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Loss K, Fandino W, Almarie B, Bazan-Perkins B, Minetto J, Aranis N, Monaco T, Aladab A, Pacheco-Barrios K, Fregni F. The impact of education level and socioeconomic status on the association between depressive symptoms and memory in an older population in Latin America: An exploratory analysis from the Brazilian Longitudinal Study of Aging (ELSI-BRAZIL). DIALOGUES IN HEALTH 2024; 5:100183. [PMID: 38975569 PMCID: PMC11226811 DOI: 10.1016/j.dialog.2024.100183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Revised: 05/02/2024] [Accepted: 05/27/2024] [Indexed: 07/09/2024]
Abstract
Purpose The globally increasing older population raises concerns about age-related conditions, including cognitive impairment and depressive symptoms. In Latin America, nearly one-third of the population is affected by either of these conditions. However, data investigating the association between cognitive impairment and depressive symptoms, particularly in Brazil, are limited to small-scale studies that have not carefully examined the critical effects of variables such as education level and socioeconomic status on this relationship. We aimed at exploring this association in a representative population-based cohort. Methods We used the Brazilian Longitudinal Study of Aging (ELSI-BRAZIL) database to examine the relationship between depressive symptoms and cognitive impairment in Brazilian older adults, adjusted for potential confounders. Direct acyclic graphs and multivariable linear regression were used to build our model. Depressive symptoms were measured using a short version of the Center for Epidemiologic Studies Scale (CES D-8), and combined memory recall test as a surrogate of cognitive impairment. Results The study included 8280 participants. Only education level was identified as a confounder for the relationship between memory loss and depressive symptoms. After adjusting for age, sex, and education level, there was strong evidence for a negative association between depressive symptoms and memory performance. For every 5-unit increase in the CES D-8 score, there was a reduction in memory capacity, translating to a loss of approximately one word in the combined words recall test (mean - 0.18, 95% CI -0.22; -0.15, P < 0.001). In addition, we found strong evidence for an interaction between socioeconomic status and depressive symptoms. Subjects belonging to medium socioeconomic status (SES) showed more pronounced memory decline, when compared to those with lower SES (mean - 0.28, 95% CI -0.42 to -0.14, P < 0.001). Conclusions In adults aged over 50, after adjusting for sex, age, and educational level, a 5-unit increase in CES D-8 score is associated with loss of one point in the combined memory recall test. This association seems to be confounded by educational level and significantly modified by socioeconomic status.
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Affiliation(s)
- Karla Loss
- Pediatrics Department. Federal University of Espirito Santo, Brazil
| | - Wilson Fandino
- Anaesthetics Department, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
| | - Bassel Almarie
- Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Blanca Bazan-Perkins
- Laboratory of Immunopharmacology, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico City, Mexico
- Tecnológico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Mexico City, Mexico
| | - Julia Minetto
- Liver Transplantation Department, Garrahan Pediatric Hospital, Buenos Aires, Argentina
| | - Nadine Aranis
- Servicio de Medicina Física y Rehabilitación, Clínica Alemana Universidad del Desarrollo, Santiago, Chile
| | | | - Aisha Aladab
- Pulmonary Division, Hamad General Hospital, Qatar
| | - Kevin Pacheco-Barrios
- Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Universidad San Ignacio de Loyola, Vicerrectorado de Investigación, Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Lima, Peru
| | - Felipe Fregni
- Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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Lee W, DiGiacomo M, Draper B, Agar MR, Currow DC. A Focus Group Study of Palliative Physician and Consultation-Liaison Psychiatrist Perceptions of Dealing with Depression in the Dying. J Palliat Care 2022; 37:535-544. [PMID: 36083631 PMCID: PMC9465534 DOI: 10.1177/08258597221121453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: To ascertain palliative physicians’ and
consultation-liaison psychiatrists’ perceptions of depression care processes in
patients with very poor prognoses, exploring key challenges and postulating
solutions. Methods: A qualitative focus group study involving three
1-h online focus groups (2 palliative medicine and 1 psychiatry) were conducted
between November-December 2020. Fellows and trainees were recruited from
Australian and New Zealand Society of Palliative Medicine (n = 11) and Royal
Australian and New Zealand College of Psychiatrists (n = 4). Data underwent
conventional qualitative content analysis. Results: Participants
perceived depression care to be complex and challenging. Perceived barriers
included: inadequate palliative care psychiatry skills with variation in
clinical approaches; lack of supportive health infrastructure (poor access to
required interventions and suboptimal linkage between palliative care and
psychiatry); lack of research support; and societal stigma. Suggested solutions
included integrating care processes between palliative care and psychiatry to
improve clinician training, establish supportive health systems and promote
innovative research designs. Conclusions: Developing clinician
training, supportive health systems and innovative research strategies centering
on integrating palliative care and psychiatry care processes may be integral to
optimising depression care when providing care to people with very poor
prognoses.
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Affiliation(s)
- Wei Lee
- Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT), Faculty of Health, 110561University of Technology Sydney, Ultimo, NSW 2007, Australia.,St Vicent's Clinical School, University of New South Wales, Sydney, Australia
| | - Michelle DiGiacomo
- Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT), Faculty of Health, 110561University of Technology Sydney, Ultimo, NSW 2007, Australia
| | - Brian Draper
- School of Psychiatry, 7800University of New South Wales, Sydney, Australia
| | - Meera R Agar
- Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT), Faculty of Health, 110561University of Technology Sydney, Ultimo, NSW 2007, Australia
| | - David C Currow
- Faculty of Science, Medicine and Health, 8691University of Wollongong, Wollongong, Australia
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Prevalence and correlates of depressive and anxiety symptoms among adults in Guangdong Province of China: A population-based study. J Affect Disord 2022; 308:535-544. [PMID: 35460741 DOI: 10.1016/j.jad.2022.04.089] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 04/01/2022] [Accepted: 04/13/2022] [Indexed: 12/19/2022]
Abstract
AIMS To examine the prevalence and health correlates of depressive and anxiety symptoms among adults living in Guangdong province of China with a large population and rapid urbanization. METHODS The Guangdong Sleep and Psychosomatic Health Survey was conducted from September to November in 2019, which was a population-based study with a representative sample of adults aged 18-85 years. Multistage stratified cluster sampling was used. A total of 13,768 inhabitants were included and face-to-face interviewed using standardized assessment tools. Depressive and anxiety symptoms were evaluated using the Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder Scale (GAD-7), respectively. RESULTS The weighted prevalence rates of depressive and anxiety symptoms were 8.6% (95% confidence interval [CI]: 8.0%-9.3%) and 6.0% (95%CI, 5.4%-6.5%) respectively. People who have never married, irregular diet rhythm, hardly exercise, poorer sleep, alcohol consumption, chronic diseases and being unemployment and retirement were more likely to suffer depressive and anxiety symptoms. Moreover, the prevalence of depressive symptoms was significantly higher in those suffering from cardiovascular disease (Odds ratio[OR]:3.89, 95%CI: 1.77-8.54), chronic nephrosis (OR:3.89, 95%CI: 1.52-9.94), hyperlipidemia (OR:2.68, 95%CI: 1.57-4.59), anemia (OR:1.96, 95%CI: 1.33-2.89) and arthritis (OR:1.93, 95%CI: 1.17-3.16). The prevalence of anxiety symptoms was evidently greater within patients with cardiovascular disease (OR:3.15, 95%CI: 1.39-7.14), chronic nephrosis (OR: 2.89, 95%CI: 1.22-6.83), hyperlipidemia (OR:2.27, 95%CI: 1.20-4.29) and diabetes (OR:1.99, 95%CI: 1.15-3.44). CONCLUSIONS Depressive and anxiety symptoms are commonly found in patients with chronic diseases. Given these adverse outcomes on health, health professionals should pay more attention to depressive and anxiety problems in health care for high-risk population.
