Depressive Symptoms In Older Women Research Articles

Adherence to Mediterranean diet is inversely associated with depressive symptoms in older women: findings from the NutBrain Study.

Data on the association of the Mediterranean diet (MD) with depressive symptoms in older people at high risk of depression are scarce. This study aimed to investigate the cross-sectional association of the adherence to the MD and its components with depressive symptoms in an Italian cohort of older men and women. A total of 325 men and 473 women aged 65–97 years (2019–2023) answered a 102-item semi-quantitative FFQ, which was used to calculate the Mediterranean diet score (MDS). Depressive symptoms were assessed using the Centre for Epidemiological Studies Depression Scale; subjects with a score of 16 or more were considered to have depression. Multivariable logistic regression was used for statistical analysis. The occurrence of depressive symptoms was 19·8 % (8·0 % men, 27·9 % women). High adherence to MDS (highest tertile) significantly reduced the odds of having depressive symptoms by 54·6 % (OR 0·454, 95 % CI 0·266, 0·776). In sex-stratified analysis, the reduction was evident in women (OR 0·385, 95 % CI 0·206, 0·719) but not in men (OR 0·828, 95 % CI 0·254, 2·705). Looking at the association of MDS components with depressive symptoms, we found an inverse significant association with fish consumption and the MUFA:SFA ratio above the median only in women (OR 0·444, 95 % CI 0·283, 0·697 and OR 0·579, 95 % CI 0·345, 0·971, respectively). High adherence to the MDS, and a high fish intake and MUFA:SFA ratio were associated with lower depressive symptoms in women only. Future longitudinal studies are needed to confirm these findings and to explore the underlying biological mechanisms.

Physical activity, physical frailty and depressive symptoms among Chinese male and female older adults: do different indicators make a difference?

Older adults become more inactive and frailer with aging. Physical status is closely linked to mental health, but it is unclear which physical indicator is more strongly associated with depressive symptoms in older adults. The present study aimed to compare relationships between self-reported physical activity, physical frailty (muscle mass, muscle strength, and gait ability) and depressive symptoms in community male and female older adults. A total of 1,180 adults aged 60 years and older were recruited to participate in this study from a Chinese community receiving annual check-up service from September 2018 to May 2019. Physical activity was assessed by the International Physical Activity Questionnaire (IPAQ). The Bio-electrical Impedance Analyzer was used to determine the muscle mass. As the indicators of muscle function, grip strength and gait ability were assessed by the dynamometer and Timed Up and Go Test (TUGT), respectively. The 15-item version of Geriatric Depression Scale (GDS-15) was used to examine depressive symptoms. Demographic variables, health status and sleep quality were collected using questionnaire. 11.8% men and 11.9% women reported depressive symptoms. Logistic regression showed that depressive symptoms was associated with low grip strength (OR = 2.42, 95% CI: 1.04-5.63), slow gait ability (OR = 3.60, 95% CI: 1.28-10.13) in older males, and associated with low level of self-reported physical activity (OR = 3.85, 95% CI: 2.00-7.42) in older females. No significant association was found between muscle mass and depressive symptoms. There were gender differences in the relationship between physical activity, physical frailty, and depressive symptoms. Grip strength and gait ability may be a better indicator of frailty for predicting depressive symptoms in older men while physical activity may be useful in predicting depressive symptoms in older women.

Interaction Between Sarcopenic Obesity and Nonlocomotive Physical Activity on the Risk of Depressive Symptoms in Community-Dwelling Older Adult Japanese Women.

This study aimed to investigate the interaction between sarcopenic obesity and locomotive and nonlocomotive physical activity (PA) on the risk of depressive symptoms in community-dwelling older Japanese women. Participants were 143 community-dwelling older women aged 64-94years. PA was measured using a three-axis accelerometer. Participants were classified according to two levels of total, locomotive, and nonlocomotive PA. Depressive symptoms were assessed by a self-administered survey consisting of the 15-item Japanese version of the Geriatric Depression Scale (GDS-15-J). The interaction between sarcopenic obesity groups and total or locomotive PA did not affect GDS-15-J scores. However, the interaction between sarcopenic obesity groups and nonlocomotive PA significantly affected GDS-15-J scores (p < .05). Moreover, sarcopenic obesity in the low PA group had significantly higher GDS-15-J scores compared with sarcopenic obesity in the high PA group (p < .05). We concluded that sarcopenic obesity combined with low nonlocomotive PA may exacerbate depressive symptoms in older women.

