Symptoms In Later Life Research Articles

Modeling Exposure to Multiple Childhood Social Risk Factors and Physical Capability and Common Affective Symptoms in Later Life.

This study presents three approaches, that is, cumulative risk, factor analysis, and latent class analysis, to summarize exposure to multiple childhood social risk factors and to compare their utility when examining associations with physical capability and common affective symptoms in adults aged 60 to 64 years. Data came from the U.K. Medical Research Council (MRC) National Survey of Health and Development, with prospective childhood social risk factor data collected in 1950 to 1957 and retrospectively in 1989. Physical capability and common affective symptom data were collected in 2006 to 2011. The cumulative risk approach and factor analysis provided evidence that children who were exposed to multiple social risk factors had lower levels of physical capability and more symptoms of common affective symptoms in later life. The cumulative social risk approach and the use of factor analysis to identify contexts of social risk, may offer viable methods for linking multiple childhood social risk exposure to aging outcomes.

INFLUENCE OF RUN AND CUT MANOEUVRES ON PATELLOFEMORAL KINETICS AND KINEMATICS

Patellofemoral pain syndrome is the most common knee pathology. Those with patellofemoral pain are much more likely to be physically active than age-matched controls. The prevalence of patellofemoral pain in...

Aging perceptions and self-efficacy mediate the association between personality traits and depressive symptoms in older adults.

Personality traits have been shown to be predictors of depressive symptoms in late life. Thus, we examined whether other more modifiable sources of individual differences such as self-efficacy and self-perceptions of aging would mediate the association between personality traits and depressive symptoms in older adults. Data were obtained from 3,507 older adult participants who took part in the 2012 Health and Retirement Study. The "Big Five" personality traits, self-efficacy, aging perceptions, and depressive symptoms were assessed. Mediation analyses tested the hypothesis that self-efficacy and aging perceptions would mediate the relationship between personality traits and depressive symptoms. All five personality traits were significant predictors of depressive symptoms. Neuroticism was positively associated with depressive symptoms and had the greatest effect compared with the other personality traits. There was a significant indirect effect of neuroticism, extraversion, and conscientiousness on depressive symptoms (including both mediators). The mediating effect of aging perceptions on the relationship between neuroticism and depressive symptoms was the strongest compared with self-efficacy, accounting for approximately 80% of the total indirect effect. Our results provide support for interventions aimed at improving self-perceptions related to efficacy and aging in order to reduce depressive symptoms in older adults. Copyright © 2016 John Wiley & Sons, Ltd.

Big Five personality traits and medically unexplained symptoms in later life

BackgroundPersonality dysfunction has been postulated as the most clinically salient problem of persons suffering from medically unexplained symptoms (MUS) but empirical studies are scarce. This study aims to compare the personality profile of older patients suffering from MUS with two comparison groups and a control group. MethodsNinety-six older patients with MUS were compared with 153 frequent attenders in primary care suffering from medically explained symptoms (MES), 255 patients with a past-month depressive disorder (DSM-IV-TR), and a control group of 125 older persons. The Big Five personality domains (NEO-Five-Factor Inventory) were compared between groups by multiple ANCOVAs adjusted for age, sex, education, partner status and cognitive functioning. Linear regression analyses were applied to examine the association between health anxiety (Whitley Index) and somatization (Brief Symptom Inventory). ResultsThe four groups differed with respect to neuroticism (P<0.001), extraversion (P<0.001), and agreeableness (P=0.045). Post hoc analyses, showed that MUS patients compared to controls scored higher on neuroticism and agreeableness, and compared to depressed patients lower on neuroticism and higher on extraversion as well agreeableness. Interestingly, MUS and MES patients had a similar personality profile. Health anxiety and somatization were associated with a higher level of neuroticism and a lower level of extraversion and conscientiousness, irrespective whether the physical symptom was explained or not. ConclusionsOlder patients with MUS have a specific personality profile, comparable to MES patients. Health anxiety and somatization may be better indicators of psychopathology than whether a physical symptom is medically explained or not.

Late-life exacerbation of PTSD symptoms in US veterans: results from the National Health and Resilience in Veterans Study.

