Depressive Symptoms In Midlife Research Articles

First-generation college graduates have similar depressive symptoms in midlife as multi-generational college graduates

PurposeHigher education may protect an individual against depressive symptoms, yet, disadvantaged socioeconomic status (SES) during childhood, often measured by lower parental education, may put them at higher risk for depressive symptoms later in life. This study evaluates if midlife depression is similar for first-generation and multi-generation college graduates. MethodsFor US Health and Retirement Study (HRS) participants ages 55–63 (N = 16,752), we defined a 4-category exposure from parents' (highest of mother or father's) and participant's own years of education, with 16 years indicating college completion: multi-gen (both ≥ 16 years: reference); first-gen (parents <16; own ≥ 16); only parent(s) (parents ≥ 16; own <16); and neither (both <16) college graduates across three birth cohorts. We used linear regressions to evaluate relationships between college completion and depressive symptoms measured by an 8-item Center for Epidemiologic Studies – Depression (CES-D) scale. Models pooled over time evaluated differences by sex, race/ethnicity, and birthplace. ResultsFirst-gen and multi-gen college graduates averaged similar depressive symptoms in midlife (β: 0.01; 95% CI: 0.15, 0.13). Results were similar by sex and race/ethnicity. ConclusionConsistent with resource substitution theory, college completion may offset the deleterious effects of lower parental education on midlife depressive symptoms for first-generation graduates.

Self-rated mental health in the transition to adulthood predicts depressive symptoms in midlife.

Self-rated mental health (SRMH), a single item asking individuals to evaluate their mental or emotional health, is included in some surveys as an indicator of risk for mental disorders and to monitor population health, yet little longitudinal research examines how well it predicts future outcomes. Following a life course perspective, the current longitudinal study of 502 Canadian high school seniors tracked into midlife examined to what extent SRMH at ages 20, 25, and 32years predicted depressive symptoms at ages 43 and 50. Hierarchical linear regressions showed that lower SRMH at age 25 and at 32years was a significant predictor of higher levels of depressive symptoms at ages 43 and 50, even when controlling for sex, participant education, marital/cohabitation status, self-rated physical health, and baseline depressive symptoms. The results provide evidence that SRMH assessed during the transition to adulthood may be useful as a broad and powerful measure of risk for mental health problems decades into the future.

Association of Midlife Depressive Symptoms with Regional Amyloid-β and Tau in the Framingham Heart Study.

Depressive symptoms predict increased risk for dementia decades before the emergence of cognitive symptoms. Studies in older adults provide preliminary evidence for an association between depressive symptoms and amyloid-β (Aβ) and tau accumulation. It is unknown if similar alterations are observed in midlife when preventive strategies may be most effective. The study aim was to evaluate the association between depressive symptoms and cerebral Aβ and tau in a predominately middle-aged cohort with examination of the apolipoprotein (APOE) ɛ4 allele as a moderator. Participants included 201 adults (mean age 53±8 years) who underwent 11C-Pittsburgh Compound B amyloid and 18F-Flortaucipir tau positron emission tomography (PET) imaging. Depressive symptoms were evaluated with the Center for Epidemiological Studies Depression Scale (CES-D) at the time of PET imaging, as well as eight years prior. Associations between depressive symptoms at both timepoints, as well as depression (CES-D≥16), with regional Aβ and tau PET retention were evaluated with linear regression adjusting for age and sex. Interactions with the APOE ɛ4 allele were explored. Depressive symptoms and depression were not associated with PET outcomes in the overall sample. However, among APOE ɛ4 allele carriers, there was a significant cross-sectional association between depressive symptoms and increased tau PET uptake in the entorhinal cortex (β= 0.446, SE = 0.155, p = 0.006) and amygdala (β= 0.350, SE = 0.133, p = 0.012). Although longitudinal studies are necessary, the results suggest that APOE ɛ4 carriers with depressive symptoms may present with higher susceptibility to early tau accumulation in regions integral to affective regulation and memory consolidation.

Taking a fresh look at mood, hormones, and menopause.

