Depressive Symptomatology In Older Adults Research Articles

Gender differences in the predictive effect of perceive emotional intelligence on depressive symptomatology in older adults

The aim of this study was to analyze the associations between emotional intelligence, gender, and depressive symptomatology in older adults. To test whether there were differences between groups in the Trait Meta-Mood Scale dimension, univariate and multivariate analysis of variance were carried out, and t tests were performed to find the differences between groups in the variables that had shown differences in the univariate analysis. Participants were 853 Spanish cognitively healthy older adults between 60 and 95 years of age, with a mean age of 71.7 (SD = 7.4), of whom 64.9% were women. Self-reports were administered to assess the different variables under study. Specifically, the Trait Meta-Mood Scale-24 was used to assess emotional intelligence, and the Centre for Epidemiologic Studies-Depression Scale to measure depressive symptomatology. The three dimensions of emotional intelligence showed differences as a function of gender and depression. Higher scores were found in the three dimensions of emotional intelligence in women. Moreover, people with higher levels of depressive symptomatology had higher scores on attention, and people with low depressive symptomatology had lower levels of clarity and repair. Women with depressive symptomatology showed high levels of attention, in contrast to men and women with low symptomatology. Considering the subjective perception of emotional intelligence, high attention to emotions and the female gender seem to be factors associated with depression in older adults, which allows us to outline a critical profile for depression that should receive special attention. Given the impact of depressive symptomatology in older adults, it is important to identify these profiles in order to detect possible risk factors for depression more effectively.

The Beck Depression Inventory-II in Community-Dwelling Middle-Aged and Older Greeks: Factor Structure and Demographic Associations

Evaluating depressive symptomatology in older adults is important for monitoring and treatment. However, few studies have examined the association of the Beck Depression Inventory-II (BDI-II) to demographic characteristics in middle-aged and older adults or have tested its factor structure using confirmatory factor analysis (CFA). Participants were 542 middle-aged and older Greek community-dwellers of a wide education range. The BDI-II score was correlated with age and education and one-way analysis of variance compared mean score in men and women, controlling for differences in education. In addition to the unidimensional model, eight models were tested using CFA: four two-factor models, a three-factor model, two bifactor models, and a hierarchical model with three first order factors and a second order factor. Age was marginally associated with BDI-II score; education was inversely associated with it in this sample of a wide range of education. Women scored higher than men, although controlling for education attenuated the differences. Internal consistency was similar to that of other studies. Of the nine models tested using CFA eight showed good fit but the bifactor models yielded anomalous factor loadings. The hierarchical model of Byrne, Stewart, Kennard, and Lee showed the best fit in terms of all the indices. The results indicate the presence of a second-order general depression factor that influences highly correlated first-order factors and extend the applicability of the hierarchical model to older community dwellers.

Depressive symptomatology in older adults treated with behavioral activation: A network perspective

BackgroundLate-life depression is a serious mental health problem. Behavioral Activation (BA) is an effective, accessible psychotherapeutic treatment for older adults. However, little is known about which symptoms decrease and how associations between depressive symptoms change during BA treatment. MethodsUsing data from a cluster-randomized trial for older adults with late-life depression, we estimated a partial correlation network and a relative importance network of depressive symptoms before and after 8 weeks of BA treatment in primary care (n = 96). Networks were examined with measures of network structure, connectivity, centrality as well as stability. ResultsThe most central symptoms at baseline and post-treatment were anhedonia, fatigue, and feeling depressed. In contrast, sleeping problems had the lowest centrality. The post-treatment network was significantly more interconnected than at baseline. Moreover, all symptoms were significantly more central at post-treatment. ConclusionOur findings highlight the utility of the network approach to better understand symptom networks of depressed older adults before and after BA treatment. Results show that network connectivity and centrality of all symptoms increased after treatment. Future studies should investigate longitudinal idiographic networks to explore symptom dynamics within individuals over time.

Isotemporal substitution analysis of time between sleep, sedentary behavior, and physical activity on depressive symptoms in older adults: a cross-sectional study.

