Depression In Older Men Research Articles

Life course rural/urban place of residence, depression and cognitive impairment among older adults: Findings from the Longitudinal Aging Study in India

AbstractBackgroundGiven the unique socioeconomic structures and rural/urban differentials in mental health outcomes in the country, this study aimed to explore the associations of childhood, adulthood and late‐life place of residence with mental health outcomes of depression and cognitive impairment among older adults in India. The study also examined the relationship between older individuals’ life‐course rural/urban place of residence and late‐life mental and cognitive health.MethodUtilizing data from the Longitudinal Aging Study in India (n = 28,041 older adults age 60 years and above), I employed multivariable logistic and linear regression models to examine the association between urban/rural residential status, life‐course residence, depression and cognitive impairment among older adults.ResultChildhood and adulthood place of residence was not associated with depression in older men and women. Current rural place of residence was positively associated with depression in older women [OR: 1.37, CI: 1.05‐ 1.80] but not men. Childhood [OR: 1.88, CI: 1.16‐ 3.04], adulthood [OR: 2.00, CI: 1.26‐ 3.16] and current rural residence [OR: 1.93, CI: 1.27‐ 2.91] was positively associated with cognitive impairment in men. Only current rural residence [OR: 1.71, CI: 1.29‐ 2.27] was associated with cognitive impairment in women. There was no significant association between life‐course place of residence and depression except in case of lifetime rural residence Respondents with urban‐urban‐urban place of residence were less likely to be depressed [Coef.: ‐0.14, CI: ‐0.21‐ ‐0.07] compared to those with rural‐rural‐rural place of residence. There were significant associations between life‐course residence and cognitive impairment except among rural‐urban‐rural and urban‐rural‐rural migrants, showing a urban advantage in cognitive function among older adults.ConclusionThis study showed significant associations between life‐course residence and depression among permanent rural/urban residents. The study also showed significant associations between life‐course residence and cognitive impairment except among rural‐urban‐rural and urban‐rural‐rural migrants. Considering the rural disadvantage, the government should continue to support policies that can promote education among people residing in rural areas. The findings also urge social scientists and gerontologists, in particular, to consider the importance of lifetime historical context while evaluating mental and cognitive health of older persons.

Network of mental activities, cognitive function and depression in older men and women

BackgroundEvidence suggests that lifestyle activities impact cognitive and mental health in older populations. However, how lifestyle factors are associated with one another, and which factors are most important for cognitive function and mental health has received comparatively little attention. DesignBayesian-Gaussian network analysis was used to investigate unique associations between mental activities (MA; i.e., activities involving cognitive engagement), global cognition, and depression at three time-points in a large sample of older adults (baseline, 2 years, and 4 years follow-up). SettingThis study used longitudinal data from participants living in Australia and participating in the Sydney Memory and Ageing Study. ParticipantsThe sample included 998 participants (55% female) aged between 70 and 90, without a diagnosis of dementia at baseline. MeasurementsNeuropsychological assessment of global cognition, self-reported depressive symptoms, and self-reported information about daily MA. ResultsCognitive functioning was positively associated with playing tabletop games and using the internet in both sexes at all time-points. MA were differentially linked in men and women. Depression was not consistently associated with MA in men across the three time-points; women who visited artistic events consistently had lower depression scores. ConclusionsEngaging with tabletop games and using the internet was associated with better cognition in both sexes, however sex acted as a modifier for other associations. These findings are useful for future investigations that consider interactive associations between MA, cognition, and mental health in older adults, and their possible roles in promoting healthy aging.

“Andropausal” Depression – biological fact or psychosocial possibility?

