Depression In Community-dwelling Older Adults Research Articles

Cognitive Distorions and Depression among Older Adults: Moderating Role of Resilience

Background: Depression is a disabling mental condition that reduces the quality of life regardless of age and circumstances. Late-life depression may be especially impairing due to its relationship with poor physical and mental health. Objective:The aim of the present study is to examine the relationship between cognitive distortions, resilience and depression among older adults. As well, this study also aimed to examine the moderating role of resilience between cognitive distortions and depression. Method: Purposive sampling strategy was used to recruited sample, and data was collected from (n=300) older adults. Cognitive distortions scale, Connor-Davidson resilience scale and Back depression inventory-II were used in this study. Results: Results showed cognitive distortions and resilience has significant positive relationship with depression. Findings also revealed that cognitive distortions and resilience were significant predictors of depression. In addition, resilience plays a significant moderating role between cognitive distortions and depression. Conclusion: This study concluded that the resilience could be an adaptive strategy to cope with stress and reduce depression in community-dwelling older adults.

Dietary Habits and Depression in Community-Dwelling Chinese Older Adults: Cross-Sectional Analysis of the Moderating Role of Physical Exercise.

Healthy diets and physical exercise, two modifiable lifestyle factors, are protective against depression in older adults. This study aimed to investigate whether physical exercise may influence the associations of dietary habits with depression in Chinese community-dwelling older adults. In the 2018 wave of the Chinese Longitudinal Healthy Longevity Survey, 12,708 community-dwelling older adults aged ≥65 years were included for analyses. Older adults' dietary habits (including daily intake of food components such as fruits, vegetables, animal oil, and so on) and physical exercise were assessed. Depression was evaluated via the 10 item Center for Epidemiologic Studies Depression (CES-D-10) scale. The influences of physical exercise on the associations of dietary habits with depression were estimated using logistic regression models adjusted for confounders. Older adults who took physical exercise had a significantly decreased probability of depression (adjusted OR = 0.73, p < 0.001). As for dietary habits, the intake of fruits, vegetables, eggs, nut products, mushrooms or algae, and vitamins were inversely associated with the prevalence of depression (adjusted ORs = 0.61-0.81; p-values: from <0.001 to 0.025), while animal oil was positively associated with it (adjusted OR = 1.52, p < 0.001). When stratified by physical exercise, older adults who ate fruits or vegetables had consistent decreased risk of depression, no matter whether they took physical exercise or not (adjusted ORs = 0.52-0.70), while the intake of eggs, nut products, and vitamins were inversely associated, and animal oil was consistently positively associated with depression only in older adults who did not take physical exercise (adjusted ORs = 0.79, 0.68, 0.63, and 1.67, respectively). Physical exercise may conceal the potential protective effects of some healthy dietary habits in terms of depression and counteract the detrimental effects of the unhealthy habits. Some dietary habits may be considered as alternative protective measures for depression in community-dwelling older adults when physical exercise cannot be performed.

Homocysteinemia and Depression in Community-Dwelling Older Adults: The Cohort Longitudinal Study “InveCeAb” (Brain Aging in Abbiategrasso)

Homocysteinemia and Depression in Community-Dwelling Older Adults: The Cohort Longitudinal Study “InveCeAb” (Brain Aging in Abbiategrasso)

Association between handgrip strength and depression among Chinese older adults: a cross-sectional study from the China Health and Retirement Longitudinal Study

BackgroundMuscle strength and depression have been identified as independent risk factors for mortality in the elderly population. This study aimed to quantify the association between handgrip strength (HGS) and depression in community-dwelling older adults.MethodsResearch data were obtained from the China Health and Retirement Longitudinal Study (CHARLS). Depression was assessed using the Center for Epidemiologic Studies Depression Scale (CESD) with a cut-off score of 20 or more. HGS was assessed with a dynamometer. Binary logistic regression and multiple linear regression models were used to test the association between HGS and depression.ResultsThe sample consisted of 7,036 CHARLS participants, with an average age of 68.9 ± 7.2. After adjusting for gender, age, marriage, body mass index, comorbidities, smoking, drinking, and sleep time, compared with participants in the lowest quartile of HGS, those in the second to the fourth quartile group had a 0.84- (95% CI 0.72 to 0.98), 0.70- (95% CI 0.58 to 0.84) and 0.46- (95% CI 0.35 to 0.61) fold risk of depression, respectively.ConclusionsThere were a negative association between HGS and depression in community-dwelling older adults. It is critical to assess muscle strength in community older adults through accessible and valid objective measures to enhance depression screening.