Association between uric acid and depressive symptoms in older adults: The Korea National Health and Nutrition Examination Survey.

Uric acid is known for its antioxidant capacity; however, whether uric acid is independently associated with depression in the older population remains controversial. The current study aimed to investigate the association between uric acid and depressive symptoms in older adults according to sex, using a large national sample population. Data from the 2016, 2018, and 2020 Korean National Health and Nutrition Examination Surveys were analyzed, and 5609 participants older than 60years were included in this study. We defined a Patient Health Questionnaire-9 score ≥5 as indicating the presence of depressive symptoms. The prevalence of depressive symptoms was higher in women with lower uric acid levels than in those with higher uric acid levels. In women, the lower levels of uric acid were significantly associated with depressive symptoms in the multivariable logistic regression analysis (odds ratio, 1.36; 95% confidence interval, 1.10-1.68; p=0.005). However, no significant association between uric acid levels and depressive symptoms was observed in men. The findings of this study suggest that uric acid is associated with depressive symptoms in older women, but not in men. Relatively lower serum uric acid levels in women compared to men and sex differences in oxidative stress may explain the significant association of uric acid levels and depressive symptoms in older women. Further research is needed on sex differences in the relationship between serum uric acid levels and depressive symptoms.

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

BackgroundGiven the unique socioeconomic structures, and the rural/urban differentials in the prevalence of mental illnesses in the country, this study aimed to explore the associations of childhood, adulthood and late-life rural/urban place of residence with mental health outcomes, namely depressive symptoms 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.MethodsUtilizing data from the Longitudinal Aging Study in India (n = 28,027 older adults age 60 years and above), the study employed multivariable logistic and linear regression models to examine the association between urban/rural residential status, life-course residence, depressive symptoms and cognitive impairment among older adults.ResultsChildhood and adulthood place of residence was not associated with depressive symptoms in older men and women. Current rural place of residence was positively associated with depressive symptoms in older women [adjusted odds ratio (aOR): 1.37, confidence interval (CI): 1.05–1.80] but not men. Childhood [aOR: 1.88, CI: 1.16–3.04], adulthood [aOR: 2.00, CI: 1.26–3.16] and current rural residence [aOR: 1.93, CI: 1.27–2.91] was positively associated with cognitive impairment in men. Only current rural residence [aOR: 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 depressive symptoms except in case of lifetime rural residence Respondents with urban-urban-urban (childhood-adulthood-current) place of residence were less likely to have depressive symptoms [adjusted coefficient (aCoef.): -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 an urban advantage in cognitive function among older adults.ConclusionsThis study showed significant associations between life-course residence and depressive symptoms 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 in mental and cognitive health among older adults, the government should continue to support policies that can improve access to education and healthcare among people residing in rural areas and women, in particular. 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.

Depression status and its influencing factors among the elderly aged 60 years and above in three provinces of China