IntroductionIn contrast to women, men do no experience a sudden cessation of gonadal function comparable to menopause. However, there is a progressive decline in hypothalamic-pituitary-gonadal function in aging men: testosterone level decline, and there is a loss of circadian rhythm of testosterone secretion.By age 75 years, mean plasma testosterone levels have decreased 35% compared with young adults, and more than 25% of men of this age are clinically hypogonadal. Age related hypogonadism, which has been termed»andropause«, is thought to be responsible for variety of symptoms experienced by elderly men, including reduced muscle and bone mass, sexual dysfunction, depression, fatigue and irritability.Objectives However, it has been difficult to establish correlations between these symptoms and plasma testosterone levels. Clinical trials of testosterone replacement have documented some symptoms relief (improved muscle strength and bone mineral density), yet studies to date on the specific relation between depression and testosterone level have been methodologically flawed.MethodsData are presented from systematic clinical and epidemiological studies with bearing on this relation: 1.population-based assessments of the relation between testosterone level, genetic factors and depression in elderly men,2.placebo-controlled clinical trials of testosterone replacement in men with major depressive disorder.ResultsResults suggest that age-related hypothalamo-pituitary-gonadal hypofunction may have particular etiologic importance in late-onset male dysthimia.ConclusionsHowever, there is still the dilemma whether late-onset depression in older men is predominantly biological (in which testosterone decline certainly plays an important role), psychosocial, or stress-diathesis origin.Disclosure of InterestNone Declared

Effect of Cognitive Rehabilitation on Cognitive State and Depression of Older Men With Mild Cognitive Impairment Living in Nursing Homes

Objectives: Aging is a sensitive period in life. Due to the increase in the aging population and the possibility of mild cognitive impairment (MCI) and depression in the elderly, it is necessary to prevent Alzheimer’s disease in these patients by improving their cognitive status and depression. The present study aims to investigate the effect of cognitive rehabilitation on the cognitive status and depression of older men with MCI. Methods & Materials: This is a quasi-experimental study with a pretest/posttest design using a control group. The study population consists of older men aged ≥60 years with MCI living in a nursing home in Kerman, Iran in 2021. Using a purposeful sampling method, 24 eligible older men were selected and randomly assigned to two groups of control (n=12) and intervention (n=12). Evaluation of cognitive state and depression was performed using the Mini-Mental State Examination and the Geriatric Depression Scale, respectively before and after the intervention. Cognitive rehabilitation program was presented at 12 one-hour sessions in the intervention group. The data were analyzed using analysis of covariance in SPSS software, version 19. Results: The cognitive rehabilitation program had a significant effect on improving cognitive state and reducing depression in the elderly with MCI (P<0.05). Conclusion: The cognitive rehabilitation program is recommended as a non-pharmacological treatment to improve cognitive status and reduce depression in older men with MCI.

Anxiety and depression: population distribution and family associations

Aim. The aim of the study was to characterize the population distribution of psychiatric phenotypes according to anxiety and depression. Methods. The level of anxiety and depression was assessed with the HADS Hospital Anxiety and Depression Scale test. Students in grades 9-11 of secondary schools in Kharkiv, as well as their parents, were tested. We tested 306 persons from 115 families. Results. The frequency of depression among men in the Kharkiv population is 9%, among women 11%, among boys 15%, among girls 22%; the frequency of increased anxiety among men is 14%, among women 22%, among boys 19%, among girls 44%. There is a positive relationship between anxiety and depression in older men and women, expressed by the association coefficient in men rDT =0.45, in women rDT =0.79. The relatives revealed a similarity in psychological types, described by the association index for depression in mother/daughter pairs r = 0.40, mother/son r = 0.03, father/daughter r = 0.20, father/son r = 0.40; for anxiety: mother/daughter r = 0.15, mother/son r = 0.05, father/daughter r = 0.24, father/son r = 0.01. Conclusions. Individuals of the younger generation are more likely to have signs of anxiety and depression than those of their parents' generation. The parent-offspring phenotype relationship is stronger in same-sex couples compared to opposite-sex couples.
 Keywords: depression, anxiety, population distribution, family analysis.

The Effect of Labor and Relationship Exclusions on Older Korean Men with Depression.

To manage depression of older men, it is necessary to identify factors that influence depression and improve them. This study used the Korean Aging Longitude Research to understand the effects of labor exclusion and relationship exclusion on depression in Korean male seniors aged 65 and older. According to research on the effect of labor exclusion and relationship exclusion on depression, depression in the case where labor was excluded was 1.69 times higher in 2014, 1.65 times higher in 2016, and 1.93 times higher in 2018 compared to the case where labor was not excluded. Depression in the case where relationship was excluded was 2.94 times higher in 2014, 3.15 times higher in 2016, and 2.57 times higher in 2018 compared to the case where relationship was not excluded. Depression in the case where labor and relationship were both excluded was 3.00 times higher in 2014, 3.23 times higher in 2016, and 2.81 times higher in 2018 compared to the case where neither labor nor relationship was excluded. Since labor exclusion and relationship exclusion have a big influence on depression in older men, it is necessary to establish plans for job creation and for the formation of social relationships for the elderly.