Compared to young individuals, older adults participate more in sedentary behavior (SB) and less in physical activity (PA). These behaviors are associated with numerous adverse health factors. The purpose of the study was to examine the hypothetical effects of substituting time spent sleeping, performing SB, and performing moderate-to-vigorous physical activity (MVPA) on depressive symptomatology in older adults. An analytical cross-sectional study employing exploratory survey methods was conducted in the city of Alcobaça in the state of Bahia, Brazil. The study included 473 older adults who answered a structured questionnaire during an interview. Exposure time to SB and PA level were assessed using the International Physical Activity Questionnaire, and depressive symptoms were analyzed using the short version of the Geriatric Depression Scale. An isotemporal replacement model was used to evaluate the effects of different SB sessions on depressive symptomatology. An increase in the risk of depressive symptoms was observed when MVPA and sleep time were substituted for the same SB time at all times tested, with maximum values of 40% and 20%, respectively. Opposite substitution of MVPA and sleep time increments reduced the risk of depressive symptomatology by 28% and 17%, respectively. The results of the present study indicate that replacing SB with the same amount of sleep or MVPA may reduce depressive symptoms. The longer the reallocation time, the greater are the benefits.

How Did the COVID-19 Lockdown Pandemic Affect the Depression Symptomatology in Mediterranean Older Adults with Metabolic Syndrome?

Background and Aims. To control the COVID-19 spread, in March 2020, a forced home lockdown was established in Spain. In the present study, we aimed to assess the effect of mobility and social COVID-19-established restrictions on depressive symptomatology in older adults with metabolic syndrome. We hypothesize that severe restrictions might have resulted in detrimental changes in depressive symptomatology. Methods. 2,312 PREDIMED-Plus study participants ( men = 53.9 %; mean age = 64.9 ± 4.8 years) who completed a COVID-19 lockdown questionnaire to assess the severity of restrictions/lockdown and the validated Spanish version of the Beck Depression Inventory-II (BDI-II) during the three established phases concerning the COVID-19 lockdown in Spain (prelockdown, lockdown, and postlockdown) were included in this longitudinal analysis. Participants were categorized according to high or low lockdown severity. Analyses of covariance were performed to assess changes in depressive symptomatology across lockdown phases. Results. No significant differences in participant depression symptomatology changes were observed between lockdown severity categories (low/high) at the studied phases. During the lockdown phase, participants showed a decrease in BDI-II score compared to the prelockdown phase (mean (95% CI), -0.48 (-0.24, -0.72), P < 0.001 ); a nonsignificantly larger decrease was observed in participants allocated in the low-lockdown category (low: -0.59 (-0.95, -0.23), high: -0.43 (-0.67, -0.19)). Similar decreases in depression symptomatology were found for the physical environment dimension. The post- and prelockdown phase BDI-II scores were roughly similar. Conclusions. The COVID-19 pandemic lockdown was associated with a decrease in depressive symptomatology that returned to prelockdown levels after the lockdown. The degree of lockdown was not associated with depressive symptomatology. The potential preventive role of the physical environment and social interactions on mental disorders during forced home lockdown should be further studied. This trial is registered with ISRCTN89898870. Retrospectively registered on 24 July 2014.

Health asymmetry as a predictor of depressive symptomatology over time among older European adults: A growth curve analysis