Depression, with or without concomitant anxiety, is one of the most burdensome medical conditions worldwide. Depression affects women more often than men and may cause significant impairment. Reproductive phase-related windows of vulnerability for depression (new or recurrent) have been recognized, including the menopause transition. Midlife depression is likely influenced by both menopause- and nonmenopause-related factors. Antidepressants and cognitive behavioral therapy remain first-line treatment options for moderate to severe major depressive disorder at any time, with proven efficacy and tolerability in midlife women. Transdermal estradiol can also be part of the treatment armamentarium, but its use as a prophylaxis against midlife depressive symptoms, although promising, warrants further investigation.

Changes in depressive symptoms over age among older Americans: Differences by gender, race/ethnicity, education, and birth cohort.

Despite concerns about recent trends in the health and functioning of older Americans, little is known about dynamics of depression among recent cohorts of U.S. older adults and how these dynamics differ across sociodemographic groups. This study examined sociodemographic differences in mid- and late-life depressive symptoms over age, as well as changes over time. Using nationally representative data from the Health and Retirement Study (1994–2014), we estimated mixed effects models to generate depressive symptoms over age by gender, race/ethnicity, education, and birth cohort in 33,280 adults ages 51–90 years. Depressive symptoms were measured using the 8-item Center for Epidemiological Studies Depression scale. Women compared to men, low compared to high education groups, and racial/ethnic minorities compared to whites exhibited higher depressive symptoms. The largest disparity resulted from education, with those without high school degrees exhibiting over two more predicted depressive symptoms in midlife compared to those with college degrees. Importantly, war babies and baby boomers (born 1942–1959) exhibited slightly higher depressive symptoms with more decreasing symptoms over age than their predecessors (born 1931–1941) at ages 51–65. We additionally observed an age-as-leveler pattern by gender, whereby females compared to males had higher depressive symptomology from ages 51–85, but not at ages 86–90. Our findings have implication for gauging the aging population's overall well-being, for public health policies aimed at reducing health disparities, and for anticipating demand on an array of health and social services.

Family Networks and Psychological Well-Being in Midlife

Scholarship has highlighted the importance of kin relations for well-being in adulthood. Much focus has been on relationships between spouses and between parents and children. However, limited research has explored the role of adult sibling relationships in well-being, and no studies have made direct comparisons among the effects of tension with these multiple family members. Using data collected from 495 adult children nested within 254 families, we examined the differential impact of tension with mothers, siblings, and spouses on depressive symptoms in midlife. Separate multi-level regression analyses showed that tension with spouses, mothers, and siblings each predicted depressive symptoms. Combined analyses revealed that greater tension with spouses was associated with higher depressive symptoms, but tension with mothers and siblings was not. However, Wald tests comparing the strength of these associations between tension and depressive symptoms indicated that these associations did not significantly vary across family members. Interactions with gender indicated that tension with mothers was more strongly associated with higher depressive symptoms for women than men. These findings highlight the importance of the quality of relationships with family members on individuals’ psychological well-being, and call for researchers to consider multiple ties and gender when examining family relationships and well-being.

Mastery and Depressive Symptoms: How Does Mastery Influence the Impact of Stressors From Midlife to Old Age?

The objective of this research is to study depressive symptoms (DS) among adults aged 40 to 79 years and examine how mastery influences the impact of sociodemographic, socioeconomic, and health factors on DS. We used a sample of the Norwegian Life Course, Generation, and Gender (LOGG) study ( N = 6,879) and analyzed how mastery influences the independent variables on DS via regression analyses. Mastery affected DS directly and influenced the effects of sociodemographic, socioeconomic, and health factors on DS. There was a stronger relationship between stressors and DS among respondents with low than high mastery. DS were most prevalent among people aged 70 to 79 years. When mastery was also controlled for, the oldest group (70-79 years) had significantly fewer DS than those aged 40 to 49 years. The influence of mastery and stressors on DS seems to vary along the life span. The result that mastery was a relatively stronger buffer against DS in midlife than in old age is discussed.

Depressive symptoms in women's midlife in relation to their body weight before, during and after childbearing years.

