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Albertini M, Lewin-Epstein N, Silverstein M, Tur-Sinai A. Becoming Sandwiched in Later Life: Consequences for Individuals' Well-Being and Variation Across Welfare Regimes. J Gerontol B Psychol Sci Soc Sci 2024; 79:gbad154. [PMID: 37846581 DOI: 10.1093/geronb/gbad154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Indexed: 10/18/2023] Open
Abstract
OBJECTIVES The experience of being sandwiched between support obligations towards both aging parents and adult offspring is likely to become more common and more relevant. We aim at assessing the effect of demographic and social sandwiching on the psychological health and subjective well-being of individuals experiencing these transitions, and to what extent, these effects vary across welfare regimes. METHODS Data are from 63,585 individuals aged 50-75 participating in the Survey of Health, Ageing and Retirement in Europe (SHARE). We estimate within- and between-individual effects using hybrid regression models to predict depressive symptoms (EURO-D) and subjective well-being (control, autonomy, self-realization, and pleasure [CASP]). RESULTS Among demographically sandwiched women, transitioning into social sandwiching and into supporting only parents was associated with a moderate but statistically significant increase in EURO-D and decline in CASP scores. The same association is not observed for male respondents. The pattern of variation among women living in countries characterized by different welfare regimes suggests that social sandwiching is less detrimental in Nordic regimes than in other welfare contexts. DISCUSSION Results from the between-individuals part of the model indicate that there is a selection into social sandwiching of more healthy individuals into support roles. However, the within-individuals part of the model indicates that the transition into social sandwiching has a detrimental effect on women's (but not men's) psychological health and well-being. The explanations for this gendered effect of social sandwiching may be found in the "invisible" support provided by women and the gendered division of specific care tasks.
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Affiliation(s)
- Marco Albertini
- Department of Political and Social Sciences, University of Bologna, Bologna, Italy
| | - Noah Lewin-Epstein
- Department of Sociology and Anthropology, Tel Aviv University, Tel Aviv, Israel
| | - Merril Silverstein
- Department of Sociology, Maxwell School, Syracuse University, Syracuse, New York, USA
| | - Aviad Tur-Sinai
- Department of Health Management Systems, Max Stern Yezreel Valley College, Yezreel Valley, Israel
- School of Nursing, University of Rochester Medical Center, Rochester, New York, USA
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Gana K, Boudouda NE, Salanova T, Broc G. What Do EURO-D Scores Capture? Disentangling Trait and State Variances in Depression Symptoms Across the Adult Life Span in Nine European Nations. Assessment 2023; 30:2580-2594. [PMID: 36840515 DOI: 10.1177/10731911231153835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
The primary purposes of the present study were to determine (a) whether the EURO-D measures trait (i.e., time-invariant) versus state (i.e., time-variant) aspects of depression and (b) whether these aspects are stable across countries and ages. In five waves of the SHARE survey (a nationally representative Survey of Health, Ageing, and Retirement in Europe), we estimated trait-state-occasion models (TSO), including multiple-nation TSO, based on data from nine European nations over a 10-year period. Also, we used local structural equation modeling to test for the moderating effects of age on the TSO parameters. Our main findings were: (a) there were differences in the trait/state variances of depressive symptoms across nations. The amount of trait variance was above 60% for Belgium, Denmark, and France. It was between 50% and 60% for Austria, Germany, Sweden, and Switzerland, while it was below 50% for Italy and Spain. (b) The effects of trait and state were almost equally the source of variance for depression symptoms across ages, with a slight advantage for the effects of trait (56% of the variance). This trend showed substantial stability across the adult life course (from age 40 up to age 95).