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Lopes MA, Nassar SM, Barcelos-Ferreira R, Folquitto JC, Litvoc J. Incidence of dementia in a population cohort of older people from São Paulo, Brazil. Int J Geriatr Psychiatry 2022; 37. [PMID: 34802177 DOI: 10.1002/gps.5660] [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] [Received: 07/09/2021] [Revised: 11/08/2021] [Accepted: 11/18/2021] [Indexed: 01/18/2023]
Abstract
OBJECTIVES To estimate the incidence of dementia in a community-dwelling older population from São Paulo city, Brazil. METHODS/DESIGN This two-phase prospective cohort study evaluated a representative cluster sample of 1370 individuals aged 60 years old and over from three different socioeconomic levels. The community screening phase consisted of a tested combination of cognitive and functional tests administered among the subjects and informants. In the hospital diagnosis phase, the Cambridge Examination was performed; the diagnosis of dementia and dementia subtypes was made according to DSM IV criteria. Incidence rates were expressed in person-years, multiplied by 1000. The risk of developing dementia was calculated using Cox regression. RESULTS Among 1370 eligible subjects, 678 were accessed, and 489 completed the evaluation. Forty-two subjects were diagnosed with dementia. The incidence rate of dementia and Alzheimer's disease (AD) were 11.2 (95% CI: 8.0-15.1) and 8.9 (95% CI: 6.1-12.5) per 1000 person-years, respectively; there were high age-specific rates of dementia among younger individuals. There was a trend of a higher risk of developing AD for women than for men. Multivariate analysis showed that older age, the presence of diabetes and the presence of amnestic MCI increased the risk of developing dementia. CONCLUSIONS The age-specific rates in younger individuals were expressively higher than in worldwide studies and supposedly affected by cardiovascular morbidity. The higher risk in women in a younger sample corroborated the interaction between sex and AD. The increased risk of amnestic MCI reinforced its contribution to the progression to dementia and AD.
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Affiliation(s)
- Marcos Antonio Lopes
- Internal Medicine Department, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Silvia Modesto Nassar
- Informatics and Statistics Department, Federal University of Santa Catarina, Florianópolis, Brazil
| | | | | | - Júlio Litvoc
- Preventive Medicine Department, School of Medicine, Universidade de São Paulo, São Paulo, Brazil
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Prevalência de depressão e fatores associados em idosos atendidos na Atenção Primária à Saúde em região metropolitana do Distrito Federal. SCIENTIA MEDICA 2021. [DOI: 10.15448/1980-6108.2021.1.38237] [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
Objetivo: verificar a prevalência de depressão e as variáveis sociodemográficas e clínicas associadas a esse transtorno nos idosos atendidos na Atenção Primária à Saúde (APS) em região metropolitana do Distrito Federal.Métodos: estudo transversal realizado entre janeiro e agosto de 2018, com idosos atendidos na Unidade Básica de Saúde da Granja do Torto, em Brasília, DF. Foi aplicado instrumento versando sobre variáveis sociodemográficas, comportamentais e clínicas. Para a avaliação dos sintomas depressivos, foi utilizada a Escala de Depressão Geriátrica, versão reduzida (EDG-15). Na análise dos dados, foi realizada a estatística descritiva e a aplicação do teste qui-quadrado para associação das variáveis categóricas, com nível de significância de 5% (p≤ 0,05).Resultados: a amostra constituiu-se de 70 idosos. Foi encontrada prevalência de 41,4% de sintomas depressivos nos idosos estudados, 35,7% com indicativo de depressão leve e 5,7% de depressão grave. No grupo com sintomas depressivos, houve predomínio do sexo feminino, idade entre 70 a 79 anos, casados, católicos, analfabetos, aposentados, de baixa renda e com duas ou mais pessoas com grau de parentesco vivendo na mesma residência. Foi identificado, no grupo com depressão, associação significativa com escolaridade (p=0,05), nível de instrução (p=0,04), renda mensal (p=0,006), condições clínicas como osteoporose (p=0,02) e artrite/artrose (p=0,03), quedas (p=0,03) e uso de antidepressivos (p=0,02), sendo, nessa classe, escitalopram o mais utilizado (p=0,004).Conclusão: foi evidenciada alta prevalência de depressão entre os idosos da APS da região metropolitana do Distrito Federal do sexo feminino com idades entre 70 e 79 anos. Variáveis como escolaridade, nível de instrução, renda mensal, osteoporose, artrite/artrose, quedas e uso de antidepressivos apresentaram diferenças estatisticamente significativas naqueles com depressão. Assim, é fundamental o rastreio precoce dos sintomas depressivos, mais precisão no diagnóstico e no tratamento desse transtorno, com intervenções não farmacológicas e farmacológicas, executadas por equipe multidisciplinar especializada, capacitada para assistir aos idosos da rede de APS, evitando os efeitos deletérios na qualidade de vida dos indivíduos desse grupo.
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Lee W, Pulbrook M, Sheehan C, Kochovska S, Chang S, Hosie A, Lobb E, Parker D, Draper B, Agar MR, Currow DC. Clinically Significant Depressive Symptoms Are Prevalent in People With Extremely Short Prognoses-A Systematic Review. J Pain Symptom Manage 2021; 61:143-166.e2. [PMID: 32688012 DOI: 10.1016/j.jpainsymman.2020.07.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 07/09/2020] [Accepted: 07/13/2020] [Indexed: 12/13/2022]
Abstract
CONTEXT Currently, systematic evidence of the prevalence of clinically significant depressive symptoms in people with extremely short prognoses is not available to inform its global burden, assessment, and management. OBJECTIVES To determine the prevalence of clinically significant depressive symptoms in people with advanced life-limiting illnesses and extremely short prognoses (range of days to weeks). METHODS A systematic review and meta-analysis (random-effects model) were performed (PROSPERO: CRD42019125119). MEDLINE, Embase, PsycINFO, CINAHL, and CareSearch were searched for studies (1994-2019). Data were screened for the prevalence of clinically significant depressive symptoms (assessed using validated depression-specific screening tools or diagnostic criteria) of adults with advanced life-limiting illnesses and extremely short prognoses (defined by survival or functional status). Quality assessment was performed using the Joanna Briggs Institute Systematic Reviews Checklist for Prevalence Studies for individual studies and Grading of Recommendations Assessment, Development and Evaluation (GRADE) across studies. RESULTS Thirteen studies were included. The overall pooled prevalence of clinically significant depressive symptoms in adults with extremely short prognoses (n = 10 studies; extremely short prognoses: N = 905) using depression-specific screening tools was 50% (95% CI: 29%-70%; I2 = 97.6%). Prevalence of major and minor depression was 10% (95% CI: 4%-16%) and 5% (95% CI: 2%-8%), respectively. Major limitations included high heterogeneity, selection bias, and small sample sizes in individual studies. CONCLUSIONS Clinically, significant depressive symptoms were prevalent in people with advanced life-limiting illnesses and extremely short prognoses. Clinicians need to be proactive in the recognition and assessment of these symptoms to allow for timely intervention.
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Affiliation(s)
- Wei Lee
- University of Technology Sydney, Ultimo, New South Wales, Australia; St Vincent Hospital, Darlinghurst, New South Wales, Australia.
| | - Marley Pulbrook
- St Vincent Hospital, Darlinghurst, New South Wales, Australia
| | | | | | - Sungwon Chang
- University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Annmarie Hosie
- St Vincent Hospital, Darlinghurst, New South Wales, Australia; University of Notre Dame Australia, New South Wales, Australia
| | - Elizabeth Lobb
- Calvary Hospital, Kogarah, New South Wales, Australia; University of Notre Dame Australia, New South Wales, Australia
| | - Deborah Parker
- University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Brian Draper
- University of New South Wales, Randwick, New South Wales, Australia
| | - Meera R Agar
- University of Technology Sydney, Ultimo, New South Wales, Australia
| | - David C Currow
- University of Technology Sydney, Ultimo, New South Wales, Australia
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The Prevalence of Depression and Anxiety and Their Lifestyle Determinants in a Large Sample of Iranian Adults: Results from a Population Based Cross-Sectional Study. SERBIAN JOURNAL OF EXPERIMENTAL AND CLINICAL RESEARCH 2020. [DOI: 10.2478/sjecr-2018-0079] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Abstract
Association of lifestyle-related factors and mental health has been less studied in Middle Eastern countries. This study aimed to examine the prevalence of two common mental health problems, i.e., depression and anxiety, and their lifestyle determinants in a large sample of Iranian population.
This study was conducted within the framework of SEPAHAN population based cross-sectional study (N=4763(. The General Practice Physical Activity Questionnaire (GPPAQ) was used to assess physical activity and the Iranian-validated version of Hospital Anxiety and Depression Scale (HADS) was applied to screen for anxiety and depression. Logistic regression was used as the main statistical method for data analysis by SPSS version 16.0. A P-value <0.05 was considered to be statistically significant.
The risk of anxiety and depression was 2.5 (OR=2.56,95% CI: 1.97-3.33) and 2.21(1.83-2.67) times higher in women than men, respectively. With every one-year increase in the age, the risk of anxiety decreased by 2% (OR=0.98,95% CI:0.97-0.99). Individuals with higher education had 56% lower risk of anxiety (OR=0.44,95% CI: 0.36-0.55) and 46% depression (OR=0.54,95% CI: 0.46-0.64) than the undergraduate group, and the risk of depression in the inactive (less than one hour of activity per week) group was 27% higher than the active group (OR=1.27,95% CI: 1.06-1.51). The risk of anxiety in the non-smoker group was 65% (OR=0.35,95% CI: 0.20-0.59) and depression was 64% lower than among smokers (OR=0.34,95% CI:0.22-0.53). In the ex-smoker group, the risk of anxiety was 60% (OR=0.40,95% CI:0.19-0.85) and depression was 59% lower than for the smoker group (OR=0.41,95% CI: 0.24-0.73).
