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Sample records for late life depression

  1. Pharmacologic treatment of depression in late life

    PubMed Central

    Flint, A J

    1997-01-01

    A number of age-related factors, including changes in pharmacokinetics and pharmacodynamics, medical comorbidity and an increased risk of drug-drug interaction, can complicate the pharmacologic management of depression in late life. Nevertheless, over 80% of elderly depressed patients will eventually respond to vigorous treatment and, when treated over 2 years, up to 75% of those will not have a relapse or recurrence of depression. This article reviews a number of issues relating to the pharmacotherapy of depression in elderly people. In particular, it discusses the similarities and differences between various antidepressant medications, issues pertaining to dosing and length of treatment, and management of the patient who does not respond to first-line treatment. The author emphasizes that, because of the high risk of relapse and recurrence, a long-term collaboration between the patient and the physician is required to successfully manage depression in late life. PMID:9347777

  2. Microvascular pathology in late-life depression.

    PubMed

    Santos, Micaela; Xekardaki, Aikaterini; Kövari, Enikö; Gold, Gabriel; Bouras, Constantin; Giannakopoulos, Panteleimon

    2012-11-15

    Since the era of Gaupp who introduced the concept of atheroscletic depressive disorder, the concept of late-life depression has been correlated with cerebrovascular comorbidities, microvascular lesions, frontal cortical and subcortical gray and white matter hyperintensities. The predominant neuropsychological deficits concern the domains of planning, organization and abstraction, with executive dysfunction being the predominant finding. MRI studies reveal a higher prevalence of white matter lesions in elderly patients with depression. Molecular mechanisms underlying the disease still remain unclear. Hyperhomocysteinemia has been associated with depression through its toxicity to neurons and blood vessels. Endothelial dysfunction is another possible mechanism referring to the loss of vasodilatation capacity. Inflammatory phenomena, such as increased peripheral leucocytes, elevated CRP and cytokine levels, could play a role in endothelial dysfunction. In this review we will briefly combine findings from neurobiological, epidemiological, structural and post-mortem data. A more complex model in late-life depression combining different modalities could be an elucidating approach to the disease's etiopathogeny in the future. PMID:22687957

  3. Cognition in Late Life Depression: Treatment Considerations

    PubMed Central

    Koenig, Aaron M.

    2014-01-01

    Opinion statement Late life depression (LLD) frequently presents with cognitive impairment, and growing evidence suggests that these disease processes are “linked” in multiple ways. For some individuals, LLD may be a recurrence of a long-standing depressive illness, while for others it may be the leading symptom of a developing neuropathological disorder. Overall, studies investigating the relationship between treatment of LLD and improvement in cognitive functioning have yielded mixed results. Research suggests that a subset of individuals with LLD and cognitive dysfunction will experience an improvement in cognitive function after antidepressant treatment, though a significant proportion will continue to exhibit cognitive impairment following resolution of their depressive symptoms. From a treatment standpoint, it is critical to ensure that an individual's depressive symptoms have been treated to remission, measured by a standardized rating scale such as the Geriatric Depression Scale (GDS). SSRI or SNRI monotherapy is often effective, and may be enhanced by employing an evidence-based psychotherapy such as Problem Solving Therapy (PST) or Interpersonal Therapy (IPT), modified to accommodate cognitive impairments that may be present. With respect to specific treatment of cognitive dysfunction, cognitive augmentation or training strategies can be helpful for some patients, and may be explored in combination with treatment of the primary depressive episode. While the introduction of a cholinesterase inhibitor (e.g. donepezil) may be considered, the potential benefit (modest improvement in cognition and functioning) must be weighed against an increased risk for worsening or recurrent depression. Finally, lifestyle factors—such as aerobic exercise, follow-up with a primary care physician for management of co-morbid medical illnesses, and regular participation in stimulating activities (such as through a senior center)—are important and should be included as