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Tomás JM, Torres Z, Oliver A, Enrique S, Fernández I. Psychometric properties of the EURO-D scale of depressive symptomatology: Evidence from SHARE wave 8. J Affect Disord 2022; 313:49-55. [PMID: 35772626 DOI: 10.1016/j.jad.2022.06.079] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 05/31/2022] [Accepted: 06/23/2022] [Indexed: 10/17/2022]
Abstract
BACKGROUND The EURO-D is a short scale to measure symptoms of depression, very used in large population surveys. Although there are numerous validation studies, its psychometric properties remain unclear. The two-factor structure (Affective Suffering and Lack of Motivation) is replicated in several studies but with different item compositions, and none reported reliability indices for both factors. For that reason, the aim of this study is to examine the factorial validity of the scale, the reliability of the dimensions, the gender differential item functioning (DIF), and the nomological validity. METHODS 46,317 participants aged 50 and over (M = 71.33), from which 57.4 % were females, in Wave 8 of the Survey of Health, Aging and Retirement in Europe (SHARE) were included. INSTRUMENTS EURO-D, R-UCLA, Self-perceived health index, and indicator of taking drugs for anxiety or depression. Factor Analyses, DIF, Reliability Index and Spearman correlations were estimated. RESULTS Factor analysis identified a bifactor structure: a general factor of Depression and two specific factors of Affective Suffering and Lack of Motivation, which reliabilities were 0.83, 0.83 and 0.79 respectively. No relevant DIF item by gender was found, but higher scores were found in women in all factors. Both factors had positive relations with loneliness, taking drugs and self-perceived health. LIMITATIONS this study has a cross-sectional design; future research may consider the longitudinal stability of the scale. CONCLUSIONS EURO-D shows adequate psychometric properties when a general factor of depression and two specific factors are considered. Women have higher scores on all dimensions.
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Affiliation(s)
- José M Tomás
- Department of Methodology for the Behavioral Sciences, University of Valencia, Valencia, Spain.
| | - Zaira Torres
- Department of Methodology for the Behavioral Sciences, University of Valencia, Valencia, Spain.
| | - Amparo Oliver
- Department of Methodology for the Behavioral Sciences, University of Valencia, Valencia, Spain.
| | - Sara Enrique
- Department of Developmental Psychology and Education, University of Valencia, Valencia, Spain.
| | - Irene Fernández
- Department of Methodology for the Behavioral Sciences, University of Valencia, Valencia, Spain.
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Aretz B. The short- and long-term effects of the Great Recession on late-life depression in Europe: The role of area deprivation. Soc Sci Med 2022; 294:114697. [PMID: 35030399 DOI: 10.1016/j.socscimed.2021.114697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 12/01/2021] [Accepted: 12/28/2021] [Indexed: 12/01/2022]
Abstract
INTRODUCTION The prevalence of depression increases in times of economic crises. Less is known about whether people living in advantaged or disadvantaged areas suffer equally from negative effects of crisis. OBJECTIVE To explore the role of area deprivation on the short- and long-term effects of the Great Recession in Europe on late-life depression. METHODS Individual panel data from Austria, Belgium, Denmark, France, Germany, Italy, Spain, Sweden, Switzerland of the SHARE (age 50+, n = 6866) between 2004 and 2017 were used. Late-life depression (LLD) was measured by the EURO-D scale (4+ symptoms). Area deprivation was assessed by a country-specific z-standardized scale measuring perceived access to various services and quality of the social and built environment. Quarterly country-level GDP and yearly unemployment data were explored to define country-specific durations of the Great Recession. Individual fixed effects panel regressions were estimated controlling for time-varying socioeconomic and health-related confounders. RESULTS Prevalence and incidence of late-life depression was generally higher in deprived than in non-deprived areas, and these differences in prevalence and incidence increased during the Great Recession. Regressions showed that the Great Recession was related to a 23% higher long-term risk of late-life depression (OR: 1.23, CI: 1.05-1.44) for all study participants. In the short-term of the Great Recession, people from deprived areas had a 22% higher risk of late-life depression (OR: 1.22, CI: 1.02-1.46) than people from non-deprived areas. CONCLUSION The findings suggest that older adults exposed to adverse area determinants suffer more from the negative short-term effects of a severe economic crisis on depression and mental health inequalities may have increased between people living in deprived versus non-deprived areas. This potential increase in mental health inequalities warrants particular attention for those people living in deprived areas.