Objective: The survey learned about the current status of depression in community's elderly aged 60 years and older and explored its influencing factors. Methods: Respondents from the "Prevention and Intervention of Key Diseases in the Elderly" project used a multi-stage stratified cluster random sampling method to complete the depression screening of 14 335 ≥60-year-old elderly people in 16 counties and districts Liaoning, Henan, and Guangdong provinces in 2019. Through the questionnaire survey on the demographic characteristics of the subjects, whether they live with their families or interact with neighbors, daily exercise, cognitive function, and activity of daily living (ADL), the PHQ-9 depression screening scale was used to assess the depression status of the elderly in the last fortnight. Binary logistic regression was used to analyze the influencing factors of depression in the elderly. Results: The prevalence of depressive symptoms among the elderly in Liaoning province, Henan province, and Guangdong province was 15.45%, and those in the three provinces were 18.17%, 18.87% and 9.93%, respectively. There were differences between urban and rural areas in the detection rate of depressive symptoms among the elderly in different regions, among which Henan: 17.09% vs. 20.61%; Guangdong province: 7.99% vs. 11.03%, the differences were statistically significant (P<0.05). The results of multivariate logistic regression analysis showed that the detection rate of depressive symptoms in older women was higher than that in men (OR=1.76, 95%CI: 1.58-1.96), in those divorced or separated (OR=2.08, 95%CI: 1.01-4.30), with cognitive dysfunction (OR=1.78, 95%CI: 1.59-1.98) or impaired essential ability of daily living (BADL) (OR=1.74, 95%CI: 1.23-2.46). The impaired instrumental ability of daily living (IADL) (OR=2.23, 95%CI: 1.97-2.54) was a risk factor for depression in the elderly (P<0.05), and the impact of IADL impairment on depression in the elderly was higher than that of BADL impairment (2.23 vs. 1.74). Results also showed that factors as: 80 years old and above (OR=0.82, 95%CI: 0.68-0.99), living with family members (OR=0.67, 95%CI: 0.57-0.80), interacting with neighbors (OR=0.86, 95%CI: 0.76-0.98), exercise multiple times per week (OR=0.82, 95%CI: 0.69-0.96), and exercise almost every day (OR=0.63, 95%CI: 0.56-0.70) were protective for depression in the elderly (P<0.05). Conclusions: The detection rate of depressive symptoms in the elderly aged 60 and above in the community is relatively high in China. Gender, marital status, social interaction, physical exercise, cognitive function, and ADL are all influencing factors of depression in the elderly. The elderly health care sector should carry out psychological prevention and intervention of critical populations.

A Non-Randomized Combined Program of Walking and Low-Load Resistance Exercise Improves Cognitive Function and Cardiometabolic Risk Factors in Community-Dwelling Elderly Women.

Background: This study examines whether changes in cardiometabolic risk factors, functional fitness, and depressive symptoms following a six-month exercise intervention were associated with cognitive function in Korean women aged 65 years and older. Methods: A non-randomized study design was used to compare post-intervention changes in measured variables between control (n = 30) and exercise (n = 30) groups. The exercise intervention consisted of three days of low-load resistance exercise and two days of walking. Cognitive function and depressive symptoms were assessed with the Korean version of the Mini–Mental State Examination and the Korean version of the Geriatric Depression Scale, respectively. Functional fitness was measured using a senior fitness test battery. Results: The exercise group showed a significant improvement in cognitive function (p < 0.001) in conjunction with significant decreases in blood glucose (p = 0.052), triglycerides (p = 0.011), insulin (p = 0.002), tumor necrosis factor-α (p = 0.043), and depressive symptoms (p = 0.006) and an increase in interleukin-10 (p = 0.037), compared with the control group. Multivariate stepwise regression showed that changes in depressive symptoms (p < 0.001), insulin resistance (p < 0.001), and upper body muscle strength (p = 0.003) were positively associated with cognitive function. Conclusion: A six-month exercise intervention consisting of walking and low-load/high-repetition elastic band resistance exercise has the potential to improve cognitive function, as well as physical function and cardiometabolic risk factors, and to decrease depressive symptoms in older women.