  4. What are the causes of late-life depression?

    PubMed

    Aziz, Rehan; Steffens, David C

    2013-12-01

    Although depression in old age is less common than depression in younger populations, it still affects more than 1 million community-living older adults. Depression in late life has been associated with reduced quality of life and increased mortality from both suicide and illness. Its causes are multifactorial but are prominently related to both biologic and social factors. Psychological factors, although less studied in elders, are also important in understanding its cause. In this article, multiple facets of late-life depression are reviewed, including its clinical presentation, epidemiology, and biopsychosocial causes. PMID:24229653

  5. Treatment-resistant Late-life Depression: Challenges and Perspectives

    PubMed Central

    Knöchel, Christian; Alves, Gilberto; Friedrichs, Benedikt; Schneider, Barbara; Schmidt-Rechau, Anna; Wenzlera, Sofia; Schneider, Angelina; Prvulovic, David; Carvalho, André F.; Oertel-Knöchel, Viola

    2015-01-01

    The current Review article provides a narrative review about the neurobiological underpinnings and treatment of treatment resistant late-life depression (TRLLD). The manuscript focuses on therapeutic targets of late-life depression, which include pharmacological, psychological, biophysical and exercise treatment approaches. Therefore, we summarize available evidences on that kind of therapies for patients suffering from late-life depression. The search for evidences of therapeutic options of late-life depression were done using searching websites as “pubmed”, and using the searching terms “depression”, “late-life depression”, “treatment”, “biophysical therapy”, “exercise therapy”, “pharmacological therapy” and “psychological therapy”. To the end, we summarize and discuss current data, providing some directions for further research. Treatment recommendations for elderly depressive patients favour a multimodal approach, containing psychological, pharmacological and secondary biophysical therapeutic options. Particularly, a combination of psychotherapy and antidepressant medication reflects the best therapeutic option. However, mostly accepted and used is the pharmacological treatment although evidence suggests that the drug therapy is not as effective as it is in younger depressive patients. Further studies employing larger samples and longer follow-up periods are necessary and may focus on comparability of study designs and involve novel approaches to establish the validity and reliability of multimodal treatment programs. PMID:26467408

  6. Depression in Late-Life: a Focus on Prevention

    PubMed Central

    Okereke, Olivia I.; Lyness, Jeffrey M.; Lotrich, Francis E.; Reynolds, Charles F.

    2013-01-01

    Depression is a leading cause of disease burden, disability and distress for millions of older adults. Thus, prevention of late-life depression is a priority research area. This article addresses the science of late-life depression prevention with the following: 1) an introduction to the Institute of Medicine framework of universal, selective and indicated prevention as it pertains to late-life depression, with particular attention to successes of indicated and selective prevention in primary care; 2) a discussion of how biomarkers can be integrated into prevention research, using interferon-alpha-induced depression as a model; 3) an outline for expansion of prevention to non-specialist care delivery systems in Low and Middle Income Countries – thus, extending the reach of current successful approaches; 4) a description of a novel approach to simultaneous testing of universal, selective and indicated prevention in late-life depression, with emphasis on study design features required to achieve practical, scalable tests of health impact. PMID:24729758

  7. The Phenomenology of Late Life Depression.

    ERIC Educational Resources Information Center

    Blazer, Dan; And Others

    The paper reports results of one project from the National Institute of Mental Health Epidemiologic Catchment Area (ECA) Program: the Duke ECA study (also known as the Piedmont Health Survey). To determine if depressive symptoms are different in the depressed elderly, 46 community subjects, over 60 years of age with a current diagnosis of…

  8. Treatment of Late-Life Depression Alleviates Caregiver Burden

    PubMed Central

    Martire, Lynn M.; Schulz, Richard; Reynolds, Charles F.; Karp, Jordan F.; Gildengers, Ariel G.; Whyte, Ellen M.