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Affiliation(s)
- Benjamin Aretz
- Department of Demography, Faculty of Spatial Sciences, University of Groningen, Groningen, the Netherlands; Institute of Sociology and Demography, University of Rostock, Rostock, Germany.
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V P, Arun V, Mc R, Nagaraj S, Krishnaveni GV, Kumaran K, Fall CH, Krishna M. Validation of EURO-D, a geriatric depression scale in South India: Findings from the Mysore study of Natal effects on Ageing and Health (MYNAH). J Affect Disord 2021; 295:939-945. [PMID: 34706466 DOI: 10.1016/j.jad.2021.08.045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Accepted: 08/21/2021] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Many of the assessment tools used to study depression amongst older people in low- and middle- income countries (LMICs) are adaptations of instruments developed in other cultural settings. There is a need to validate those instruments in LMICs. METHODS 721 men and women aged 55-80 years from the Mysore Birth Records Cohort underwent standardised assessments for sociodemographic characteristics, cardiometabolic risk factors, cognitive function and mental health. Sensitivity, specificity and level of agreement of EURO-D diagnosis of depression with diagnosis of depression derived by the Geriatric Mental State (GMS) examination were calculated. To validate the EURO-D score against GMS depressive episode, we used maximum Youden's index as the criterion for each cut-off point. Concurrent validity was assessed by measuring correlations with the WHO Disability Assessment Schedule (WHO DAS II). RESULTS Of the 721 (408 men and 313 women) who participated in this study, 138 (54 men and 84 women) were diagnosed with depression. Women had higher depression scores on the EURO-D scale and disability on the WHO DAS II scale. A maximum Youden's Index of 0.60 was observed at a EURO-D cut-off of 6, which corresponded to 95% sensitivity, 64% specificity, kappa value of 0.6 and area under the curve (AUC) of 80%. There was significant and positive correlation between EURO-D and WHO DAS II scores. LIMITATIONS Future independent validation studies in other settings are required. DISCUSSION This study supports the use of the EURO-D scale for diagnosing depression amongst older adults in South India.
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Affiliation(s)
- Prajwal V
- SJCE JSS Science and Technology University Mysore India
| | - Vanishri Arun
- SJCE JSS Science and Technology University Mysore India
| | - Ramya Mc
- CSI Holdsworth Memorial Hospital, Mysore, India
| | | | | | - Kalyanaraman Kumaran
- CSI Holdsworth Memorial Hospital, Mysore, India; MRC Lifecourse Epidemiology Unit, University of Southampton, United Kingdom
| | - Caroline Hd Fall
- MRC Lifecourse Epidemiology Unit, University of Southampton, United Kingdom
| | - Murali Krishna
- CSI Holdsworth Memorial Hospital, Mysore, India; Foundation for Research and Advocacy in Mental Health, Mysore, India.
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Abuladze L, Opikova G, Lang K. Factors associated with incidence of depressiveness among the middle-aged and older Estonian population. SAGE Open Med 2020; 8:2050312120974167. [PMID: 33282303 PMCID: PMC7682222 DOI: 10.1177/2050312120974167] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 10/26/2020] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE Relatively scant research among older Estonian population describes factors associated with the incidence of depressive symptoms. This study identifies factors associated with the incidence of depressiveness among middle-aged and older Estonians over 2- and 4-year periods. METHOD In this cross-sectional analysis, logistic regression models are used to identify the factors associated with the incidence of depressiveness over 2- and 4-year periods. The data were drawn from the Survey of Health, Ageing and Retirement in Europe (SHARE) 2011-2015 which included Estonian population aged 53 years and older in 2013. After excluding those younger than 53 years, not interviewed 2 years later, those with depressive symptoms at baseline in 2013, and missing values for depressiveness or other variables, our analytical sample comprised 2513 people. RESULTS Among those who were not depressive in 2013, 21.9% became depressive within 2 years; 16.1% of non-depressive individuals since 2011 became depressive by 2015. No age differences in incidence remained in adjusted models. Women have almost 50% higher odds of becoming depressive. A previous history of depressiveness and the presence of everyday activity limitations were important factors increasing the incidence of depression. DISCUSSION Changes related to the individual's unique ageing experience are important explanatory factors related to the likelihood of developing depressive symptoms, rather than age itself. To diminish the incidence of depressive symptoms among older Estonian population, public health interventions should attempt to address factors which complicate existing health problems and facilitate continued independence and community involvement, both of which contribute to overall satisfaction with life.