Muscle Strength And The Onset Of Depressive Symptoms Among Older Japanese Women: The Otassha Study

Geriatric depression is a crucial public health concern. Cardiorespiratory fitness protects from the development of geriatric depression. However, the potential benefit of maintaining muscular fitness for preventing depressive symptoms remains unclear. PURPOSE: To prospectively investigate the relationship between knee extensor muscle strength and depressive symptoms in older women. METHODS: We conducted a 2-year cohort study of older Japanese women living independently in Itabashi, Tokyo, recruited through the Basic Resident Register. They underwent a baseline comprehensive geriatric examination, evaluating isometric knee extensor muscle strength (newtons/kilogram of body weight) and depressive symptoms (assessed by 15-item Geriatric Depression Scale [GDS]) via an interview-based questionnaire in 2017 or 2018. Their age, body mass index, smoking and alcohol consumption habits, comorbidities, working statuses, hobbies, volunteer activities, sleep durations, years of education, and dietary patterns were assessed as covariates. Participants free of stroke, dementia, or depression, were followed up. The onset of depressive symptoms was defined as a GDS score ≥ 5 points at follow-up. A logistic regression model was established by adjusting the baseline GDS score and the covariates. We performed a sensitivity analysis with the GDS cutoff of ≥6 points as an outcome variable. RESULTS: We recruited 1365 women in 2017 and 2018, and 1087 were eligible for this analysis. In 2019 and 2020, 642 women (mean age 71.4 years [standard deviation: 4.1]) provided valid data. Of them, 72 women (11.2%) developed depressive symptoms. After adjusting for the covariates, the odds ratio (95% confidence interval) of depressive symptoms was 0.69 (0.35, 1.33) for the middle tertile and 0.49 (0.23, 1.00) for the highest muscle strength tertiles using the lowest tertile as reference (p for trend = 0.006). The sensitivity analysis also supports a linear association between muscle strength and depression (p for trend = 0.02). CONCLUSIONS: This study suggests an inverse dose-response relationship between muscle strength and the onset of depressive symptoms in older Japanese women. It may be required to test whether muscle-strengthening training is beneficial in alleviating depressive symptoms in older women.

Ambient air pollution exposure and increasing depressive symptoms in older women: The mediating role of the prefrontal cortex and insula

Exposures to fine particulate matter (PM2.5) and nitrogen dioxide (NO2) have been associated with the emergence of depressive symptoms in older adulthood, although most studies used cross-sectional outcome measures. Elucidating the brain structures mediating the adverse effects can strengthen the causal role between air pollution and increasing depressive symptoms. We evaluated whether smaller volumes of brain structures implicated in late-life depression mediate associations between ambient air pollution exposure and changes in depressive symptoms. This prospective study included 764 community-dwelling older women (aged 81.6 ± 3.6 in 2008–2010) from the Women's Health Initiative Memory Study (WHIMS) Magnetic Resonance Imaging study (WHIMS-MRI; 2005–06) and WHIMS-Epidemiology of Cognitive Health Outcomes (WHIMS-ECHO; 2008–16). Three-year average annual mean concentrations (scaled by interquartile range [IQR]) of ambient PM2.5 (in μg/m3; IQR = 3.14 μg/m3) and NO2 (in ppb; IQR = 7.80 ppb) before WHIMS-MRI were estimated at participants' addresses via spatiotemporal models. Mediators included structural brain MRI-derived grey matter volumes of the prefrontal cortex and structures of the limbic-cortical-striatal-pallidal-thalamic circuit. Depressive symptoms were assessed annually by the 15-item Geriatric Depression Scale. Structural equation models were constructed to estimate associations between exposure, structural brain volumes, and depressive symptoms. Increased exposures (by each IQR) were associated with greater annual increases in depressive symptoms (βPM2.5 = 0.022; 95% Confidence Interval (CI) = 0.003, 0.042; βNO2 = 0.019; 95% CI = 0.001, 0.037). The smaller volume of prefrontal cortex associated with exposures partially mediated the associations of increased depressive symptoms with NO2 (8%) and PM2.5 (13%), and smaller insula volume associated with NO2 contributed modestly (13%) to the subsequent increase in depressive symptoms. We demonstrate the first evidence that the smaller volumes of the prefrontal cortex and insula may mediate the subsequent increases in depressive symptoms associated with late-life exposures to NO2 and PM2.5.

