Depression In Older Population Research Articles

Association of perceived childhood socio-economic status and health with depressive symptoms among middle-aged and older adults in India: using data from LASI Wave I, 2017–2018

BackgroundChildhood adverse experience has been linked with poor health outcomes across the life course. Nevertheless, whether such an association or direction could be projected to older people’s life remains still unclear and needs to generate more evidence, particularly in India. Therefore, this study was conducted to examine the association of childhood socio-economic status and health with depressive symptoms amongst middle- aged and older adults in India.MethodsThe data for the study was drawn from national representative survey “Longitudinal Ageing Study in India (LASI)” Wave I, 2017–2018 in order to conduct cross-sectional study. Multivariable regression analysis was used to examine the association of childhood socioeconomic status and health with depressive symptoms in the older population.ResultsPoor childhood health was significantly and positively associated with depressive symptoms (AoR: 1.56, CI: 1.19, 2.04). Likewise, respondents who were bedridden for a month during their childhood had high odds of developing depressive symptoms (AoR: 1.16 CI: 1.01, 1.34). In addition to this, the odds of having depressive symptoms increased significantly among the average (AoR: 1.28 CI: 1.08, 1.51) and poor childhood socioeconomic status group (AoR: 1.31 CI: 1.11, 1.55) as compared to the higher socioeconomic category.ConclusionsChildhood socioeconomic status and health have a significant role in determining mental health in later life. Results suggest that considering childhood socioeconomic status and health is important while diagnosing depression in older population in order to identify the significant associated factors in early childhood and thus help in preventing depressive symptoms in later life.

The development of depressive symptoms in older adults from a network perspective in the English Longitudinal Study of Ageing

An increased understanding of the interrelations between depressive symptoms among older populations could help improve interventions. However, studies often use sum scores to understand depression in older populations, neglecting important symptom dynamics that can be elucidated in evolving depressive symptom networks. We computed Cross-Lagged Panel Network Models (CLPN) of depression symptoms in 11,391 adults from the English Longitudinal Study of Ageing. Adults aged 50 and above (mean age 65) were followed over 16 years throughout this nine-wave representative population study. Using the eight-item Center for Epidemiological Studies Depression Scale, we computed eight CLPNs covering each consecutive wave. Across waves, networks were consistent with respect to the strength of lagged associations (edge weights) and the degree of interrelationships among symptoms (centrality indices). Everything was an effort and could not get going displayed the strongest reciprocal cross-lagged associations across waves. These two symptoms and loneliness were core symptoms as reflected in strong incoming and outgoing connections. Feeling depressed was strongly predicted by other symptoms only (incoming but not strong outgoing connections were observed) and thus was not related to new symptom onset. Restless sleep had outgoing connections only and thus was a precursor to other depression symptoms. Being happy and enjoying life were the least central symptoms. This research underscores the relevance of somatic symptoms in evolving depression networks among older populations. Findings suggest the central symptoms from the present study (everything was an effort, could not get going, loneliness) may be potential key intervention targets to mitigate depression in older adults.

Global prevalence of depression in older adults: A systematic review and meta-analysis of epidemiological surveys.

The reported prevalence of depressive symptoms (depression hereafter) among older adults varied widely across different studies. This was a meta-analysis to systematically examine the global prevalence of depression among older populations and its associated factors. A systematic literature search was performed in PubMed, EMBASE, PsycINFO, and Web of Science. Due to the differences in demographic and clinical characteristics between studies, random-effects model was used to calculate the pooled prevalence of depression and its 95% confidence interval (95% CI). In total, 55 studies with 59,851 individuals met the study criteria and were included in the analyses. The overall prevalence of depression was 35.1% (95%CI: 30.2-40.4%). Subgroup analyses revealed that different sampling methods (Q=10592.49, p=0.037), Geriatric Depression Scale versions (Q=13712.55, p<0.001) and income levels (Q=14.028, P<0.001) were significantly associated with the pooled prevalence of depression in older adults. In the meta-regression analyses, time of survey (B=0.012, z=2.30, p=0.029) was positively associated, and mean age (B=-0.018, z=2.10, p=0.044) was negatively associated with the prevalence of depression in older populations. The funnel plot and Egger's test did not reveal any significant publication bias (Egger's test: t=1.93, p=0.059). This meta-analysis found that over a third of older populations globally had depression. Effective preventive measures, regular screening and timely interventions are needed to address this highly prevalent public health problem among older adults.

