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Reiner A, Steinhoff P. The association of social networks and depression in community-dwelling older adults: a systematic review. Syst Rev 2024; 13:161. [PMID: 38902787 PMCID: PMC11188217 DOI: 10.1186/s13643-024-02581-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 06/10/2024] [Indexed: 06/22/2024] Open
Abstract
BACKGROUND AND OBJECTIVE Depression is a globally prevalent mental condition, particularly among older adults. Previous research has identified that social networks have a buffering effect on depression. Existing systematic reviews have either limited their research to specific geographic areas or provided evidence from over a decade ago. The vast body of recent literature particularly from the last decade emphasizes the need for a comprehensive review. This systematic review aims to analyze the association of structural aspects of social networks and depression in older adults. METHODS The electronic databases APA PsycINFO, ProQuest, PSYINDEX, PubMed, Scopus, SocINDEX, and Web of Science were searched from date of data base inception until 11 July 2023. Studies were eligible for inclusion if they reported on community-dwelling older adults (defined as a mean age of at least 60 years old), had an acceptable definition for depression, referred to the term social network in the abstract, and were published in English. Quality was appraised using the Newcastle Ottawa Scale for cross-sectional and longitudinal studies. Outcome data were extracted independently from each study and analyzed by direction of the relationship, social network domain and cross-sectional or longitudinal study design. RESULTS In total, 127 studies were included. The study categorizes structural network aspects into seven domains and finds that larger and more diverse networks, along with closer social ties, help mitigate depression. The literature on the relationships between depression and network density, homogeneity, and geographical proximity is scarce and inconclusive. DISCUSSION AND IMPLICATIONS: Despite inconsistent findings, this review highlights the importance of quantifying complex social relations of older adults. Limitations of this review include publication and language bias as well as the exclusion of qualitative research. Further research should use longitudinal approaches to further investigate the reciprocal relationship between social networks and depression. Following this review, interventions should promote the integration of older adults in larger and more diverse social settings. Other: This work was supported by the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation) under Grant [454899704]. This systematic review was pre-registered. The review-protocol can be accessed at https://doi.org/10.17605/OSF.IO/6QDPK .
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Affiliation(s)
- Amelie Reiner
- Institute of Sociology and Social Psychology, University of Cologne, Albertus-Magnus-Platz, 50923, Cologne, Germany.
| | - Paula Steinhoff
- Institute of Sociology and Social Psychology, University of Cologne, Albertus-Magnus-Platz, 50923, Cologne, Germany
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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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Sex differences in adult mood and in stress-induced transcriptional coherence across mesocorticolimbic circuitry. Transl Psychiatry 2020; 10:59. [PMID: 32066699 PMCID: PMC7026087 DOI: 10.1038/s41398-020-0742-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 12/26/2019] [Accepted: 01/08/2020] [Indexed: 12/22/2022] Open
Abstract
Women are approximately two times as likely to be diagnosed with major depressive disorder (MDD) compared to men. While sex differences in MDD might be driven by circulating gonadal hormones, we hypothesized that developmental hormone exposure and/or genetic sex might play a role. Mice were gonadectomized in adulthood to isolate the role of developmental hormones. We examined the effects of developmental gonadal and genetic sex on anhedonia-/depressive-like behaviors under non-stress and chronic stress conditions and performed RNA-sequencing in three mood-relevant brain regions. We used an integrative network approach to identify transcriptional modules and stress-specific hub genes regulating stress susceptibility, with a focus on whether these differed by sex. After identifying sex differences in anhedonia-/depressive-like behaviors (female > male), we show that both developmental hormone exposure (gonadal female > gonadal male) and genetic sex (XX > XY) contribute to the sex difference. The top biological pathways represented by differentially expressed genes were related to immune function; we identify which differentially expressed genes are driven by developmental gonadal or genetic sex. There was very little overlap in genes affected by chronic stress in males and females. We also identified highly co-expressed gene modules affected by stress, some of which were affected in opposite directions in males and females. Since all mice had equivalent hormone exposure in adulthood, these results suggest that sex differences in gonadal hormone exposure during sensitive developmental periods program adult sex differences in mood, and that these sex differences are independent of adult circulating gonadal hormones.
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de Amorim JSC, Torres KCL, Carvalho AT, Martins-Filho OA, Lima-Costa MF, Peixoto SV. Inflammatory markers associated with fall recurrence and severity: The Bambuí Cohort Study of Aging. Exp Gerontol 2020; 132:110837. [PMID: 31935439 DOI: 10.1016/j.exger.2020.110837] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 11/21/2019] [Accepted: 01/10/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND The aim of this study was to analyze the association between inflammatory markers and recurrent and severe falls in 1304 community-dwelling older adults from the Bambuí Cohort Study of Aging. METHODS Information about falls in the previous 12 months was collected, and classified based on recurrence (two or more falls) and severity (requirement of medical attention). The screened biomarkers included interleukins (IL-1β, IL-6, IL-10, and IL-12, TNF), chemokines (CXCL8, CXCL9, CXCL10, CCL2, and CCL5), and high-sensitive C-reactive protein (hs-PCR). Potential confounders included sociodemographic, behavioral, and health indicators. Associations were evaluated through logistic regression, using odds ratios (OR) and 95% confidence intervals (95% CI), with Stata 13.1. RESULTS The prevalence of recurrent and severe falls was 10.7% and 9.0%, respectively. After adjustments, elevated levels of IL-12 (OR: 1.92; 95% CI: 1.09-3.37) and CXCL9 (OR: 1.67; 95% CI: 1.05-2.66) were found to be associated with recurrent falls, while elevated levels of TNF (OR: 1.58; 95% CI: 1.01-2.50), IL-12 (OR: 2.04; 95% CI: 1.13-3.70), CXCL10 (OR: 1.75; 95% CI: 1.04-2.92), and CCL5 (OR: 1.90; 95% CI: 1.18-3.07) were associated with severe falls. CONCLUSIONS The results highlight a wide range of biomarkers not yet explored in the literature and suggest that inflammation may be an important component of recurrent and severe falls.
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Affiliation(s)
- Juleimar Soares Coelho de Amorim
- Postgraduate Program in Public Health, René Rachou Research Institute, Oswaldo Cruz Foundation in the State of Minas Gerais, Belo Horizonte, Brazil.