Ambient Air Pollution and Increasing Depressive Symptoms in Older Women: The Mediating Role of The Prefrontal Cortex

Exposure to air pollution may accelerate brain aging and increase risk of late-life depressive symptoms (DS). Brain structures underlying these associations are unknown. Longitudinal data from 829 community-dwelling women without dementia (baseline age 81.6 ± 3.6 years old) who participated in both the Women’s Health Initiative Memory Study Magnetic Resonance Imaging study (WHIMS-MRI; 2005-06) and the WHIMS-Epidemiology of Cognitive Health Outcomes (2008-16) were analyzed to examine whether volumetric measures of brain structures mediated associations between long-term exposure to ambient air pollutants and annual increases in DS (as measured by annually assessed 15-item Geriatric Depression Scale). Annual PM2.5 (fine particulate matter of aerodynamic diameter <2.5) and NO2 were estimated at the participants’ residence using regionalized universal kriging models and aggregated to the 3-year average prior to the WHIMS-MRI. Structural equation models were constructed to estimate associations between exposure, structural brain variables, and trajectories of DS (standardized on baseline mean and SD). Living in locations with higher NO2 (standardized β = 0.023; 95% Confidence Interval (CI) = 0.004, 0.042) or PM2.5 (standardized β = 0.021; 95% CI = 0.004, 0.038) was associated with larger annual increases in DS (~60% larger annual increase in DS). Higher NO2, but not PM2.5, was associated with smaller prefrontal cortical volumes (standardized β = -0.431; 99% CI = -0.518; -0.344). Prefrontal cortical volume explained 30.4% of the total association between annual DS increase and NO2. These findings underscore the importance of the prefrontal cortex in associations between NO2 exposure and increasing DS in later-life.

Air Quality Improvement Is Associated With Decreasing Depressive Symptoms in Older Women

Air pollution exposure is an environmental risk factor in brain aging and may also be associated with late-life depressive symptoms (DS). It is unknown if air quality (AQ) improvement is associated with reductions in DS in later life. Longitudinal data from 917 cognitively intact women with no prior history of depression (baseline age 66.4 ± 1.6 years old) participating in the Women’s Health Initiative Memory Study of Younger Women (WHIMSY; 2008-2016) were analyzed to examine whether AQ improvement over the 5-years prior to WHIMSY baseline was associated with trajectories of DS (measured by 15-item Geriatric Depression Scale). Annual PM2.5 (fine particulate matter of aerodynamic diameter <2.5) and NO2 were estimated at the participants’ residence using regionalized universal kriging models. Estimates were aggregated to the 3-year average at 5 years (remote) and immediately (recent) before WHIMSY baseline. Associations between AQ improvement (difference between remote to recent exposure) and trajectories of DS were estimated using linear mixed effect models, adjusting for sociodemographic, lifestyle, and clinical covariates. AQ improved prior to baseline (PM2.5: 1.62 ± 1.45 μg/m3 and NO2: 3.70 ± 2.81 ppb). Women residing in locations with greater improvement in NO2 (per IQR = 4.34 ppb) or PM2.5 (per IQR = 2.30 μg/m3) reported significant annual reductions in DS (βNO2=3.1%, p=.046; βPM25=1.6%, p=.046), similar to the effect of engaging in moderate to vigorous physical activity four times or more a week. These findings suggest that improving air quality may reduce depressive symptoms in older women.