SummaryObjectiveThis study aimed to examine how weight and weight changes related to pregnancy were associated with depressive symptoms 11–16 years after childbirth.MethodWe followed 16,998 first‐time mothers from the Danish National Birth Cohort up till 16 years after birth and estimated associations between depressive symptoms and pre‐pregnancy body mass index (BMI) (kg m−2), weight changes in different time periods, and BMI‐adjusted waist circumference 7 years after birth (WCBMI, cm). Depressive symptoms were estimated by the Center for Epidemiologic Studies Depression 10‐item scale. Multiple logistic regression analyses were used to estimate odds ratios (OR) and 95% confidence intervals.ResultsCompared with normal‐weight, we found that underweight, overweight and obesity were associated with greater odds of depressive symptoms (1.29, 1.24 and 1.73, respectively). Compared with weight change ±1 BMI unit during the total follow‐up period, greater odds for depressive symptoms were observed with weight loss (OR 1.14, 0.96–1.36) or gain of 2–2.99 kg m−2 (OR 1.11, 0.92–1.33) or gain of ≥3 kg m−2 (OR 1.68, 1.46–1.94). WCBMI > 2.2 cm was associated with greater odds of depressive symptoms (OR 1.16, 0.99–1.36) than waist circumference as predicted by BMI.ConclusionLow and high pre‐pregnancy BMI, weight changes and WCBMI larger than predicted were associated with more depressive symptoms in midlife.

Depressive symptoms in midlife: the role of reproductive stage.

The aim of the study was to determine the prevalence of depression among community-dwelling women in the premenopause, menopausal transition (MT), and postmenopause stage. We also sought to clarify the direct and indirect contribution of menopausal status on the risk of depression. Cross-sectional survey of 1,612 women aged 45 to 55 years living in the Perth metropolitan region, who were recruited using a random sample of the electoral roll (voting is compulsory in Australia), was conducted. Women with clinically significant symptoms of depression had Patient Health Questionnaire (PHQ-9) scores of at least 10, and those with major depression, reported symptoms consistent with Diagnostic and Statistical Manual of Mental Disorders, 5th ed (DSM-5), criteria. We used past and current gynecological and reproductive data to classify women as premenopausal, undergoing the MT, and postmenopausal. Other study measures included age, place of birth, education, marital status, drinking habit, number of children, medical illnesses, and history of premenstrual syndrome, postnatal depression, and past depression or anxiety. We investigated the direct and indirect effect of reproductive status with mediation/modulation analysis. Among the women included in the survey, 8.2%, 11.5%, and 13.0% of women in premenopause, MT, and postmenopause had PHQ-9 at least 10, whereas major depression was present in 2.2%, 3.4%, and 3.6% of them. Reproductive status did not affect the prevalence of major depression, but more postmenopausal than premenopausal women had PHQ-9 score equal to or greater than 10 (P = 0.013). Compared with premenopausal women, MT was associated with a direct odds ratio (OR) 1.35 (95% confidence interval [CI] = 0.90, 2.01) and indirect OR 1.08 (95% CI = 0.92, 1.26) for PHQ-9 at least 10. Similarly, the direct and indirect effect of the postmenopause on the odds of PHQ-9 at least 10 was OR 1.31 (95% CI = 0.87, 1.98) and OR 1.29 (95% CI = 1.10, 1.52). The slight, but not significant, excess of depressive symptoms during MT and early postmenopause cannot be attributed to a direct effect of reproductive status.

Associations Between Self-Reported and Objectively Recorded Early Life Stress, FKBP5 Polymorphisms, and Depressive Symptoms in Midlife

BackgroundFK506-binding protein 51 is involved in hypothalamic-pituitary-adrenal axis regulation. Single nucleotide polymorphisms (SNPs) in the FKBP5 gene have been shown to interact with retrospectively self-reported early life stress (ELS) in patients with psychiatric disorders. We examined interactions between three selected FKBP5 SNPs and self-reported and objectively recorded ELS in relation to depressive symptoms in midlife. MethodsThis study comprised 1431 Helsinki Birth Cohort Study participants genotyped for FKBP5 SNPs shown to alter cortisol metabolism (rs1360780, rs9470080, and rs9394309). Participants completed the Beck Depression Inventory (BDI) at ages 61.5 years (time 1) and 63.4 years (time 2); 165 and 181 participants were separated from their parents in childhood as a result of evacuations during World War II as indicated by self-reports and the Finnish National Archives registry, respectively. ResultsAssociations between self-reported and objectively recorded ELS, but not stressful events in midlife, and the mean BDI score (average of time 1 and time 2) or mild to severe BDI scores (10–63 points at time 1 and time 2), or both, were moderated by the FKBP5 variants (p values for interactions < .05; p values between self-reported and objectively recorded ELS in these interactions > .18). Mean BDI scores or odds for having mild to severe BDI scores, or both, increased according to number of minor alleles and haplotypes derived from these alleles in the separated groups, but not in the nonseparated groups. ConclusionsFKBP5 variations in combination with self-reported and objectively recorded ELS predict more pronounced depressive symptoms in midlife. Our findings confirm previous retrospective findings in a prospective epidemiologic study setting.