| | - Karen Cecília Lima Torres
- Laboratory of Diagnostic and Monitoring Biomarkers, René Rachou Research Institute, Oswaldo Cruz Foundation in the State of Minas Gerais, Belo Horizonte, Brazil; Faculty of Medicine, University José do Rosário Vellano, UNIFENAS, Belo Horizonte, Brazil
| | - Andréa Teixeira Carvalho
- Laboratory of Diagnostic and Monitoring Biomarkers, René Rachou Research Institute, Oswaldo Cruz Foundation in the State of Minas Gerais, Belo Horizonte, Brazil
| | - Olindo Assis Martins-Filho
- Laboratory of Diagnostic and Monitoring Biomarkers, René Rachou Research Institute, Oswaldo Cruz Foundation in the State of Minas Gerais, Belo Horizonte, Brazil
| | - Maria Fernanda Lima-Costa
- Center of Studies in Public Health and Aging, René Rachou René Rachou Research Institute, Oswaldo Cruz Foundation in the State of Minas Gerais, Belo Horizonte, Brazil
| | - Sérgio Viana Peixoto
- Laboratory of Diagnostic and Monitoring Biomarkers, René Rachou Research Institute, Oswaldo Cruz Foundation in the State of Minas Gerais, Belo Horizonte, Brazil; Federal University of Minas Gerais, Nursing School, Belo Horizonte, Brazil
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Luna E, Ruiz M, Malyutina S, Titarenko A, Kozela M, Pająk A, Kubinova R, Bobak M. The prospective association between frequency of contact with friends and relatives and quality of life in older adults from Central and Eastern Europe. Soc Psychiatry Psychiatr Epidemiol 2020; 55:1001-1010. [PMID: 32040668 PMCID: PMC7394932 DOI: 10.1007/s00127-020-01834-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 02/03/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE Studies suggest that frequent contact with friends and relatives promote mental wellbeing in later life, but most evidence comes from Western populations. We investigated the prospective relationship between frequency of contact with friends and relatives and quality of life (QoL) among older Central and Eastern European (CEE) adults and whether depressive symptoms mediated the hypothesised longitudinal relationship. METHODS Data from 6106 participants from the Health, Alcohol and Psychosocial factors In Eastern Europe (HAPIEE) study were used. Frequency of contact with friends and relatives was measured at baseline. QoL, at baseline and follow-up, was measured by the Control, Autonomy, Self-realisation, and Pleasure (CASP) 12-item scale. After assessing the prospective association using multivariable linear regression, the mediational hypothesis was tested using path analysis. RESULTS There was a significant prospective association between frequency of contact with friends and relatives and CASP-12 score (0-36) in fully adjusted models. Per every one unit increase in frequency of contact, there was a 0.12 (95% CI 0.06, 0.17) increase in CASP-12 score at follow-up, accounting for sociodemographic, health-related and baseline QoL. Pathway results showed that 81% of the longitudinal effect of frequency of contact on QoL was mediated through depressive symptoms. CONCLUSIONS Frequent contact with friends and relatives improves QoL of older Central and Eastern European adults, partly through buffering against depressive symptoms. Interventions to improve QoL at older ages should incorporate effective management of common mental disorders such as depression.
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Affiliation(s)
- Eliazar Luna
- Research Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 6BT, UK.
| | - Milagros Ruiz
- Research Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 6BT, UK
- Faculty of Physical Education and Sport, Charles University, José Martího 31162 52, Prague, Czech Republic
| | - Sofia Malyutina
- Laboratory of Ethipathogenesis and Clinics of Internal Diseases, Institute of Internal and Preventive Medicine, 175/1, Borisa Bogatkova street, Novosibirsk, Russia
| | - Anastasiya Titarenko
- Laboratory of Ethipathogenesis and Clinics of Internal Diseases, Institute of Internal and Preventive Medicine, 175/1, Borisa Bogatkova street, Novosibirsk, Russia
| | - Magdalena Kozela
- Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, Grzegórzecka 20, 31-531, Krakow, Poland
| | - Andrzej Pająk
- Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, Grzegórzecka 20, 31-531, Krakow, Poland
| | - Ruzena Kubinova
- Centre for Environmental Health Monitoring, National Institute of Public Health, Srobarova 48, 10042, Prague, Czech Republic
| | - Martin Bobak
- Research Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 6BT, UK
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Amorim JSCD, Torres KCL, Teixeira-Carvalho A, Martins-Filho OA, Lima-Costa MF, Peixoto SV. Inflammatory markers and occurrence of falls: Bambuí Cohort Study of Aging. Rev Saude Publica 2019; 53:35. [PMID: 30942277 PMCID: PMC6474745 DOI: 10.11606/s1518-8787.2019053000855] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Accepted: 05/29/2018] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE Analyze whether inflammatory markers are associated with falls among older adults living in Bambuí. METHODS Study that analyzed baseline data from a Bambuí Cohort Study of Aging, involving 1,250 participants. Data about falls were collected from previous 12 months, classified as single or multiple occurrence and severity (participant seeking health services). Information about sociodemographic characteristics, health behaviors and health condition was also collected and used as confounding factors. The exposures of interest included interleukins (IL-1β, IL-6, IL-8, IL-10, IL-12), tumor necrosis factor (TNF), ultra-sensitive C-reactive protein (us-CRP) and chemokines (CXCL9, CCL5, CCL10, MCP1). Data were processed through logistic regression, obtaining odds ratio and 95% confidence interval (95%CI). RESULTS The prevalence of falls was 27.1%; 40.1% of the older adults reported multiple falls and 33.3% sought health services. After adjustments, the following elevated levels were associated with falls: us-CRP (OR = 1.46, 95%CI 1.04–2.03), CCL5 (OR = 1.38, 95%CI 1.01–1.90) and CXCL9 (OR = 1.43, 95%CI 1.02–2.02). An association was observed between the number of elevated markers and the occurrence of falls: two (OR = 1.47, 95%CI 1.02–2.12) and three (OR = 2.08, 95%CI 1.12–3.87) elevated biomarkers indicated fall probability of 32.0% and 39.4%, respectively. CONCLUSIONS Elevated levels of us-CRP, CCL5 and CXCL9, which were associated with falls, may contribute to a proper understanding of the mechanism associated with the occurrence of falls among older people.
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Affiliation(s)
- Juleimar Soares Coelho de Amorim
- Instituto René Rachou. Fundação Oswaldo Cruz. Fiocruz Minas. Programa de Pós-Graduação em Saúde Coletiva. Belo Horizonte, MG, Brasil
| | - Karen Cecília Lima Torres
- Instituto René Rachou. Fundação Oswaldo Cruz. Fiocruz Minas. Grupo Integrado de Pesquisas em Biomarcadores. Belo Horizonte, MG, Brasil
| | - Andréa Teixeira-Carvalho
- Instituto René Rachou. Fundação Oswaldo Cruz. Fiocruz Minas. Grupo Integrado de Pesquisas em Biomarcadores. Belo Horizonte, MG, Brasil
| | - Olindo Assis Martins-Filho
- Instituto René Rachou. Fundação Oswaldo Cruz. Fiocruz Minas. Grupo Integrado de Pesquisas em Biomarcadores. Belo Horizonte, MG, Brasil
| | - Maria Fernanda Lima-Costa
- Instituto René Rachou. Fundação Oswaldo Cruz. Fiocruz Minas. Núcleo de Estudos em Saúde Pública e Envelhecimento. Belo Horizonte, MG, Brasil
| | - Sérgio Viana Peixoto
- Instituto René Rachou. Fundação Oswaldo Cruz. Fiocruz Minas. Núcleo de Estudos em Saúde Pública e Envelhecimento. Belo Horizonte, MG, Brasil.,Universidade Federal de Minas Gerais. Escola de Enfermagem. Departamento de Enfermagem Aplicada. Belo Horizonte, MG, Brasil
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Neves CVB, Mambrini JVDM, Torres KCL, Teixeira-Carvalho A, Martins-Filho OA, Lima-Costa MF, Peixoto SV. Association of metabolic syndrome with inflammatory markers in a sample of community-dwelling older adults. CAD SAUDE PUBLICA 2019; 35:e00129918. [PMID: 30916180 DOI: 10.1590/0102-311x00129918] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Accepted: 09/27/2018] [Indexed: 12/20/2022] Open
Abstract
The study aimed to identify the cutoff points for inflammatory markers that best discriminate the occurrence of metabolic syndrome in community-dwelling older adults. Baseline data were used from the elderly cohort in the city of Bambuí, Minas Gerais State, Brazil. The target exposure was presence of metabolic syndrome, defined according to the Adult Treatment Panel III criterion, and the outcomes included the following inflammatory markers: cytokines (IL-1β, IL-6, IL-10, IL-12 e TNF), chemokines (CXCL8, CXCL9, CCL2, CXCL10, and CCL5), and C-reactive protein (CRP). Definition of the cutoff points for the inflammatory markers was based on the Classification and Regression Tree (CART) method. The associations between these markers and metabolic syndrome were estimated by logistic regression models, obtaining odds ratios and 95% confidence intervals, considering adjustment for confounding factors. Prevalence of metabolic syndrome was 49.1%, and IL-1β, IL-12, and TNF levels were not associated statistically with this exposure. After adjustment, presence of metabolic syndrome was associated with higher IL-6 and CRP levels and lower CXCL8 and CCL5. Significant associations were also observed with intermediate serum CXCL9 and CXCL10 levels. The combination of markers also showed a significant and consistent association with metabolic syndrome. In addition to demonstrating an association between metabolic syndrome and a wide range of biomarkers (some not previously described in the literature), the results highlight that this association occurs at much lower levels than previously demonstrated, suggesting that metabolic syndrome plays an important role in the inflammatory profile of the older adults.
