Moulineaux, France; Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France; INSERM U894, Centre de Psychiatrie et Neurosciences, Paris, France
| | - Yann Le Strat
- Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France; INSERM U894, Centre de Psychiatrie et Neurosciences, Paris, France; Assistance Publique-Hôpitaux de Paris, Department of Psychiatry, Louis-Mourier Hospital, Colombes, France
| | - Jean-Pierre Schuster
- Assistance Publique-Hôpitaux de Paris, Service universitaire de Psychiatrie de l'adulte et du sujet âgé, Hôpitaux Universitaires Paris Ouest, Corentin Celton Hospital, Issy-les-Moulineaux, France
| | - Cédric Lemogne
- Assistance Publique-Hôpitaux de Paris, Service universitaire de Psychiatrie de l'adulte et du sujet âgé, Hôpitaux Universitaires Paris Ouest, Corentin Celton Hospital, Issy-les-Moulineaux, France; Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France; INSERM U894, Centre de Psychiatrie et Neurosciences, Paris, France
| | - Frédéric Limosin
- Assistance Publique-Hôpitaux de Paris, Service universitaire de Psychiatrie de l'adulte et du sujet âgé, Hôpitaux Universitaires Paris Ouest, Corentin Celton Hospital, Issy-les-Moulineaux, France; Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France; INSERM U894, Centre de Psychiatrie et Neurosciences, Paris, France
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Parisi JM, Franchetti MK, Rebok GW, Spira AP, Carlson MC, Willis SL, Gross AL. Depressive symptoms and inductive reasoning performance: findings from the ACTIVE reasoning training intervention. Psychol Aging 2014; 29:843-51. [PMID: 25244465 DOI: 10.1037/a0037670] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Within the context of the Advanced Cognitive Training for Independent and Vital Elderly study (ACTIVE; Ball et al., 2002; Jobe et al., 2001; Willis et al., 2006), we examined the longitudinal association of baseline depressive symptoms on inductive reasoning performance over a 10-year period between the reasoning training and control conditions (N = 1,375). At baseline, 322 participants (23%) reported elevated depressive symptoms, defined by a score ≥9 on the 12-item version of the Center for Epidemiological Studies Depression Scale (CES-D; Mirowsky & Ross, 2003; Radloff, 1977). Differences in baseline depressive status were not associated with immediate posttraining gains or with subsequent annual change in reasoning performance, suggesting that the presence of elevated baseline depressive symptoms does not impact the ability to benefit from reasoning training.
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Affiliation(s)
- Jeanine M Parisi
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health
| | | | - George W Rebok
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health
| | - Adam P Spira
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health
| | - Michelle C Carlson
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health
| | - Sherry L Willis
- Department of Psychiatry and Behavioral Sciences, University of Washington
| | - Alden L Gross
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health
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Abstract
As the population ages, primary care providers will be frequently called on to manage psychiatric disorders suffered by their older patients. This overview of delirium, dementia, depression, and alcohol and substance misuse highlights the common presentations and suggests initial approaches to treatment. The challenges facing caregivers are also discussed.
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Affiliation(s)
- Shaune DeMers
- Division of Geriatric Psychiatry, Harborview Medical Center and University of Washington, Box 359760, 325 Ninth Avenue, Seattle, WA 98104-2499, USA.