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Affiliation(s)
- Liili Abuladze
- Estonian Institute for Population Studies, School of Governance, Law and Society, Tallinn University, Tallinn, Estonia
| | - Galina Opikova
- The Institute of Family Medicine and Public Health, Faculty of Medicine, University of Tartu, Tartu, Estonia
| | - Katrin Lang
- The Institute of Family Medicine and Public Health, Faculty of Medicine, University of Tartu, Tartu, Estonia
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Gonçalves-Pereira M, Prina AM, Cardoso AM, da Silva JA, Prince M, Xavier M. The prevalence of late-life depression in a Portuguese community sample: A 10/66 Dementia Research Group study. J Affect Disord 2019; 246:674-681. [PMID: 30611911 DOI: 10.1016/j.jad.2018.12.067] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 11/20/2018] [Accepted: 12/20/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND Late life depression is associated with a significant burden of disease. Estimating depression in older adults can be difficult and requires different methodological approaches from those fitting younger adults. As community prevalence data is scarce in Portugal, we estimated the prevalence of depression in a sample of older Portuguese adults. Moreover, we investigated the association between depression and disability. METHODS A cross-sectional comprehensive one-phase survey was conducted of all residents aged 65 and over of one urban and one rural catchment area in Southern Portugal. Standardized 10/66 assessments include a comprehensive cognitive module and the Geriatric Mental State (GMS)-AGECAT. Information on demographics, non-communicable disease risk factors and disability/functioning (WHODAS 2.0) was also recorded. Depression was assessed using both ICD-10 and EURO-D criteria. RESULTS We interviewed 1405 older people (mean age 74.9, SD = 6.7 years; 55.5% women) after 313 (18.2%) refusals to participate. The prevalence rate for ICD-10 depression was 4.4 (95% CI 3.5-5.6) and 18.0 (95% CI 16.0-20.1) using the EURO-D case definition. As compared with having no depression, ICD-10 depression was associated with a higher level of disability, even after adjusting for confounders (4.8, 95% CI 2.8-8.1). The same happened with subsyndromal depression ('EURO-D only') cases (2.2, 95% CI 1.4-3.5). LIMITATIONS Non-generalisability of findings outside of catchment areas. CONCLUSIONS In this sample of older Portuguese people, the prevalence of depression was high and so were the associated levels of disability. EURO-D diagnoses may provide a better picture of clinically significant old age depression as a basis for health and social service planning.
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Affiliation(s)
- Manuel Gonçalves-Pereira
- CEDOC, Nova Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisboa, Portugal.
| | - A Matthew Prina
- King's College London, Social Epidemiology Research Group, Health Service and Population Research, Institute of Psychiatry, Psychology & Neuroscience, De Crespigny Park, London SE5 8AF, UK.
| | - Ana M Cardoso
- CEDOC, Nova Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisboa, Portugal.
| | - Joaquim Alves da Silva
- Nova Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa; Champalimaud Clinical Centre, Champalimaud Centre for the Unknown, Lisboa, Portugal.
| | - Martin Prince
- King's College London, Centre for Global Mental Health, Health Service and Population Research, Institute of Psychiatry, Psychology & Neuroscience, De Crespigny Park, London SE5 8AF, UK.
| | - Miguel Xavier
- CEDOC, Nova Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisboa, Portugal; Directorate General of Health, Min. Health, Portugal.