More than 60% of US military veterans are 55 years or older. Although several case studies have suggested that older age is associated with a higher likelihood of reactivated or delayed-onset posttraumatic stress disorder (PTSD) symptoms in veterans, population-based data on the prevalence and determinants of this phenomenon are lacking. Using data from the National Health and Resilience in Veterans Study (NHRVS: Wave 1 = October 2011-December 2011; Wave 2 = September 2013), a nationally representative, cohort study of US veterans, we evaluated the prevalence and determinants of exacerbated PTSD symptoms in 1,441 veterans 55 years or older using a DSM-IV-based measure in 2011 and a DSM-5-based measure in 2013. Veterans whose worst trauma occurred at least 5 years prior to Wave 2 of the NHRVS (mean = 28.6 years) and who reported a clinically significant increase (ie, ≥ 0.5 standard deviation [SD]; mean = 1.27, SD = 0.78) in PTSD symptoms from Wave 1 (lifetime) to Wave 2 (past-month) were identified as having exacerbated PTSD symptoms. Results revealed that 9.9% of older US veterans experienced exacerbated PTSD symptoms an average of nearly 3 decades after their worst trauma. A multivariable logistic regression model indicated that greater self-reported cognitive difficulties at Wave 1 independently predicted exacerbated PTSD symptoms at Wave 2. Post hoc analysis revealed that this association was driven by greater severity of executive dysfunction (adjusted odds ratio range, 1.27-3.22). Approximately 1 in 10 older US veterans experiences a clinically significant exacerbation of PTSD symptoms in late life. Executive dysfunction may contribute to risk for exacerbated PTSD symptoms. These results suggest that exacerbated PTSD symptoms are prevalent in US veterans and highlight potential targets for identifying veterans at risk for this phenomenon.

Depressive symptoms in older people in Greece and Cyprus

IntroductionDepression is fast becoming a major public health problem with a very high prevalence rate in the 65 and over age group.ObjectivesThe aim of the present study was to estimate the prevalence of depression in Greeks and Cypriots older adults.MethodsA cross-sectional study was conducted among the 445 participants, 239 members of three day care centers for older people, in the municipality of Patras, West-Greece and 206 older adults (110 in the community, 65 in outpatient clinics, 31 in nursing homes) in Cyprus, aged &gt; 60 years. A questionnaire was administered including socio-demographic characteristics. Depression was assessed using the Greek version of Geriatric Depression Scale (GDS-15).ResultsThe overall prevalence of depression according to GDS-15 was 33% (28% moderate, 5% severe type). Depressive symptoms were more frequent in women (41,6% vs. 28,3%, P &lt; 0,001), in not married (43,0% vs. 29,3%, P &lt; 0,001), in elderly with chronic diseases (36,8% vs. 25,0%, P = 0,007), in older people dwellers of urban areas compared to rural (36,3% vs. 26,4%, P = 0,028) and in ages between 70 to 80 years old (38,7% vs. 31,6%, P = 0,038). Moreover, higher prevalence of depression was measured in Greeks compared to Cypriots (44,3% vs. 20,6%, P &lt; 0,001). In a univariate analysis, the following variables were significantly associated with depression: female gender (P &lt; 0,001), co-morbidity (P = 0,004), higher age group (P = 0,018), place of living (P = 0,022) and Greek nationality (P &lt; 0,001).ConclusionsHigh prevalence and several risk factors are strongly associated with depression, whereas Greeks are in higher danger of developing depressive symptoms in late life, than Cypriots.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Poster Number: EI 67 - Alcohol and Marijuana Use to Self-Medicate Bipolar Disorder Symptoms in Later Life: A Case Study Approach

Introduction: The use of substances to self-medicate, that is to alleviate or treat various negative states, has been acknowledged as a common coping mechanism for various psychiatric conditions. Self-medication with substances is associated with various negative outcomes, including the development of substance use disorders. Extant literature shows that 60% of community samples with bipolar disorder (BD) have reported abusing one or more substances at some point in their lives. Aside from sharing a common cause of psychopathology, self-medication may be one contributing factor to the high co-occurrence of BD and substance use. Understanding people's interpretations and reasons for use could help inform interventions and assess readiness to change. Given the high prevalence of co-occurring BD and substance use and the complex unique trajectories of each person, we used a case study approach to highlight individual experiences during these types of co-occurrence in later life. The lens of a life course framework with a focus on personal theories on self medication allowed us to uncover how and when the use of different substances fit into the participant's lives over time and across mood states.