| | - Kyl Dinsio
- Division of Geriatric Psychiatry, Harborview Medical Center and University of Washington, Box 359760, 325 Ninth Avenue, Seattle, WA 98104-2499, USA
| | - Whitney Carlson
- Division of Geriatric Psychiatry, Harborview Medical Center and University of Washington, Box 359760, 325 Ninth Avenue, Seattle, WA 98104-2499, USA
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Maust DT, Oslin DW, Marcus SC. Effect of Age on the Profile of Psychotropic Users: Results from the 2010 National Ambulatory Medical Care Survey. J Am Geriatr Soc 2014; 62:358-64. [DOI: 10.1111/jgs.12640] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Donovan T. Maust
- Department of Psychiatry; University of Michigan; Ann Arbor Michigan
- Center for Clinical Management Research; Veterans Affairs Ann Arbor Healthcare System; Ann Arbor Michigan
| | - David W. Oslin
- Department of Psychiatry; Perelman School of Medicine; University of Pennsylvania; Philadelphia Pennsylvania
- Veterans Integrated Service Networks 4 Mental Illness Research, Education, and Clinical Center; Philadelphia Veterans Affairs Medical Center; Philadelphia Pennsylvania
| | - Steven C. Marcus
- School of Social Policy and Practice; University of Pennsylvania; Philadelphia Pennsylvania
- Center for Health Equity Research and Promotion; Philadelphia Veterans Affairs Medical Center; Philadelphia Pennsylvania
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Chiang CC, Lin CL, Tsai YY, Peng CL, Liao YT, Sung FC. Patients with blepharitis are at elevated risk of anxiety and depression. PLoS One 2013; 8:e83335. [PMID: 24386181 PMCID: PMC3875469 DOI: 10.1371/journal.pone.0083335] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2013] [Accepted: 11/02/2013] [Indexed: 12/14/2022] Open
Abstract
Purpose Population-based cohort study on the risk of anxiety and depression in patients with blepharitis is limited. This study evaluated whether blepharitis patients are at a higher risk of anxiety and depression. Design A retrospective cohort study. Methods We used the universal insurance claims data from 1997 to 2010 in Taiwan to identify annually patients with newly diagnosed blepharitis (N = 9764) and without the disease (N = 39056). Incidences, rate ratios (IRR) and hazard ratios (HR) of anxiety and depression were measured for both cohorts by baseline demographic characteristics and comorbidities until the end of 2010. Results Compared with the non-blepharitis cohort, the blepharitis cohort had higher incidence of anxiety (15.9 vs. 9.5 per 1000 person-years), with an adjusted HR of 1.58 (95% confidence interval (CI) = 1.46–1.70). The incidence of depression was also higher in the blepharitis cohort (7.66 vs. 5.05 per 1000 person-years), with an adjusted HR of 1.42 (95% CI = 1.28–1.58). The blepharitis cohort to the non-blepharitis cohort IRR decreased from 1.73 in the first quartile to 1.32 in the 4th quartile for anxiety, and from 1.67 to 1.29 for depression. Conclusions Patients with blepharitis are at elevated risks of anxiety and depression. The risk is higher in earlier period after the diagnosis of blepharitis, and declines by time, but remains significantly higher for those with blepharitis than those without blepharitis.
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Affiliation(s)
- Chun-Chi Chiang
- Department of Ophthalmology, China Medical University Hospital, Taichung, Taiwan
- School of Medicine, China Medical University, Taichung, Taiwan
| | - Cheng-Li Lin
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - Yi-Yu Tsai
- Department of Ophthalmology, China Medical University Hospital, Taichung, Taiwan
- School of Medicine, China Medical University, Taichung, Taiwan
| | - Chiao-Ling Peng
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - Ya-Tang Liao
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - Fung-Chang Sung
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
- Department of Public Health, China Medical University College of Public Health, Taichung, Taiwan
- * E-mail:
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Kazer MW, Grossman S, Kerins G, Kris A, Tocchi C. Validity and Reliability of the Geriatric Sexuality Inventory. J Gerontol Nurs 2013; 39:38-45. [DOI: 10.3928/00989134-20130916-03] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2013] [Accepted: 08/15/2013] [Indexed: 11/20/2022]
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Lee H, Lee JA, Brar JS, Rush EB, Jolley CJ. Physical activity and depressive symptoms in older adults. Geriatr Nurs 2013; 35:37-41. [PMID: 24144579 DOI: 10.1016/j.gerinurse.2013.09.005] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2013] [Revised: 09/09/2013] [Accepted: 09/10/2013] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Depressive symptoms are prevalent in older adults, and physical activity (PA) may have beneficial effects on depression. The purpose of this study was to explore the association between physical activity and depressive symptoms, taking into account demographic factors, and the associations between selected demographic factors and physical activity levels in community-dwelling older adults (age ≥ 60 years). METHODS Data were drawn from the National Health and Nutrition Examination Survey 2005-2006. Descriptive statistics and logistic models were used in data analysis. RESULTS Four percent of participants reported moderate depressive symptoms, and 24% of subjects exhibited sedentary PA. Factors associated with increased risk of moderate depression included age, sedentary PA, and chronic medical conditions (ps < 0.05). Sedentary PA was significantly associated with age, race, education, BMI, smoking status, alcohol use, and taking psychotropics (ps < 0.05). DISCUSSION PA is a protective factor for depression in older adults, and clinical implications to encourage PA are discussed.