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Affiliation(s)
| | | | | | | | | | | | - Sérgio Viana Peixoto
- Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Brasil.,Escola de Enfermagem, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
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Esteves CS, Lima MP, Gonzatti V, de Oliveira CR, de Lima Argimon II, Irigaray TQ. Depressive Symptoms and Cognitive Functioning of Elderly from the Family Health Strategy. AGEING INTERNATIONAL 2019. [DOI: 10.1007/s12126-017-9313-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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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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Amaral TLM, Amaral CDA, Lima NSD, Herculano PV, Prado PRD, Monteiro GTR. Multimorbidity, depression and quality of life among elderly people assisted in the Family Health Strategy in Senador Guiomard, Acre, Brazil. CIENCIA & SAUDE COLETIVA 2019; 23:3077-3084. [PMID: 30281744 DOI: 10.1590/1413-81232018239.22532016] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Accepted: 09/28/2016] [Indexed: 11/22/2022] Open
Abstract
This study analyzed the association between multimorbidity, depression and quality of life among the elderly in the Family Health Strategy (FHS). A cross-sectional study was conducted among the elderly in the FHS in Senador Guiomard (State of Acre). The study employed the Geriatric Depression Scale (GDS-15) and the Quality of Life Questionnaire (WHOQOL-BREF). Differences in descriptive variables in elderly people with and without multimorbidity were estimated using Pearson's chi-squared test, while the associations between multimorbidity and depression and quality of life were estimated using the logistic regression technique. It was seen that elderly people with depression represented 27% of the sample, this being more prevalent among elderly people with multimorbidity than those without, the former being twice as likely to be subject to depression. Likewise, individuals with multimorbidity had a greater chance of worse quality of life in the physical, social and total quality of life domains (all with p ≤ 0.010), though not in the environmental domain (p = 0.493). Thus, multimorbidity in the elderly is associated with the presence of depression and poor quality of life, which imposes the challenge on the FHS of guaranteeing the elderly living out their senescence without suffering and diminished quality of life.
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Affiliation(s)
- Thatiana Lameira Maciel Amaral
- Centro de Ciências da Saúde e do Desporto, Universidade Federal do Acre. Rodovia BR 364/nº 6637/Km 04, Distrito Industrial. 69915-900 Rio BrancoACBrasil.
| | | | - Nathália Silva de Lima
- Centro de Ciências da Saúde e do Desporto, Universidade Federal do Acre. Rodovia BR 364/nº 6637/Km 04, Distrito Industrial. 69915-900 Rio BrancoACBrasil.
| | - Patrícia Vasconcelos Herculano
- Centro de Ciências da Saúde e do Desporto, Universidade Federal do Acre. Rodovia BR 364/nº 6637/Km 04, Distrito Industrial. 69915-900 Rio BrancoACBrasil.
| | - Patrícia Rezende do Prado
- Centro de Ciências da Saúde e do Desporto, Universidade Federal do Acre. Rodovia BR 364/nº 6637/Km 04, Distrito Industrial. 69915-900 Rio BrancoACBrasil.
| | - Gina Torres Rego Monteiro
- Departamento de Epidemiologia e Métodos Quantitativos em Saúde, Escola Nacional de Saúde Pública, Fiocruz. Rio de JaneiroRJBrasil
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Corrêa ML, Carpena MX, Meucci RD, Neiva-Silva L. Depression in the elderly of a rural region in Southern Brazil. CIENCIA & SAUDE COLETIVA 2018; 25:2083-2092. [PMID: 32520256 DOI: 10.1590/1413-81232020256.18392018] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Accepted: 11/05/2018] [Indexed: 11/22/2022] Open
Abstract
The aim of this study is to estimate the prevalence of depression and its associated factors in elderly residents of the rural area of Rio Grande/RS. In this cross-sectional population-based study performed with 994 elderly (≥ 60 years), whose sampling was based on the 2010 Demographic Census, the Patient Health Questionnaire 9 (PHQ-9) was used for Major Depressive Episode (EDM) screening. Descriptive, bivariate and multivariate analyses were performed using logistic regression. The overall prevalence for Major Depressive Episode screening was 8.1%. The variables independently associated with depression were: female gender, continuous use of medications, chronic diseases, body mass index and worse health perception. The creation of programs target at the elderly in the rural area, aimed at screening, early diagnosis of depression and maintenance of treatment, encompassing several factors related to health, are important actions that must be fostered by the health system.
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Affiliation(s)
- Mariana Lima Corrêa
- Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas. R. Marechal Deodoro 1.160, Centro. 96020-220, Pelotas, RS, Brasil.
| | - Marina Xavier Carpena
- Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas. R. Marechal Deodoro 1.160, Centro. 96020-220, Pelotas, RS, Brasil.
| | - Rodrigo Dalke Meucci
- Programa de Pós-Graduação em Saúde Pública, Universidade Federal do Rio Grande. Rio Grande, RS, Brasil
| | - Lucas Neiva-Silva
- Programa de Pós-Graduação em Saúde Pública, Universidade Federal do Rio Grande. Rio Grande, RS, Brasil
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Vicente ART, Castro-Costa É, Firmo JDOA, Lima-Costa MF, Loyola Filho AID. Religiousness, social support and the use of antidepressants among the elderly: a population-based study. CIENCIA & SAUDE COLETIVA 2018. [PMID: 29538576 DOI: 10.1590/1413-81232018233.05922016] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
The purpose of the study was to investigate whether religiousness and social support were associated with the use of antidepressants among community-dwelling elders. The research involved 1,606 older adults who make up the cohort of Bambuí Project, a study on ageing and health. The dependent variable was the use of antidepressants in the last 90 days, and the exposures of interest were social support and religiousness. Logistic regression was used to test the associations and to estimate crude and adjusted Odds Ratio and their 95% confidence intervals. The chances of use of antidepressants were significantly lower among older people with higher level of religiosity (OR = 0.45; 95% CI: 0.29 to 0.70), but none of the descriptors social support was associated with the event. In this population, it is possible that religion occupies a prominent role in the arsenal of health problems coping strategies, especially mental. Health professionals attending this particular segment of the population (elderly people with depressive disorders) should consider religiousness of patients when the proposed guidelines and treatment in coping with their mental suffering.