This current study’s results demonstrated significant associations between unhealthy lifestyle factors and increased risk of anxiety and depression. Hence, special attention must be paid to preventive intervention programmes aiming to enhance healthy lifestyle among at-risk populations.
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Kawasaki T, Tozawa R. Grit in Community-Dwelling Older Adults with Low Back Pain Is Related to Self-Physical Training Habits. PM R 2020; 12:984-989. [PMID: 31901016 DOI: 10.1002/pmrj.12318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Accepted: 12/30/2019] [Indexed: 11/07/2022]
Abstract
INTRODUCTION Self-management is an effective way to manage chronic low back pain (LBP) and is frequently recommended. However, the psychological aspects, including grit (ie, perseverance and passion for long-term goals), of the habit of self-management remain unclear. OBJECTIVE To investigate the relationship between grit and the self-directed exercise. DESIGN Cross-sectional observational study. SETTING Community-dwelling older adults. PARTICIPANTS Fifty-nine older adults with LBP (30 men, 29 women; mean age 72 ± 5 years, range 65-82 years). INTERVENTION Not applicable. MAIN OUTCOME MEASURES Primary outcome measures included grit scores on the Short Grit Scale and the number of months performing self-directed exercise. Correlation and multiple regression analyses were performed to determine the relationship between participants' grit and duration of self-directed exercise. RESULTS A significant positive correlation between grit and the duration of self-directed exercise habits was observed (r = 0.49, P < .001). Furthermore, in multiple regression analysis, grit was a significant factor of the duration of self-directed exercise. CONCLUSION Low grit was associated with reduced self-directed exercise in individuals with LBP self-directed exercise.
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Affiliation(s)
- Tsubasa Kawasaki
- Institute of Sports Medicine and Science, School of Human and Social Sciences, Tokyo International University, Kawagoe-City, Japan
| | - Ryosuke Tozawa
- Department of Physical Therapy, Faculty of Health Science, Ryotokuji University, Urayasu-City, Japan
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Mendes-Chiloff CL, Lima MCP, Torres AR, Santos JLF, Duarte YO, Lebrão ML, Cerqueira ATDAR. Depressive symptoms among the elderly in São Paulo city, Brazil: prevalence and associated factors (SABE Study). REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2019; 21Suppl 02:e180014. [PMID: 30726359 DOI: 10.1590/1980-549720180014.supl.2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Accepted: 07/08/2015] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To estimate the prevalence of depressive symptoms in the elderly in São Paulo city, Brazil (SABE Study), in 2006 and to identify risk factors associated with the 2006 prevalence and protective factors among those who did not have depressive symptoms in the assessments conducted in 2000 and 2006. METHODS In this cross-sectional and longitudinal study, the Geriatric Depression Scale was used for inclusion in the cohort in 2000 and also in 2006. RESULTS The prevalence of depressive symptoms in 2006 was 14.2% (95%CI 11.8 - 16.7), and 74.8% of the participants did not present depressive symptoms in 2000 neither in 2006. Logistic regression models were constructed, with different groups of variables (socio-demographic variables, status and perception of health and memory) adjusted for sex and age. In the final logistic regression model, the following factors were associated with depressive symptoms: self-assessment of vision, oral health, memory and of general health as poor, dependence for basic activities of daily living, and moderate or severe family dysfunction. Protective factors against presenting depressive symptoms in the 2000 and 2006 phases were: being male, absence of pulmonary disease and positive self-assessment of health. CONCLUSION Depressive symptoms were frequent among the elderly, and were associated with health problems, dependence and family dysfunction. These factors should be addressed in health policy planning for the care of these elderly.
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Affiliation(s)
- Cristiane Lara Mendes-Chiloff
- Departamento de Neurologia, Psicologia e Psiquiatria, Faculdade de Medicina de Botucatu, Universidade Estadual "Júlio de Mesquita Filho" - Botucatu (SP), Brasil
| | - Maria Cristina Pereira Lima
- Departamento de Neurologia, Psicologia e Psiquiatria, Faculdade de Medicina de Botucatu, Universidade Estadual "Júlio de Mesquita Filho" - Botucatu (SP), Brasil
| | - Albina Rodrigues Torres
- Departamento de Neurologia, Psicologia e Psiquiatria, Faculdade de Medicina de Botucatu, Universidade Estadual "Júlio de Mesquita Filho" - Botucatu (SP), Brasil
| | - Jair Lício Ferreira Santos
- Departamento de Medicina Social, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo - Ribeirão Preto (SP), Brasil
| | - Yeda Oliveira Duarte
- Departamento de Enfermagem Médico-cirúrgica, Escola de Enfermagem, Universidade de São Paulo - São Paulo (SP), Brasil
| | - Maria Lúcia Lebrão
- Departamento de Epidemiologia, Faculdade de Saúde Pública, Universidade de São Paulo - São Paulo (SP), Brasil
| | - Ana Teresa De Abreu Ramos Cerqueira
- Departamento de Neurologia, Psicologia e Psiquiatria, Faculdade de Medicina de Botucatu, Universidade Estadual "Júlio de Mesquita Filho" - Botucatu (SP), Brasil
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ALEXANDRINO-SILVA CLÓVIS, RIBEIZ SALMAROSE, FRIGERIO MARIABEATRIZ, BASSOLLI LUCAS, ALVES TÂNIAFERRAZ, BUSATTO GERALDO, BOTTINO CÁSSIO. Prevention of depression and anxiety in community-dwelling older adults: the role of physical activity. ARCH CLIN PSYCHIAT 2019. [DOI: 10.1590/0101-60830000000185] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
| | | | | | | | | | | | - CÁSSIO BOTTINO
- University of São Paulo, Brazil; University of São Paulo, Brazil
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Alizadeh Z, Feizi A, Rejali M, Afshar H, Keshteli AH, Adibi P. The Predictive Value of Personality Traits for Psychological Problems (Stress, Anxiety and Depression): Results from a Large Population Based Study. J Epidemiol Glob Health 2018; 8:124-133. [PMID: 30864753 PMCID: PMC7377556 DOI: 10.2991/j.jegh.2017.11.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Accepted: 11/11/2017] [Indexed: 11/12/2022] Open
Abstract
The current study aimed to determine the prognostic values of personality traits for common psychological problems in a large sample of Iranian adult. In a large sample of healthy people (n = 4763) who lived in Isfahan province; the NEO-FFI was used to assess the personality traits; depression and anxiety were assessed using the "Hospital Anxiety and Depression Scale (HADS)" also stress was measured through Persian validated version of General Health Questionnaire (GHQ-12). Receiver Operating Characteristics Curve (ROC) analysis was used as main statistical method for data analysis. ROC analysis showed neuroticism was the best predictor for all psychological problems with highest area under the curve (AUC) (95% confidence interval) for stress, 0.837 (0.837-0.851), anxiety 0.861 (0.847-0.876) and depression 0.833 (0.820-0.846) (p < .001) and the corresponding cut-off points (sensitivity, specificity), were 21.5 (77%, 66%), 22.5 (81%, 77%) and 20.5 (77%, 74%), respectively. Other personality traits were significant protective factors for being affected with psychological problems (p < .001). Similar findings were observed separately in women and men. The present study showed that the neuroticism is significant risk factor for being affected with three psychological problems while other traits are significant protective factors. Personality traits are useful indices for screening psychological problems and an effective pathway toward prevention in general population.