Effectiveness of an Online Dementia Prevention Program on Cognitive Function and Depression in Community-Dwelling Older Adults during the COVID-19 Pandemic in Korea.

(1) Background: Continuous participation in a comprehensive dementia prevention program is important for community-dwelling older adults during the coronavirus disease (COVID-19) pandemic, as limitations on their communities and social participation have increased and participation in daily tasks has decreased. These factors can negatively affect their cognitive function and symptoms of depression. This study aimed to introduce an evidence-based online dementia prevention program in the South Korean context and to identify its effect on cognitive function and symptoms of depression in community-dwelling older adults during the COVID-19 pandemic. (2) Methods: One hundred and one community-dwelling older adults without dementia participated in twelve sessions of an online dementia prevention program designed by occupational therapists. Cognitive function and symptoms of depression were assessed before and after the program. Cognitive function was tested using the Cognitive Impairment Screening Test and symptoms of depression were assessed using the Korean version of the Short Geriatric Depression Scale. The participants' opinions were gathered using open-ended questions. (3) Results: After the program, according to the raw score, orientation was maintained and attention, visuospatial function, executive function, memory, and language function increased. The memory and total cognitive score was improved significantly. Symptoms of depression significantly decreased. The program's benefits according to the participants were participation in new activities, boredom reduction, online communication, and reminiscence. (4) Conclusions: An online dementia prevention program is effective in maintaining and increasing cognitive function and preventing depression in community-dwelling older adults. An online dementia prevention program is a useful method in providing opportunities to participate in cognitive training and continuous daily activities during the COVID-19 pandemic.

Correction to: Psychological Resilience Moderates the Effect of Perceived Stress on Late-Life Depression in Community-Dwelling Older Adults

Correction to: Psychological Resilience Moderates the Effect of Perceived Stress on Late-Life Depression in Community-Dwelling Older Adults

Risk Prediction Models for Depression in Community-Dwelling Older Adults

ObjectiveTo develop streamlined Risk Prediction Models (Manto RPMs) for late-life depression. DesignProspective study. SettingThe Survey of Health, Ageing and Retirement in Europe (SHARE) study. ParticipantsParticipants were community residing adults aged 55 years or older. MeasurementsThe outcome was presence of depression at a 2-year follow up evaluation. Risk factors were identified after a literature review of longitudinal studies. Separate RPMs were developed in the 29,116 participants who were not depressed at baseline and in the combined sample of 39,439 of non-depressed and depressed subjects. Models derived from the combined sample were used to develop a web-based risk calculator. ResultsThe authors identified 129 predictors of late-life depression after reviewing 227 studies. In non-depressed participants at baseline, the RPMs based on regression and Least Absolute Shrinkage and Selection Operator (LASSO) penalty (34 and 58 predictors, respectively) and the RPM based on Artificial Neural Networks (124 predictors) had a similar performance (AUC: 0.730–0.743). In the combined depressed and non-depressed participants at baseline, the RPM based on neural networks (35 predictors; AUC: 0.807; 95% CI: 0.80–0.82) and the model based on linear regression and LASSO penalty (32 predictors; AUC: 0.81; 95% CI: 0.79–0.82) had satisfactory accuracy. ConclusionsThe Manto RPMs can identify community-dwelling older individuals at risk for developing depression over 2 years. A web-based calculator based on the streamlined Manto model is freely available at https://manto.unife.it/ for use by individuals, clinicians, and policy makers and may be used to target prevention interventions at the individual and the population levels.

Physical Frailty and Oral Frailty Associated with Late-Life Depression in Community-Dwelling Older Adults.