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Affiliation(s)
- Adriano Roberto Tarifa Vicente
- Núcleo de Estudos em Saúde Pública e Envelhecimento, Centro de Pesquisas René Rachou, Fiocruz. Av. Augusto de Lima 1715, Barro Preto. 30190-002 Belo Horizonte MG Brasil.
| | - Érico Castro-Costa
- Núcleo de Estudos em Saúde Pública e Envelhecimento, Centro de Pesquisas René Rachou, Fiocruz. Av. Augusto de Lima 1715, Barro Preto. 30190-002 Belo Horizonte MG Brasil.
| | - Josélia de Oliveira Araújo Firmo
- Núcleo de Estudos em Saúde Pública e Envelhecimento, Centro de Pesquisas René Rachou, Fiocruz. Av. Augusto de Lima 1715, Barro Preto. 30190-002 Belo Horizonte MG Brasil.
| | - Maria Fernanda Lima-Costa
- Núcleo de Estudos em Saúde Pública e Envelhecimento, Centro de Pesquisas René Rachou, Fiocruz. Av. Augusto de Lima 1715, Barro Preto. 30190-002 Belo Horizonte MG Brasil.
| | - Antônio Ignácio de Loyola Filho
- Núcleo de Estudos em Saúde Pública e Envelhecimento, Centro de Pesquisas René Rachou, Fiocruz. Av. Augusto de Lima 1715, Barro Preto. 30190-002 Belo Horizonte MG Brasil.
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Shao P, Xu Y, Pan CW. Factors associated with and prevalence of depressive features amongst older adults in an urban city in eastern China. S Afr J Psychiatr 2017; 23:1064. [PMID: 30263196 PMCID: PMC6138213 DOI: 10.4102/sajpsychiatry.v23i0.1064] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Accepted: 01/30/2017] [Indexed: 11/30/2022] Open
Abstract
Background Mental health problems have become serious for older Chinese adults who have lived through the process of urbanisation. This current research aimed to determine the prevalence of and associated factors for depressive features in a community-based sample of older adults in China. Methods A community-based survey of 4077 adults aged 60 or older was conducted in Suzhou, China. Information including demographic characteristics, health behaviours, social support, disease histories and physical function was collected using a pre-designed questionnaire. Depressive features were assessed using the self-rating depression scale. Multivariate logistic regression analysis was performed to identify associated factors for depression. Results The overall prevalence of depressive features in the surveyed population was 47.4% (45.9% in men and 48.5% in women). In a multiple logistic regression analysis, the significant variables of depressive features were no fixed occupation (odds ratio [OR] = 0.28; 95% confidence interval [CI]: 0.21–0.37), doing non-technical and service work (OR = 0.23; 95% CI: 0.19–0.28) or being a manager and technical personnel (OR = 0.25; 95% CI: 0.19–0.32), physical activities (OR = 0.71; 95% CI: 0.61–0.82), never taking dietary supplements (OR = 0.73; 95% CI: 0.58–0.91), not having hobbies (OR = 1.34; 95% CI: 1.15–1.56), never interacting with neighbours (OR = 1.79; 95% CI: 1.28–2.50), cold relationship with a spouse (OR = 3.34; 95% CI: 1.18–9.45) and limited activities of daily living (OR = 2.27; 95% CI: 1.91–2.69). Conclusion There is an urgent need for public policy interventions to address depression in elderly people located in Suzhou in China.
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Affiliation(s)
- Ping Shao
- School of Public Health, Medical College of Soochow University, China.,Department of Health Management, Medical College of Hangzhou Normal University, China
| | - Yong Xu
- School of Public Health, Medical College of Soochow University, China
| | - Chen-Wei Pan
- School of Public Health, Medical College of Soochow University, China
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Hellwig N, Munhoz TN, Tomasi E. Sintomas depressivos em idosos: estudo transversal de base populacional. CIENCIA & SAUDE COLETIVA 2016; 21:3575-3584. [DOI: 10.1590/1413-812320152111.19552015] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2015] [Accepted: 04/28/2016] [Indexed: 11/22/2022] Open
Abstract
Resumo Foi realizado um estudo transversal de base populacional na cidade de Pelotas, Rio Grande do Sul, em 2014, com o objetivo de medir a prevalência e identificar os fatores associados aos sintomas depressivos em idosos. A amostragem foi realizada por conglomerados em dois estágios. Todos os idosos (≥ 60 anos) residentes nos domicílios selecionados foram convidados a participar. A ocorrência dos sintomas depressivos foi medida utilizando-se a GDS-10 (Geriatric Depression Scale) com o ponto de corte ≥ 5. Foram obtidas informações de 1.451 idosos. A prevalência dos sintomas depressivos foi de 15,2% (IC95% 13,2-17,2). Após análise multivariável, a ocorrência de sintomas depressivos foi maior entre as mulheres, os idosos de pior situação econômica, aqueles que não trabalhavam, os fisicamente inativos, aqueles com pior autoavaliação de saúde e naqueles com incapacidade funcional. Maior atenção deve ser dada à identificação de sintomas depressivos em idosos e seus fatores associados para fundamentar políticas e planejamentos de intervenções para tratamento e manejo desta doença em nível coletivo.
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do Nascimento KKF, Pereira KS, Firmo JOA, Lima-Costa MF, Diniz BS, Castro-Costa E. Predictors of incidence of clinically significant depressive symptoms in the elderly: 10-year follow-up study of the Bambui cohort study of aging. Int J Geriatr Psychiatry 2015; 30:1171-6. [PMID: 25703304 DOI: 10.1002/gps.4271] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Revised: 01/26/2015] [Accepted: 01/26/2015] [Indexed: 12/25/2022]
Abstract
OBJECTIVE We aim to evaluate the incidence rate and predictors of clinically significant depressive symptoms (CSDS) over 10 years of follow-up from a population-based cohort study (the Bambui Cohort Study of Aging). METHODS We calculated the predictors of incidence of CSDS over 10 years of follow-up by the Cox proportional regression analysis. Depressive symptoms were evaluated by GHQ-12 and scores of five or higher indicated CSDS. RESULTS The annualized incidence rate of clinically significant depressive symptoms was 46 per 1000 person-year. In the multivariate analysis, the main predictors of CSDS were cognitive impairment (HR = 1,69 CI95% [1,20 - 2.37], p = 0.002), diabetes (HR = 1.59 CI95% [1.14 - 2.20], p = 0.006), use of 2 to 4 (HR = 1,95 CI95% [1.21 - 3.15], p = 0.006) and of 5 or more medications in the last 90 days (HR = 2.19 CI95% [1.31 - 3.66], p = 0.003) and higher baseline depressive symptoms (HR = 2.12 CI95% [1.61 - 2.78], p < 0.001). CONCLUSION These results highlight the importance of higher depressive symptoms, cognitive impairment and endocrine-metabolic disorders to the development of depressive symptoms in older adults. These findings provide a framework for the development of interventions to prevent the emergence of clinically significant depressive symptoms in the elderly.