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Affiliation(s)
- Zeinab Alizadeh
- Department of Public Health, Faculty of Health, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
- Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Awat Feizi
- Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
- Psychosomatic Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mehri Rejali
- Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamid Afshar
- Psychosomatic Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Peyman Adibi
- Department of Internal Medicine, School of Medicine and Integrative Functional, Gastroenterology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Physical Activity and Academic Performance: The Mediating Effect of Self-Esteem and Depression. SUSTAINABILITY 2018. [DOI: 10.3390/su10103633] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
An important step to enhance the academic efficiency of students is increasing their physical activity. For this reason, it is necessary to see to what extent physical activity is related to the academic performance of the students and what might mediate this. A major objective of the study is to explore self-esteem and depression as mediators between physical activity and academic performance. On the basis of informed consent to participate in the study, 358 participants have been selected from Universities in Pakistan, and they were asked about their physical activity, depression during their study and self-esteem through self-report. Participants self-reported their self-esteem, level of depression and their physical activity through standardized measures; the Rosenberg Self-esteem scale (1965), the University stress scale (2016), and the short form of the International Physical Activity questionnaire (2003), respectively. Academic performance had been measured as the cumulative grade point average (CGPA) of the last two consecutive semesters. Self-esteem and depression were found to be significant mediators between physical activity and academic performance. The total effect of physical activity on academic performance was significant but smaller than the total indirect effect through mediators. Though total indirect effect is the combination of the effect of self-esteem and depression, but the larger contribution is of self-esteem which has been found to be the strongest mediator between physical activity and academic performance. The study has implications for future research, both in terms of testing the model and testing psychological constructs. Also, the study emphasizes that the importance of physical activity has to be kept in mind while designing a curriculum of an educational institution in order to foster sustainable development.
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Family status and later-life depression among older adults in urban Latin America and the Caribbean. AGEING & SOCIETY 2018. [DOI: 10.1017/s0144686x18000879] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractRapid fertility declines in Latin American and Caribbean countries since the 1960s have contributed to smaller family sizes among the current cohorts of older adults. This may have mental health implications in these societies as the family unit is highly valued as a source of social support. Utilising data from the 2000 Survey of Health, Well-being and Aging in Latin America and the Caribbean (SABE), this study examines the association between parental status, marital status and the likelihood of experiencing depressive symptoms among adults 60 years and older in seven cities within Latin America and the Caribbean (N = 9,756): Buenos Aires, Bridgetown, São Paulo, Santiago, Havana, Mexico City and Montevideo. Results from multivariate logistic regressions indicate that parental status is not significantly associated with depressive symptoms. Nonetheless, unmarried older adults, both those living alone and those living with others, are more vulnerable to experiencing depressive symptoms than their married counterparts. Marriage is especially protective for older adults in Havana and Montevideo. Older adults’ perceived income adequacy significantly moderates the relationship between marital status and depressive symptoms. Other significant covariates, such as experiencing disability and comorbidity, showed positive associations with depressive symptoms. While families may still represent a critical component for the mental health of older adults, broader investments in health across the lifespan are needed to improve individual psychological wellbeing.
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Alizadeh Z, Feizi A, Rejali M, Afshar H, Keshteli AH, Adibi P. The Predictive Value of Personality Traits for Psychological Problems (Stress, Anxiety and Depression): Results from a Large Population Based Study. J Epidemiol Glob Health 2018. [DOI: 10.1016/j.jegh.2017.11.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Zeinab Alizadeh
- Department of Public Health, Faculty of Health, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
- Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Awat Feizi
- Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
- Psychosomatic Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mehri Rejali
- Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamid Afshar
- Psychosomatic Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Peyman Adibi
- Department of Internal Medicine, School of Medicine and Integrative Functional, Gastroenterology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Abstract
BACKGROUND The present study investigated changes in the trajectories of depressive symptoms in the elderly and attempted to identify risk factors that influence these changes according to gender. METHODS All data were obtained from a subsample of subjects who participated in the Korean Longitudinal Study of Ageing between 2006 and 2012; 3,667 individuals (1,566 men and 2,101 women) aged 60 years and older were included in the present study. A group-based trajectory model was employed to determine the appropriate number of groups and to observe changes in depressive symptoms according to research year. Following the trajectory analysis, a multinomial regression analysis was performed to examine depressive symptom-related risk factors that influenced membership in the different trajectory groups. RESULTS Significant gender differences were found in the trajectories of depressive symptoms among four groups (normal, mild depressed, worsening, and depressed) in men and five groups (normal, mild depressed, worsening, improving, and depressed) in women. Among the trajectory groups, physical health status such as chronic diseases, self-rated health (SRH), and somatic pain showed statistically significant differences in both genders. In addition, employment in men and social participation in women were associated with the trajectories. CONCLUSIONS The present study suggested that maintaining one's physical health status played an important role in preventing depressive symptoms and that employment in men and social participation in women were preventative against the development of depressive symptoms.
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Psychotic symptoms in older people without dementia from a Brazilian community-based sample: A seven years' follow-up. PLoS One 2017. [PMID: 28622335 PMCID: PMC5473532 DOI: 10.1371/journal.pone.0178471] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Studies of the incidence of psychotic symptoms in elderly people at risk of dementia are scarce. This is a seven year follow up study aiming to determine the incidence of psychotic symptoms and their correlation with other clinical aspects, in particular the rate of development of cognitive impairment. METHODS Cohort study of a community-based sample of elderly subjects. At study entry in 2004, the sample was composed of 1,125 individuals aged 60 years and older. Of this total, 547 subjects were re-evaluated in 2011 and submitted to the original study protocol. Of these, 199 showed no psychotic symptoms at phase I, while 64 already had psychotic symptoms in 2004. RESULTS The incidence of at least one psychotic symptom in the 7 year period was 8.0% (Visual/tactile hallucinations: 4.5%; Persecutory delusions: 3.0%; Auditory hallucinations: 2.5%). Development of psychotic symptoms was associated with epilepsy (OR: 7.75 and 15.83), lower MMSE (OR: 0.72) and reported depression (OR: 6.48). A total of 57.8% of individuals with psychotic symptoms developed cognitive impairment after 7 years. Visual/tactile hallucinations were the only psychotic symptom predictive of this impairment, which was related to lower MMSE and greater functional impairment. CONCLUSIONS The incidence of psychotic symptoms and the conversion rate to cognitive impairment was in the upper range when compared with previous reports. Visual/tactile hallucinations were the most frequent symptoms and were predictive of cognitive impairment over the 7 year period. A significant relationship was found between the incidence of psychotic symptoms and low MMSE scores, as well as clinical comorbities such as epilepsy, reported depression, diabetes and syphilis.
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Araújo LFSCD, Ribeiz SRI, Martins CB, Bottino CMC. Serum cortisol level and depression severity in a sample of Brazilian elders. ARCH CLIN PSYCHIAT 2017. [DOI: 10.1590/0101-60830000000117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Silva AR, Sgnaolin V, Nogueira EL, Loureiro F, Engroff P, Gomes I. Doenças crônicas não transmissíveis e fatores sociodemográficos associados a sintomas de depressão em idosos. JORNAL BRASILEIRO DE PSIQUIATRIA 2017. [DOI: 10.1590/0047-2085000000149] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
RESUMO Objetivo Investigar a associação das doenças crônicas não transmissíveis e fatores sociodemográficos com sintomas de depressão em idosos. Métodos Foi realizado um estudo transversal com 1.391 idosos cadastrados na Estratégia Saúde da Família. Os dados sociodemográficos e de doenças crônicas não transmissíveis foram coletados pelos agentes comunitários de saúde. A Escala de Depressão Geriátrica abreviada foi utilizada para investigar os sintomas de depressão. Resultados Aproximadamente 81% referiram ao menos uma doença crônica não transmissível. Os sintomas depressivos foram associados com sexo feminino, doença coronariana, insuficiência cardíaca e acidente vascular cerebral; ≥ 8 anos de estudo e ter companheiro foram protetores. Dentre as doenças crônicas não transmissíveis, as cardiovasculares e as cerebrovasculares têm associação independente com sintomas de depressão. Conclusões Esses resultados corroboram a hipótese de que a doença vascular seja um fator de risco para o comprometimento encefálico associado à depressão. Evidencia-se o importante papel dos agentes comunitários de saúde, na Estratégia Saúde da Família, com potencial utilidade nas políticas públicas para a saúde mental do idoso.