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Portellano-Ortiz C, Conde-Sala JL. Cognition and its association with the factors of the EURO-D: Suffering and Motivation. Findings from SHARE Wave 6. Int J Geriatr Psychiatry 2018; 33:1645-1653. [PMID: 30159923 DOI: 10.1002/gps.4967] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2017] [Accepted: 07/31/2018] [Indexed: 11/08/2022]
Abstract
UNLABELLED The aims of this study were (1) to analyse the relationship between cognition and clinical and sociodemographic variables, (2) to explore the relationship between cognitive tests and factors of EURO-D depression scale (Suffering and Motivation), and (3) to determine the relevance of cognition with respect to clinical and sociodemographic variables in the scores of the EURO-D factors. METHOD About 63 755 participants in the Survey of Health, Ageing and Retirement in Europe (SHARE) Wave 6 (2015) were included. Instruments are as follows: the SHARE study, the EURO-D scale, and cognitive tests. Bivariate, correlation, and multiple linear regression analyses were performed. RESULTS In the regression analysis with cognition, the variables associated with poor cognition were higher age (β = .29), lower educational level (β = -.26), economic difficulties (β = .17), and depression (β = .10). The correlation between cognition and EURO-D factors was weak in Suffering (r = -0.139) and moderate in Motivation (r = -0.382). In the regression analysis with the EURO-D, loneliness, poor self-perceived physical health, female gender, and low cognition were associated with higher depression levels. The main differences in the predictor variables of each factor were cognition (Motivation = -0.248, P < .001; Suffering = 0.002, P = .648) and the female sex (Motivation = 0.015, P < .001, Suffering = 0.175, P < .001). CONCLUSIONS In the EURO-D depression scale, poor cognition was associated with higher scores in the Motivation factor only, while the female gender presented higher scores in the Suffering factor.
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Affiliation(s)
| | - Josep Lluís Conde-Sala
- Faculty of Psychology, University of Barcelona, Barcelona, Spain.,Girona Biomedical Research Institute (IDIBGI), Research Unit, Healthcare Institute, Salt, Spain
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Portellano-Ortiz C, Garre-Olmo J, Calvó-Perxas L, Conde-Sala JL. Factor structure of depressive symptoms using the EURO-D scale in the over-50s in Europe. Findings from the SHARE project. Aging Ment Health 2018; 22:1477-1485. [PMID: 28856915 DOI: 10.1080/13607863.2017.1370688] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVES The aims of this study are: to analyze the factor structure of the EURO-D depression scale; to explore the variables associated with depressive symptoms in the total sample and in the EURO-D factors; and to compare the presence of depressive symptoms and the factor distribution in 15 European countries. METHOD 62,182 participants in Wave 5 (2013) of the Survey of Health, Aging and Retirement in Europe (SHARE) were included. INSTRUMENTS The SHARE study and the EURO-D scale. Factor, bivariate and multilevel analyses were performed. RESULTS Higher levels of depressive symptoms were associated with a poorer self-perception of physical health (η2 = 0.22) and economic difficulties (η2 = 0.07). Factor analysis of the EURO-D identified two factors: Suffering and Motivation. Higher levels of depressive symptoms were associated with female gender and younger age (≤60) in the Suffering factor, and with less activity and exercise, older age (≥71), widowhood and lower educational level in the Motivation factor. Poorer self-perception of physical health and economic difficulties were associated with higher depressive symptomatology in both factors. CONCLUSIONS Poorer self-perception of physical health, female gender, economic difficulties, widowhood, lower levels of activity and exercise and lower educational level were associated with higher depressive symptomatology. In the countries of southern Europe, the Motivation factor predominated.