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Affiliation(s)
- Kenia Kelly Fiaux do Nascimento
- Laboratory of Investigation in Clinical Neuroscience, Federal University of Minas Gerais Medical School, Belo Horizonte, MG, Brazil
| | - Kelly Silva Pereira
- Laboratory of Investigation in Clinical Neuroscience, Federal University of Minas Gerais Medical School, Belo Horizonte, MG, Brazil
| | - Josélia O A Firmo
- René Rachou Research Center, Oswaldo Cruz Foundation, Belo Horizonte, MG, Brazil
| | - Maria Fernanda Lima-Costa
- René Rachou Research Center, Oswaldo Cruz Foundation, Belo Horizonte, MG, Brazil.,Department of Social and Preventive Medicine, Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Breno S Diniz
- Laboratory of Investigation in Clinical Neuroscience, Federal University of Minas Gerais Medical School, Belo Horizonte, MG, Brazil.,Department of Social and Preventive Medicine, Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil.,Department of Mental Health, Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Erico Castro-Costa
- René Rachou Research Center, Oswaldo Cruz Foundation, Belo Horizonte, MG, Brazil
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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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Bretanha AF, Facchini LA, Nunes BP, Munhoz TN, Tomasi E, Thumé E. Depressive symptoms in elderly living in areas covered by Primary Health Care Units in urban area of Bagé, RS. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2015; 18:1-12. [PMID: 25651007 DOI: 10.1590/1980-5497201500010001] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2013] [Accepted: 05/30/2014] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To identify the prevalence of depressive symptoms and associated factors in elderly. METHODS Cross-sectional study of population-based sample of 1,593 individuals aged 60 years or more in the urban area of Bagé, Rio Grande do Sul, Brazil, in 2008. Data were collected in household interviews. The prevalence of depressive symptoms was assessed using the Geriatric Depression Scale. The analysis was performed using Poisson regression with robust variance estimation. RESULTS The prevalence of depressive symptoms was 18.0%, with the 95% confidence interval 16.1 - 19.9. The majority of the sample consisted of women (62.8%). The mean age was 70 years, with a 8.24 standard deviation (SD); 25.1% of seniors aged 60 to 64 years and 31.2% were 75 years or older. In the adjusted analysis, depressive symptoms were significantly associated (p value < 0.05) with the elderly female, yellow, brown or indigenous descendancy, lower economic status, retired, with history of heart problems, incapacity to basic and instrumental activities of daily living, worse self-rated health and dissatisfaction with life in general. Age, marital status, education, self-reported hypertension and diabetes were not associated with depressive symptoms after adjusting for confounders. CONCLUSION The high prevalence of depressive symptoms in the population requires investment in preventive actions, noting the need for practices that promote active aging with the maintenance of functional activity, improving self-rated health and life satisfaction.
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Affiliation(s)
| | | | | | - Tiago N Munhoz
- Faculdade de Medicina, Universidade Federal de Pelotas, Pelotas, RS, Brasil
| | - Elaine Tomasi
- Faculdade de Medicina, Universidade Federal de Pelotas, Pelotas, RS, Brasil
| | - Elaine Thumé
- Universidade Federal de Pelotas, Pelotas, RS, Brasil
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Santiago LM, Mattos IE. Depressive symptoms in institutionalized older adults. Rev Saude Publica 2015; 48:216-24. [PMID: 24897042 PMCID: PMC4206148 DOI: 10.1590/s0034-8910.2014048004965] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2013] [Accepted: 11/11/2013] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To estimate the prevalence of depressive symptoms among institutionalized
elderly individuals and to analyze factors associated with this
condition. METHODS This was a cross-sectional study involving 462 individuals aged 60 or older,
residents in long stay institutions in four Brazilian municipalities. The
dependent variable was assessed using the 15-item Geriatric Depression
Scale. Poisson’s regression was used to evaluate associations with
co-variables. We investigated which variables were most relevant in terms of
presence of depressive symptoms within the studied context through factor
analysis. RESULTS Prevalence of depressive symptoms was 48.7%. The variables associated with
depressive symptoms were: regular/bad/very bad self-rated health;
comorbidities; hospitalizations; and lack of friends in the institution.
Five components accounted for 49.2% of total variance of the sample:
functioning, social support, sensory deficiency, institutionalization and
health conditions. In the factor analysis, functionality and social support
were the components which explained a large part of observed variance. CONCLUSIONS A high prevalence of depressive symptoms, with significant variation in
distribution, was observed. Such results emphasize the importance of health
conditions and functioning for institutionalized older individuals
developing depression. They also point to the importance of providing
opportunities for interaction among institutionalized individuals.
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Affiliation(s)
- Lívia Maria Santiago
- Departamento de Fonoaudiologia, Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | - Inês Echenique Mattos
- epartamento de Epidemiologia e Métodos Quantitativos em Saúd, Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil
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Lino VTS, Portela MC, Camacho LAB, Atie S, Lima MJB, Rodrigues NCP, Barros MBDL, Andrade MKDN. Screening for depression in low-income elderly patients at the primary care level: use of the patient health questionnaire-2. PLoS One 2014; 9:e113778. [PMID: 25473845 PMCID: PMC4256208 DOI: 10.1371/journal.pone.0113778] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Accepted: 10/29/2014] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Depression is one of the most common mental disorders and a leading cause of disability worldwide. It constitutes a serious public health problem, particularly among elderly individuals. Most depressed elderly patients are treated by primary care (PC) physicians. The "Patient Health Questionnaire" (PHQ-2) is an instrument used for the detection of depression in PC settings. OBJECTIVE Evaluate the performance of the PHQ-2 in a low-income and uneducated elderly PC population. METHODS A non-probabilistic population sample of 142 individuals was selected from the healthcare unit's users ≧ 60 years. Criterion validity was assessed by estimating the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the PHQ-2 in comparison with the structured interview using the DSM-IV. The estimates of sensitivity and specificity were obtained from varying cut-offs of the PHQ-2 score. A Receiver Operator Characteristic (ROC) curve was constructed and the area under the curve (AUC) was calculated. RESULTS The group was predominantly female (73.9%), with low education level (mean 3 years of schooling). The mean age was 72.5 years old. The prevalence of depression was 26.1%. The best values of sensitivity (0.74), specificity (0.77), PPV (0.50) e NPV (0.90) were obtained with score equal to 1. The AUC was 0.77, indicating a modest performance of the test accuracy. CONCLUSION The simplicity of the PHQ-2 is an advantage for its use in PC. The high NPV indicated that 90% of those who tested negative would not need additional tests. However, the low PPV indicated that the PHQ-2 is not sufficient to screen for depression. The application of the instrument could be the first step of the screening, that would include a second step to all those with positive tests formerly.
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Affiliation(s)
| | | | | | - Soraya Atie
- National Public Health School/Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
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Diniz BS, Reynolds CF, Butters MA, Dew MA, Firmo JOA, Lima-Costa MF, Castro-Costa E. The effect of gender, age, and symptom severity in late-life depression on the risk of all-cause mortality: the Bambuí Cohort Study of Aging. Depress Anxiety 2014; 31:787-95. [PMID: 24353128 PMCID: PMC4062606 DOI: 10.1002/da.22226] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2013] [Revised: 11/12/2013] [Accepted: 11/20/2013] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Increased mortality risk and its moderators is an important, but still under recognized, negative outcome of late-life depression (LLD). Therefore, we aimed to evaluate whether LLD is a risk factor for all-cause mortality in a population-based study with over 10 years of follow-up, and addressed the moderating effect of gender and symptom severity on mortality risk. METHODS This analysis used data from the Bambuí Cohort Study of Aging. The study population comprised 1.508 (86.5%) of all eligible 1.742 elderly residents. Depressive symptoms were annually evaluated by the GHQ-12, with scores of five or higher indicating clinically significant depression. From 1997 to 2007, 441 participants died during 10,648 person-years of follow-up. We estimated the hazard ratio for mortality risk by Cox regression analyses. RESULTS Depressive symptoms were a risk factor for all-cause mortality after adjusting for confounding lifestyle and clinical factors (adjusted HR = 1.24 CI95% [1.00-1.55], P = .05). Mortality risk was significantly elevated in men (adjusted HR = 1.45 CI95% [1.01-2.07], P = 0.04), but not in women (adjusted HR = 1.13 CI95% [0.84-1.48], P = 0.15). We observed a significant interaction between gender and depressive symptoms on mortality risk ((HR = 1.72 CI95% [1.18-2.49], P = 0.004). CONCLUSION The present study provides evidence that LLD is a risk factor for all-cause mortality in the elderly, especially in men. The prevention and adequate treatment of LLD may help to reduce premature disability and death among elders with depressive symptoms.