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Affiliation(s)
- Heeyoung Lee
- University of Pittsburgh, School of Nursing, Pittsburgh, PA, USA
| | - Jung-Ah Lee
- University of California, Irvine, Program in Nursing Science, Irvine, CA, USA.
| | - Jaspreet S Brar
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, PA, USA; The Western Psychiatric Institute and Clinic is the official name of the clinic within the University of Pittsburgh Medical Center
| | - Elizabeth B Rush
- University of California, Irvine, Department of Psychology and Social behavior, Irvine, CA, USA
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Dabelko-Schoeny H, Anderson KA, Guada J. Adult day services: a service platform for delivering mental health care. Aging Ment Health 2013; 17:207-14. [PMID: 23020155 DOI: 10.1080/13607863.2012.724653] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVES The purpose of this study was to understand the degree to which mental health services targeting anxiety and depression disorders are offered by adult day services (ADS) centers in the US. In addition, researchers wanted to determine whether staffing and organizational characteristics are associated with the provision of medication management, individual counseling, and group counseling for participants with anxiety or depression. METHOD Data were drawn from the MetLife National Study of ADS. Hierarchical logistic regression analyses were conducted to determine which staffing and organizational factors were associated with the provision of services to treat anxiety and depression. RESULTS Approximately, three in four adult day programs provided medication management for the treatment of anxiety and depression while 38% provided individual counseling and almost 30% group counseling. Programs offering medication management were more likely to have more registered nurse (RN) service hours available per shift and higher costs. Programs that provided individual and group counseling for participants with anxiety or depression were more likely to have more hours of RN and social work services available and a lower percentage of participants who pay privately for services. CONCLUSION The results suggest that ADS are well positioned to act as a platform for delivering mental health care to older persons with anxiety or depression.
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Biological mechanisms of age-related disease and geriatric clinical research: a commentary from the NIMH. Am J Geriatr Psychiatry 2013; 21:415-7. [PMID: 23570885 DOI: 10.1016/j.jagp.2012.09.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2012] [Accepted: 09/26/2012] [Indexed: 11/21/2022]
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Calati R, Salvina Signorelli M, Balestri M, Marsano A, De Ronchi D, Aguglia E, Serretti A. Antidepressants in elderly: metaregression of double-blind, randomized clinical trials. J Affect Disord 2013; 147:1-8. [PMID: 23245467 DOI: 10.1016/j.jad.2012.11.053] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2012] [Revised: 11/20/2012] [Accepted: 11/21/2012] [Indexed: 10/27/2022]
Abstract
BACKGROUND Depression is common in the elderly and in the last few years this led to a significant increase in antidepressant prescription rates. However, little is known about antidepressant efficacy profile in relation with socio-demographic and clinical features in this population. The aim of the present study was to define the most suitable socio-demographic and clinical profile for the use of antidepressant treatments in late-life depression. METHODS MEDLINE, EMBASE and PsycINFO were searched for randomized controlled trials (RCTs) focused on efficacy of antidepressants of all classes in major depressed elderly subjects (>60 years old). Reviews and meta-analyses focusing on this topic have been considered as well. Thirty-four RCTs were included and socio-demographic and clinical features were investigated via meta-regression analysis as moderators of efficacy measures (standardized mean difference based on Hamilton Depressive Rating Scale and Montgomery-Asberg Depression Rating Scale). RESULTS A lower rate of response to antidepressants of all classes was found in patients of male gender, of older age, and with a longer mean duration of the current episode. On the contrary, a higher rate of response was found in patients with a higher baseline severity and at their first episode of illness. Subsamples treated with selective serotonin reuptake inhibitors alone yielded similar results. LIMITATIONS RCTs only have been included. CONCLUSIONS A number of socio-demographic and clinical features have been found to moderate antidepressant efficacy in elderly population. Those variables could help clinicians for a more individualized treatment.