Late-life depression is a major mental health problem and constitutes a heavy public health burden. Frailty, an aging-related syndrome, is reciprocally related to depressive symptoms. This study investigated the associations of physical frailty and oral frailty with depression in older adults. This large-scale cross-sectional study included 1100 community-dwelling older adults in Taiwan. The participants completed a dental examination and questionnaires answered during personal interviews. The 15-item Geriatric Depression Scale was used to assess depression, and information on physical conditions and oral conditions was collected. Multivariable logistical regression analysis was conducted to examine associations of interest. Significant factors associated with depression were pre-physical frailty (adjusted odds ratio (aOR) = 3.61), physical frailty (aOR = 53.74), sarcopenia (aOR = 4.25), insomnia (aOR = 2.56), pre-oral frailty (aOR = 2.56), oral frailty (aOR = 4.89), dysphagia (aOR = 2.85), and xerostomia (aOR = 1.10). Depression exerted a combined effect on physical frailty and oral frailty (aOR = 36.81). Physical frailty and oral frailty were significantly associated with late-life depression in community-dwelling older adults in a dose–response manner. Developing physical and oral function interventions to prevent depression among older adults is essential.

Lifetime pathogen burden, inflammatory markers, and depression in community-dwelling older adults

The link between pathogen exposure and mental health has long been hypothesized, but evidence remains limited. We investigated the association of seropositivity to common pathogens and total pathogen burden with depression and mental health and explored the role of mediating inflammatory cytokines. We profiled in 884 participants in the Singapore Longitudinal Ageing Studies, mean (SD) age: 67.9 (8.1) years, their seropositivities for 11 pathogens (CMV, HSV 1, HSV 2, HHV-6, EBV, VZV, RSV, Dengue, Chikungunya, H. Pylori and Plasmodium) and pathogen burden, Geriatric Depression Scale (GDS) score at baseline and 3–4 and 6–8 years follow-up, and baseline Mental Component Score (MCS) of 12-Item Short Form Survey (SF-12). Inflammatory markers included CRP, TNF-α, IL-6, MIP-1α, sgp130, sTNF-RI, sTNF-RII, C3a, and MCP-2. Controlling for age, sex, ethnicity, education, marital status, living alone, and smoking status, high pathogen burden (7 + cumulative infections) compared to low pathogen burden (1–5 cumulative infections) was significantly associated with period prevalence (the highest GDS score from baseline and follow-up measurements) of depressive symptoms (OR = 2.36, 95% CI = 1.05–5.33) and impaired mental health (OR = 2.25, 95% CI = 1.18–4.30). CMV seropositivity and HSV1 seropositivity, which are highly prevalent and most widely studied, were associated with estimated 2-fold increased odds of depression, but only HSV1 seropositivity was significantly associated with depression after adjusting for confounders. Notably, adjusted for confounders, RSV, H. pylori and Plasmodium seropositivity were significantly associated with increased odds, and Dengue seropositivity was associated with unexpectedly deceased odds of depressive symptoms and impaired mental health. The association of pathogen exposure with depression and mental health were at least in parts explained by inflammatory markers. Adding certain inflammatory markers to the models attenuated or weakened the association. Bootstrap method showed that MIP-1α significantly mediated the association between pathogen burden and mental health. In conclusion, lifelong pathogen burden and specific infections are associated with depression and impaired mental health in older adults.

The impact of the COVID-19 pandemic on depression in community-dwelling older adults: a prospective cohort study.

There are growing concerns about the impact of the COVID-19 pandemic on the mental health of older adults. We examined the effect of the pandemic on the risk of depression in older adults. We analyzed data from the prospective cohort study of Korean older adults, which has been followed every 2 years. Among the 2308 participants who completed both the third and the fourth follow-up assessments, 58.4% completed their fourth follow-up before the outbreak of COVID-19 and the rest completed it during the pandemic. We conducted face-to-face diagnostic interviews using Mini International Neuropsychiatric Interview and used Geriatric Depression Scale. We performed generalized estimating equations and logistic regression analyses. The COVID-19 pandemic was associated with increased depressive symptoms in older adults [b (standard error) = 0.42 (0.20), p = 0.040] and a doubling of the risk for incident depressive disorder even in euthymic older adults without a history of depression (odds ratio = 2.44, 95% confidence interval 1.18-5.02, p = 0.016). Less social activities, which was associated with the risk of depressive disorder before the pandemic, was not associated with the risk of depressive disorder during the pandemic. However, less family gatherings, which was not associated with the risk of depressive disorder before the pandemic, was associated with the doubled risk of depressive disorder during the pandemic. The COVID-19 pandemic significantly influences the risk of late-life depression in the community. Older adults with a lack of family gatherings may be particularly vulnerable.