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Affiliation(s)
- Cristina Portellano-Ortiz
- a Department of Cognition, Development and Educational Psychology, Faculty of Psychology , University of Barcelona , Barcelona , Spain
| | - Josep Garre-Olmo
- b Research Unit , Girona Biomedical Research Institute (IDIBGI) , Institut d'Assistència Sanitària , Salt , Spain.,c Department of Medical Sciences , University of Girona , Girona , Spain
| | - Laia Calvó-Perxas
- b Research Unit , Girona Biomedical Research Institute (IDIBGI) , Institut d'Assistència Sanitària , Salt , Spain
| | - Josep Lluís Conde-Sala
- a Department of Cognition, Development and Educational Psychology, Faculty of Psychology , University of Barcelona , Barcelona , Spain.,b Research Unit , Girona Biomedical Research Institute (IDIBGI) , Institut d'Assistència Sanitària , Salt , Spain
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Portellano-Ortiz C, Garre-Olmo J, Calvó-Perxas L, Conde-Sala JL. Depression and associated variables in people over 50 years in Spain. Rev Psiquiatr Salud Ment (Engl Ed) 2016; 11:216-226. [PMID: 27939026 DOI: 10.1016/j.rpsm.2016.10.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Revised: 09/21/2016] [Accepted: 10/05/2016] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Depression is a common and disabling psychiatric disorder in adulthood and is associated with higher mortality and functional disability. OBJECTIVES To determine the association between clinical and sociodemographic variables with depression in a sample of people over 50 years old living in Spain, and compare the prevalence of depression with the other Survey of Health, Ageing and Retirement (SHARE) countries. MATERIAL AND METHODS There were 5,830 participants in the Spanish sample of the Wave 5, 2013, of SHARE. Tools used: EURO-D (Depression) and CASP-12 (Quality of Life). STATISTICAL ANALYSIS Bivariate, and binary logistic. RESULTS The variables associated with depression in the binary logistic regression (EURO-D ≥4) were poor self-perceived physical health (OR=13.34; 95% CI: 9.74-18.27), having more than 2 difficulties in Activities of Daily Living (ADL) (OR=4.46; 95% CI: 3.13-6.34) and female gender (OR=2.16; 95% CI: 1.83-2.56). Depression was more common among participants with Alzheimer (76.4%), emotional disorders (73.9%), Parkinson (57.4%), hip fracture (55.4%), and rheumatism (50.9%). Compared with other European countries, Spain had a percentage of people with depression (29.3%) that was higher than the European average (27.9%). CONCLUSIONS The most important variables associated with depression were poor perceived physical health, presence of difficulties in ADL, and female gender.
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Affiliation(s)
| | - Josep Garre-Olmo
- Instituto de Investigación Biomédica de Girona (IdIBGI), IAS Unidad de Investigación, Salt, Girona, España; Departamento de Ciencias Médicas, Universidad de Girona, Girona, España
| | - Laia Calvó-Perxas
- Instituto de Investigación Biomédica de Girona (IdIBGI), IAS Unidad de Investigación, Salt, Girona, España
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Guerra M, Prina A, Ferri C, Acosta D, Gallardo S, Huang Y, Jacob K, Jimenez-Velazquez I, Llibre Rodriguez J, Liu Z, Salas A, Sosa A, Williams J, Uwakwe R, Prince M. A comparative cross-cultural study of the prevalence of late life depression in low and middle income countries. J Affect Disord 2016; 190:362-368. [PMID: 26544620 PMCID: PMC4679114 DOI: 10.1016/j.jad.2015.09.004] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Revised: 08/19/2015] [Accepted: 09/05/2015] [Indexed: 11/21/2022]
Abstract
BACKGROUND Current estimates of the prevalence of depression in later life mostly arise from studies carried out in Europe, North America and Asia. In this study we aimed to measure the prevalence of depression using a standardised method in a number of low and middle income countries (LMIC). METHODS A one-phase cross-sectional survey involving over 17,000 participants aged 65 years and over living in urban and rural catchment areas in 13 sites from 9 countries (Cuba, Dominican Republic, Puerto Rico, Mexico, Venezuela, Peru, China, India and Nigeria). Depression was assessed and compared using ICD-10 and EURO-D criteria. RESULTS Depression prevalence varied across sites according to diagnostic criteria. The lowest prevalence was observed for ICD-10 depressive episode (0.3 to 13.8%). When using the EURO-D depression scale, the prevalence was higher and ranged from 1.0% to 38.6%. The crude prevalence was particularly high in the Dominican Republic and in rural India. ICD-10 depression was also associated with increased age and being female. LIMITATIONS Generalisability of findings outside of catchment areas is difficult to assess. CONCLUSIONS Late life depression is burdensome, and common in LMIC. However its prevalence varies from culture to culture; its diagnosis poses a significant challenge and requires proper recognition of its expression.