ObjectiveSubjective (SH) and objective health (OH) measures are associated with depressive symptomatology in older adults. We explored whether the discrepancy between SH and OH (operationalised as ‘health asymmetry’ with four categories: ‘health optimistic’, ‘health pessimistic’ and ‘good health realistic’ and ‘poor health realistic’) may also relate to depressive symptomatology 1) cross-sectionally, and 2) longitudinally, among older European adults. MethodsAdults (n = 26,520), aged 50+, from 11 European countries, were assessed over six waves of data collection (2006–2020) in the SHARE study. A hierarchical multi-level growth curve model explored whether health asymmetry was associated with depressive symptomology at baseline, and with depressive symptom trajectories across time, accounting for country of origin. ResultsAt baseline, 11.8% of older adults were classified as health pessimistic, with 15.5% being health optimistic, 42.9% being poor health realistic and 29.8% being good health realistic. A positive linear trend in depressive symptomatology was noted across 14 years of SHARE data (β = 0.11, p < .001). Health pessimists displayed higher levels of depressive symptoms than both health realistic groups and health optimists. However, health pessimists experienced a less steep increase in depressive symptoms across time (β = −0.10, p < .001), relative to good health realists. ConclusionHealth pessimists experience elevated levels of depressive symptoms, but show less growth in depressive symptomatology than expected. Further research is required to understand the underlying causes of the varying depressive symptom trajectories among these groups.

Does emotional dysregulation mediate the relationship between disability and depressive symptoms in older people?

BackgroundEmotion dysregulation has been consistently linked to psychopathology, and the relationship between disability and depressive symptomatology in old age is well-known. ObjectiveTo examine the mediational role of emotional dysregulation in the relationship between perceived disability and depressive symptomatology in older adults. MethodsTwo hundred eighty-three participants, aged 60–96 years (M±SD=74.22±8.69; 62.9% women; 29.0% with long-term care support [LTC-S] and 71.0% community residents without LTC-S), were assessed with the Geriatric Depression Scale-8 (GDS-8), the World Health Organization Disability Assessment Schedule-2 (WHODAS-2), and the Difficulties in Emotion Regulation Scale-16 (DERS-16). ResultsA mediation model was established, which revealed: (1) a moderate association between WHODAS-2 and GDS-8 (β=0.20; p<.001); (2) DERS-16 partially and weakly mediated the relationship between WHODAS-2 and GDS-8 (β=0.003; p<.01). The model explained 31.9% of the variance of depressive symptoms. An inconsistent mediation model was obtained in the LTC-S group. ConclusionsGlobally, our findings indicate that disability has an indirect relationship with depressive symptomatology through emotional dysregulation (except for those in the LTC-S). Accordingly, we present suggestions for the treatment of depressive symptoms and for the inclusion of other emotion regulation variables in the study of the disability-depressive symptom link in future studies with older people in the LTC-S.

Patterns of polyphenol intake and risk of depressive symptomatology in a population-based cohort of older adults

Current evidence suggests that some isolated polyphenols (PP) may exert promising effects for the risk of depression in young adults, however studies among older adults remain limited. The aim of the current study was to examine the prospective association between patterns of PP intake and the risk of depressive symptomatology (DS) in older adults. The study sample was based on the Three-City (3C) Bordeaux cohort of adults aged 65 years and over and without DS at the time of recruitment. The intakes of PP, summarised into 21PP classes, were determined using a 24-h recall combined with the Phenol-Explorer database. In addition, the patterns of PP intake were identified by a Principal Component Analysis (PCA). DS was evaluated using the Center for Epidemiologic Studies Depression Scale (CES-D) over a period of 15 years with a reassessment every 2-3 years. The incident DS was reported for CES-D score ≥16 and/or the use of antidepressant treatment. The association between the patterns of PP intake at baseline and the risk of DS was computed using multivariate random-effect logistic regression models. Among the 1074 participants (mean age 75.7y, SD 4.8y), 423 (39.4%) developed a DS during the follow-up. Distinct patterns of PP intake were identified, explaining up to 50% of the variance. The two first patterns, mainly driven by stilbenes and dihydroflavonols and by hydroxyicnnamic acid and alkylmethoxyphenols respectively, were not associated with the odds of DS. Furthermore, a higher score on the third pattern, mainly driven by monomeric flavanols and theaflavins, was associated with a significant 27% lower risk of DS over time (Odd Ratio=0.73, 95% Confidence Interval [0.55; 0.97]). This prospective study suggested that a pattern high in monomeric flavanols and theaflavins intakes, mainly provided by tea, was associated with a reduced risk of DS in older adults. These results provide promising evidence on combined PP intakes that would require further confirmation in other samples.