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Affiliation(s)
| | | | | | | | - Paula Engroff
- Pontifícia Universidade Católica do Rio Grande do Sul, Brasil
| | - Irenio Gomes
- Pontifícia Universidade Católica do Rio Grande do Sul, Brasil
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Pilania M, Bairwa M, Khurana H, Kumar N. Prevalence and Predictors of Depression in Community-Dwelling Elderly in Rural Haryana, India. Indian J Community Med 2017; 42:13-18. [PMID: 28331248 PMCID: PMC5348997 DOI: 10.4103/0970-0218.199792] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Background: Depression in the elderly has been emerged as a serious public health challenge in the developing countries. Elderly population with depression is on rise in India, but is not adequately addressed. This study was planned to ascertain the prevalence of depression among elderly in a rural population of Haryana and assess its socio-demographic correlates. Methods: This study was a community based, cross sectional study, which was conducted in Community Health Centre (CHC), Chiri of Rohtak district (Haryana, India). Of total 124 Anganwadi centres in study area, 10 were randomly selected. A total 500 elderly persons aged 60 years and above were randomly screened for depression. Long form of Geriatric Depression Scale (GDS- 30) was used with cut off score at 22. The Pearson’s Chi-squared test, student’s t test, and multiple logistic regression were used to assess the association of depression in the elderly with its risk factors. Result: In our study, the prevalence of depression in the elderly was 14.4% (95% CI: 11.6- 17.8). Mean age of study population was 68.5 ± 7.7 years. Depression in the elderly had significant association with female gender [OR=2.7 (95% CI 1.4- 5.0)], not being consulted for major decisions [OR=2.7 (95% CI 1.5- 4.7)], presence of any chronic morbidity [OR=2.4 (95% CI 1.3- 4.5)], spending day without doing any activity, work or hobby [OR=3.8 (2.1- 7.1)], and death of any close relative in the last 1 year [OR=2 (1.1- 3.7)] after adjustment of various factors. Conclusion: Our study revealed that the prevalence of depression in the elderly was 14.4% in a rural community of north India.
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Affiliation(s)
- Manju Pilania
- Department of Community Medicine School of Public Health, PGIMER, Chandigarh, India
| | - Mohan Bairwa
- Centre for Health Systems & Policy Research and Institute of Health Management Research, IIHMR University, Jaipur, India
| | - Hitesh Khurana
- Department of Psychiatry, Pt. B D Sharma PGIMS, Rohtak, India
| | - Neelam Kumar
- Department of Community Medicine, Pt. B D Sharma PGIMS, Rohtak, India
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Andrade FCD, Wu F, Lebrão ML, Duarte YADO. Life expectancy without depression increases among Brazilian older adults. Rev Saude Publica 2016; 50:12. [PMID: 27143612 PMCID: PMC4902655 DOI: 10.1590/s1518-8787.2016050005900] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Accepted: 05/30/2015] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To estimate life expectancy with and without depressive symptoms in older adults for the years 2000 and 2010. METHODS We evaluated individuals aged 60 years or older (n = 1,862 in 2000 and n = 1,280 in 2010), participants of the Saúde, Bem-Estar e Envelhecimento (SABE – Health, Wellbeing and Aging) study in in Sao Paulo, Southeastern Brazil. Depression was measured using the shorter version of the Geriatric Depression Scale (GDS-15); respondents scoring ≥ 6 were classified as having depression. Estimates of life expectancy with and without depression were obtained using the Sullivan method. RESULTS Data from 2000 indicate that 60-year-old men could expect to live, on average, 14.7 years without depression and 60-year-old women could expect to live 16.5 years without depression. By 2010, life expectancy without depression had increased to 16.7 years for men and 17.8 years for women. Expected length of life with depression differed by sex, with women expected to live more years with depression than men. CONCLUSIONS Between 2000 and 2010, life expectancy without depression in Sao Paulo increased. However, older adults in Brazil, especially older women, still face a serious burden of mental illness.
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Affiliation(s)
- Flávia Cristina Drumond Andrade
- Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Champaign, IL, EUA
| | - Fan Wu
- San Francisco Department of Public Health, Community Behavioral Health Services, San Francisco, CA, EUA
| | - Maria Lúcia Lebrão
- Departamento de Epidemiologia, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, SP, Brasil
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Avila R, Lopes MA, Nakano EY, Bottino CM. Normative data of Fuld Object Memory Evaluation test for brazilian elderly population. ARQUIVOS DE NEURO-PSIQUIATRIA 2015; 74:138-44. [DOI: 10.1590/0004-282x20150200] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Accepted: 10/02/2015] [Indexed: 11/22/2022]
Abstract
ABSTRACT Objective This study aims to present normative data for Fuld Object Memory Evaluation test stratified by sex, gender, age, and education for the Brazilian elderly population. Method We evaluated 2.132 healthy elderly both genders, with a mean age of 70.30 years (± 7.28) from two community-based samples in Brazil drawn from different economic areas who were screened with cognitive and functional tests and the memory test. Statistical analyses were performed by independent t-test, one-way analysis of variance and multiple linear regression. Results Statistical analyses showed that memory scores tend to improve significantly with increasing years of education and decrease significantly as age increased. Conclusion We conclude that gender, education and age had effect on the Fuld Object Memory Evaluation performance in this Brazilian community-based sample.
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Nogueira EL, Rubin LL, Giacobbo SDS, Gomes I, Cataldo Neto A. Screening for depressive symptoms in older adults in the Family Health Strategy, Porto Alegre, Brazil. Rev Saude Publica 2015; 48:368-77. [PMID: 25119932 PMCID: PMC4203085 DOI: 10.1590/s0034-8910.2014048004660] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2012] [Accepted: 01/21/2014] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To analyze the prevalence of depression in older adults and associated
factors. METHODS Cross-sectional study using a stratified random sample of 621 individuals
aged ≥ 60 from 27 family health teams in Porto Alegre, RS, Southern Brazil,
between 2010 and 2012. Community health agents measured depression using the
15-item Geriatric Depression Scale. Scores of ≥ 6 were considered as
depression and between 11 and 15 as severe depression. Poisson regression
was used to search for independent associations of sociodemographic and
self-perceived health with both depression and its severity. RESULTS The prevalence of depression was 30.6% and was significantly higher in women
(35.9% women versus 20.9% men, p < 0.001). The variables
independently associated with depression were: female gender (PR = 1.4,
95%CI 1.1;1.8); low education, especially illiteracy (PR = 1.8, 95%CI 1.2;2
6); regular self-rated health (OR = 2.2, 95%CI 1.6;3.0); and poor/very poor
self-rated health (PR = 4.0, 95%CI 2.9;5.5). Except for education, the
strength of association of these factors increases significantly in severe
depression. CONCLUSIONS A high prevalence of depression was observed in the evaluations conducted by
community health agents, professionals who are not highly specialized. The
findings identified using the 15-item Geriatric Depression Scale in this way
are similar to those in the literature, with depression more associated with
low education, female gender and worse self-rated health. From a primary
health care strategic point of view, the findings become still more
relevant, indicating that community health agents could play an important
role in identifying depression in older adults.
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Affiliation(s)
- Eduardo Lopes Nogueira
- Instituto de Geriatria e Gerontologia, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | | | - Sara de Souza Giacobbo
- Instituto de Geriatria e Gerontologia, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - Irenio Gomes
- Instituto de Geriatria e Gerontologia, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - Alfredo Cataldo Neto
- Instituto de Geriatria e Gerontologia, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brasil
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Ramos GCF, Carneiro JA, Barbosa ATF, Mendonça JMG, Caldeira AP. Prevalência de sintomas depressivos e fatores associados em idosos no norte de Minas Gerais: um estudo de base populacional. JORNAL BRASILEIRO DE PSIQUIATRIA 2015. [DOI: 10.1590/0047-2085000000067] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Objetivo Avaliar a prevalência e os fatores associados aos sintomas depressivos em idosos não institucionalizados. Métodos Estudo transversal, analítico, de base populacional, cujos dados foram coletados entre maio e julho de 2013, em visitas domiciliares. Foi aplicado um questionário com variáveis sociodemográficas, comorbidades, utilização de serviços de saúde, escala de fragilidade (Edmonton Frail Scale), teste Timed Get Up and Go e a Escala de Depressão Geriátrica (Geriatric Depression Scale – GDS-15). Para análise estatística, as variáveis foram dicotomizadas. Conduziram-se análises bivariadas (teste qui-quadrado de Pearson) adotando-se nível de significância menor que 0,20 para inclusão das variáveis independentes no modelo múltiplo. O modelo final foi gerado por meio de análise de regressão logística múltipla e as variáveis mantidas apresentaram associação com sintomas depressivos em um nível de significância de 0,05 (p < 0,05). Resultados A prevalência de sintomas depressivos foi de 27,5%. As variáveis independentes associadas a sintomas depressivos foram: não ter companheiro (a) (OR = 1,81; IC 95% 1,214-2,713), não saber ler (OR = 1,84; IC 95% 1,19-2,836), percepção negativa sobre a própria saúde (OR = 2,12; IC 95% 1,373-3,256), tabagismo (OR = 2,31; IC 95% 1,208-4,431), alto risco de quedas (OR = 1,78; IC 95% 1,000-3,184) e fragilidade (OR = 2,38; IC 95% 1,510-3,754). Conclusões A alta prevalência de sintomas depressivos identificada entre idosos comunitários alerta para a necessidade de maiores cuidados com a população idosa.