Anxiety trajectories in the second half of life: Genetic and environmental contributions over age.

Clinically significant anxiety symptoms are prevalent among the elderly, yet knowledge about the longitudinal course of anxiety symptoms in later life remains scarce. The goals of this study were to (a) characterize age trajectories of state anxiety symptoms in the second half of life, and (b) estimate genetic and environmental contributions to individual differences in the age trajectory of state anxiety. This study was based on data from 1,482 participants in the Swedish Adoption/Twin Study of Aging who were aged 50 and older at their first occasion (512 complete twin pairs, 458 singletons) and had up to 6 measurement occasions spanning 11 years. Consistent with life span developmental theories of age-related emotional change, anxiety symptom levels declined during the transition from midlife to the mid-60s, followed by a mild increase that gradually plateaued in the 80s. There were substantial individual differences in the age trajectory of anxiety. After accounting for effects of sex, cohort, mode of testing, and proximity to death, this longitudinal variation was partitioned into biometric sources. Nonshared environmental variance was highest in the late 60s and declined thereafter, whereas genetic variance increased at an accelerated pace from approximately age 60 onward. There was no evidence for effects of rearing or other shared environment on anxiety symptoms in later life. These findings highlight how the etiology of anxiety symptoms changes from midlife to old age.

Gait Speed and the Natural Course of Depressive Symptoms in Late Life; An Independent Association With Chronicity?

IntroductionPsychomotor slowing is a core feature of depression in late life, but its prognostic value with respect to course and chronicity is unclear. We investigated whether gait speed can predict chronicity of depressive symptoms. Furthermore, we tested whether (1) cognitive slowing and (risk factors for) vascular diseases, (2) a marker of chronic inflammation, and (3) specific somatic conditions could explain this association. MethodsIn the population-based Longitudinal Aging Study Amsterdam, 271 aged participants with clinically relevant depressive symptoms (Center for Epidemiologic Studies Depression Scale ≥16) were followed during a period of 6 years. With 14 successive Center for Epidemiologic Studies Depression Scale observations, 3 clinical course types of depressive symptoms were defined. ResultsRemission, fluctuating course, and chronic course of depressive symptoms were seen in 21%, 48%, and 30%, respectively. Slowed gait speed at baseline was associated with a chronic course of depressive symptoms using remission as the reference (odds ratio 0.56, 95% confidence interval 0.41–0.77). Processing speed and vascular risk factors explained this association only for 2%. Specific somatic comorbidity (number of chronic diseases, chronic obstructive pulmonary disease, osteoarthritis) or inflammation influenced the odds ratio. LimitationSome variables were not measured with as much detail as would be possible in a clinical study setting. ConclusionsSlowed gait speed is a robust predictor of chronicity of depressive symptoms in late life, independent of somatic comorbidity and partly in concert with a slowed processing speed. Results suggest that slowed gait speed is an integral part of the depressive syndrome, probably a subtype associated with chronic course, independent of somatic comorbidity.

Is cognitive lifestyle associated with depressive thoughts and self-reported depressive symptoms in later life?