The association of adverse childhood experiences with mid-life depressive symptoms and quality of life among incarcerated males: exploring multiple mediation

Objectives: To explore the association of experiencing death, trauma, and abuse during childhood with depressive symptoms and quality of life at mid-life among incarcerated men and to understand how current social support and coping strategies mediate the impact of childhood trauma histories on mental health.Methods: Study participants were 192 male inmates in a maximum security prison. Participants completed measures of adverse childhood experiences related to death, trauma, and abuse, and depressive symptoms and quality of life. Data were analyzed using multiple mediation modeling.Results: Men who reported having experienced adverse childhood experiences reported more depressive symptoms and lower quality of life than their counterparts. The results showed that in models both unadjusted and adjusted for age, race, education, number of years served, and whether the inmate had a life sentence, the association between adverse childhood experiences and quality of life were partially explained by the total of the indirect effects (point estimate = −.5052; CI.95 = −1.0364, −.0429 and point estimate = −.7792; CI.95 = −1.6369, −.0381), primarily via social support. However, the associations between adverse childhood experiences and depressive symptoms were not explained by social support and coping.Conclusion: Adverse childhood experiences are associated with deleterious mental health effects in later life. Social support and coping partially mediate the association between adverse childhood experiences and quality of life. The high prevalence of childhood trauma among aging prison inmates warrants attention to increasing social support mechanisms to improve mental health.

Racial/ethnic disparities in midlife depressive symptoms: The role of cumulative disadvantage across the life course.

This study examines the role of cumulative disadvantage mechanisms across the life course in the production of racial and ethnic disparities in depressive symptoms at midlife, including the early life exposure to health risk factors, the persistent exposure to health risk factors, and varying mental health returns to health risk factors across racial and ethnic groups. Using data from the over-40 health module of the National Longitudinal Study of Youth (NLSY) 1979 cohort, this study uses regression decomposition techniques to attend to differences in the composition of health risk factors across racial and ethnic groups, differences by race and ethnicity in the association between depressive symptoms and health risk factors, and how these differences combine within racial and ethnic groups to produce group-specific levels of--and disparities in--depressive symptoms at midlife. While the results vary depending on the groups being compared across race/ethnicity and gender, the study documents how racial and ethnic mental health disparities at midlife stem from life course processes of cumulative disadvantage through both unequal distribution and unequal associations across racial and ethnic groups.

Partnership and Extended Family Relationship Quality Moderate Associations Between Lifetime Psychiatric Diagnoses and Current Depressive Symptoms in Midlife

Adult close relationships, both in marriage and extended family, are hypothesized to be foremost among potential supports and influences on adult development, and the quality of these close relationships has been associated with symptoms of depression and anxiety. In a socioeconomically diverse sample of 182 midlife Black/African American and White/European American men and women, we examined whether close relationship quality moderated the association between lifetime diagnosis of mood and/or anxiety disorder and current symptoms of depression and anxiety. Results supported a buffering hypothesis, such that adults with these lifetime diagnoses and higher quality, supportive, and reciprocal extended family relationships had low depressive symptoms, comparable to those who had no lifetime history of mood/anxiety disorders. Further evidence for a buffering effect of close relationships was seen when both marital and extended family relationships were examined together. When the three risk factors were considered together, that is, lifetime diagnoses, extended family quality, and marital quality, they were additive with respect to predicting depressive symptoms.