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Affiliation(s)
- Breno S. Diniz
- Department of Mental Health, Federal University of Minas Gerais Medical School, Belo Horizonte, MG, Brazil
| | - Charles F. Reynolds
- Department of Psychiatry, University of Pittsburgh Medical School, Pittsburgh, PA, USA
| | - Meryl A. Butters
- Department of Psychiatry, University of Pittsburgh Medical School, Pittsburgh, PA, USA
| | - Mary Amanda Dew
- Department of Psychiatry, University of Pittsburgh Medical School, Pittsburgh, PA, USA
| | - Josélia O. A. Firmo
- René Rachou Research Center, Oswaldo Cruz Foundation, Belo Horizonte, MG, Brazil
| | - Maria Fernanda Lima-Costa
- René Rachou Research Center, Oswaldo Cruz Foundation, Belo Horizonte, MG, Brazil,Department of Social and Preventive Medicine, Federal University of Minas Gerais Medical School, Belo Horizonte, MG, Brazil
| | - Erico Castro-Costa
- René Rachou Research Center, Oswaldo Cruz Foundation, Belo Horizonte, MG, Brazil,Department of Social and Preventive Medicine, Federal University of Minas Gerais Medical School, Belo Horizonte, MG, Brazil
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Coelho CLS, Crippa JAS, Santos JLF, Pinsky I, Zaleski M, Caetano R, Laranjeira R. Higher prevalence of major depressive symptoms in Brazilians aged 14 and older. BRAZILIAN JOURNAL OF PSYCHIATRY 2014; 35:142-9. [PMID: 23904019 DOI: 10.1590/1516-4446-2012-0875] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2012] [Accepted: 10/02/2012] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Depression is a highly prevalent condition and is considered a major public health issue. The aim of the present study was to estimate the prevalence of depressive symptoms in the Brazilian population and establish their sociodemographic correlates. METHOD A cross-sectional study was conducted between November 2005 and April 2006. Data were collected in face-to-face interviews using a standardized questionnaire. The sample consisted of 3,007 interviews with individuals aged 14 years and older and followed a probabilistic design covering the Brazilian national territory. Depressive symptoms were assessed according to the Center for Epidemiologic Studies Depression Scale. RESULTS The observed prevalence of depressive symptoms was 28.3% (13% mild/moderate; 15.3% major/severe; p < 0.01). Increased depressive symptom rates were associated with being a female, being 45 years of age and older, having lower educational attainment, being single, having family income of up to 2.5 times minimum wage, and living in the northern region of Brazil (p < 0.05). CONCLUSIONS The prevalence of depressive symptoms in Brazil is high, with major depressive symptoms being the most frequent form of this symptomatology. Considering the biopsychosocial model of mental disorders, this survey points to the involvement of psychosocial factors in the prevalence of depressive symptoms in Brazil.
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Affiliation(s)
- Cassiano L S Coelho
- Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.
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Schwarzbach M, Luppa M, Forstmeier S, König HH, Riedel-Heller SG. Social relations and depression in late life-a systematic review. Int J Geriatr Psychiatry 2014; 29:1-21. [PMID: 23720299 DOI: 10.1002/gps.3971] [Citation(s) in RCA: 162] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2012] [Accepted: 03/12/2013] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Social relations have become the focus of much research attention when studying depressive symptoms in older adults. Research indicates that social support and being embedded in a network may reduce the risk for depression. The aim of the review was to analyze the association of social relations and depression in older adults. METHODS Electronic databases were searched systematically for potentially relevant articles published from January 2000 to December 2012. Thirty-seven studies met the inclusion criteria for this review. RESULTS Factors of social relations were categorized into 12 domains. Factors regarding the qualitative aspects of social relations seem to be more consistent among studies and therefore provide more explicit results. Thus, social support, quality of relations, and presence of confidants were identified as factors of social relations significantly associated with depression. The quantitative aspects of social relations seem to be more inconsistent. Cultural differences become most obvious in terms of the quantitative aspects of social relations. CONCLUSION Despite the inconsistent results and the methodological limitations of the studies, this review identified a number of factors of social relations that are significantly associated with depression. The review indicates that it is needful to investigate social relations in all their complexity and not reduce them to one dimension. Simultaneously, it is important to conduct longitudinal studies because studies with cross-sectional design do not allow us to draw conclusions on causality. Beyond that, cultural differences need to be considered.
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Affiliation(s)
- Michaela Schwarzbach
- Institute of Social Medicine, Occupational Health and Public Health, Public Health Research Unit, University of Leipzig, Leipzig, Germany
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23
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Lino VTS, Portela MC, Camacho LAB, Atie S, Lima MJB. Assessment of social support and its association to depression, self-perceived health and chronic diseases in elderly individuals residing in an area of poverty and social vulnerability in rio de janeiro city, Brazil. PLoS One 2013; 8:e71712. [PMID: 23951227 PMCID: PMC3741124 DOI: 10.1371/journal.pone.0071712] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2013] [Accepted: 07/01/2013] [Indexed: 11/19/2022] Open
Abstract
Objectives Social support (SS) influences the elderly ability to cope with the losses of ageing process. This study was aimed at assessing SS among elderly users of a primary healthcare unit in a poor and violent area of Rio de Janeiro City, and at verifying its association with depression, self-perceived health (SPH), marital status and chronic illnesses. Methods A cross-sectional study was performed based on a convenience sample of 180 individuals aged 60 years or older. SS was measured with part of the Brazilian version of Medical Outcomes Study's SS scale, and SPH and depression were assessed, respectively, through one question and the Brazilian version of the Structured Clinical Interview for DSM-IV Axis I Disorders. SS medians were calculated for the categories of SPH, depression, marital status and chronic illnesses variables, and differences were evaluated with the Kruskal-Wallis and Mann-Whitney tests. Additionally, Pearson's chi-square test and logistic regression were employed to identify unadjusted and adjusted associations between SS and those variables. Results The participant’s mean age was 73 years old, and level of education was 3 years of school education on average. They were predominantly females (73.3%), and non-married (55.0%). Among them, 74.4% perceived their SS as satisfactory, 55.0% perceived their health as good, 27.8% were diagnosed with major depression and 83.3% had hypertension. Especially for those depressed and with bad SPH, the medians of SS measure were much lower than for others, reaching an unsatisfactory level. Moreover, controlling for other factors, non-depressed individuals were more likely (OR = 2.32) to have satisfactory SS. Conclusion in the violent and poor area explored in this research low SS is highly prevalent in the elderly. Depressed individuals are more likely to have low SS and this condition should be investigated in depressed elderly. The reduced scale is useful for low education individuals.
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Affiliation(s)
- Valeria T S Lino
- National Public Health School, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.