940Physical frailty and the onset of depressive symptom in older Japanese women

Abstract Background The co-occurrence of physical frailty and depressive symptoms is highly prevalent in late life. However, their causal direction remains unclear. This study examined whether frailty and its components (slowness, weakness, exhaustion, low activity, and weight loss) predict the onset of depressive symptoms among older Japanese women. Methods In a two-year cohort study conducted in a metropolitan area of Tokyo, we collected baseline data in October 2017 and follow-up data in September 2019. Participants were community-dwelling older Japanese women, aged 65 to 80 years without any neurological diseases or depressive symptoms. Logistic regression analyses were applied to estimate odds ratios (OR) of the onset of depressive symptoms (15-item Geriatric Depression Scale [GDS] score ≥ 6) across the baseline frailty status or its components classified by the Japanese version of Cardiovascular Health Study criteria. Results Of the 477 women analysed (275 robust and 202 prefrail/frail). 6 (2.2%) robust and 16 (7.9%) prefrail or frail women developed depressive symptoms. After being adjusted for various covariates including baseline GDS score, the OR of the depressive symptom onset was 3.04 (95% confidence interval [CI]: 0.99, 10.47) in the prefrail or frail women. Among the five frailty components, slowness (OR: 7.55, 95%CI: 1.11, 48.98) and exhaustion (OR: 5.00, 95%CI: 1.60, 16.13) were independently associated with the onset of depressive symptoms. Conclusions Physical frailty status, particularly slowness and exhaustion, predict future depressive symptoms in older women. Key messages Early detection and intervention targeting physical frailty may help prevent depressive symptoms in later life.

Affective Symptoms and Health-Related Quality of Life Among Women with Stress Urinary Incontinence: Cross-Sectional Study.

PurposeTo evaluate the relationship between affective symptoms, clinical variables of uro-gynaecological history and health-related quality of life (QoL) among women with stress urinary incontinence (SUI) in comparison to healthy controls.Patients and MethodsIn a cross-sectional study, 80 women 30 to 80 years of age diagnosed with SUI and 97 controls without symptoms of SUI provided sociodemographic data and answered the King’s Health Questionnaire (KHQ) for assessing the QoL among individuals with urinary incontinence. Symptoms of anxiety and depression were assessed by Hospital Anxiety and Depression (HAD) scale with a threshold ≥7. A multiple regression was performed to reveal the cross-sectional predictors of affective symptoms and QoL among women with SUI.ResultsWomen with SUI had a significantly higher prevalence of symptoms of anxiety and depression than the controls (50% vs 11% and 29% vs 3.1%, respectively; both p<0.001) and worse health-related QoL on all domains of the KHQ. In multiple logistic regression models adjusted for sociodemographic and clinical variables of uro-gynaecological history, perceived symptoms of mild-to-severe depression were associated with a higher amount of leakage (OR=3.59; 1.04–12.4), older age (≥55 years old vs <55 years old) (OR=5.82; 1.47–23.1) and higher BMI (OR=1.13; 1.01–1.27). In addition, when controlled for all domains of the KHQ, perceived depressive symptoms were associated with the “emotions” domain of the KHQ (OR=1.06; 1.02–1.09). Perceived anxiety symptoms (independent of age) were related to shorter duration of SUI, low parity, absence of comorbidities and to higher scores on the “personal relationships” and “emotions” domains of the KHQ.ConclusionWomen with SUI have a significantly poorer QoL than their counterparts without SUI. It was determined that one-half of women with SUI had anxiety symptoms, while one-third of women with SUI had depressive symptoms. In addition, this study indicated that QoL was associated with anxiety symptoms in middle-aged women and with depressive symptoms in older women, especially those with a shorter duration of SUI.

Exposure to fine particulate matter and temporal dynamics of episodic memory and depressive symptoms in older women

Exposure to fine particulate matter and temporal dynamics of episodic memory and depressive symptoms in older women

Exposure to fine particulate matter and temporal dynamics of episodic memory and depressive symptoms in older women