Risk factors and consequences of depression in later life: Findings from the health in men study (HIMS).

The Health In Men Study (HIMS) has been collecting data on risk factors and health events for the past 25 years in a large community-representative sample of older men. This paper summarises key-findings of the study about depression in later life. Narrative review of selected HIMS studies published over the past 15 years describing risk factors associated with prevalent and incident depression in older men, as well as clinical outcomes associated with depression. Data from HIMS showed that cardiovascular diseases and risk factors are associated with increased risk of depression, but this association is neither specific nor causative. Findings from HIMS are not supportive of the vascular hypothesis of depression in later life. Studies investigating lifestyle have generated risk tables capable of guiding risk reduction strategies. Other potentially modifiable risk factors associated with depression in the HIMS cohort included abnormal allostatic inflammatory response, high plasma homocysteine and low testosterone. The results from HIMS also showed that depression is most likely a prodromal manifestation of dementia rather that a true risk factor, but it increases frailty and mortality. The association between depression and suicide in older men is largely mediated by deteriorating health and increasing frailty. HIMS has contributed to advance knowledge about risk factors associated with depression, as well as the health consequences of depression in older men. The study is ongoing and the investigators welcome the opportunity to share data with colleagues who are interested in the health of older people.

Geriatrik Erkeklerde Nokturi ve Ayrıntılı Geriatrik Değerlendirme Parametreleri

Aim: The aim of this study was to demonstrate the relationship between nocturia and geriatric syndromes, and comprehensive geriatric assessment parameters (CGA) in older men.Material and Methods: A total of 397 older outpatient men who had undergone CGA were included in this cross-sectional study. For the nocturia variable, the question, ‘Generally, during the past 30 days, how many times did you usually urinate after you have gone to sleep at night until the time you got up in the morning?’’ was used.Results: The mean age of patients was 75.6 ± 8.1. There was a significant positive correlation between the frequency of nocturia and number of drugs, Timed-up Go, and Insomnia severity score (p<0.05), while there was a significant negative correlation between Mini Nutritional Assessment, Basic activities of daily living (BADL) and Tinetti total score, and hand grip strength (p<0.05). The prevalence of patients with 0, ≥1, ≥2, ≥3, and ≥4 nocturnal episodes was 11.6%, 88.4%, 70.5%, 47.3% and 25.4%, respectively. Patients with nocturia ≥2 had lower MNA scores and had a higher fall risk, depression, and dynapenia compared to patients with nocturia ≤1. There were higher rates of insomnia, depression, frailty, dynapenia, lower BADL and nutritional status with ≥3 nocturia episodes compared to ≤ 2 nocturia episodes (p<0.05).Conclusions: Nocturia is common and associated with dynapenia, insomnia, frailty, polypharmacy, incontinence, increased fall risk and depression in older men. Therefore, nocturia is important for geriatric practice and ≥3 nocturia episodes may be used as a marker of poor health status in older men.

Low levels of serum urate are associated with a higher prevalence of depression in older adults: a nationwide cross-sectional study in Korea

BackgroundSoluble urate has been shown to serve as an antioxidant, especially in the central nervous system. Although there are intriguing data suggesting that low levels of serum urate are associated with worse outcomes in neurodegenerative diseases, its impact on mental health has not been adequately assessed. Thus, we aimed to investigate the association between serum urate and depression using a large, nationally representative sample.MethodsInformation on participants’ socio-demographic characteristics as well as physical and mental health conditions were retrieved from the Korea National Health and Nutrition Examination Survey (KNHANES) 2016 dataset. The Patient Health Questionnaire (PHQ)-9 was applied to identify depressive symptoms. Analyses were stratified by age: young adults (aged 19–39 years), middle-aged adults (aged 40–59 years), and older adults (aged 60 years and older).ResultsA total of 5332 participants were included. Serum urate concentrations were divided into sex-specific quartiles based on their distribution: ≤ 4.9 (Q1), 5.0–5.7 (Q2), 5.8–6.6 (Q3), and ≥ 6.7 (Q4) mg/dL in men and ≤ 3.7 (Q1), 3.8–4.3 (Q2), 4.4–4.9 (Q3), and ≥ 5.0 (Q4) mg/dL in women. There was a significant negative linear relationship between serum urate quartiles and PHQ-9 scores in older adults (p for trend = 0.020 in men and p for trend = 0.048 in women). Compared to high levels (Q3 and Q4) of serum urate, low levels (Q1 and Q2) were significantly associated with the overall burden of depression in older women (OR 1.78, 95% CI 1.21, 2.61) and clinically relevant depression in older men (OR 3.35, 95% CI 1.16, 9.70), even after adjustment.ConclusionsBased on the KNHANES data, low levels of serum urate are associated with a higher prevalence of depression in older adults. This may have clinical implications for mental health.