Investigating the Link Between IADL and Depressive Symptoms in Older Adults: A Cross-Sectional Serial Mediation Model

ABSTRACT Objectives There is a dearth of research on the psychological processes that underlie the negative relation between impaired instrumental activities of daily living (IADL) and depressive symptoms in older adults. Drawing on the stress process model and the resilience framework, we investigated whether purpose in life and resilience serially mediate the relationship between impaired IADL and depressive symptoms. Methods We recruited 111 cognitively healthy community-dwelling older adults (ages 54–85; M = 66.5) who scored a minimum of 25 points on the Mini-Mental State Examination. Results We found that purpose in life and resilience serially mediated the relationship between IADL and depressive symptomatology in older adults. This association held true when we controlled for covariates. Additional sensitivity analyses also supported these findings. Conclusions This study extends our understanding of how IADL limitations contribute to depressive symptoms. Using a community-dwelling, cognitively healthy sample, we demonstrate that functional limitations indirectly influence older adults’ depressive symptoms through a decreased sense of purpose in life and decreased resilience. Clinical implications Our findings have implications for intervention programs that aim to alleviate IADL limitations and mental health issues in an aging population and promote healthy aging by improving psychosocial resources (i.e., purpose in life and resilience).

Visit-To-Visit Blood Pressure Variability and Subthreshold Depressive Symptoms in Older Adults

ObjectivesDepression is related to increased risk for dementia, possibly through links with cerebrovascular disease. Blood pressure variability is an emerging risk factor for cerebrovascular disease and dementia, but relationships with affective symptoms remain understudied. DesignRetrospective analysis of prospective cohort study. SettingAlzheimer's Disease Neuroimaging Initiative. Participants505 older adults without history of dementia or recent depression underwent three to four blood pressure measurements over 12 months and completed a self-report measure of depressive symptoms (Geriatric Depression Scale – 15 Item) at study baseline and 24-months follow-up. MeasurementsBlood pressure variability was calculated as variability independent of mean and maximum minus minimum. Regression models investigated relationships between blood pressure variability and severity of self-reported depressive symptoms at 24-months follow-up after controlling for several variables, including average blood pressure, antihypertensive use, antidepressant use, and baseline depressive symptom severity. ResultsElevated diastolic blood pressure variability was related to greater total depressive symptom score at follow-up (ß = .16 [95% CI 0.02, .30]; p = 0.03), with specific contribution from increased severity of symptoms of dysphoria (odds ratio = 1.35 [95% CI 1.07, 1.75]; p = 0.02). Blood pressure variability was not significantly related to other symptom subscales, including those reflecting life satisfaction or withdrawal. ConclusionsFindings suggest that elevated diastolic blood pressure variability is related to subthreshold depressive symptomatology in older adults without history of dementia or recent depression, independent of average blood pressure. Blood pressure variability may be an understudied vascular risk factor linked with depression and cognitive impairment, with potential therapeutic implications.

Association of vision loss and depressive symptomatology in older adults assessed for ocular health in senior living facilities.

People with vision loss are at increased risk for major depressive disorder (MDD) and subclinical depression. However, screening for depression is rarely done in eye care settings or among groups in the general population known to have vision disorders. We examined the prevalence of depression, using the Patient Health Questionnaire - 2 (PHQ-2), among a group of older adults (N=204; mean age=82.15) at two senior living facilities (SLFs) and determined the relationships between severity of depression and objective visual findings, visual function, beliefs about taking an active role in one's own eye care (i.e., patient activation) and level of social support. Approximately 50% of the sample had impaired vision in at least one eye, and close to 30% of the sample obtained a score on the PHQ-2 indicating the likely presence of major depressive disorder. Visual testing findings were related to visual function (e.g., ability to read), but not to depression. Patient activation was also not significantly related to the level of depression. However, impaired visual functioning and less social support were both strong predictors of depression. These two variables and their interaction accounted for 17% of the total PHQ-2score variance. These data indicate the potential utility of screening for depression as part of vision care in populations likely to have significant vision loss. The findings also suggest that a comprehensive approach to depression prevention and/or reduction in SLF and similar populations may require interventions to address reduced visual functioning and methods to strengthen social networks.