The effect of polluting cooking fuels on depression among older adults in six low- and middle-income countries

BackgroundLittle is known about the association between polluting cooking fuel and depression among older adults living in low- and middle-income countries (LMICs). ObjectiveTo evaluate the association between polluting cooking fuel and depression in older population of LMICs. MethodsWe derived data from WHO Study on global AGEing and adult health (SAGE), which was conducted in six LMICs including China, India, Ghana, South Africa, Mexico and Russia. We applied logistic regression with the propensity score method to examine the relationship of polluting cooking fuel and depression among adults ≥50 years old. ResultsOverall, the odds ratio (OR) of depression was 1.57 [95% confidence intervals (CIs), 1.26–1.93] for older adults relying on polluting cooking fuel in six LMICs. In India and China, polluting cooking fuel was associated with depression with ORs of 2.06 (95%CI, 1.44–2.94) and 1.59 (95%CI, 1.01–2.49), respectively. Positive OR of depression was identified for those polluting cooking fuel users aged over 65 years old (OR, 1.65; 95%CI,1.16–2.36) and those aged 50–65 (OR, 1.50; 95%CI,1.14–1.97). Polluting cooking fuel was associated with depression for females (OR, 1.80; 95%CI, 1.32–2.46), however we did not observe significant association for males. Positive effect of polluting cooking fuel was identified in both rural (OR, 1.72; 95%CI, 1.26–2.34) and urban areas (OR, 1.44; 95%CI, 1.07–1.95). For individuals relying on solid fuel, cooking in a room used for living/sleeping and using open stove/fire was associated with depression with ORs of 1.30 (95%CI, 1.14–1.48) and 1.15 (95%CI, 1.01–1.31), respectively. However, no significant effect was identified for hood. ConclusionPolluting cooking fuel was related to depressive symptoms among older adults in LMICs. In addition, cooking ventilation could be useful intervention to control health hazard of solid fuel.

Guided Self-Help Behavioral Activation Intervention for Geriatric Depression: Protocol for Pilot Randomized Controlled Trial.

BackgroundAging is a social concern. The increased incidence of depression in older populations in China poses a challenge to the health care system. Older adults who are depressed often suffer from a lack of motivation. Behavioral activation treatment, an evidence-based guided self-help treatment, is effective in reducing anhedonia and amotivation in depression; however, the efficacy of guided self-help behavioral activation in older adults with depression is not yet known.ObjectiveThe aim of this study is to pilot a self-help guided intervention for the treatment of depression in older adults.MethodsThis study has been designed as a pilot randomized controlled trial with inpatients (n=60; to be randomly allocated 1:1) between the ages of 60 and 70 and who have major depressive disorder. Patients attending clinical psychological clinics at the Mental Health Center of Chongqing will be randomized to either receive guided self-help behavioral activation (intervention) or to be on a 6-week waiting list (control). Participants in the treatment group will receive 6 sessions of guided self-help behavioral activation delivered over the telephone. The waiting list control group will receive the intervention after a period of 6 weeks. Exclusion criteria will be individuals who are at significant risk of harming themselves or others, who have a primary mental health disorder other than depression, or who have an intellectual disability that would hamper their ability to participate in the intervention. Effects of the treatment will be observed using outcomes in 3 domains: (1) clinical outcomes (symptom severity, recovery rate), (2) process variables (patient satisfaction, attendance, dropout), and (3) economic outcomes (cost and resource use). We will also examine mediators of outcomes in terms of patient variables (behavioral activation or inhibition motivation). We hypothesize that guided self-help behavioral activation will have a beneficial effect.ResultsThe study was approved by the research ethics committee of the Mental Health Center of Chongqing in November 2019. As of July 2020, recruitment had not yet begun. Data collection is expected to be completed by December 2020. Data analysis is expected to be completed by June 2021. Results will then be disseminated to patients, to the public, to clinicians, and to researchers through publications in journals and presentations at conferences.ConclusionsThis will be the first study in China to investigate guided self-help interventions for patients who are older adults and who are depressed, a group which is currently underrepresented in mental health research. The intervention is modular and adapted from an empirically supported behavioral activation treatment for depression. The generalizability and broad inclusion criteria are strengths.Trial RegistrationChinese Clinical Trial Register ChiCTR1900026066; http://www.chictr.org.cn/showprojen.aspx?proj=43548International Registered Report Identifier (IRRID)PRR1-10.2196/18259

Nurses' Late-Life Depression Knowledge and Attitudes Toward Depression: A Cross-Sectional Study.