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Soares WB, Ribeiz SRI, Bassitt DP, De Oliveira MC, Bottino CMC. Psychotic symptoms in older people without dementia from a Brazilian community-based sample. Int J Geriatr Psychiatry 2015; 30:437-45. [PMID: 24990116 DOI: 10.1002/gps.4156] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2014] [Revised: 05/18/2014] [Accepted: 05/21/2014] [Indexed: 11/08/2022]
Abstract
BACKGROUND The international prevalence of psychotic symptoms in older subjects without dementia varies from 0.9% to 8.0%. However, an analysis of these symptoms in developing countries has not been undertaken. AIMS To determine the prevalence and to correlate these symptoms with socioeconomic and clinical characteristics. METHOD A community-based sample aged 60 years and older was evaluated. Those who screened positive for dementia, cognitive and functional impairment or significant depressive symptoms were excluded, resulting in 1125 individuals. RESULTS The prevalence of psychotic symptoms was 9.1% (visual/tactile hallucinations, 7.8%; auditive hallucinations, 7.5%; persecutory delusions, 2.9%). Subjects with psychotic symptoms had lower Mini Mental State Examination and The Bayer Activities of Daily Living Scale scores, fewer years of schooling, belonged to lower socioeconomic classes compared with non-psychotic subjects, and 80% had clinical comorbidities. CONCLUSIONS The prevalence was in the upper range of international data. Significant relationships were found between psychotic symptoms and lower Mini Mental State Examination score, fewer years of schooling and lower socioeconomic class. Clinical comorbidity was also very frequent.
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Affiliation(s)
- Walter Barbalho Soares
- Old Age Research Group (PROTER), Institute of Psychiatry, University of São Paulo (USP), São Paulo, SP, Brazil; Department of Clinical Medicine, Federal University of Rio Grande do Norte (UFRN), Natal, RN, Brazil
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Del Brutto OH, Mera RM, Del Brutto VJ, Maestre GE, Gardener H, Zambrano M, Wright CB. Influence of depression, anxiety and stress on cognitive performance in community-dwelling older adults living in rural Ecuador: results of the Atahualpa Project. Geriatr Gerontol Int 2015; 15:508-14. [PMID: 25155360 PMCID: PMC11006020 DOI: 10.1111/ggi.12305] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/30/2014] [Indexed: 12/01/2022]
Abstract
AIM To assess the relationship between cognitive status and self-reported symptoms of depression, anxiety and stress of older adults living in an underserved rural South American population. METHODS Community-dwelling Atahualpa residents aged ≥60 years were identified during a door-to-door census, and evaluated with the Depression Anxiety Stress Scale-21 (DASS-21) and the Montreal Cognitive Assessment (MoCA). We explored whether positivity in each of the DASS-21 axes was related to total and domain-specific MoCA performance after adjustment for age, sex and education. RESULTS A total of 280 persons (59% women; mean age, mean age 70 ± 8 years) were included. Based on established cut-offs for the DASS-21, 12% persons had depression, 15% had anxiety and 5% had stress. Mean total MoCA scores were significantly lower for depressed than for not depressed individuals (15.9 ± 5.5 vs 18.9 ± 4.4, P < 0.0001). Depressed participants had significantly lower total and domain-specific MoCA scores for abstraction, short-term memory and orientation. Anxiety was related to significantly lower total MoCA scores (17 ± 4.7 vs 18.8 ± 4.5, P = 0.02), but not to differences in domain-specific MoCA scores. Stress was not associated with significant differences in MoCA scores. CONCLUSION The present study suggests that depression and anxiety are associated with poorer cognitive performance in elderly residents living in rural areas of developing countries.
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Affiliation(s)
- Oscar H Del Brutto
- School of Medicine, Universidad Espíritu Santo – Ecuador
- Department of Neurological Sciences, Hospital-Clínica Kennedy, Guayaquil
| | - Robertino M Mera
- Gastroenterology Department, Vanderbilt University, Nashville, Tennessee
| | | | - Gladys E Maestre
- Departments of Psychiatry and Neurology, and Gertrude H. Sergievsky Center, Columbia University, New York, New York
| | - Hannah Gardener
- McKnight Brain Institute and Department of Neurology, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | | | - Clinton B Wright
- McKnight Brain Institute and Department of Neurology, Miller School of Medicine, University of Miami, Miami, Florida, USA
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Gomes CDS, Maciel ÁCC, Freire ADNF, Moreira MDA, Ribeiro MDO, Guerra RO. Depressive symptoms and functional decline in an elderly sample of urban center in northeastern Brazil. Arch Gerontol Geriatr 2014; 58:214-8. [DOI: 10.1016/j.archger.2013.10.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2013] [Revised: 10/23/2013] [Accepted: 10/26/2013] [Indexed: 10/26/2022]
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Deslandes AC. Exercise and Mental Health: What did We Learn in the Last 20 Years? Front Psychiatry 2014; 5:66. [PMID: 24982639 PMCID: PMC4055854 DOI: 10.3389/fpsyt.2014.00066] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Accepted: 05/23/2014] [Indexed: 01/04/2023] Open
Affiliation(s)
- Andrea Camaz Deslandes
- Neuroscience of Exercise Lab (LaNEx), Psychiatric Institute, Universidade Federal do Rio de Janeiro , Rio de Janeiro , Brazil
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Ribeiz SRI, Duran F, Oliveira MC, Bezerra D, Castro CC, Steffens DC, Busatto Filho G, Bottino CMC. Structural brain changes as biomarkers and outcome predictors in patients with late-life depression: a cross-sectional and prospective study. PLoS One 2013; 8:e80049. [PMID: 24244606 PMCID: PMC3828217 DOI: 10.1371/journal.pone.0080049] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2013] [Accepted: 09/30/2013] [Indexed: 11/25/2022] Open
Abstract
The relationship between structural changes in grey matter and treatment response in patients with late-life depression remains an intriguing area of research. This magnetic resonance imaging (MRI) study compares the baseline grey matter volume of elderly people with and without major depression (according to the DSM-IV-TR criteria) and assesses its association with antidepressant treatment response. Brain MRI scans were processed using statistical parametric mapping and voxel-based morphometry. The sample consisted of 30 patients with depression and 22 healthy controls. We found a significant volumetric reduction in the orbitofrontal cortex bilaterally in patients in comparison with controls. According to their remission status after antidepressant treatment, patients were classified as remitted or not remitted. Compared with controls, remitted patients showed a volumetric reduction in the orbitofrontal cortex bilaterally and in another cluster in the right middle temporal pole. Non-remitted patients showed an even greater volumetric reduction in the orbitofrontal cortex bilaterally compared with controls. To investigate predictive factors of remission after antidepressant treatment, we used a logistic regression. Both baseline Mini Mental State Examination score and baseline left superior lateral orbitofrontal cortex volume (standardized to the total grey matter volume) were associated with remission status. Our findings support the use of regional brain atrophy as a potential biomarker for depression. In addition, baseline cognitive impairment and regional grey matter abnormalities predict antidepressant response in patients with late-life depression.
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Affiliation(s)
- Salma R. I. Ribeiz
- Old Age Research Group (PROTER), Institute of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil
- * E-mail:
| | - Fabio Duran
- Laboratory of Psychiatric Neuroimaging (LIM 21), Institute and Department of Psychiatry, University of São Paulo, São Paulo, Brazil
| | - Melaine C. Oliveira
- Institute of Mathematic and Statistics (IME), University of São Paulo, São Paulo, Brazil
| | - Diana Bezerra
- Old Age Research Group (PROTER), Institute of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil
| | - Claudio Campi Castro
- Department of Diagnostic Imaging, Heart Institute (InCor), University of São Paulo School of Medicine, São Paulo, Brazil
| | - David C. Steffens
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, Connecticut, United States of America
| | - Geraldo Busatto Filho
- Laboratory of Psychiatric Neuroimaging (LIM 21), Institute and Department of Psychiatry, University of São Paulo, São Paulo, Brazil
| | - Cássio M. C. Bottino
- Old Age Research Group (PROTER), Institute of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil
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Barcelos-Ferreira R, Nakano EY, Steffens DC, Bottino CMC. Quality of life and physical activity associated to lower prevalence of depression in community-dwelling elderly subjects from Sao Paulo. J Affect Disord 2013; 150:616-22. [PMID: 23499164 DOI: 10.1016/j.jad.2013.02.024] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2013] [Accepted: 02/15/2013] [Indexed: 11/24/2022]
Abstract
BACKGROUND Studies investigating major depression and associated factors in older people from developing countries are scarce. METHODS Cross-sectional study of a community-based sample of 1563 elderly subjects aged 60 years or older from Sao Paulo, Brazil. The frequency of major depression (MD) and the relationship with sociodemographic factors, cognitive and functional impairment (CFI), clinically significant depressive symptoms (CSDS) and clinical diseases were analyzed. A brief instrument for screening of depressive symptoms in elderly people, the Mini Mental State Examination, the Fuld Object Memory Evaluation, the Informant Questionnaire on Cognitive Decline in the Elderly, the Bayer Activities of Daily Living Scale, the Cambridge Mental Disorders of the Elderly Examination, and a sociodemographic and clinical questionnaire were applied to the subjects. RESULTS Major depression was diagnosed in 60 patients (3.8%). A higher odds ratio of MD was associated with female gender, being widowed, previous depressive episode, hypertension, use of psychotropic medication, (CFI), and alcohol use. A lower odds ratio of depression diagnosis was associated with physical activity and going to cinema. LIMITATIONS The cross-sectional design of the study; our sample was restricted only to community residents, excluding persons in hospitals or nursing homes. CONCLUSION Our study shows significant association between depression and potentially modifiable factors, reinforcing the benefit of probable preventive measures, to incentive healthy lifestyle, leisure activities and the practice of physical exercise, as well as the diagnosis and treatment of CSDS, especially in primary care.