Personal, behavioral, and perceived environmental factors associated with late-life depression in older men and women.

IntroductionPrevious investigations on factors associated with depression were highly focused on personal characteristics and health behaviors; however, few studies used an ecological perspective on the issue, much less on sex differences. This study examined the factors associated with depression, including any sex differences.MethodsA total of 1025 Taiwanese adults older than 65 years were recruited. Their personal demographics, lifestyle behaviors, and perceived environmental factors were obtained through a telephone-based survey. The multiple factors associated with depression in older adults were examined using logistic regression analyses.ResultsFully logistic regression analyses revealed that poor self-rated health (odds ratio =2.54) was correlated with a greater likelihood of depression. Aside from poor self-rated health, being older, sufficient leisure time spent in walking, and perceptions of a safe environment were associated with lower risks of depression in older men, whereas having hypertension and excessive TV viewing were associated with higher risks of depression in older women.ConclusionApart from self-rated health, sex differences in the associations of factors such as leisure-time walking, TV watching, and safe traffic environment with depression were observed among older adults. Strategies applied for geriatric depression prevention should take into consideration different sex group.

Effects of a multicomponent exercise program combined with calcium-vitamin D3-enriched milk on health-related quality of life and depressive symptoms in older men: secondary analysis of a randomized controlled trial.

Osteoporosis is associated with both lower health-related quality of life and depression in older people. We examined the independent and combined effects of a multi-component exercise program and calcium-vitamin D3 fortified milk on health-related quality of life (HR-QoL) and depression in older men. In this 12-month, factorial design randomized controlled trial, 180 healthy community-dwelling men aged 50-79years with normal to below average bone mineral density were allocated into one of four groups: exercise + fortified milk; exercise; fortified milk; or controls. Exercise consisted of high-intensity resistance training with weight-bearing exercise (3days per week; 60-75min per session). Men assigned to fortified milk consumed 400ml/day of low-fat milk containing 1000mg/day calcium and 800IU/day vitamin D3. Questionnaires were used to assess HR-QoL (SF-36) and depressive symptoms (Center for Epidemiologic Studies Depression Scale) at baseline, and 6 and 12months. A linear mixed model analysis was used to test whether there was a synergistic interaction between exercise and calcium-vitamin D3. If no significant interactions were detected, the main effects of exercise and fortified milk were examined. Mean adherence to the exercise program and fortified milk was 67% (95% CI 61, 73%) and 90% (95% CI 86, 93%), respectively. There were no exercise-by-fortified milk interactions nor main effects of exercise or calcium-vitamin D for any of the HR-QoL measures or depressive symptoms. In healthy community-dwelling older men, exercise training and/or calcium-vitamin D fortified milk did not improve HR-QoL or depressive symptoms.

Assessing the relationship between multimorbidity and depression in older men and women: the International Mobility in Aging Study (IMIAS)

Objectives: Our study aims to assess whether multimorbidity is an independent risk factor for the development of depression in older adults living in Canada, Brazil, Colombia, and Albania and examines differences in incidence of depression regarding social and psychosocial characteristics.Methods: The longitudinal International Mobility Aging Study (IMIAS) collected information from adults between 65–74 years old. Depression was defined by a 16 or higher score assessed by the Centre for Epidemiological Studies Depression (CES-D) Scale. Multimorbidity was defined as having two or more chronic conditions, which were self-reported by participants using a list of eight physical chronic conditions. Poisson regression was performed to estimate the relative risk of depression in older adults with multimorbidity compared to those living with 0–1 chronic conditions, adjusting for sex, age, education, number of doctor visits, degree of assistance needed, social support, and smoking status. The analysis was stratified by study region (Canada; Latin America; Albania).Results: Crude and adjusted models showed no statistically significant associations between multimorbidity and the incidence of depression in any of the study regions, confirmed by sensitivity analyses. However, the incidence of depression varied across study region, confirmed by the intra-class correlation coefficient which indicated that 13% of variations in depression incidence were due to geographic differences.Conclusion: Multimorbidity does not appear to increase the risk of developing depression in older adults between 65–74. Higher rates of depression in Latin America and Albania (compared to Canada) may be attributed to lifecourse exposures to social and economic adversity in these regions.