    2010-01-01

    Objectives To describe the burden experienced by family caregivers of older adults with depression and to examine the positive effects on caregivers of treating late-life depression. Design Two-phase treatment study for major depressive disorder (MDD) that included 6 weeks of open treatment with antidepressant medication for all older patients followed by 16 weeks of randomized treatment for patients who were partial responders, comparing a combination of medication and interpersonal psychotherapy with medication alone. Setting Primary care and university late-life mental health research clinic. Participants Adults aged 60 and older participating in a randomized trial for treatment of MDD who enrolled in a family caregiver study and their caregiver (N = 244 dyads). Measurements Improvement in patient symptoms during open treatment (lower scores on the Hamilton Rating Scale for Depression (HRSD)) and remission of depression during randomized treatment (3 consecutive weekly HRSD scores of ≤7) were examined as predictors of lower general caregiver burden and burden specific to patient depression. Results Caregivers reported a moderate to high level of general caregiver burden on average. Change in patient depression during open treatment was associated with significantly decreased depression-specific burden (β = −0.22, P =.001) and a trend toward lower general burden (β = − 0.08, P =.08). Caregivers of patients who remitted showed significantly decreased depression-specific burden (F (1,76) = 4.27, P =.04). Conclusion Treatment of late-life depression has benefits that extend to the family members on whom patients depend. Caregiver education and support may strengthen these effects. PMID:19943833

  9. Late-life Depressive Symptoms: Prediction Models of Change

    PubMed Central

    García-Peña, Carmen; Wagner, Fernando A.; Sánchez-García, Sergio; Espinel-Bermúdez, Claudia; Juárez-Cedillo, Teresa; Pérez-Zepeda, Mario; Arango-Lopera, Victoria; Franco-Marina, Francisco; Ramírez-Aldana, Ricardo; Gallo, Joseph

    2013-01-01

    Background Depression is a well-recognised problem in the elderly. The aim of this study was to determine the factors associated with predictors of change in depressive symptoms, both in subjects with and without baseline significant depressive symptoms. Methods Longitudinal study of community-dwelling elderly people (>60 years or older), baseline evaluations, and two additional evaluations were reported. Depressive symptoms were measured using a 30-item Geriatric Depression Scale, and a score of 11 was used as cutoff point for significant depressive symptoms in order to stratify the analyses in two groups: with significant depressive symptoms and without significant depressive symptoms. Sociodemographic data, social support, anxiety, cognition, positive affect, control locus, activities of daily living, recent traumatic life events, physical activity, comorbidities, and quality of life were evaluated. Multi-level generalised estimating equation model was used to assess the impact on the trajectory of depressive symptoms. Results 7,882 subjects were assessed, with 29.42% attrition. At baseline assessment, mean age was 70.96 years, 61.15% were women. Trajectories of depressive symptoms had a decreasing trend. Stronger associations in those with significant depressive symptoms, were social support (OR .971, p<.001), chronic pain (OR 2.277, p<.001) and higher locus of control (OR .581, p<.001). In contrast for those without baseline significant depressive symptoms anxiety and a higher locus of control were the strongest associations. Conclusions New insights into late-life depression are provided, with special emphasis in differentiated factors influencing the trajectory when stratifying regarding basal status of significant depressive symptoms. Limitations The study has not included clinical evaluations and nutritional assessments PMID:23731940

  10. APATHY IN LATE-LIFE DEPRESSION: COMMON, PERSISTENT, AND DISABLING

    PubMed Central

    Yuen, Genevieve S.; Bhutani, Saumya; Lucas, Bryony J.; Gunning, Faith M.; AbdelMalak, Bassem; Seirup, Joanna K.; Klimstra, Sibel A.; Alexopoulos, George S.