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Affiliation(s)
- Ricardo Barcelos-Ferreira
- Old Age Research Group (Proter), Institute of Psychiatry, University of Sao Paulo Medical School, Sao Paulo, Brazil.
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Relationship between physical activity and depression and anxiety symptoms: a population study. J Affect Disord 2013; 149:241-6. [PMID: 23489405 DOI: 10.1016/j.jad.2013.01.035] [Citation(s) in RCA: 101] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2012] [Revised: 12/05/2012] [Accepted: 01/28/2013] [Indexed: 11/23/2022]
Abstract
BACKGROUND There are few studies evaluating the association between practice of physical activity and mood in a population sample. This study evaluated the frequency of symptoms of depression and anxiety in the population of the city of Sao Paulo and their association with the report of practice of regular physical activity. METHODS This survey was conducted with the adult population of Sao Paulo between July and December of 2007. The sample was composed of 1042 volunteers (both genders) with a mean age of 41.9±14.4 years. The volunteers were evaluated using the Beck Depression Inventory, the Beck Anxiety Inventory, and two simple questions designed to evaluate and classify physical activity. Socioeconomic status was also determined according to Brazil's Economic Classification Criterion. RESULTS People who do not engage in physical activity are two times more likely to exhibit symptoms of depression (PR: 2.1) and anxiety (PR: 2.5) compared with those who regularly practice physical activity and a higher prevalence of symptoms for anxiety (9.8%) and depression (10.9%) was observed among those claiming to not practice regular physical activity and 63.2% related did not practice any physical activity regularly. CONCLUSION Altogether, these results suggest that people who do not practice physical activity have a higher chance of exhibiting symptoms of depression and anxiety when compared to those who perform physical activity regularly. In this sense, regular physical activity must be encouraged, and this incentive should be routine in both current and future public health policies. Although the methodology in the present study does not allow assigning a relation of cause and effect, we observed associations between symptoms of depression, anxiety and physical activity.
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Castro-de-Araújo LFS, Barcelos-Ferreira R, Martins CB, Bottino CM. Depressive morbidity among elderly individuals who are hospitalized, reside at long-term care facilities, and are under outpatient care in Brazil: a meta-analysis. BRAZILIAN JOURNAL OF PSYCHIATRY 2013; 35:201-7. [DOI: 10.1590/1516-4446-2012-0905] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2012] [Accepted: 09/24/2012] [Indexed: 11/22/2022]
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Peltzer K, Phaswana-Mafuya N. Depression and associated factors in older adults in South Africa. Glob Health Action 2013; 6:1-9. [PMID: 23336621 PMCID: PMC3549465 DOI: 10.3402/gha.v6i0.18871] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2012] [Revised: 12/30/2012] [Accepted: 12/30/2012] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Late-life depression is an important public health problem because of its devastating consequences. The study aims to investigate the prevalence and associated factors of self-reported symptom-based depression in a national sample of older South Africans who participated in the Study of Global Ageing and Adult Health (SAGE wave 1) in 2008. METHODS We conducted a national population-based cross-sectional study with a probability sample of 3,840 individuals aged 50 years or above in South Africa in 2008. The questionnaire included socio-demographic characteristics, health variables, anthropometric and blood pressure measurements as well as questions on depression symptoms in the past 12 months. Multivariable regression analysis was performed to assess the association of socio-demographic factors, health variables, and depression. RESULTS The overall prevalence of symptom-based depression in the past 12 months was 4.0%. In multivariable analysis, functional disability, lack of quality of life, and chronic conditions (angina, asthma, arthritis, and nocturnal sleep problems) were associated with self-reported depression symptoms in the past 12 months. CONCLUSIONS Self-reported depression in older South Africans seems to be a public health problem calling for appropriate interventions to reduce occurrence. Factors identified to be associated with depression, including functional disability, lack of quality of life, and chronic conditions (angina, asthma, arthritis, and nocturnal sleep problems), can be used to guide interventions. The identified protective and risk factors can help in formulating public health care policies to improve quality of life among older adults.
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Affiliation(s)
- Karl Peltzer
- HIV/AIDS/SIT/and TB (HAST), Human Sciences Research Council, Pretoria, South Africa.
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Bezerra DM, Pereira FRS, Cendes F, Jackowski MP, Nakano EY, Moscoso MAA, Ribeiz SRI, Avila R, Castro CCD, Bottino CMC. DTI voxelwise analysis did not differentiate older depressed patients from older subjects without depression. J Psychiatr Res 2012; 46:1643-9. [PMID: 23040088 DOI: 10.1016/j.jpsychires.2012.09.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2012] [Revised: 08/19/2012] [Accepted: 09/01/2012] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Neuroimaging has been widely used in studies to investigate depression in the elderly because it is a noninvasive technique, and it allows the detection of structural and functional brain alterations. Fractional anisotropy (FA) and mean diffusivity (MD) are neuroimaging indexes of the microstructural integrity of white matter, which are measured using diffusion tensor imaging (DTI). The aim of this study was to investigate differences in FA or MD in the entire brain without a previously determined region of interest (ROI) between depressed and non-depressed elderly patients. METHOD Brain magnetic resonance imaging scans were obtained from 47 depressed elderly patients, diagnosed according to DSM-IV criteria, and 36 healthy elderly patients as controls. Voxelwise statistical analysis of FA data was performed using tract-based spatial statistics (TBSS). RESULTS After controlling for age, no significant differences among FA and MD parameters were observed in the depressed elderly patients. No significant correlations were found between cognitive performance and FA or MD parameters. CONCLUSION There were no significant differences among FA or MD values between mildly or moderately depressed and non-depressed elderly patients when the brain was analyzed without a previously determined ROI.
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Affiliation(s)
- Diana Moitinho Bezerra
- Old Age Research Group - PROTER, Institute and Department of Psychiatry, University of São Paulo, São Paulo, Brazil.
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Barcelos-Ferreira R, Lopes MA, Nakano EY, Steffens DC, Bottino CMC. Clinical and sociodemographic factors in a sample of older subjects experiencing depressive symptoms. Int J Geriatr Psychiatry 2012; 27:924-30. [PMID: 21989903 DOI: 10.1002/gps.2803] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2011] [Accepted: 08/31/2011] [Indexed: 11/11/2022]
Abstract
OBJECTIVES This study aims to determine the frequency of clinically significant depressive symptoms (CSDS) in a community sample of older Brazilians and to examine their relationship with sociodemographic factors, cognitive and functional impairment (CFI), and medical illness. METHODS A total of 1145 subjects aged 60 years or older living in the City of Ribeirao Preto, State of Sao Paulo, Brazil, were interviewed. The following instruments were used: a 10-item scale for screening of depressive symptoms in older people, the mini mental state examination, the Fuld object memory evaluation, the informant questionnaire on cognitive decline in the elderly, the Bayer activities of daily living scale, and a sociodemographic and clinical questionnaire. RESULTS The frequency of CSDS was 15.7%. Logistic regression analysis indicated that being previously depressed, having CFI, having lower level of education, using psychotropics, and not engaging in physical exercise were related to CSDS. On the other hand, being a woman, older, medically ill, employed, or married was not associated with CSDS. CONCLUSIONS Consistent with previous reports, lower education, lack of physical activity, and CFI were significantly associated with higher frequencies of CSDS. Further investigations are necessary to clarify the occurrence of depression and possible modifiable factors in developing countries such as Brazil.
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Affiliation(s)
- Ricardo Barcelos-Ferreira
- Old Age Research Group (Proter), Institute of Psychiatry, University of Sao Paulo Medical School, Brazil.