Analysis of Factors Associated With Depression in Community-Dwelling Older Adults in Wuhan, China.

Objectives: This study aimed to identify the independent factors associated with depression in community-dwelling older adults in Wuhan, China.Methods: Four hundred and seventy older adults (aged ≥65 years) from four communities dwelling on Junshan Street in Wuhan, China were included in this study. Participants completed a questionnaire that asked questions pertaining to age, gender, educational level, income, living situation, care situation, social support, and social engagement. The 30-item Geriatric Depression Scale (GDS-30), the Fried frailty phenotype scale, the activities of daily living (ADL) scale, the mini nutritional assessment scale-short form (MNA-SF), and the Mini-cog scale were used to assess depression, frailty, self-care ability, malnutritional risk, and cognitive dysfunction, respectively. Differences in age, gender, educational level, income, living situation, care situation, social support, social engagement, ADL score, risk of malnutrition, frailty, and cognitive dysfunction between the non-depression (GDS-30 score <10 points) and depression groups (GDS-30 score ≥10 points) were compared using a chi-square test. Moreover, correlations between factors and depression were analyzed using Pearson’s correlation. Then, significant variables (p < 0.05) from the chi-square test were included in a multivariable logistic regression model to identify the independent factors associated with depression.Results: The incidence of depression among the participants was 14.04%. Age (p < 0.001), educational level (p < 0.001), living situation (p < 0.001), social support (p = 0.001), ADL score (p = 0.023), frailty (p < 0.001), and cognitive dysfunction (p < 0.001) were all significantly associated with depression, in which age, poor social support, frailty, and cognitive dysfunction were identified as independent factors.Conclusion: Improving social support and effective interventions for frailty and cognitive dysfunction may help relieve depression in community-dwelling older adults.

Usefulness of Orientation to the Year as an Aid to Case Finding of Mild Cognitive Impairment or Depression in Community-Dwelling Older Adults

Mild cognitive impairment (MCI) and depression are common and frequently misdiagnosed in older adults in primary care. In particular, depression combined with cognitive dysfunction is associated with a higher risk of dementia. We tried to find the usefulness of orientation to time as an easy case-finding tool for suspecting MCI or depression. This cross-sectional study included 2668 community-dwelling adults aged 70–84 years from the Korean Frailty and Aging Cohort Study (mean age of 76.0 ± 3.9 years). MCI was defined based on the criteria from the National Institute on Aging and the Alzheimer’s Association; depression was defined as a score of ≥6 on the Geriatric Depression Scale—Short Form (GDS-SF). Time orientation to year, month, day of the week, date, and season were tested. The sensitivity for the diagnosis of each of MCI and depression was the highest for the orientation to year (MCI, 17.7%; depression, 16.0%). For the diagnosis of MCI or depression, orientation to the year had the highest sensitivity (15.5%), and the specificity, PPV, NPV was 95.5%, 67.0%, 65.5%. In conclusion, asking “what year is it?” can be helpful as an aid to case finding to suspect MCI or depression in community and primary care settings.

Psychological Resilience Moderates the Effect of Perceived Stress on Late-Life Depression in Community-Dwelling Older Adults

Depression is a disabling mental condition that reduces the quality of life regardless of age and circumstances. Late-life depression may be especially impairing due to its relationship with poor physical and mental health. Repeated or prolonged exposures to stressful events deserve a particular interest among late-life depression risk factors. One factor that may help to cope with these stressful situations is the resilience. The objective of the study was to examine the moderating effect of resilience on the relationship between perceived stress (PS) and depression. A total of 1020 community-dwelling older adults aged from 60 to 101 years (M = 68.5, SD = 6.99) completed the Perceived Stress Scale, Hospital Anxiety and Depression Scale, and Brief Resilience Scale. A moderation effect has been tested using PROCESS for SPSS. Depressive symptomatology was positively related to PS (r = .598; p < .001) and inversely related to resilience (r = − .444; p < .001). Moreover, the negative impact of PS on depressive symptoms was buffered for individuals with higher resilience (β = − .014; p < .001). The resilience could be an adaptive strategy to cope with stress and reduce depression in community-dwelling older adults.