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Borges LJ, Benedetti TRB, Xavier AJ, d'Orsi E. Fatores associados aos sintomas depressivos em idosos: estudo EpiFloripa. Rev Saude Publica 2013; 47:701-10. [DOI: 10.1590/s0034-8910.2013047003844] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2011] [Accepted: 03/04/2013] [Indexed: 11/22/2022] Open
Abstract
OBJETIVO Analisar a prevalência e fatores associados a sintomas depressivos em idosos. MÉTODOS Estudo epidemiológico transversal e de base domiciliar (inquérito EpiFloripa Idoso) com 1.656 idosos, realizado por conglomerados em dois estágios, setores censitários e domicílios, em Florianópolis, SC. A prevalência de sintomas depressivos (desfecho) foi obtida por meio da Geriatric Depression Scale (GDS-15), e testadas associações segundo variáveis sociodemográficas, de saúde, comportamentais e sociais. Foram calculadas razões de prevalências brutas e ajustadas com intervalo de 95% de confiança por regressão de Poisson. RESULTADOS A prevalência de sintomas depressivos foi de 23,9% (IC95% 21,84;26,01). Os fatores de risco associados no modelo final foram: escolaridade de cinco a oito anos (RP = 1,50; IC95% 1,08; 2,08), um a quatro anos (RP = 1,62; IC95% 1,18; 2,23) e nenhum ano de estudo (RP = 2,11; IC95% 1,46;3,05); situação econômica pior quando comparada com a que tinha aos 50 anos (RP = 1,33; IC95% 1,02;1,74); déficit cognitivo (RP = 1,45; IC95% 1,21;1,75); percepção de saúde regular (RP = 1,95; IC95% 1,47;2,60) e ruim (RP = 2,64; IC95% 1,82;3,83); dependência funcional (RP = 1,83; IC95% 1,43; 2,33); e dor crônica (RP = 1,35; IC95% 1,10;1,67). Grupo etário de 70 a 79 anos (RP = 0,77; IC95% 0,64;0,93); atividade física de lazer (RP = 0,75; IC95% 0,59;0,94); participação em grupos de convivência ou religiosos (RP = 0,80; IC95% 0,64;0,99); e ter relação sexual (RP = 0,70; IC95% 0,53;0,94) mostraram-se fatores protetores ao aparecimento dos sintomas depressivos. CONCLUSÕES Situação clínica adversa, desvantagem socioeconômica e pouca atividade social e sexual mostraram-se associadas aos sintomas depressivos em idosos.
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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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Schwarzbach M, Luppa M, Sikorski C, Fuchs A, Maier W, van den Bussche H, Pentzek M, Riedel-Heller SG. The relationship between social integration and depression in non-demented primary care patients aged 75 years and older. J Affect Disord 2013; 145:172-8. [PMID: 22871528 DOI: 10.1016/j.jad.2012.07.025] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2012] [Revised: 07/18/2012] [Accepted: 07/18/2012] [Indexed: 11/15/2022]
Abstract
BACKGROUND Social integration seems to be associated with depression in late life. But the measurement of social integration still lacks a strong consensus. To date in most studies the different domains of social integration have been examined separately. AIMS In order to improve comparability among studies, we used the social integration index (SII), which covers all domains of social integration, to examine the association of social integration and depression in non-demented primary care patients aged 75 years and older. METHOD Data were derived from the longitudinal German study on Aging, Cognition and Dementia in primary care patients. Included in the cross-sectional survey were 1028 non-demented subjects aged 75 years and older. The GDS-15 Geriatric Depression Scale was used to measure depression with a threshold of ≥6. Associations of the SII and further potential risk factors and depression were analysed using multivariate logistic regression models. RESULTS The SII was significantly associated with depression in the elderly. After full adjustment for all variables, odds of depression were significantly higher for lower levels of the SII, having a care level, impaired vision and mobility and subjective memory complaints. CONCLUSION Because the social integration index covers several aspects of social integration, the results seem to be more significant than considering only one of these domains alone. Further research is needed to prove the practicability of the social integration index and to supply the literature with consistent results regarding the association of social integration and depression. Elderly with depression could benefit from increased social networks and enhanced social integration, which points to the development of social programs and social policies that maximize the engagement of older adults in social activities and volunteer roles.
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Affiliation(s)
- Michaela Schwarzbach
- Institute of Social Medicine, Occupational Health and Public Health, Public Health Research Unit, University of Leipzig, Philipp-Rosenthal-Straße 55, D-04103 Leipzig, Germany.
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Seney ML, Walsh C, Stolakis R, Sibille E. Neonatal testosterone partially organizes sex differences in stress-induced emotionality in mice. Neurobiol Dis 2012; 46:486-96. [PMID: 22394611 DOI: 10.1016/j.nbd.2012.02.014] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2011] [Revised: 01/29/2012] [Accepted: 02/20/2012] [Indexed: 10/28/2022] Open
Abstract
Major depressive disorder (MDD) is a debilitating disorder of altered mood regulation. Despite well established sex differences in MDD prevalence, the mechanism underlying the increased female vulnerability remains unknown. Although evidence suggests an influence of adult circulating hormone levels on mood (i.e. activational effects of hormones), MDD prevalence is consistently higher in women across life stages (and therefore hormonal states), suggesting that additional underlying structural or biological differences place women at higher risk. Studies in human subjects and in rodent models suggest a developmental origin for mood disorders, and interestingly, a developmental process also establishes sex differences in the brain. Hence, based on these parallel developmental trajectories, we hypothesized that a proportion of the female higher vulnerability to MDD may originate from the differential organization of mood regulatory neural networks early in life (i.e. organizational effects of hormones). To test this hypothesis in a rodent system, we took advantage of a well-established technique used in the field of sexual differentiation (neonatal injection with testosterone) to masculinize sexually dimorphic brain regions in female mice. We then investigated adult behavioral consequences relating to emotionality by comparing neonatal testosterone-treated females to normal males and females. Under baseline/trait conditions, neonatal testosterone treatment of female mice did not influence adult emotionality, but masculinized adult locomotor activity, as revealed by the activational actions of hormones. Conversely, the increased vulnerability of female mice to develop high emotionality following unpredictable chronic mild stress (UCMS) was partially masculinized by neonatal testosterone exposure, with no effect on post-UCMS locomotion. The elevated female UCMS-induced vulnerability did not differ between adult hormone treated groups. These results demonstrate that sex differences in adult emotionality in mice are partially caused by the organizational effects of sex hormones during development, hence supporting a developmental hypothesis of the human adult female prevalence of MDD.
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Affiliation(s)
- Marianne L Seney
- Department of Psychiatry, University of Pittsburgh Medical School, Pittsburgh, PA 15219, USA
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Sass A, Gravena AAF, Pilger C, Mathias TADF, Marcon SS. Depressão em idosos inscritos no Programa de Controle de hipertensão arterial e diabetes mellitus. ACTA PAUL ENFERM 2012. [DOI: 10.1590/s0103-21002012000100014] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJETIVO: Identificar a presença de sintomas depressivos em idosos inscritos no Programa de controle de hipertensão arterial e diabetes mellitus em um município do Noroeste do Paraná. MÉTODOS: Estudo descritivo transversal, realizado nas unidades básicas de saúde de Sarandi - PR, com 100 idosos cadastrados no Programa Hiperdia. A seção de saúde mental do questionário Brazil Old Age Schedule (BOAS) foi usada. Os testes Mann-Whitney e Qui-quadrado foram empregados para analisar a associação entre sintomas de depressão e características sociodemográficas e estado nutricional. RESULTADOS: A maioria dos idosos era do sexo feminino (82,0%). A prevalência de sintomas depressivos foi de 30,0%, dos quais 20,0% classificados como depressão maior. Os sintomas depressivos foram mais frequentes nas mulheres (31,7%); em idosos com 80 anos e mais (33,3%); sem nenhuma escolaridade (39,1%), que moravam só (43,7%) e que apresentavam baixo peso (33,3%) ou obesidade (32,5%). CONCLUSÃO: As equipes da estratégia saúde da família devem estar atentas para a presença de sintomas depressivos em idosos, sobretudo aqueles que pertencem aos grupos de convivência já instalados.