Prevalence And Factors Associated With Depressive Symptomatology In Older Adults Of The “Micaela Bastidas” Health Center, Lima-Peru

Objetivo: Evaluar los factores asociados a la depresión en adultos mayores residentes en una zona urbano marginal de Perú. Material y Métodos: Es un estudio transversal analítico en adultos mayores de 60 años residentes de una zona urbano marginal de Lima.&nbsp; Se evaluó la variable dependiente usando la escala de depresión geriátrica de 15 items, se consideró la presencia de depresión con un puntaje ≥ 6. Los factores asociados a la depresión, se calcularon usando razones de prevalencia crudas y ajustadas con intervalos de confianza al 95% (IC 95%) mediante regresiones de poisson con varianza robusta. Resultados: De los 142 adultos mayores con una edad promedio y desviación estándar fue 70,4±8,14. La prevalencia de la presencia de depresión fue 55,6% (mujeres 39,6% y hombres 53,4%). El no tener escolaridad (RPa: 1,40; IC 95%: 1,04 – 1,88) y no estar trabajando (RPa: 1,50; IC 95%: 1,09 – 2,05) fueron factores de riesgo que aumentaban la presencia de depresión. Conclusión: La prevalencia de presencia de depresión en adultos mayores de una zona urbano marginal de Perú fue alta. Los adultos mayores que no completaron su escolaridad y no trabajaban presentaron más probabilidades de presentar depresión.

Relevancia del apoyo social en el estrés y síntomas depresivos en la tercera edad

Objetivo: determinar la relación entre los niveles de estrés y la sintomatología depresiva en adultos mayores de un centro integral de atención en Independencia, Lima. Materiales y métodos: estudio correlacional, de corte transversal. La muestra estuvo conformada por 152 adultos mayores entre los 60 y 80 años. El tipo de muestreo fue no probabilístico. Se usaron como instrumentos el Cuestionario de Estrés Percibido (CEP), la Escala de Autoevaluación para la Depresión de Zung y una ficha sociodemográfica. Para el análisis de los datos se utilizó el paquete estadístico STATA versión 14. Se empleó el Chi-cuadrado en el análisis de las variables categóricas. Resultados: se halló relación significativa entre los niveles de estrés y la sintomatología depresiva. El 74.34% de los participantes se encuentra dentro de los límites normales con respecto a la sintomatología depresiva y el 92.11% obtuvo un nivel de estrés bajo. Conclusión: los niveles de estrés y la sintomatología depresiva son condiciones psicológicas que pueden manifestarse en diferentes grados y relacionarse en personas de la tercera edad. La participación del adulto mayor en un Centro integral de atención en el que se les brinda apoyo social podría ayudar a desarrollar recursos para afrontar y disminuir esta sintomatología y el efecto de los cambios biopsicosociales propios del envejecimiento

Determinants of Quality of Life in Pre-Frail Older Adults According to Phenotypic Criteria: the VERISAUDE Study

Frailty is a dynamic clinical syndrome considered as part of an age-associated continuum of severity, including pre-frailty as an intermediate frailty status with potential reversibility to robustness. The main purpose of this study was to analyse the relationship between the different domains of quality of life, functional dependence and depressive symptomatology in older adults diagnosed as pre-frail, before progression to frailty occurs. Logistic regression analyses were conducted to examine whether sex, age, level of education and scores in the Geriatric Depression Scale 15-item Short Form (GDS-SF) and the Instrumental Activities of Daily Living Lawton scale determine the worst score in the WHOQOL-BREF (World Health Organization Quality of Life) in older adults meeting one or two frailty phenotypic criteria. Depressive symptomatology (GDS-SF score) was the main determinant of poor quality of life in both groups, and in all areas of WHOQOL-BREF. Age was only associated with poor satisfaction with own health. Female sex and low educational level were linked to low physical QOL and poor self-rated health, respectively, but only in older adults meeting one frailty criterion. Association between functional status and WHOQOL-BREF scores was only found in the univariate analysis. These results underline the importance of identifying multiple aspects, but mainly the presence of depressive symptomatology, as risk factors for all dimensions of quality of life in the pre-frailty process, where interventions might be targeted to reduce the progression of pre-frailty and frailty in older adults.