Key components of cognitive lifestyle are educational attainment, occupational complexity and engagement in cognitively stimulating leisure activities. Each of these factors is associated with experiencing fewer depressive symptoms in later life, but no study to date has examined the relationship between overall cognitive lifestyle and depressive symptoms. This task is made more complex because relatively few older participants in cross-sectional studies will be currently experiencing depression. However, many more will show evidence of a depressive thinking style that predisposes them towards depression. This study aimed to investigate the extent to which cognitive lifestyle and its individual components are associated with depressive thoughts and symptoms. Two hundred and six community-dwelling participants aged 65+ completed the depressive cognitions scale, the geriatric depression scale and the lifetime of experiences questionnaire, which assesses cognitive lifestyle. Correlational analysis indicated that each of the individual lifestyle factors—education, occupational complexity and activities in young adulthood, mid-life and later life—and the combined cognitive lifestyle score was positively associated with each other and negatively with depressive symptoms, while all except education were negatively associated with depressive thoughts. Depressive thoughts and symptoms were strongly correlated. Cognitive lifestyle score explained 4.6 % of the variance in depressive thoughts and 10.2 % of the variance in depressive symptoms. The association of greater participation in cognitive activities, especially in later life, with fewer depressive symptoms and thoughts suggests that preventive interventions aimed at increasing participation in cognitively stimulating leisure activity could be beneficial in decreasing the risk of experiencing depressive thoughts and symptoms in later life.

Mutual Influence and Older Married Adults' Anxiety Symptoms: Results From The Irish Longitudinal Study on Ageing.

This study analyzed dyadic data to examine the direct and indirect associations between husbands' and wives' reports of marital strain and generalized anxiety symptoms in later life. Data were from 1,114 married couples with at least one spouse aged 60 or older, drawn from the initial 2009-2011 wave of The Irish Longitudinal Study on Ageing. Structural equation modeling was used to analyze dyadic data according to individual influence and mutual influence frameworks. Mutual influence exhibited better model fit than individual influence. Findings revealed that perceptions of marital strain were related with husbands' and wives' own generalized anxiety symptoms. Further, husbands' anxiety symptoms were significantly related with wives' anxiety symptoms, and vice versa, illustrating bidirectional feedback. Finally, husbands' and wives' perceptions of marital strain were significantly indirectly related with their partners' anxiety symptoms, with these associations being mediated by spouses' own anxiety symptoms. Anxiety is a relational experience and may even be provoked by one's marriage. Mutual influence modeling indicated that husbands' and wives' perceptions of the marriage and reports of anxiety were influential for both spouses' anxiety symptoms. These results suggest that emotional contagion may be the pathway for partner effects of marital strain on spouses' well-being. Findings also suggest that efforts to reduce anxiety symptoms may be most effective when taking marital context and quality into account.

The Association Between Midlife Physical Activity and Depressive Symptoms in Late Life: Age Gene/Environment Susceptibility—Reykjavik Study

There is little evidence on the long-term association between physical activity (PA) and depressive symptoms in old age. We examined the association of midlife PA and depressive symptoms in late life. A large community-based population residing in Reykjavik, Iceland, participated in a longitudinal study with an average of 25 years of follow up. Midlife PA was categorized as active and inactive groups (n = 4,140, Active = 1,292, Inactive = 2,848, mean age 52±7 years). The main outcome had six or higher depressive symptoms assessed by the 15-item Geriatric Depression scale. Participants who had a history of depression (n = 226), and were diagnosed with dementia (n = 393), and had incomplete cognitive data (n = 595) and incomplete analytical data (n = 422) were excluded. Level of weekly PA was ascertained by a questionnaire at midlife. Depressive symptoms were assessed on average 25 (±4) years later. After controlling for demographic and health-related risk factors, those who were active at midlife were less likely to have high level of depressive symptomatology (6 or higher Geriatric Depression scale scores, odds ratio = 0.58, 95% confidence interval: 0.41-0.83, p < .005) compared with those who were inactive in midlife. After full adjustment of three domains of late-life cognitive function the results remained significant (odds ratio = 0.61, 95% confidence interval: 0.43-0.86, p = .005). Our study shows that midlife PA is associated with lower depressive symptoms 25 years later. Participating in regular PA in midlife may improve mental health in late life.

Television watching and depression symptoms in later life: An Interdisciplinary approach to the leisure cultures and lives of older Korean adults

Television watching and depression symptoms in later life: An Interdisciplinary approach to the leisure cultures and lives of older Korean adults

Clinical Significance of Individual GAD Symptoms in Later Life.