BackgroundEmerging data suggests PM2.5 (particulate matter with aerodynamic diameter <2.5 μm) may be associated with both earlier declines in episodic memory (EM) and increased depressive symptoms in older adults. Although late-life depressive symptoms are associated with EM, no longitudinal studies have examined the inter-relationship among PM2.5, depressive symptoms and EM. MethodsOlder women (n = 2,202; aged 67–83 in 1999) enrolled in the Women’s Health Initiative Study of Cognitive Aging completed up to eight annual assessments of depressive symptoms (15-item Geriatric Depression Scale) and EM (California Verbal Learning Test). A nationwide spatiotemporal model (1999–2010) was used to estimate ambient PM2.5 exposure at residential locations. Univariate and bivariate structural equation models (SEMs) for latent-change scores were used to examine how 3-year average PM2.5 preceding each assessment affects the temporal dynamics and bidirectional relations of annual changes in depressive symptoms and EM. ResultsIn univariate SEMs, one inter-quartile (4.04 μg/m3) increment of 3-year PM2.5 was significantly (p < 0.05) associated with accelerated declines in verbal learning (List A trials 1–3: β = −1.48) and free-recall memory (short-delay: β = −1.43; long-delay: β = −1.11), but not with change in depressive symptoms (β = 0.12; p = 0.71). In bivariate SEMs, significant associations were observed between PM2.5 and accelerated declines in EM measures (β = −1.44 to −0.99; p < 0.05) and between EM performance and changes in depressive symptoms (β = −0.08 to −0.05; p < 0.05), with significant indirect PM2.5 effects on changes in depressive symptoms (β = 0.08–0.10; p < 0.05). These findings were robust with adjustment for multiple demographic, lifestyle, and clinical factors, and remained after excluding subjects with dementia or mild cognitive impairment. No associations were found between PM2.5 and change in depressive symptoms or depressive symptoms and subsequent EM decline. ConclusionsFindings suggest that PM2.5 neurotoxicity may damage brain areas implicated in EM, followed by manifestation of depressive symptoms. Our data did not support depressive symptoms as the neuropsychological mediator of accelerated brain aging associated with PM2.5 exposure.

Depressive symptoms and health-related quality of life in older women with gynecologic Cancers

ObjectivesThis study aims to assess factors associated with depressive symptoms in older women with gynecologic cancers and to examine the association of depression with health-related quality of life (HRQOL). Materials and methodsWomen aged 65 and older previously diagnosed with cervical, ovarian, or uterine cancer (n=1977) were identified from the Surveillance, Epidemiology, and End Results – Medicare Health Outcomes Survey database and compared to propensity-matched cancer-free controls (n=9885). Women with and without depressive symptoms were compared by cancer status. Logistic regression was used to identify factors associated with depressive symptoms, and linear regression was used to determine the association of depressive symptoms with HRQOL measures. ResultsThe prevalence of depressive symptoms was higher among older women with gynecologic cancer (31.9%, 32.2%, and 25.3% for cervical, ovarian, and uterine cancer, respectively) than cancer-free older women (24.9%) (p=0.05). Adjusting for demographic and clinical factors, older women with ovarian cancer were significantly more likely to have depressive symptoms than controls (Prevalence Odds Ratio = 1.74, 95% CI: 1.31, 2.32, p < 0.01). Among older women with gynecologic cancer, comorbid conditions and functional limitations were strongly associated with depressive symptoms. Women with depressive symptoms showed significant decrements in both physical and mental measures of HRQOL. ConclusionThis study gives insight into correlates of depressive symptoms that may be used to better identify women with gynecologic cancers who are at risk of depression. The relatively high prevalence of depressive symptoms and significant deficits in HRQOL underscore the need for effective screening and treatment of depression in older women with gynecologic cancers.

Exposure to fine particulate matter and the temporal dynamics of episodic memory and depressive symptoms in older women