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Affiliation(s)
- Arethuza Sass
- Hospital Metropolitano de Sarandi; Universidade Estadual de Maringá, Brasil
| | | | - Calíope Pilger
- Universidade Estadual de Maringá, Brasil; Universidade do Centro-oeste do Paraná, Brasil
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Depressive symptoms in old age: relations among sociodemographic and self-reported health variables. Int Psychogeriatr 2011; 23:941-9. [PMID: 21486519 DOI: 10.1017/s1041610211000627] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Depression in old age is a complex multifactorial phenomenon that is influenced by several biopsychosocial variables. Depressive symptoms are associated with the presence of chronic diseases, with being female, with low education and low income levels, and with poor perceived health assessment. In impoverished areas, older adults may have more physical disability, as they may have less access to health services. Therefore, they may be more likely to report depressive symptoms. METHODS Population-based cross-sectional research was undertaken using data from the FIBRA study conducted in Ermelino Matarazzo, a poor subdistrict of the city of São Paulo, Brazil. The participants comprised 303 elderly people, aged 65 years and over, who attended a single-session data collection effort carried out at community centers. The protocol comprised sociodemographic and self-reported health variables, and the Geriatric Depression Scale. RESULTS The majority of the subjects reported five or fewer symptoms of depression (79.21%), reported one or two self-reported chronic diseases (56.86%), declared themselves to have one or two self-reported health problems (46.15%), and had good perceived health assessment (40.27%). The presence of depressive symptoms was associated with a higher number of self-reported health problems, poor perceived health assessment, and lower schooling levels, in the total sample and in analyses including men only. For women, depressive symptoms were associated with the number of self-reported health problems and family income. CONCLUSION The presence of health problems, such as falls and memory problems, lower perceived health, and low education (and low family income for women) were associated with a higher presence of depressive symptoms among elderly people in this poor area of São Paulo.
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Clemente AS, Loyola Filho AI, Firmo JOA. Concepções sobre transtornos mentais e seu tratamento entre idosos atendidos em um serviço público de saúde mental. CAD SAUDE PUBLICA 2011; 27:555-64. [DOI: 10.1590/s0102-311x2011000300015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2010] [Accepted: 12/06/2010] [Indexed: 11/22/2022] Open
Abstract
Para compreender os modos de pensar e agir de pacientes idosos diante dos transtornos mentais, foram entrevistados 13 idosos (> 60 anos), atendidos em hospital público de Belo Horizonte, Minas Gerais, Brasil. A análise dos dados foi baseada no modelo de Signos, Significados e Ações. A maioria dos idosos negou a presença de qualquer transtorno mental, mas identificou signos de sofrimento mental, articulados em três categorias: nervoso, problema de cabeça e doidura. Todos referiram a sintoma que justificaria tratamento e destacaram como causas de transtornos mentais, problemas familiares e vivenciais, físicos, de alimentação e sono, fraqueza moral e debilidade atribuída ao envelhecimento. Apesar de a procura do atendimento ser atribuída à iniciativa de outrem, o tratamento é bem aceito e avaliado, mesmo com certas ressalvas articuladas aos seus próprios conceitos sobre causas e conseqüências de tais perturbações. Os medicamentos foram apontados como principal medida de tratamento, apesar dos efeitos adversos, da baixa eficácia e do modo como são preconizados pelos profissionais de saúde.
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Affiliation(s)
- Adauto Silva Clemente
- Fundação Oswaldo Cruz, Brasil; Fundação Hospitalar do Estado de Minas Gerais, Brasil
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Alexandrino-Silva C, Alves TF, Tófoli LF, Wang YP, Andrade LH. Psychiatry: life events and social support in late life depression. Clinics (Sao Paulo) 2011; 66:233-8. [PMID: 21484039 PMCID: PMC3059858 DOI: 10.1590/s1807-59322011000200009] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2010] [Revised: 09/20/2010] [Accepted: 11/03/2010] [Indexed: 01/30/2023] Open
Abstract
OBJECTIVES To examine the association of life events and social support in the broadly defined category of depression in late life. INTRODUCTION Negative life events and lack of social support are associated with depression in the elderly. Currently, there are limited studies examining the association between life events, social support and late-life depression in Brazil. METHODS We estimated the frequency of late-life depression within a household community sample of 367 subjects aged 60 years or greater with associated factors. ''Old age symptomatic depression'' was defined using the Composite International Diagnostic Interview 1.1 tool. This diagnostic category included only late-life symptoms and consisted of the diagnoses of depression and dysthymia as well as a subsyndromal definition of depression, termed ''late subthreshold depression''. Social support and life events were assessed using the Comprehensive Assessment and Referral Evaluation (SHORT-CARE) inventory. RESULTS ''Old age symptomatic depression'' occurred in 18.8% of the patients in the tested sample. In univariate analyses, this condition was associated with female gender, lifetime anxiety disorder and living alone. In multivariate models, ''old age symptomatic depression'' was associated with a perceived lack of social support in men and life events in women. DISCUSSION Social support and life events were determined to be associated with late-life depression, but it is important to keep in mind the differences between genders. Also, further exploration of the role of lifetime anxiety disorder in late-life depression may be of future importance. CONCLUSIONS We believe that this study helps to provide insight into the role of psychosocial factors in late-life depression.
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Affiliation(s)
- Clóvis Alexandrino-Silva
- Section of Psychiatry Epidemiology, Institute and Department of Psychiatry, Medical School, University of São Paulo, 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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Lima MTDR, Silva RDSE, Ramos LR. Fatores associados à sintomatologia depressiva numa coorte urbana de idosos. JORNAL BRASILEIRO DE PSIQUIATRIA 2009. [DOI: 10.1590/s0047-20852009000100001] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJETIVO: Analisar a associação, em uma coorte urbana de idosos, entre sintomatologia depressiva e outros indicadores de capacidade funcional com a mortalidade após 15 anos de seguimento. MÉTODOS: Foram estudados os casos de 1.667 idosos (> 65 anos) residentes em Vila Clementino, na cidade de São Paulo, por meio de uma avaliação multidimensional da capacidade funcional e dos atestados de óbito referentes a mortes ocorridas entre 1991 (início do estudo) e abril de 2006. Na análise univariada foram calculadas as razões de chances e sua significância estatística foi avaliada pelo intervalo de confiança (95%). Na análise múltipla foi empregada a regressão logística. RESULTADOS: Entre os idosos estudados, 21,1% eram deprimidos em 1991. Na análise univariada, as maiores proporções de deprimidos foram observadas entre indivíduos do sexo feminino, com mais de 80 anos, analfabetos, viúvos ou solteiros, com alto nível de dependência física e de déficit cognitivo, usuários de mais medicamentos e entre os que morreram no período de seguimento de 15 anos. Na análise múltipla, controlando-se por sexo e idade, a presença de dependência física e o fato de ser usuário de mais medicamentos foram os principais preditores da ocorrência de depressão. CONCLUSÕES: A ocorrência de sintomatologia depressiva parece estar diretamente relacionada aos níveis de incapacidade física observados entre os idosos.
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