There are age-related differences in the manifestation of generalized anxiety disorder (GAD) symptoms and their associated impact on psychosocial and functional status. However, it remains unclear whether specific symptoms (or symptom patterns) are of comparable clinical significance across different functional domains. A sample of 865 self-reported worriers (aged 60 years and older) who endorsed GAD screening questions in the Alcohol Use Disorder and Associated Disabilities Interview Schedule, Diagnostic and Statistical Manual of Mental Disorders, fourth edition, were derived from Wave 1 of the National Epidemiological Survey of Alcohol and Related Conditions. Being easily fatigued was significantly associated with occupational disability and a functional disability variable (restricting usual activity in any way). Irritability was significantly associated with social friction (arguments with friends, family, or colleagues) and a functional disability variable (found was unable to do something wanted to do), and poor self-perceived health was also associated with the same functional disability variable. Excessive worry, despite being among the least reported symptoms, was significantly associated with distress. These findings suggest that individual GAD symptoms are differentially associated with aspects of clinical significance relevant to daily life, such as social, occupational, and functional ability. The differential impact of individual symptoms on functional status may be diluted when using symptom sum scores. A nuanced approach to assessing the clinical significance of individual GAD symptoms in older adults may be fruitful for efforts aimed at early detection and treatment.

A Life-span Perspective on Combat Exposure and PTSD Symptoms in Later Life: Findings From the VA Normative Aging Study.

We tested a life-span model of combat exposure on posttraumatic stress disorder (PTSD) symptoms in later life, examining the direct and indirect effects of prewar, warzone, and postwar factors. The sample included 947 male World War II and Korean War veterans from the VA Normative Aging Study (Mage = 65, SD = 7). They completed mail surveys on childhood family environment, military service and postwar experience, stressful life events, and PTSD symptoms (response rates > 80%). We constructed an initial path model testing cumulative advantage and disadvantage pathways. Although all hypothesized relationships were significant, the model was not a good fit to the data. Subsequent models showed that all three life-span periods had both direct and indirect effects on PTSD symptoms and that there were interesting cross-links between the two sets of pathways. The life-span perspective provides a useful heuristic to model various developmental effects on later-life outcomes. A supportive childhood family environment can have lifelong protective effects, whereas a conflictual one can set up lifelong patterns of pessimistic appraisals.

Depression as a risk factor for cognitive impairment in later life: the Health In Men cohort study.

Depression is an established risk factor for dementia in later life, but it is unclear if this relationship is causal. This study aimed to determine if clinically significant depressive symptoms are likely to be causally related to cognitive impairment in later life. Observational cohort study of 4568 men aged 70-89 years living in Perth, Western Australia, who were free of cognitive impairment at the beginning of follow-up. Current clinically significant depressive symptoms were defined by a score of 7 or more on the Geriatric Depression Scale 15 items. Past depression was ascertained via electronic medical records, by self-report or use of antidepressants. A score of 27 or less on the Telephone Interview for Cognitive Status modified or a recorded diagnosis of dementia in electronic medical records established the presence of cognitive impairment. During the 5-year follow-up, 534 men developed cognitive impairment, 811 died and 1455 were lost. The presence of clinically significant depressive symptoms at study entry was associated with increased risk rate (RR) of cognitive impairment (RR = 2.59, 95% confidence interval: 95%CI = 1.57-4.27), death (RR = 5.07, 95%CI = 3.32-7.75) and loss to follow-up (RR = 2.03, 95%CI = 1.32-3.13). These associations remained statistically significant after adjustment for age, country of birth, education, smoking history, and prevalence hypertension, diabetes, coronary heart disease and stroke. History of past clinically significant depressive symptoms was not associated with incident cognitive impairment (RR = 1.09, 95%CI = 0.78-1.52). The lack of association between past depression and cognitive impairment suggests that the link between depression and cognitive impairment is not causal and that the presence of clinically significant depressive symptoms in later life may herald the onset of cognitive impairment in at least some people.