    2014-01-01

    Objectives The aims of this study were to examine: (1) the relationship between apathy and disability in late-life depression, and (2) the functional significance of improvement in apathy following escitalopram treatment in terms of its relationship to disability. Methods Subjects were 71 non-demented elderly with non-psychotic major depression. After a 2-week single-blind placebo period, subjects who had Hamilton Depression Rating Scale (HDRS) ≥ 18 received escitalopram 10mg daily for 12 weeks. Apathy and disability were assessed with the Apathy Evaluation Scale (AES) and the World Health Organization Disability Assessment Scale II (WHODAS) respectively. These measures and the HDRS were administered at baseline and again following 12 weeks of treatment. Results At baseline, 38% of depressed subjects had significant apathy (AES ≥ 36.5). Severity of apathy at baseline significantly correlated with severity of disability. In a multivariate regression model, baseline severity of apathy, but not the overall depressive syndrome (HDRS), significantly correlated with baseline disability. Following escitalopram treatment, improvement in apathy significantly correlated with improvement in disability measures, while change in the rest of the depressive syndrome did not. The overall change in apathy and disability in response to escitalopram treatment was significant but small. Conclusions Apathy is common in late-life depression and is associated with disability above and beyond the influence of other depressive symptoms. Given the strong relationship between apathy and disability, understanding the neurobiology of apathy and developing treatments for apathy may improve the functional outcomes of late-life depression. PMID:25047306

  11. Appetite Loss and Neurocognitive Deficits in Late-Life Depression

    PubMed Central

    Potter, Guy G.; McQuoid, Douglas R.; Steffens, David C.

    2015-01-01

    Objectives Examine association of appetite loss symptoms to neurocognitive performance in late-life depression (LLD). Methods Cross-sectional data from individuals aged 60+ with Major Depressive Disorder (N =322). Participants received clinical assessment of depression and neuropsychological testing. Factor analysis was used to characterize depression symptom factors, and composite scales were developed for episodic memory, psychomotor executive functions, verbal fluency, and working memory span. Results Factor analysis produced a five-factor solution: (1) Anhedonia/Sadness, (2) Suicidality/Guilt, (3) Appetite/Weight Loss, (4) Sleep Disturbance, and (5) Anxiety/Tension. In separate multivariate models for each neurocognitive domain and including all 5 depression factors, higher appetite-loss-related symptoms were associated with lower performance in episodic memory, psychomotor executive functions, and verbal fluency; results were significant with covariates of age, education, race, sex, age of depression onset, and illness burden. No other depression factors were associated with neurocognitive performance in these models. In an additional set of models, the Appetite factor mediated the association between global depression severity and neurocognitive performance. Discussion A factor of appetite and weight loss symptoms in LLD was uniquely associated with neurocognitive performance, in contrast to lack of association among other depression symptom factors. Conclusion Cognitive deficits are a major adverse outcome of LLD, and prominent appetite loss during acute depression may be a marker for these deficits, independent of overall depression severity. Research is needed to understand the mechanisms that may explain this association, and how it is related to the cognitive and symptomatic course of LLD. PMID:25315155

  12. Late-life depression in the primary care setting: Challenges, collaborative care, and prevention

    PubMed Central

    Hall, Charles A.; Reynolds, Charles F.

    2014-01-01

    Late-life depression is highly prevalent worldwide. In addition to being a debilitating illness, it is a risk factor for excess morbidity and mortality. Older adults with depression are at risk for dementia, coronary heart disease, stroke, cancer and suicide. Individuals with late-life depression often have significant medical comorbidity and, poor treatment adherence. Furthermore, psychosocial considerations such as gender, ethnicity, stigma and bereavement are necessary to understand the full context of late-life depression. The fact that most older adults seek treatment for depression in primary care settings led to the development of collaborative care interventions for depression. These interventions have consistently demonstrated clinically meaningful effectiveness in the treatment of late-life depression. We describe three pivotal studies detailing the management of depression in primary care settings in both high and low-income countries. Beyond effectively treating depression, collaborative care models address additional challenges associated with late-life depression. Although depression treatment interventions are effective compared to usual care, they exhibit relatively low remission rates and small to medium effect sizes. Several studies have demonstrated that depression prevention is possible and most effective in at-risk older adults. Given the relatively modest effects of treatment in averting years lived with disability, preventing late-life depression at the primary care level should be highly prioritized as a matter of health policy. PMID:24996484

  13. Diagnosis and Treatment of Depression and Cognitive Impairment in Late-Life

    PubMed Central

    Morimoto, Sarah Shizuko; Kanellopoulos, Dora; Manning, Kevin J.; Alexopoulos, George S.