Precautionary Behavior and Depression in Older Adults during the COVID-19 Pandemic: An Online Cross-Sectional Study in Hubei, China.

The large-scale COVID-19 pandemic has not only resulted in the risk of death but also augmented the levels of depression in community-dwelling older adults. The present study aimed to investigate the characteristics of depression in Chinese older adults during the COVID-19 pandemic, to examine the association of individual precautionary behavior with older adults’ depression levels, and to identify the moderating role of socioeconomic indicators in the aforementioned association. Five hundred and sixteen older adults were recruited from five cities of Hubei province in China. They were asked to complete an online questionnaire survey. Results showed that 30.8% of participants indicated a significant depressive symptom during the pandemic. Older adults’ depression levels differed significantly in marital status, living situation, education level, household income, subjective health status, and infected cases of acquaintances. Precautionary behavior change showed significant inverse associations with older adults’ depression levels, where household income moderated this relationship. This is the first study to investigate the characteristics, behavioral correlates, and moderators of depression among Chinese older adults during the COVID-19 pandemic. Research findings may provide new insights into interventions and policy-making on individual precautionary behavior and mental health among older adults for future pandemics.

Effectiveness of a village-based intervention for depression in community-dwelling older adults: a randomised feasibility study

BackgroundAlthough a focus on late-life depression may help preventing suicide in older adults, many older people, especially those living in rural areas, have relatively low accessibility to treatment. This study examined the feasibility and effectiveness of a village-based intervention for depression targeting older adults living in rural areas.MethodsA community-based randomised pilot trial was performed in two small rural villages in South Korea. Two villages were randomly selected and assigned to the intervention or active control group; all older adults living in the two villages (n = 451) were included in the intervention program or received standard Community Mental Health Service (CMHS) care, and the effectiveness of the program was examined using representative samples from both groups (n = 160). The 12-week intervention included case management according to individual risk level and group-based activities. Healthy residents living in the intervention village who played major roles in monitoring at-risk older individuals were supervised by CMHS staff. The score on the Korean version of the Geriatric Depression Scale-Short Form (SGDS-K) was the primary outcome, while social network, functional status, and global cognitive function were secondary outcomes. Linear mixed models including the factors of intervention group, time, and their interaction were used to examine group differences in changes in primary and secondary outcomes from baseline to follow up.ResultsOverall, there was no significant group × time interaction with respect to the SGDS-K score, but older individuals with more depressive symptoms at baseline (SGDS-K ≥ 6) tended to have a lower likelihood of progressing to severe depression at post-intervention. The social network was strengthened in the intervention group, and there was a significant group × time interaction (F[df1, df2], 5.29 [1, 153], p = 0.023).ConclusionThis study examined a 12-week village-based intervention for late-life depression in which the CMHS helped village-dwellers deal with late-life depression in their communities. Although the intervention improved social interactions among older adults, it did not reduce depressive symptoms. Further studies including more rural villages and long-term follow up are needed to confirm the effectiveness of this prevention program.Trial registrationNCT04013165 (date: 9 July 2019, retrospectively registered).

DETECTION OF DEPRESSION USING THE UCLA THREE-ITEM LONELINESS SCALE IN OLDER CHINESE

Loneliness is a significant and independent risk factor for later life depression. This study aimed to validate the Chinese version of the UCLA 3-item Loneliness Scale and to ascertain the cut-off point in detecting depression in community-dwelling older adults. The English version of the UCLA was translated into Chinese by six experienced social workers, clinical psychologists and researchers, and content validity was established by consultation and revision with 10 older adults. 1,919 older adults aged 60 years and over (average age = 76.3±8.0) were recruited from local NGOs, they were interviewed for demographic information, and assessed using the 3-item loneliness scale and the Patient Health Questionnaire (PHQ-9). Cronbach’s α of the Chinese loneliness scale was 0.87; the average score was 4.0 ± 3.0 out of 9, and it significantly correlated with living alone (r = 0.18, p < 0.001), unmarried (r = 0.12, p < 0.001), no emotional support (r = 0.14, p < 0.001), and depression (r = 0.41, p < 0.001). Using PHQ-9 cut-off score of 5 for mild and above depression, the area under the curve (AUC) was 0.73 ± 0.1 (p < .001, 95% CI 0.71-0.76) with 77% sensitivity and 61% specificity. We determined a cut-off point of 3 for loneliness using the Youden index, which revealed better sensitivity over alternative definitions of loneliness. A cut-off point of 3 in the Chinese UCLA 3-item loneliness scale can reliably identify possible depression in community-dwelling older Chinese.