The BDNF Val66Met polymorphism does not moderate the effect of self-reported physical activity on depressive symptoms in midlife

The brain-derived neurotrophic factor (BDNF) Val66Met single nucleotide polymorphism may be associated with clinical and subsyndromal depression, but physical activity improves mood and increases BDNF expression. The aim of the study was to examine whether the BDNF polymorphism moderates an effect of physical activity on depressive symptoms. BDNF genotype, physical activity measured by the Paffenbarger Questionnaire, and depressive symptoms using the Center for Epidemiology Depression Scale (CES-D) were collected on 1072 participants (mean age=44). Multiple linear regression was used to examine the association between BDNF genotype, physical activity, and depressive symptoms. After adjusting for family income, age, and education, depressive symptoms were higher in Met carriers compared to Val homozygotes (p=0.03), but this was only significant in men. Physical activity was associated with fewer depressive symptoms, but only in women (p=0.01). BDNF genotype did not moderate the effect of physical activity on depressive symptoms (p=0.94). In midlife, the BDNF Val66Met polymorphism neither attenuates nor magnifies the effect of physical activity on depressive symptoms.

Prospective Association of Morning Salivary Cortisol with Depressive Symptoms in Mid-Life: A Life-Course Study

ObjectiveAssociations of cortisol and depression vary at different life-stages, yet population-based, prospective studies are scarce. We aimed to assess associations of morning cortisol with depressive symptoms in mid-life taking account of lifetime psychological health.MethodsParticipants were 5,403 men and women from the 1958 British Birth Cohort whose salivary cortisol was assessed at 45y (45min after waking (T1) and 3h later (T2)) and who completed the 5-item Mental-Health Index (MHI-5) about depressive symptoms at age 50y. Lifetime psychological health was identified from child and adult measures.ResultsFor women, higher T2 cortisol at 45y predicted depression (MHI-5 scores ≤52) at 50y (odds ratio [OR]=1.17; 95% confidence intervals [CI] 1.05,1.30 per standard deviation increase in T2 cortisol), attenuating when adjusted for current (45y) and previous (7-42y) psychological health (OR=1.11; 95% CI 0.98, 1.24). Similarly, an association in women of flatter cortisol delta (T2-T1) with depressive symptoms at 50y weakened after adjustment for current (45y) and previous (7-42y) psychological health. For men, lower T2 cortisol at 45y predicted greater depressive symptoms at 50y and the association strengthened when adjusted for lifetime psychological health. Likewise, lower cortisol AUC predicted higher risk of depression for men after adjusting for prior psychological health (OR=0.85; CI 0.72, 1.00). Associations were largely unaltered by control for covariates.ConclusionsIn women, higher cortisol in late morning at 45y is prospectively associated with depressive symptoms at 50y through a link with lifetime psychological health. In men, lower cortisol predicts subsequent symptoms, independent of depressive history.

Midlife vs Late-Life Depressive Symptoms and Risk of Dementia

Depression and dementia are common in older adults and often co-occur, but it is unclear whether depression is an etiologic risk factor for dementia. To clarify the timing and nature of the association between depression and dementia. We examined depressive symptoms assessed in midlife (1964-1973) and late life (1994-2000) and the risks of dementia, Alzheimer disease (AD), and vascular dementia (VaD) (2003-2009) in a retrospective cohort study. Depressive symptoms were categorized as none, midlife only, late life only, or both. Cox proportional hazards models (age as timescale) adjusted for demographics and medical comorbidities were used to examine depressive symptom category and risk of dementia, AD, or VaD. Kaiser Permanente Medical Care Program of Northern California. Thirteen thousand five hundred thirty-five long-term Kaiser Permanente members. Any medical record diagnosis of dementia or neurology clinic diagnosis of AD or VaD. Subjects had a mean (SD) age of 81.1 (4.5) years in 2003, 57.9% were women, and 24.2% were nonwhite. Depressive symptoms were present in 14.1% of subjects in midlife only, 9.2% in late life only, and 4.2% in both. During 6 years of follow-up, 22.5% were diagnosed with dementia (5.5% with AD and 2.3% with VaD). The adjusted hazard of dementia was increased by approximately 20% for midlife depressive symptoms only (hazard ratio, 1.19 [95% CI, 1.07-1.32]), 70% for late-life symptoms only (1.72 [1.54-1.92]), and 80% for both (1.77 [1.52-2.06]). When we examined AD and VaD separately, subjects with late-life depressive symptoms only had a 2-fold increase in AD risk (hazard ratio, 2.06 [95% CI, 1.67-2.55]), whereas subjects with midlife and late-life symptoms had more than a 3-fold increase in VaD risk (3.51 [2.44-5.05]). Depressive symptoms in midlife or in late life are associated with an increased risk of developing dementia. Depression that begins in late life may be part of the AD prodrome, while recurrent depression may be etiologically associated with increased risk of VaD.