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Instrumental activities of daily living performance in healthy and cognitively intact seniors from a Brazilian sample and its relation to age and other socio-demographic variables. Int Psychogeriatr 2012; 24:784-93. [PMID: 22217431 DOI: 10.1017/s104161021100250x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Studies on functional capacity in community-dwelling older people have shown associations between declines in instrumental activities of daily living (IADL) and several factors. Among these, age has been the most consistently related to functional capacity independent of other variables. We aimed at evaluating the performance of a sample of healthy and cognitively intact Brazilian older people on activities of daily living and to analyze its relation to social-demographic variables. METHODS We conducted a secondary analysis of data collected for previous epidemiological studies with community-dwelling subjects aged 60 years or more. We selected subjects who did not have dementia or depression, and with no history of neurological diseases, heart attack, HIV, hepatitis or arthritis (n = 1,111). Functional capacity was assessed using the Brazilian version of the Older American Resources and Services Questionnaire (BOMFAQ). ADL performance was analyzed according to age, gender, education, and marital status (Pearson's χ2, logistic regression). RESULTS IADL difficulties were present in our sample, especially in subjects aged 80 years or more, with lower levels of education, or widowed. The logistic regression analysis results indicated that "higher age" and "lower education" (p ≤ 0.001) remained significantly associated with IADL difficulty. CONCLUSIONS Functional decline was present in older subjects even in the absence of medical conditions and cognitive impairment. Clinicians and researchers could benefit from knowing what to expect from older people regarding IADL performance in the absence of medical conditions.
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Caramelli P, Barbosa MT, Sakurai E, Santos ELD, Beato RG, Machado JCB, Guimarães HC, Teixeira AL. The Pietà study: epidemiological investigation on successful brain aging in Caeté (MG), Brazil. Methods and baseline cohort characteristics. ARQUIVOS DE NEURO-PSIQUIATRIA 2011; 69:579-84. [PMID: 21877023 DOI: 10.1590/s0004-282x2011000500002] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2011] [Accepted: 05/19/2011] [Indexed: 11/22/2022]
Abstract
OBJECTIVES: To present the methods and baseline characteristics of the Pietà study, a population-based survey investigating successful brain aging in the oldest-old. METHOD: The study was conducted in Caeté (MG), Brazil. In 2007, 1,251 individuals aged 75+ years were living in the city and were invited to participate. Participants responded to a general health questionnaire and were submitted to clinical, neurological, cognitive, psychiatric and functional evaluations. A subgroup was submitted to neuropsychological testing, blood tests and magnetic resonance of the skull. Individuals were classified as having cognitive impairment-no dementia, dementia, parkinsonism, psychiatric disorders or successful brain aging. RESULTS: We evaluated 639 individuals (51.1% of the target population; 64% women), aged 81.4±5.2 years and with 2.7±2.6 years of schooling. Almost 30% of the elderly were illiterates and 82.1% belonged to middle/middle-low socioeconomic levels. Almost 50% were widows, but only 14.3% were living alone. CONCLUSION: The Pietà cohort is representative of the oldest-old Brazilian population. We believe the results of the study may contribute to increase our knowledge about healthy and pathological brain aging in the oldest-old.
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Moraes C, Pinto JA, Lopes MA, Litvoc J, Bottino CMC. Impact of sociodemographic and health variables on mini-mental state examination in a community-based sample of older people. Eur Arch Psychiatry Clin Neurosci 2010; 260:535-42. [PMID: 20169355 DOI: 10.1007/s00406-010-0104-3] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2009] [Accepted: 01/29/2010] [Indexed: 11/24/2022]
Abstract
The mini-mental state examination (MMSE) has been widely used as a screening instrument for cognitive disorders. Age, schooling and many other sociodemographic and health variables may be associated with a worse performance on the MMSE. The objectives of this study were to investigate the distribution of MMSE percentiles in a large Brazilian community-based elderly sample, divided according to age and schooling, and to evaluate the impact of sociodemographic and health variables on groups of elderly people with lower cognitive performance. The MMSE was applied to a sample of 2,708 adults, aged 60 years and older. Of this population, 1,563 individuals were living in the city of São Paulo, while 1,145 were living in the city of Ribeirão Preto. The subjects were divided into six groups according to the amount of schooling that they had received (no formal education, 1-4 and ≥5 years) and age (<75 and ≥75 years old). To each one of the subgroups a stepwise logistic regression was applied, considering the following dependent variable: subjects who scored under or above the 15th percentile on MMSE. High scores on a depression scale, high scores on a memory complaints scale and low socio-economic levels were associated with poorer performance on the MMSE. Being currently employed and being married were related to higher scores on the test. Many sociodemographic and health variables can influence MMSE performance, with impacts depending on age and schooling. Clinicians and primary care physicians should pay attention to variables that may be associated with worse cognitive performance.
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Affiliation(s)
- Camila Moraes
- Institute and Department of Psychiatry, University of São Paulo, SP, Brazil
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Depressive morbidity and gender in community-dwelling Brazilian elderly: systematic review and meta-analysis. Int Psychogeriatr 2010; 22:712-26. [PMID: 20478096 DOI: 10.1017/s1041610210000463] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Although studies indicate that community-dwelling elderly have a lower prevalence of major depression compared with younger age groups, prevalence estimates in Brazil show that clinically significant depressive symptoms (CSDS) and depression are frequent in the older population. However, a systematic review and meta-analysis of prevalence of and factors associated with depressive disorders and symptoms in elderly Brazilians has not previously been reported. The aims were (i) to perform a survey of studies dating from 1991 to 2009 on the prevalence of depressive disorders and CSDS in elderly Brazilians residing in the community; (ii) to determine depression prevalence and identify associated factors; and (iii) develop a meta-analysis to indicate the combined prevalence and the influence of gender on depressive morbidity in this population. METHODS Studies were selected from articles dated between January 1991 and May 2009, extracted from Medline, LILACS and SciELO databases. RESULTS A total of 17 studies were found, 13 with CSDS, 1 with major depression alone and 3 with major depression and dysthymia, involving the evaluation of 15,491 elderly people. The average age of participants varied between 66.5 and 84.0 years. Prevalence rates of 7.0% for major depression, 26.0% for CSDS, and 3.3% for dysthymia were found. The odds ratios for major depression and CSDS were greater among women. There was a significant association between major depression or CSDS and cardiovascular diseases. CONCLUSION The review indicates greater prevalence of both major depression and CSDS compared to rates reported in the international literature, while the prevalence of dysthymia was found to be similar. The high prevalence of CSDS and its significant association with cardiovascular diseases reinforces the importance of evaluating subthreshold depressive symptoms in the elderly in the community.
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Hoffmann EJ, Ribeiro F, Farnese JM, Lima EWB. Sintomas depressivos e fatores associados entre idosos residentes em uma comunidade no norte de Minas Gerais, Brasil. JORNAL BRASILEIRO DE PSIQUIATRIA 2010. [DOI: 10.1590/s0047-20852010000300004] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJETIVO: Verificar a prevalência de sintomas depressivos de uma população idosa residente em uma comunidade de Montes Claros, Minas Gerais, Brasil, e avaliar sua associação com aspectos biopsicossociais e capacidade funcional. MÉTODOS: Estudo transversal, observacional e de base populacional. Foi avaliada a totalidade dos idosos residentes na área de abrangência de uma Equipe de Saúde da Família, sendo eles entrevistados em seus domicílios. Foi utilizado questionário adaptado do Brazil Old Age Schedule (BOAS) para coletar os dados biopsicossociais. Para avaliar sintomas depressivos, foi aplicada a Escala de Depressão Geriátrica abreviada (EDG-15). A escala de Katz foi utilizada para avaliar as atividades básicas de vida diária (ABVD) e a escala de Pfeffer, para atividades instrumentais de vida diária (AIVD). As associações foram verificadas mediante submissão dos dados à análise bivariada e multivariada. RESULTADOS: A prevalência de sintomatologia depressiva foi de 20,9%. Apresentaram associação significativa com sintomas depressivos: dificuldade para dormir (RP = 2,04; p = 0,002) e dependência para AIVD (RP = 3,22; p < 0,001). CONCLUSÃO: Há alta prevalência de sintomas depressivos entre idosos no âmbito comunitário, sendo mais frequentes entre idosos com dificuldade para dormir e com dependência funcional para AIVD.
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New research in low-tech solutions to a significant public health problem: assessment of depression in the elderly. Am J Geriatr Psychiatry 2009; 17:537-41. [PMID: 19546652 DOI: 10.1097/jgp.0b013e3181a93f67] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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