Depression in Community-Dwelling Older Adults Living Alone in China: Association of Social Support Network and Functional Ability.

Older adults who live alone are more likely to experience depressive symptoms compared to those who live with others. The current study aimed to investigate the prevalence of depression and identify its associated factors among community-dwelling older adults living alone in China. A cross-sectional questionnaire survey was conducted with a total of 172 older adults living alone in Nanjing city, Jiangsu province of mainland China. The prevalence of depression among this group of Chinese older adults was 18.6%. The possibility of depression among older adults who had social isolation risk was 2.59 times higher than those who had no such risk. Compared with older adults who had normal functional abilities, the possibility of depression was 3.31 times higher in older adults with mild functional impairments and 4.72 times higher in those with severe functional impairments. The results suggest that health care providers should develop effective interventions to help older adults living alone maintain their mental health by enhancing their functional abilities and increasing their social support networks and social engagement. [Research in Gerontological Nursing, 13(2), 82-90.].

The associations between various sleep-wake disturbances and depression in community-dwelling older adults- the Yilan study, Taiwan

Objectives: Given the close relationship between sleep-wake disturbances and depression, an in-depth investigation of such a relationship is imperative. The present study aims at elucidating the relationship between various sleep-wake disturbances and depression in older adults and at examining the influence of co-occurring anxiety on such associations.Method: A community-based survey using the cohort from the Yilan Study in Taiwan was conducted from August 2013 to November 2016. Adults aged 65 and older were randomly selected to participate in the study. The Hospital Depression and Anxiety Scale was used to measure clinical depressive and anxiety symptoms. Insomnia and daytime sleepiness were defined through the Athens Insomnia Scale and the Epworth Sleepiness Scale, respectively. Furthermore, the use of hypnotics, subjective sleep duration and sleep-wake scheduling were evaluated. Their relationship with depression was examined through logistic regression analyses.Results: There were 2620 participants surveyed and 247 (9.4%) had depression. Before controlling for anxiety, insomnia (OR: 1.78, 95% CI: 1.23-2.55), daytime sleepiness (OR: 1.79, 95% CI: 1.27-2.53), and long sleepers (OR: 1.77, 95% CI: 1.24-2.53) have a higher likelihood for depression in the multivariable regression analysis. However, when including anxiety into the multivariable regression model, only those with daytime sleepiness and long sleepers had an elevated risk for depression. Therefore, the association between insomnia and depression turned to be statistically non-significant.Conclusion: In older adults, various sleep-wake disturbances differ in their relationship with depression. In addition, daytime sleepiness and long sleep duration were mostly characteristic of depression when co-occurring anxiety was considered.

Feasibility and Effect of a Multidimensional Support Program to Improve Gerotranscendence Perception and Depression for Older Adults: A Pragmatic Cluster-Randomized Control Study.

Improving perception of gerotranscendence can increase life satisfaction in older adults to achieve successful aging. The purpose of this study was to evaluate the feasibility and effect of a multidimensional support program (MSP) on gerotranscendence and depression in community-dwelling older adults. Using a cluster-randomized control trial design, four sites (98 participants) were randomly assigned to a MSP or control group. The Gerotranscendence Scale and Geriatric Depression Scale were administered pre- and postintervention. A total of 91 participants completed the study. The mean attendance rates in the MSP and control groups were 85.5% and 84.3%, respectively. The MSP was found to significantly enhance the perception of gerotranscendence in older adults but not their level of depression. This study demonstrated the MSP is a feasible and effective program to improve perception of gerotranscendence and may potentially lead to positive psychological well-being for older adults. [Res Gerontol Nurs. 2019; 12(3):148-158.].

Relationship between exercise practice and depression in community-dwelling older adults

Relationship between exercise practice and depression in community-dwelling older adults