TPS 732: Neurological effects in adults, Exhibition Hall, Ground floor, August 27, 2019, 3:00 PM - 4:30 PM Background/Aim: Older adults with higher PM2.5 (particulate matter with aerodynamic diameter <2.5 μm) exposures have earlier declines in episodic memory (EM), occurring in the preclinical stage of dementias. Emerging data also suggest PM2.5 exposure may increase depressive symptoms. Although late-life depressive symptoms are associated with EM, the inter-relationship between PM2.5, depressive symptoms, and EM is unexamined. Methods: Older women (n = 2,202; aged 67-83 in 1999) enrolled in the Women’s Health Initiative Study of Cognitive Aging completed up to eight annual assessments of depressive symptoms (15-item Geriatric Depression Scale) and EM (California Verbal Learning Test; scaled on T-score metric). A nationwide spatiotemporal model (1999-2010) estimated 3-year average ambient PM2.5 exposure at residential locations preceding each assessment. Univariate and bivariate latent-change score structural equation models (SEM) examined how exposures affect the temporal dynamics and bidirectional relation of annual changes in depressive symptoms and EM. Results: In univariate SEMs, one inter-quartile (4.04 μg/m3) greater PM2.5 exposure was associated with accelerated declines (p<.05) in verbal learning (List A trials 1-3: β=-1.477) and free-recall memory (short-delay: β=-1.426; long-delay: β=-1.106), but not with change in depressive symptoms (β=.119; p=.709). In bivariate SEM, elevated PM2.5 exposures also accelerated the declines in EM measures (β=-1.443 to -.985; p<.05), which subsequently increased depressive symptoms (β=-.078 to -.053; p<.05), resulting in significant indirect PM2.5 effects on changes in depressive symptoms (β=.077 to .095; p<.05). In contrast, there was no appreciable association between PM2.5 and change in depressive symptoms and no association between depressive symptoms with subsequent EM decline. Findings remained after adjusting for multiple demographic, lifestyle, and clinical factors. Conclusions: Findings suggest that PM2.5 neurotoxicity may damage brain areas implicated in EM, followed by manifestation of depressive symptoms. Our data did not support depressive symptoms as the neuropsychological mediator of accelerated brain aging associated with PM2.5 exposure.

Gender Differences in the Relationship between Living alone and Depressive Symptoms in Elderly Korean Adults

This study examined gender differences in the relationship between living alone and depressive symptoms in elderly Korean adults and the variables that influence this relationship. We conducted a secondary analysis using fourth-wave data from adults 65 yr of age or older who participated in the Korean Longitudinal Study of Aging. Depressive symptoms were measured using the 10-item short-form of the Center for Epidemiological Studies Depression Scale. Multiple logistic regression analyses were used. After controlling for the factors of formal and informal social activities, financial support from children, employment, activities of daily living, instrumental activities of daily living, self-rated health, frequency of meals, and gender, living alone (AOR=1.45, 95% CI =1.09-1.93, P=0.010) was an independent risk factor that contributed to depressive symptoms in late life. Living alone was more likely to elevate depressive symptoms in older women but not in older men. Gender differences in the depressive effect of living alone in late life may differ across diverse cultures.

Particulate Air Pollutants and Trajectories of Depressive Symptoms in Older Women

Although several environmental factors contribute to the etiology of late-life depressive symptoms, the role of ambient air pollution has been understudied. Experimental data support the neurotoxicity of airborne particulate matter with aerodynamic diameter of ≤2.5 μm (PM2.5), but it remains unclear whether long-term exposure is associated with late-life depressive symptoms. Our secondary aim was to explore whether the observed associations between exposure and depressive symptoms are explained by dementia risk. Prospective community-dwelling cohort study from the Women's Health Initiative Study of Cognitive Aging (1999-2010). Our analyses included 1,989 older women (baseline age 73.3 ± 3.75) with no prior depression or cognitive impairment. Participants completed annual assessments of depressive symptoms (15-item Geriatric Depression Scale). Average ambient PM2.5 exposure at the residential location was estimated by spatiotemporal modeling for the 3-years preceding each neuropsychological assessment. Participants underwent separate annual examinations for incident dementia defined by DSM-IV. Latent-class mixture models examined the association between PM2.5 and identified trajectories of symptoms. Six trajectories of depressive symptoms were identified. Across all women, PM2.5 exposure was positively associated with depressive symptoms. The effect was especially strong in two clusters with sustained depressive symptoms (n = 625 sustained-mild [31%]; n = 125 sustained-moderate; [6%]). Among those with sustained-moderate symptoms, the estimated adverse effect of PM2.5 exposure was greater than that of hypertension. Among women without dementia, associations were modestly attenuated. Long-term exposure to ambient fine particles was associated with increased depressive symptoms among older women without prior depression or cognitive impairment.

Particulate Air Pollutants and Trajectories of Depressive Symptoms in Older Women

Particulate Air Pollutants and Trajectories of Depressive Symptoms in Older Women