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Affiliation(s)
- Raffaella Calati
- IRCCS Centro S. Giovanni di Dio, Fatebenefratelli, Brescia, Italy
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Quality of life, health care utilization, and control in older adults with asthma. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2013; 1:157-62. [PMID: 24565454 DOI: 10.1016/j.jaip.2012.12.003] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 07/12/2012] [Revised: 12/12/2012] [Accepted: 12/14/2012] [Indexed: 11/23/2022]
Abstract
BACKGROUND Older adults with asthma have worse quality of life, asthma control and increased health care utilization than do healthy peers. Factors that contribute to this are currently unknown. OBJECTIVE To identify demographic, psychological or physiologic characteristics associated with asthma quality of life, control and health care utilization in older adults. METHODS By using a cross-sectional design, subjects older than 65 years with a history of physician-diagnosed asthma were enrolled. Demographic, psychological and physiological characteristics (including spirometry, atopy testing and exhaled nitric oxide) were collected. Correlations between these factors and the mini Asthma Quality of Life Questionnaire, Asthma Control Questionnaire and health care utilization were assessed. RESULTS Seventy subjects were enrolled in the study, with a mean age of 73.3 years and mean duration of asthma diagnosis of 28.5 years. Higher depression screening scores and self-reported depression were strongly correlated with poorer quality of life and asthma control after controlling for confounding effects through a regression model. In addition, worse overall functional status was correlated with poorer asthma quality of life (P < .01), presence of atopy was associated with decreased health care utilization (P < .01) and subjects who lived alone were more likely to have unscheduled visits to a physician's office (P = .06). CONCLUSIONS Comorbid depression is strongly associated with poorer asthma quality of life and control in older adults. In addition, worse functional status and living alone may be associated with poorer outcomes. Screening for these conditions is important in the care of the elderly asthmatic population.
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Nour K, Hébert M, Lavoie JP, Dallaire B, Wallach I, Moscovizt N, Regenstreif A, Billette V. [Specialized mental health services for the elderly: a pilot study of the evaluation process]. SANTE MENTALE AU QUEBEC 2013; 38:81-102. [PMID: 24336991 DOI: 10.7202/1019187ar] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
In Quebec, the Centre de santé et services sociaux (CSSS) Cavendish offers specialized services for the elderly with mental health problems (SSSM 60+) (Nour et al., 2011a). This article describes a targeted segment of the population reached (considering the exclusion criteria, only 50% of the elderly receiving services from the SSSM 60+ were followed). The article presents the model of individual changes relating to services, and explores the psychosocial mediators that influence the efficiency of services. This population experiences various psychosocial problems, the most important being mild to moderate symptoms of depression. Services and interventions by the SSSM 60+ team appear to increase significantly the therapeutic alliance and the feeling of empowerment in this clientele. Prioritizing these two concepts during service delivery appears to be an avenue to consider.
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Affiliation(s)
- Kareen Nour
- Direction de santé publique de la Montérégie
| | - Marijo Hébert
- Centre de recherche et d'expertise en gérontologie sociale, CSSS Cavendish
| | - Jean-Pierre Lavoie
- Centre de recherche et d'expertise en gérontologie sociale, CSSS Cavendish
| | | | | | | | | | - Véronique Billette
- Centre de recherche et d'expertise en gérontologie sociale, CSSS Cavendish
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Incidence of late-life depression: a systematic review. J Affect Disord 2012; 142:172-9. [PMID: 22940498 DOI: 10.1016/j.jad.2012.05.010] [Citation(s) in RCA: 91] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2011] [Revised: 05/02/2012] [Accepted: 05/02/2012] [Indexed: 11/21/2022]
Abstract
BACKGROUND In the past years, many studies have examined the prevalence of late-life depression. However, incidence studies, especially those including the oldest age groups, remained rare. The objective of this article is therefore to provide a systematic review on incidence of depressive disorders in latest life. METHODS A systematic search of the literature published between 1985 and 2011 was conducted using MEDLINE, Web of Science, PsycInfo and Cochrane databases. Inclusion criteria were: incidence specified for persons aged≥70 years at baseline, population-based sample or primary care sample. Incidence rates or risks were extracted or calculated. RESULTS We found 20 studies reporting incidence according to categorical (n=14) or dimensional diagnoses (n=6). The incidence of depressive disorders varied considerably. Major Depression (MD) was found to occur less often than Minor Depression (MinD), whereas clinically relevant depressive symptoms are at least as frequent as MinD. The incidence rate of MD was 0.2-14.1/100 person-years, and incidence of clinically relevant depressive symptoms was 6.8/100 person-years. Female incidence was mostly higher than male. Associations between age and incidence revealed to be rather inconsistent between studies. LIMITATIONS Methodological diversity of the studies concerning diagnostics, data collection methods, incidence definitions and sampling make the results difficult to interprete. CONCLUSIONS This review is the first to have focused on incidence studies on depression in latest life. The frequent occurrence of clinically relevant depressive symptoms will have to be considered in future health care planning. Physical health and psychosocial influences appear to be key variables in depression prevention.