A 35-Year Longitudinal Assessment of Cognition and Midlife Depression Symptoms: The Vietnam Era Twin Study of Aging

To determine whether early adult cognitive ability is a risk factor for depressive symptoms in midlife and how genetic and environmental influences explain the association and to examine cross-sectional relationships between depressive symptoms and specific cognitive abilities at midlife. A 35-year longitudinal and cross-sectional twin study of cognitive aging. Large multicenter study in the United States. One thousand two hundred thirty-seven male twins aged 51 to 60 years. At the age of 20 years and midlife, participants completed the same version of a general cognitive ability test (Armed Forces Qualification Test [AFQT]). Midlife testing included an extensive neurocognitive protocol assessing processing speed, verbal memory, visual-spatial memory, working memory, executive function, and visual-spatial ability. Participants completed the Center for Epidemiologic Studies Depression Scale before cognitive testing and provided health and life style information during a medical history interview. Lower age 20 AFQT scores predicted higher levels of depressive symptoms at age 55 years (r = -0.16,p <0.001). In bivariate twin modeling, 77% of the correlation between early cognitive ability and midlife depressive symptoms was due to shared genetic influences. Controlling for current age, age 20 AFQT, and nonindependence ofobservations, depressive symptoms were associated with worse midlife AFQT scores and poorer performance in all cognitive domains except verbal memory. Results suggest that low cognitive ability is a risk factor for depressive symptoms; this association is partly due to shared genetic influences. Crosssectional analyses indicate that the association between depressive symptoms and performance is not linked to specific cognitive domains.

Indicators of Job Strain at Midlife and Cognitive Functioning in Advanced Old Age

We used data from SWEOLD, a Swedish nationally representative study of individuals aged 77 years or older, to examine midlife indicators of job strain in relation to cognitive performance and impairment. In all, 827 participants completed an abridged 11-point version of the Mini-Mental State Examination in-person in 1992 and/or 2002 and had self-reported and/or occupation-based scores for job control and demands from data collected in 1968. Seventeen percent scored below the cutoff for cognitive impairment. Controlling for age, sex, education, self-rated health, and year of cognitive screening, low self-reported and occupation-based job control at midlife was associated with poorer cognitive performance later (ps < .001). For the occupation-based measure, low job control was also associated with greater likelihood of impairment, whereas having an active job (high job control/high job demands) was associated with better cognitive performance and lower likelihood of impairment (ps < .01). Childhood environment, midlife depressive symptoms, and social activity had limited influence, whereas the influence of both adulthood socioeconomic position and work complexity on these results was more pronounced. Job control at midlife, by itself and in combination with job demands, may influence cognitive functioning later above and beyond demographic variables and other occupational characteristics.

Depressive symptoms in midlife and risk of dementia four decades later in female members of an integrated health care delivery system

Depressive symptoms in midlife and risk of dementia four decades later in female members of an integrated health care delivery system

Relations among menopausal symptoms, sleep disturbance and depressive symptoms in midlife

Objectives To investigate the relations among hot flashes, other menopausal symptoms, sleep quality and depressive symptoms in midlife women. Methods A large population-based cross-sectional study of 639 women (ages 45–54 years) consisting of a questionnaire including the Center for Epidemiologic Studies-Depression (CES-D) Scale, demographics, health behaviors, menstrual history, and menopausal symptoms. Results After controlling for menopausal status, physical activity level, smoking status and current self-reported health status elevated CES-D score is associated with frequent nocturnal hot flashes, frequent trouble sleeping, experiencing hot flashes, nausea, headaches, weakness, visual problems, vaginal discharge, irritability, muscle stiffness, and incontinence. Conclusions The present study found significant links between depressive symptoms and several menopausal symptoms including hot flashes, sleep disturbance, irritability, muscle stiffness, and incontinence after controlling for covariates. These findings suggest that a potential mechanism in which bothersome menopausal symptoms may influence depressed mood during the midlife is through sleep disturbance.