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Affiliation(s)
- M. Guerra
- Institute of Memory, Depression and Disease Risk, Avda Constructores 1230, Lima 12, Peru,Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King׳s College London, London, UK,Peruvian University, Cayetano, Heredia, Lima, Peru
| | - A.M. Prina
- Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King׳s College London, London, UK
| | - C.P. Ferri
- Federal University of Sao Paulo, UNIFESP, Sao Paulo, Brasil
| | - D. Acosta
- National University Pedro Henriquez Urena
| | - S. Gallardo
- Institute of Memory, Depression and Disease Risk, Avda Constructores 1230, Lima 12, Peru,Corresponding author
| | | | - K.S. Jacob
- Christian Medical College, Vellore, India
| | | | | | | | - A. Salas
- Central University of Venezuela, Caracas, Venezuela
| | - A.L. Sosa
- National Autonomous University of Mexico
| | - J.D. Williams
- Department of Community Health, Voluntary Health Services, Chennai, India
| | | | - M. Prince
- Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King׳s College London, London, UK
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Buber I, Engelhardt H. Children's impact on the mental health of their older mothers and fathers: findings from the Survey of Health, Ageing and Retirement in Europe. Eur J Ageing 2008; 5:31-45. [PMID: 28798560 PMCID: PMC5546383 DOI: 10.1007/s10433-008-0074-8] [Citation(s) in RCA: 76] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
The relation between social support and mental health has been thoroughly researched and structural characteristics of the social network have been widely recognised as being an important component of social support. The aim of this paper is to clarify the association between children and depressive mood states of their older parents. Based on international comparative data from the Survey of Health, Ageing and Retirement in Europe we analysed how the number of children, their proximity and the frequency of contact between older parents and their children are associated with the mental health of older people, using the EURO-D index. Our results indicate a positive association of children and depressive mood since childless men and women report more depressive symptoms. Moreover, few contacts with children were associated with an increased number of depressive symptoms. The family status was related to mental health as well: older men and women living with a spouse or partner had the lowest levels of depression. Interestingly, the presence of a spouse or partner was more relevant for the mental health of older people than the presence of, or contact with, their children.
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Affiliation(s)
- Isabella Buber
- Vienna Institute of Demography, Austrian Academy of Sciences, Wohllebengasse 12-14, 6th Floor, 1040 Vienna, Austria
| | - Henriette Engelhardt
- Otto-Friedrich-University of Bamberg, Lichtenhaidestrasse 11, 3rd Floor, Postfach 1549, 96045 Bamberg, Germany
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Verropoulou G, Tsimbos C. Socio-demographic and health-related factors affecting depression of the Greek population in later life: an analysis using SHARE data. Eur J Ageing 2007; 4:171-81. [PMID: 28794786 DOI: 10.1007/s10433-007-0060-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Depression in later life is one of the most prevalent conditions forecasted to rise to the second most burdensome health condition worldwide by 2020. Using data from the 2004 Study of Health Ageing and Retirement in Europe (SHARE: release 1) on 857 Greek males and 1,032 females aged 50 or higher this study explores, firstly, associations of socio-demographic and health related indicators with depressive symptoms (EURO-D) and, secondly, attempts to identify patterns and structures among them. To achieve the first objective, the 12-item summated EURO-D scale is used in binary form with a cut-off point clinically validated by the EURODEP. Use of logistic regression pinpoints strong associations with gender, years of education, co-morbidity, disability, cognitive function and past depression. Women, less educated persons, those with poor physical health, declining cognitive function and a history of depression are significantly more at risk of scoring higher than three at the EURO-D scale. The role of age is not as clear. To achieve the second objective, multiple correspondence analysis is used in the first instance and factor analysis for binary data subsequently; two components are identified within EURO-D and continuous factor scores are produced. These factors are called "affective suffering" and "motivation". Linear regression models reveal that the first component is responsible for the gender while the second for the age differentials in EURO-D; additionally we find that, apart from physical health indicators which are strongly related to both factors, other associations differ. Further exploration of this differentiation seems of interest, particularly as there is an indication that "motivation" may be an affectively neutral condition.
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