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Byers AL, Vittinghoff E, Lui LY, Hoang T, Blazer DG, Covinsky KE, Ensrud KE, Cauley JA, Hillier TA, Fredman L, Yaffe K. Twenty-year depressive trajectories among older women. ACTA ACUST UNITED AC 2012; 69:1073-9. [PMID: 23026957 DOI: 10.1001/archgenpsychiatry.2012.43] [Citation(s) in RCA: 104] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
CONTEXT Despite the frequent occurrence of depressive symptoms among older adults, especially women, little is known about the long-term course of late-life depressive symptoms. OBJECTIVE To characterize the natural course of depressive symptoms among older women (from the young old to the oldest old) followed up for almost 20 years. DESIGN Using latent-class growth-curve analysis, we analyzed women enrolled in an ongoing prospective cohort study (1988 through 2009). SETTING Clinic sites in Baltimore, Maryland; Minneapolis, Minnesota; the Monongahela Valley near Pittsburgh, Pennsylvania; and Portland, Oregon. PARTICIPANTS We studied 7240 community-dwelling women 65 years or older. MAIN OUTCOME MEASURE The Geriatric Depression Scale short form (score range, 0-15) was used to routinely assess depressive symptoms during the follow-up period. RESULTS Among older women, we identified 4 latent classes during 20 years, with the predicted probabilities of group membership totaling 27.8% with minimal depressive symptoms, 54.0% with persistently low depressive symptoms, 14.8% with increasing depressive symptoms, and 3.4% with persistently high depressive symptoms. In an adjusted model for latent class membership, odds ratios (ORs) for belonging in the increasing depressive symptoms and persistently high depressive symptoms classes, respectively, compared with a group having minimal depressive symptoms were substantially and significantly (P < .05) elevated for the following variables: baseline smoking (ORs, 4.69 and 7.97), physical inactivity (ORs, 2.11 and 2.78), small social network (ORs, 3.24 and 6.75), physical impairment (ORs, 8.11 and 16.43), myocardial infarction (ORs, 2.09 and 2.41), diabetes mellitus (ORs, 2.98 and 3.03), and obesity (ORs, 1.86 and 2.90). CONCLUSIONS During 20 years, almost 20% of older women experienced persistently high depressive symptoms or increasing depressive symptoms. In addition, these women had more comorbidities, physical impairment, and negative lifestyle factors at baseline. These associations support the need for intervention and prevention strategies to reduce depressive symptoms into the oldest-old years.
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Affiliation(s)
- Amy L Byers
- Department of Psychiatry, University of California, San Francisco, CA 94121, USA.
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Abstract
OBJECTIVES Increasing evidence suggests that depression is a risk factor for cognitive impairment, but it is unclear if this is true among the oldest old. We determined whether elevated depressive symptoms predicted 5-year incident mild cognitive impairment (MCI) or dementia, and neuropsychological test performance among oldest-old women. DESIGN Prospective. SETTING Three study sites. PARTICIPANTS 302 women ≥85 years (mean, 87 ± 2). MEASUREMENTS Depressive symptoms were measured with the 15-item Geriatric Depression Scale (GDS); scores of 6 or more indicated elevated symptoms. Five years later, participants completed neuropsychological testing and clinical cognitive status was adjudicated. RESULTS In analyses of MCI versus normal cognition, 70% of women with GDS score 6 or more at baseline developed MCI versus 37% with GDS score less than 6. After adjustment for age, education, alcohol, and benzodiazepine use, and study site, GDS score 6 or more remained independently associated with much greater likelihood of developing MCI (multivariable odds ratio [MOR] = 3.71, 95% confidence interval (CI): 1.30-10.59). In analyses of dementia versus normal cognition, 65% of women with GDS score 6 or more developed dementia compared with 37% of those with GDS score less than 6 (MOR = 3.15, 95% CI: 1.03-9.65). Only 19% of women with GDS score 6 or more had normal cognitive status 5 years later, compared with 46% of those with GDS score less than 6 (MOR = 0.28, 95% CI: 0.11-0.73). Women with elevated depressive symptoms had worse scores on tests of global cognition and working memory. CONCLUSION Elevated depressive symptoms are an important risk factor for cognitive disorders and lower cognitive performance among women living to their ninth and tenth decades.
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Balkanska P. Communication Problems Within Families With Patients With Dementia. PSYCHOLOGICAL THOUGHT 2012. [DOI: 10.5964/psyct.v5i2.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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