Low Hemoglobin Levels and Risk of Developing Depression in the Elderly: Results From the Prospective PRO.V.A. Study.

Low hemoglobin negatively affects health in the elderly, but research about the association with risk for depression is limited. We investigated the association between baseline hemoglobin concentrations and incident depression in a cohort of nondepressed elderly individuals. As part of the Northern Italian Progetto Veneto Anziani (PRO.V.A.) study, randomly drawn, community-dwelling subjects aged ≥ 65 years underwent prospective clinical and laboratory assessments between October 1995 and December 2002. The association between baseline hemoglobin and depression was assessed with adjusted Cox regression analyses. Baseline serum hemoglobin concentrations were further categorized in gender-specific tertiles; anemia was defined as serum hemoglobin < 13 g/dL for men and < 12 g/dL for women. Moreover, hemoglobin concentration was measured at follow-up, and changes in concentration from baseline to follow-up were investigated. Depression was defined by a score of ≥ 11/30 on the validated Geriatric Depression Scale and confirmed by psychogeriatric specialists. Among 1,303 elderly individuals (566 men, 737 women) without depression at baseline, 294 subjects (177 women, 117 men; global incidence rate = 50 [95% confidence interval (CI), 0-170] per 1,000 patient years) developed depression during 4.4 years of follow-up. Low baseline serum hemoglobin concentration was most strongly associated with incident depression at follow-up in men (hazard ratio [HR] = 1.39; 95% CI, 1.12-1.69; P = .002), but not in women (P = .50). Men with the lowest baseline tertile hemoglobin concentration (HR = 1.68; 95% CI, = 1.02-3.08; P = .04) or with anemia (HR = 2.02; 95% CI, = 1.13-3.64; P = .02) had greater risk of depression, whereas findings were nonsignificant for women. Low follow-up hemoglobin concentration in men was less strongly associated with incident depression (HR = 1.15; 95% CI, 1.01-1.33; P = .05), as were the lowest endpoint tertile hemoglobin concentration (P = .03) and presence of anemia (P = .05). Low baseline hemoglobin strongly predicted incident depression in older men, but not in women.​.

The long-term risk of recognized and unrecognized myocardial infarction for depression in older men.

The association between myocardial infarction (MI) and depression is well described. Yet, the underlying mechanisms are unclear and the contribution of psychological factors is uncertain. We aimed to determine the risk of recognized (RMI) and unrecognized (UMI) myocardial infections on depression, as both have a similar impact on cardiovascular health but differ in psychological epiphenomena. Participants of the Rotterdam Study, 1823 men aged ⩾55 years, were followed for the occurrence of depression. RMI and UMI were ascertained using electrocardiography and medical history at baseline. We determined the strength of the association of RMI and UMI with mortality, and we studied the relationship of RMI and UMI with depressive symptoms and the occurrence of major depression. The risk of mortality was similar in men with RMI [adjusted hazard ratio (aHR) 1.71, 95% confidence interval (CI) 1.45-2.03] and UMI (aHR 1.58, 95% CI 1.27-1.97). Men with RMI had on average [unstandardized regression coefficient (B) 1.14, 95% CI 0.07-2.21] higher scores for depressive symptoms. By contrast, we found no clear association between UMI and depressive symptoms (B 0.55, 95% CI -0.51 to 1.62) in men. Analysis including occurrence of major depression as the outcome were consistent with the pattern of association. The discrepant association of RMI and UMI with mortality compared to depression suggests that the psychological burden of having experienced an MI contributes to the long-term risk of depression.

Depression, Sex and Gender Roles in Older Adult Populations: The International Mobility in Aging Study (IMIAS).