    2015-01-01

    Cognitive impairment in late life depression is prevalent, disabling, and heterogeneous. Although mild cognitive impairment in depression does not usually progress to dementia, accurate assessment of cognition is vital to prognosis and treatment planning. For example, executive dysfunction often accompanies late-life depression, influences performance across cognitive domains, and is associated with poor antidepressant treatment outcomes. Here, we review how assessment can capture dysfunction across cognitive domains, and discuss cognitive trajectories frequently observed in late-life depression in the context of the neurobiology of this disorder. Furthermore we review the efficacy of a sample of interventions tailored to specific cognitive profiles. PMID:25655026

  14. Functional Connectivity in Apathy of Late-life Depression: A Preliminary Study

    PubMed Central

    Alexopoulos, George S.; Hoptman, Matthew J.; Yuen, Genevieve; Kanellopoulos, Dora; Seirup, Joanna; Lim, Kelvin O.; Gunning, Faith M.

    2012-01-01

    Background Apathy is common in late-life depression and is associated with disability and poor antidepressant response. This study examined whether resting functional connectivity (FC) of the nucleus accumbens (NAcc) and the dorsal anterior cingulate (dACC) with other structures can distinguish apathetic depressed older patients from nonapathetic depressed patients and normal subjects. PMID:23261142

  15. COGNITION AS A THERAPEUTIC TARGET IN LATE-LIFE DEPRESSION: POTENTIAL FOR NICOTINIC THERAPEUTICS

    PubMed Central

    Zurkovsky, Lilia; Taylor, Warren D.; Newhouse, Paul A.

    2013-01-01

    Depression is associated with impairments to cognition and brain function at any age, but such impairments in the elderly are particularly problematic because of the additional burden of normal cognitive aging and in some cases, structural brain pathology. Individuals with late-life depression exhibit impairments in cognition and brain structural integrity, alongside mood dysfunction. Antidepressant treatment improves symptoms in some but not all patients, and those who benefit may not return to the cognitive and functional level of nondepressed elderly. Thus, for comprehensive treatment of late-life depression, it may be necessary to address both the affective and cognitive deficits. In this review, we propose a model for the treatment of late-life depression in which nicotinic stimulation is used to improve cognitive performance and improve the efficacy of an antidepressant treatment of the syndrome of late-life depression. The cholinergic system is well-established as important to cognition. Although muscarinic stimulation may exacerbate depressive symptoms, nicotinic stimulation may improve cognition and neural functioning without a detriment to mood. While some studies of nicotinic subtype specific receptor agonists have shown promise in improving cognitive performance, less is known regarding how nicotinic receptor stimulation affects cognition in depressed elderly patients. Late-life depression thus represents a new therapeutic target for the development of nicotinic agonist drugs and parallel treatment of cognitive dysfunction along with medical and psychological approaches to treating mood dysfunction may be necessary to ensure full resolution of depressive illness in aging. PMID:23933385

  16. Involvement of Brain-Derived Neurotrophic Factor in Late-Life Depression

    PubMed Central

    Dwivedi, Yogesh

    2013-01-01

    Brain-derived neurotrophic factor (BDNF), one of the major neurotrophic factors, plays an important role in the maintenance and survival of neurons, synaptic integrity, and synaptic plasticity. Evidence suggests that BDNF is involved in major depression, such that the level of BDNF is decreased in depressed patients and that antidepressants reverse this decrease. Stress, a major factor in depression, also modulates BDNF expression. These studies have led to the proposal of the neurotrophin hypothesis of depression. Late-life depression is associated with disturbances in structural and neural plasticity as well as impairments in cognitive behavior. Stress and aging also play a crucial role in late-life depression. Many recent studies have suggested that not only expression of BDNF is decreased in the serum/plasma of patients with late-life depression, but structural abnormalities in the brain of these patients may be associated with a polymorphism in the BDNF gene, and that there is a relationship between a BDNF polymorphism and antidepressant remission rates. This review provides a critical review of the involvement of BDNF in major depression, in general, and in late-life depression, in particular. PMID:23570887