Effects of Recent Stress and Variation in the Serotonin Transporter Polymorphism (5-HTTLPR) on Depressive Symptoms: A Repeated-Measures Study of Adults Age 50 and Older

Depending on genetic sensitivity to it, stress may affect depressive symptomatology differentially. Applying the stress-diathesis hypothesis to older adults, we postulate: (1) recent stress will associate with increased depressive symptom levels and (2) this effect will be greater for individuals with at least one short allele of the serotonin transporter gene promoter region (5-HTTLPR). Further, we employ a design that addresses specific limitations of many prior studies that have examined the 5-HTTLPR × SLE relation, by: (a) using a within-person repeated-measures design to address fluctuations that occur within individuals over time, increase power for detecting G×E, and address GE correlation; (b) studying reports of exogenous stressful events (those unlikely to be caused by depression) to help rule out reverse causation and negativity bias, and in order to assess stressors that are more etiologically relevant to depressive symptomatology in older adults. The sample is drawn from the Health and Retirement Study, a U.S. population-based study of older individuals (N=28,248; mean age=67.5; 57.3% female; 80.7% Non-Hispanic White, 14.9% Hispanic/Latino, 4.5% African American; genetic subsample=12,332), from whom measures of depressive symptoms and exogenous stressors were collected biannually (1994-2010). Variation in the 5-HTTLPR was characterized via haplotype, using two single nucleotide polymorphisms (SNPs). Ordered logit models were constructed to predict levels of depressive symptoms from 5-HTTLPR and stressors, comparing results of the most commonly applied statistical approaches (i.e., comparing allelic and genotypic models, and continuous and categorical predictors) used in the literature. All models were stratified by race/ethnicity. Overall, results show a main effect of recent stress for all ethnic groups, and mixed results for the variation in 5-HTTLPR×stress interaction, contingent upon statistical model used. Findings suggest there may be a differential effect of stressors and 5-HTTLPR on depressive symptoms by ethnicity, but further research is needed, particularly when using a haplotype to characterize variation in 5-HTTLPR in population-based sample with a diverse ethnic composition.

ANXIETY AND 10-YEAR RISK OF INCIDENT AND RECURRENT DEPRESSIVE SYMPTOMATOLOGY IN OLDER ADULTS

Anxiety has been shown to often precede depression in children and young adults. Only a small number of investigations have examined this form of comorbidity in older adults and the temporal relationship of these syndromes remains unclear. The objective was to verify whether trait anxiety predicts incident/recurrent depressive symptomatology in older adults independently of variables susceptible to explain this relationship in this population, such as cognitive complaints, subjective health, and baseline depressive symptoms. A random sample of 4,649 individuals aged 65 years or older from the Three-City Study, a prospective longitudinal study with a 10-year follow-up, was used. Incident and recurrent depressive symptomatology were determined by Center for Epidemiological Studies Depression Scale cutoff scores. Anxiety was measured using the trait scale of the State-Trait Anxiety Inventory. Cox proportional hazards models were used to determine the independent risk of depressive symptomatology for baseline anxiety, cognitive complaints, subjective health, and depressive symptoms, adjusting for sociodemographic, mental health, and physical health covariates. Incident depressive symptomatology was independently predicted by baseline anxiety, depressive symptoms, cognitive complaints, and subjective health. Recurrent depressive symptomatology was independently predicted by baseline anxiety and depressive symptoms, but not by cognitive complaints and subjective health. Anxiety was associated with a higher risk of incident depressive symptomatology only in participants without a history of a major depressive episode, and with a higher risk of recurrent depressive symptomatology in men than in women. Trait anxiety constitutes an important independent risk factor for subsequent depressive symptomatology in older adults.