ObjectivesTo assess the associations between gender roles and depression in older men and women and whether gender roles are independent risk factors for depression.MethodsInternational cross-sectional study of adults between 65 and 74 years old (n = 1,967). Depression was defined by a score of 16 or over in the Center for Epidemiologic Studies Depression Scale (CES-D). A validated 12-item Bem Sex Role Inventory (BSRI) was used to classify participants in gender roles (Masculine, Feminine, Androgynous, and Undifferentiated) using research site medians of femininity and masculinity as cut-off points. Poisson regressions were fitted to estimate the prevalence ratios (PR) of depression for each gender role compared to the masculine role, adjusting for sex, sufficiency of income, education, marital status, self-rated health, and chronic conditions.ResultsAmong men, 31.2% were androgynous, 26% were masculine, 14.4% were feminine, and 28.4% were undifferentiated; among women, the corresponding percentages were 32.7%, 14.9%, 27%, and 25.4%. Both in men and in women, depressive symptoms (CES-D≥16) were more prevalent in those endorsing the undifferentiated type, compared to masculine, feminine or androgynous groups. However, after adjusting for potential confounders, compared to the masculine group only those endorsing the androgynous role were 28% less likely to suffer from depression: PR of 0.72 (95% CI: 0.55–0.93). In fully adjusted models, prevalence rates of depression were not different from masculine participants in the two other gender groups of feminine and undifferentiated.ConclusionsAndrogynous roles were associated with lower rates of depression in older adults, independently of being a man or a woman.

Inflammation mediates the association between fatty acid intake and depression in older men and women

Antioxidants and fatty acids are associated with depression and inflammation, and inflammation appears to predict depression risk; hence, the associations between these nutrients and depression may be mediated by inflammation. We hypothesized that inflammatory markers interleukin (IL)-6 and C-reactive protein (CRP) mediate the associations between antioxidant and fatty acid intakes, and depression. Participants were from the Hunter Community Study, a longitudinal cohort of adults aged 55-85 years. Dietary intake was assessed using the Older Australian’s Food Frequency Questionnaire. Fasting blood samples were drawn for analysis of nutrient and inflammatory biomarkers. Depressive symptoms were assessed using the 20-item Center for Epidemiologic Studies—Depression scale at baseline and at 5-year follow-up. Linear mixed models were used to investigate longitudinal associations between dietary intakes and depression, and mediation analyses were carried out to determine if IL-6 and/or CRP were the mediators. Analyses were conducted on men and women separately and adjusted for potential confounders. Fruit and monounsaturated fat intakes were negatively associated with depression, whereas total fat and saturated fat intakes were positively associated with depression in both sexes. Omega-3 polyunsaturated fat was inversely associated with depression in men only. IL-6 was a significant mediator of the association between fruits with low carotenoid content and depression in women. CRP significantly mediated the relationship between total fat, saturated fat, and monounsaturated fat intakes and depression in women, and saturated fat intake and depression in men. Our findings raise the possibility that the association between fatty acid intake and depression is partially mediated by inflammatory markers.

Prospective longitudinal study of testosterone and incident depression in older men: The Health In Men Study

BackgroundDepression in older men has been associated with low circulating testosterone concentration but data from prospective studies are limited. MethodsWe conducted a prospective longitudinal study in a community representative cohort of 3179 older men free of clinically significant depressive symptoms at baseline. The main objective of this study was to determine if low serum testosterone, dihydrotestosterone and estradiol concentrations are associated with the development of depressive symptoms. Incident depression was assessed with the Patient Health Questionnaire and via an electronic health record database (The West Australian Data Linkage System). The main exposures of interest were serum testosterone, dihydrotestosterone and estradiol measured by liquid chromatography–mass spectrometry and calculated free testosterone in baseline blood samples (collected between 2001 and 2004). ResultsOne hundred and thirty five men (4.2%) developed depression over a median follow up time of 9.4 years (range 8.4–10.9). Men with incident depression were older (median age 77.7 vs 76.1 years, z=−3.82, p=0<0.001) and were more likely to have cardiovascular disease (43.0% vs 32.6%, χ2=6.32, p=0.012) and diabetes (22.2% vs 13.2%, χ2=8.95, p=0.003). Low serum total testosterone (<6.4nmol/L) was associated with incident depression (HR 2.07, 95%CI 1.17–3.68) and this remained significant after adjustment for relevant potential confounding factors (HR 1.86, 95%CI 1.05–3.31). Low serum dihydrotestosterone, estradiol and calculated free testosterone were not associated with risk of depression. ConclusionsLow serum total testosterone, but not calculated free testosterone, was associated with incident depression in this sample of older men.