Depression in older population is more common now. Due to increasing numbers of older patients in hospitals, nurses have more opportunities to care for these patients. Therefore, nurses should have correct knowledge of late-life depression and more favorable attitudes about depression. The study aimed to understand hospital nurses’ knowledge level of late-life depression and attitudes about depression. A cross-sectional research design was used. A convenience sample of 307 nurses from 3 hospitals in Taiwan was recruited. Nurses scored 55.15% in the Late-Life Depression Quiz. The average score of the Revised Depression Attitude Questionnaire was 71.76 (SD = 6.13). The study also found that hospital nurses had more favorable attitudes about depression when their late-life depression knowledge was higher; their interest level in providing care for older patients with depression was greater; they had ever taken care of older patients with depressive symptoms or depression; they had never received in-service training on depression in the past year; and they had ever attended lectures about depression in school. Hospital nurses’ knowledge about late-life depression was limited, and they had neutral to slightly favorable attitudes about depression in Taiwan. It is suggested to carefully examine and evaluate in-service training related to depression for nurses in hospitals. In addition, developing appropriate interventions to increase hospital nurses’ knowledge level of late-life depression and attitudes toward depression is recommended.

Serum 25-Hydroxyvitamin D Levels and Depression in Older Adults: A Dose–Response Meta-Analysis of Prospective Cohort Studies

ObjectiveThe association between serum vitamin D and risk of depression in older adults is controversial. We performed a dose–response meta-analysis of prospective cohort studies to examine the association between serum 25-hydroxyvitamin D [25(OH)D] concentrations and the risk of depression in older population. MethodsStudies published before February 2018 in the PubMed, Cochrane Library, Web of Science, PsycINFO, and EMBASE databases were systematically searched. Prospective cohort studies that examined the association between serum 25(OH)D levels and the risk of depression in older adults were included. A random-effects model was used to calculate the pooled hazard ratio and the corresponding 95% confidence intervals. A nonlinear dose–response association was examined using restricted cubic spline functions. ResultsSix prospective studies covering 16,287 older adults with 1,157 cases of depression were included and analyzed. The pooled hazard ratio of depression for per 10-ng/mL increment in serum 25(OH)D was 0.88 (95% confidence intervals: 0.78–0.99, I2 = 79.0%, p <0.001 for heterogeneity). A linear dose–response association between serum 25(OH)D concentrations and incident depression was observed (p = 0.96 for nonlinearity). ConclusionSerum 25(OH)D concentration is negatively associated with the risk of depression in older adults. This meta-analysis suggests that increasing 25(OH)D levels may be a useful approach to reduce the risk of depression in older adults and highlights the need for further large-scale clinical studies.

Prevalence of depression and factors associated with it in geriatric population in rural area of Vadodara, Gujarat

Background: Geriatric depression is becoming a global public health problem causing considerable morbidity and disability. This problem is also increasing in India but still not sufficient work has been done on depression in many parts of India. This study aimed to find out prevalence of and factors associated with depression in elderly population in Vadodara, Gujarat.Methods: A community based cross sectional study was performed among 176 participants of more than 60 years of age. Simple random sampling was done to select talukas, villages and participants. Depression was screened by Geriatric Depression Scale-15 (GDS 15). Person with score more than 5 was considered as depressed. Descriptive and bivariate analysis was conducted with the help of SPSS version 11.5 for windows.Results: The overall prevalence of depression in old age was 34.1% but in female it was higher (64.7%) than male (14.81%). Bivariate analysis revealed that gender (OR=10.64, 95% CI: 5.093 – 21.82), p&lt;0.001), lower education (OR=4.167, 95% CI: 1.991 – 8.719, p&lt;0.001) and cognitive impairment (MMSE score) (OR=121.333, 95% CI: 37.384 – 393.79, p&lt;0.001) were independently associated with depression.Conclusions: Gender, lower education and cognitive impairment are some of the factors associated with depression in older population.

Use of proton-pump inhibitors is associated with depression: a population-based study.

Treatment with proton-pump inhibitors (PPIs) might be associated with neuropsychological side effects. We examined the association between use of PPIs and depressive symptoms in an elderly population. Mood was assessed by the 30-item Geriatric Depression Scale (GDS) in all 344 inhabitants of Tuscania (Italy) aged 75 years and over, without exclusion criteria; depression was defined by a GDS score ≥11. Use of PPIs was associated with a higher GDS score in linear regression analysis (B = 2.43; 95% CI = 0.49-4.38; p = 0.014) after adjusting; also, use of PPIs was associated with increased adjusted probability of depression in logistic regression (OR = 2.38; 95% CI = 1.02-5.58; p = 0.045). Higher PPIs dosages were associated with increased probability of depression (p for trend = 0.014). This association was independent of the diagnosis of peptic disease, as well as the use of antidepressant medications. No association was found between use of H2-blockers or antacids and the GDS score. Calculation of the population attributable risk indicated that 14% of depression cases could be avoided by withdrawal of PPIs. Use of PPIs might represent a frequent cause of depression in older populations; thus, mood should be routinely assessed in elderly patients on PPIs.