Sixteen-Month Evaluation of Depressive Symptomatology in Older Adults

We examined the prevalence of depressive symptoms over time in a sample of community-residing older adults at baseline, 2 months, 6 months, and 14 months. The nonprobability sample (N = 222) was 90% female, 87% Caucasian, 15% Hispanic, and 12% African American with an average age of 75 years. If depressive symptoms had been measured at only one time, 19% of the sample would have scored above the cutoff versus 39% scoring above the cutoff when measured at all 4 periods. The findings provide evidence that depressive symptoms in older adults are variable and fluctuate over time. The significance of this research was the longitudinal evaluation of depressive symptoms in community-residing elders.

Perceived social isolation makes me sad: 5-year cross-lagged analyses of loneliness and depressive symptomatology in the Chicago Health, Aging, and Social Relations Study.

We present evidence from a 5-year longitudinal study for the prospective associations between loneliness and depressive symptoms in a population-based, ethnically diverse sample of 229 men and women who were 50-68 years old at study onset. Cross-lagged panel models were used in which the criterion variables were loneliness and depressive symptoms, considered simultaneously. We used variations on this model to evaluate the possible effects of gender, ethnicity, education, physical functioning, medications, social network size, neuroticism, stressful life events, perceived stress, and social support on the observed associations between loneliness and depressive symptoms. Cross-lagged analyses indicated that loneliness predicted subsequent changes in depressive symptomatology, but not vice versa, and that this temporal association was not attributable to demographic variables, objective social isolation, dispositional negativity, stress, or social support. The importance of distinguishing between loneliness and depressive symptoms and the implications for loneliness and depressive symptomatology in older adults are discussed.

Sibling death and death fear in relation to depressive symptomatology in older adults.

Previously overlooked factors in elders' depressive symptomatology were examined, including death fear, sibling death, and sibling closeness. Participants were 150 elders (61 men, 89 women) aged 65-97 years with at least one sibling. Measures were proportion of deceased siblings, sibling closeness, the Death Fear Subscale of the Death Attitude Profile-Revised, and the Center for Epidemiological Studies-Depression scale (20-item adult form). Age and education were exogenous variables in a structural equation model. Death fear, sibling closeness, and proportion of dead siblings were directly related to depression, with path coefficients of .42, -.24, and .13, respectively. Proportion of dead siblings had indirect effects on depression, as did age and education. Depressive symptomatology in old age is influenced by death fear related to sibling death as well as by poor relationships with them; it must be understood within a situational context including death fear and sibling relationships.

Vascular Disease and Future Risk of Depressive Symptomatology in Older Adults: Findings from the Health, Aging, and Body Composition Study

The vascular depression hypothesis suggests that age-related vascular diseases and risk factors contribute to late-life depression. Although neuroimaging studies provide evidence for an association between depression and severity of vascular lesions in the brain, studies of depression and indicators of vascular risk have been less consistent. We examined 1796 elders ages 70-79 from the Health, Aging and Body Composition study without depression at baseline and examined the association between prevalent vascular disease and related conditions at baseline and 2-year incidence of elevated depressive symptoms, defined as a score > 8 on the 10-item Center for Epidemiologic Studies Depression (CES-D) scale. After adjustment for demographic data and physical and cognitive functioning, several vascular conditions remained associated with increased risk of depressive symptomatology including metabolic syndrome and its components (low high-density lipoprotein cholesterol and high fasting glucose), coronary heart disease, a positive Rose questionnaire for angina, and high hemoglobin a1c. Cumulative vascular risk based upon a composite of 10 vascular diseases and risk factors was independently associated with incident elevated depression at 2-year follow-up after controlling for demographic data, physical and cognitive functioning, and selected comorbid medical conditions. These results provide support for the vascular depression hypothesis in demonstrating an association between vascular conditions and risk factors and subsequent risk of depressive symptomatology. Older adults with vascular conditions and risk factors require close monitoring of depressive symptoms.