Eating alone and depression in older men and women by cohabitation status: The JAGES longitudinal survey.

Background: eating by oneself may be a risk factor for mental illness among older adults, but may be influenced by cohabitation status. We examined the association between eating alone and depression in the context of cohabitation status in older adults in Japan.Design: a longitudinal, population-based study.Setting: data from the Japan Gerontological Evaluation Study.Subjects: we analysed 17,612 men and 19,581 women aged ≥65 without depression (Geriatric Depression Scale <5) at baseline in 2010.Methods: eating status was classified into two categories: eating with others and eating alone. The risk of depression onset by 2013 was estimated using Poisson regression.Results: after adjusting for socioeconomic status, physical health, nutritional status, social support, social participation, frequency of meet friends, employment status and marital status, the adjusted rate ratio (ARR) for depression onset in men who ate alone compared with those who ate with others was 2.36 (95% confidence intervals [CI]: 1.18–4.71) for those living alone and 1.03 (95% CI: 0.81–1.32) for those living with others. Among women, the ARR for depression for those who ate alone compared with those who ate with others was 1.31 (95% CI: 1.00–1.72) for those living alone and 1.21 (95% CI: 1.01–1.44) for those living with others.Conclusions: eating alone may be a risk factor for depression. Among men, the effect of eating alone on depression may be reinforced by living alone, but appears to be broadly comparable in women living alone and women living with others.

Vitamin D concentration and its association with past, current and future depression in older men: The Health In Men Study

BackgroundVitamin D deficiency has been associated with depression in later life, but it remains unclear whether this association is truly causal. MethodsObservational study examining the retrospective, cross-sectional and prospective associations between vitamin D concentration and depressed mood in a community-derived sample of 3105 older men living in metropolitan Perth, Western Australia. We measured the plasma concentration of 25-hydroxyvitamin D using standard procedures. Past depression was ascertained by direct questioning and through the use of administrative health data linkage. A geriatric depression scale score equal or greater 7/15 established the presence of current depression. Incident depression was established by a patient health questionnaire (PHQ-9) score ≥10 or by administrative health data linkage during the 6-year follow up (range 0.1–10.9 years). ResultsVitamin D concentration <50nmol/L was associated with greater odds of current (OR=1.65, 95% CI=1.13, 2.42) but not past depression (OR=1.15, 95% CI=0.83, 1.58). Of the 2740 men with no past or current history of depression, 81 developed clinically significant symptoms during follow up. The adjusted hazard ratio of incident depression for men with plasma vitamin D <50nmol/L was 1.03 (95% CI=0.59, 1.79; adjusted for age, living arrangements, season, and prevalent cardiovascular diseases). ConclusionsOur results do not support a role for vitamin D in the causation of depression, although a small antidepressant effect of vitamin D cannot be entirely discarded. Large randomised placebo-controlled trials are required to dismiss or establish with certainty the causal link between vitamin D deficiency and depression.

Shards of sorrow: Older men's accounts of their depression experience

The experience of depression is diverse based on social locations and context. A sociological perspective building on masculinity, illness work, and the self provides a useful theoretical framework to understand how older men negotiate emotional suffering. This article examines older men's accounts of their depression experience from a social constructionist approach. This analysis is based on data from 77 in-depth interviews with depressed older men who participated in a larger mixed-method study, the Men's Health and Aging Study (MeHAS). We show how older men construct depression accounts in which they integrate biological and social factors associated with feeling a loss of control. This is experienced as a shamed masculine self given their inability to perform manhood acts, which leads them to severe social bonds. Men's accounts also shed light on how they resist the shaming of the masculine self by deploying two primary strategies: acting overtly masculine through aggressive behavior and by retracting from social interactions that may lead to feelings of shame. These strategies appear futile and they are only partially able to embrace alternative masculine values in line with roles as grandparents and older, wiser men. Depression in older men is characterized by an ongoing negotiation of limited statuses and roles given dominant conceptions of masculinity.