Adverse childhood experiences (ACEs) and later-life depression: perceived social support as a potential protective factor

ObjectiveTo investigate associations between adverse childhood experiences (ACEs) and later-life depressive symptoms; and to explore whether perceived social support (PSS) moderates these.MethodWe analysed baseline data from the Mitchelstown (Ireland) 2010–2011...

Worry and Depression in the Old and Young: Differences and Mediating Factors

Objective: This study examined whether differences in habitual negative self-thinking and coping strategies might contribute to the age differences in worry and depression. Method: 60 undergraduate students (age range: 18–24 years, M = 19.10, SD = 1.3) and 45 community-dwelling older adults (age range: 60–89 years, M = 73.5, SD = 7.5) participated. Participants completed self-report measures of worry, depression, negative self-thinking, and coping styles. Results: We replicated previous findings that older adults were less worried and less depressed than younger adults. Older adults also reported engaging in less habitual negative thinking and using more problem solving as a coping strategy than younger adults. Furthermore, negative self-thinking and problem-solving skills were found to partially mediate age differences in worry and fully mediate depression scores. Conclusions: These results suggest that habitual negative thinking and problem-solving skills play a role in explaining the lower rates of worry and depression in older populations.

Participation in productive activities and depression among older Europeans: Survey of Health, Ageing and Retirement in Europe (SHARE)

Although engagement in productive activities is associated with favourable outcomes with respect to the health and well-being of older individuals, the association between such activities and depression in older populations remains relatively unexplored. The purpose of this study was to evaluate the association among five productive activities (paid work, formal volunteering, caregiving, informal helping and caring for grandchildren) with depression in older adults in 14 European countries. This cross-sectional study used the first two waves of data collected by the Survey of Health, Ageing and Retirement in Europe and analysed a total sample of 7238 relatively healthy community residents aged 60 years and older from 14 European countries. The Survey of Health, Ageing and Retirement in Europe excluded potential participants with a past history of depression, cognitive impairment and physical limitations. Depression was categorised using the EURO-D instrument, and associations with participating in productive activities were investigated. Depression was less prevalent among those individuals who were employed or self-employed and those who participated in formal volunteering or informal helping, whereas caregiving was associated with a higher risk of depression. Caring for grandchildren was not associated positively or negatively with depression. Formal volunteering and caregiving remained associated with depression after adjustment for age, sex, marital status, education, economic status, country and presence of long-term illness. Availability of formal volunteering may be important in reducing depression risk, whereas caregiving is associated with a higher risk of depression in older European adults. Further research is required to clarify the direction of causation and evaluate interventions.

2681 – Cognitive deficits in unipolar old-age depression: a population-based study

Introduction Recognition of cognitive deficits in old-age depression is especially important since they contribute to poor function outcome, have strong implications for coping abilities and treatment compliance. However, substantial variability in cognitive deficits among older depressed persons has been reported. Clinical and demographic characteristics are likely to have contributed to inconsistencies in previous findings. Objective To assess effects of unipolar depression on cognitive performance in a population-based sample of elderly persons (60+ years). Methods An extensive cognitive test battery was administered. Eighty-nine persons fulfilled ICD-10 criteria for unipolar depression (mild, n=48; moderate; n=38, severe; n=3) after thorough screening for dementia (DSM-IV criteria), psychiatric comorbidities, antidepressant pharmacotherapy, and lastly preclinical dementia. Results Unipolar old-age depression was associated with deficits in processing speed, attention, executive function, verbal fluency, and episodic free recall. No depression-related deficits were observed in short-term memory, semantic memory, or spatial ability. Increasing age did not exacerbate the cognitive deficits in old-age depression. The cognitive deficits remained significant after exclusion of persons with preclinical dementia, except free recall, where performance differences were at trend level. Conclusions Cognitive deficits in unipolar old-age depression involve a number of cognitive domains, and are also present among persons with mild depression. Importantly, no statistically significant performance differences between mild and moderate/severe depression were observed. Given the prevalence of depression in older populations, the impact of this disorder on cognitive functioning may be relatively large at the population level.