Big Five Personality and Medically Unexplained Symptoms in Later Life

Personality dysfunction has been hypothesized to be the most clinically salient problem of elderly patients with medically unexplained symptoms (MUS). Empirical data on personality traits in patients suffering from MUS are limited, especially in older adults. In later life MUS frequently co-occurs with medically explained symptoms (MES) as well as with a depressive disorder. The aim of this study was to compare the Big Five personality traits in older patients suffering from MUS, MES, depressed older persons and an elderly primary care control group. Based on studies in younger aged adults, we hypothesize that there are differences in personality traits in patients with MUS and MES. Furthermore we hypothesized that there is a relation between the Big Five personality traits and health anxiety and/or somatization in patients with MUS and MES.

Meaning in Life and depressive symptoms: a person-oriented approach in residential and community-dwelling older adults

Objectives: In current society, an increasing population of older adults and a high prevalence of depressive symptoms in late life is noticeable. A possible protective resource is ‘Meaning in Life’. The objective of this study is to identify from a person-oriented view (a) Meaning in Life-profiles, based on Presence of Meaning and Search for Meaning dimensions, and (b) their associations with depressive symptoms.Methods: A sample of 205 residential older adults (M = 83.20 years, SD = 7.26) and 280 community-dwelling older adults (M = 75.98 years, SD = 4.76) completed questionnaires of Meaning in Life and depressive symptoms. First, cluster analyses examined potential Meaning in Life-profiles. Second, analyses of variance tested associations between these distinct profiles and depressive symptoms.Results: In both samples, three distinguishable profiles emerged, a ‘Low Presence Low Search’, a ‘High Presence High Search’ and a ‘High Presence Low Search’. Furthermore, older adults with a High Presence Low Search profile witnessed less depressive symptoms, compared to those with a Low Presence Low Search profile. Residential older adults within the High Presence High Search cluster scored in-between the two other clusters for depressive symptoms. However, community-dwelling older adults within this cluster reported similar levels of depressive symptoms as the High Presence Low Search group.Conclusion: Similar Meaning in Life-profiles were detected in residential as well as community-dwelling older adults. In both samples, older adults with a High Presence Low Search profile reported less depressive feelings, pointing to the importance of spontaneously experiencing Meaning in Life in this life stage.

Depressive symptoms in late life in urban and semi-urban areas of South-West Greece: An undetected disorder?

Objective:The objective of this study was to estimate the prevalence and probable under-diagnosis of depressive symptoms in elderly of an urban and semi-urban area in Greece.Materials and Methods:A cross-sectional study was conducted among the members of 4 days care centers for older people (KAPI), three in the municipality of Patras, West-Greece, and in one in Tripolis, Peloponnese, Greece. A total of 378 individuals took part in the study, aged >60 years. A questionnaire was developed to collect basic demographic data, including three questions from the European Health Interview Survey, regarding self-reported or by a physician-diagnosed depression. Moreover, to all participants the Greek validated version of the Geriatric Depression Scale-15 (GDS-15) was applied, to screen for depressive symptoms.Results:According to GDS-15, 48.1% of the studied population screened positive for depressive symptoms (38.6% moderate, 9.5% severe), whereas having ever been affected with chronic depression reported 19.0% by themselves. In 162 members of KAPI of Patras and in 106 of Tripolis, who never reported have been affected by depression and depressive symptoms were observed in 27.7% and 44.7%, respectively. In 28 individuals from Patras, who reported not to know if they have depression and in 10 from Tripolis, depressive symptoms were observed in 60.7% and 90%, respectively, applying the GDS-15.Conclusion:Except the high prevalence, the present study reveals a remarkable under-detection of depressive symptoms in older adults. Various interventions in primary care are necessary so as to increase detection rates of depression among the elderly.

Cholesterol and depressive symptoms in older men across time.

This study aimed to examine reciprocal relations between cholesterol and depression. We assessed cholesterol and depressive symptoms twice over a 3-year interval, using 842 men from the Veterans Affairs Normative Aging Study (M = 64, standard deviation = 8). Because depressive symptoms were skewed, we used zero-inflated Poisson analyses. Cross-lagged models showed that cholesterol levels at T1 predicted the existence of depressive symptoms at T2, covarying T1 depressive symptoms, age, smoking status, body mass index, and medications. Depressive symptoms at T1 did not predict cholesterol at T2. Low cholesterol levels may be risk factors for development of depressive symptoms in late life.