  17. Longitudinal associations between BDNF promoter methylation and late-life depression.

    PubMed

    Kang, Hee-Ju; Kim, Jae-Min; Bae, Kyung-Yeol; Kim, Sung-Wan; Shin, Il-Seon; Kim, Hye-Ran; Shin, Myung-Geun; Yoon, Jin-Sang

    2015-04-01

    Reduced brain-derived neurotrophic factor (BDNF) function has been suggested as a risk factor for late-life depression. BDNF secretion is influenced by epigenetic (DNA promoter methylation) and genetic (val66met polymorphism) profiles. We investigated the independent and interactive effects of BDNF methylation and val66met polymorphism on late-life depression. In total, 732 Korean community residents aged ≥ 65 years were evaluated, and 521 of them without depression at baseline were followed up 2 years later. Depression was determined using the Geriatric Mental State Schedule, and depression severity was evaluated with the Geriatric Depression Scale. Demographic and clinical covariates were obtained. The effects of BDNF methylation and polymorphism on the diagnosis of depression were investigated using a multivariate logistic regression model, and the relationships between BDNF methylation and depression severity were evaluated using partial correlation tests. Higher BDNF methylation was independently associated with the prevalence and incidence of depression and severe depressive symptoms. No significant methylation-genotype interactions were found. BDNF promoter methylation could be a proxy biomarker for depression late in life. PMID:25648279

  18. Mindfulness-based cognitive therapy in patients with late-life depression: A case series

    PubMed Central

    Mathur, Sonal; Sharma, Mahendra Prakash; Bharath, Srikala

    2016-01-01

    Depression is the most common mental illness in the elderly, and cost-effective treatments are required. Therefore, this study is aimed at evaluating the effectiveness of a mindfulness-based cognitive therapy (MBCT) on depressive symptoms, mindfulness skills, acceptance, and quality of life across four domains in patients with late-onset depression. A single case design with pre- and post-assessment was adopted. Five patients meeting the specified inclusion and exclusion criteria were recruited for the study and assessed on the behavioral analysis pro forma, geriatric depression scale, Hamilton depression rating scale, Kentucky inventory of mindfulness skills, Acceptance and Action Questionnaire II, The World Health Organization quality of life Assessment Brief version (WHOQO-L-BREF). The therapeutic program consisted of education regarding the nature of depression, training in formal and informal mindfulness meditation, and cognitive restructuring. A total of 8 sessions over 8 weeks were conducted for each patient. The results of this study indicate clinically significant improvement in the severity of depression, mindfulness skills, acceptance, and overall quality of life in all 5 patients. Eight-week MBCT program has led to reduction in depression and increased mindfulness skills, acceptance, and overall quality of life in patients with late-life depression. PMID:27512325

  19. Mindfulness-based cognitive therapy in patients with late-life depression: A case series.

    PubMed

    Mathur, Sonal; Sharma, Mahendra Prakash; Bharath, Srikala

    2016-01-01

    Depression is the most common mental illness in the elderly, and cost-effective treatments are required. Therefore, this study is aimed at evaluating the effectiveness of a mindfulness-based cognitive therapy (MBCT) on depressive symptoms, mindfulness skills, acceptance, and quality of life across four domains in patients with late-onset depression. A single case design with pre- and post-assessment was adopted. Five patients meeting the specified inclusion and exclusion criteria were recruited for the study and assessed on the behavioral analysis pro forma, geriatric depression scale, Hamilton depression rating scale, Kentucky inventory of mindfulness skills, Acceptance and Action Questionnaire II, The World Health Organization quality of life Assessment Brief version (WHOQO-L-BREF). The therapeutic program consisted of education regarding the nature of depression, training in formal and informal mindfulness meditation, and cognitive restructuring. A total of 8 sessions over 8 weeks were conducted for each patient. The results of this study indicate clinically significant improvement in the severity of depression, mindfulness skills, acceptance, and overall quality of life in all 5 patients. Eight-week MBCT program has led to reduction in depression and increased mindfulness skills, acceptance, and overall quality of life in patients with late-life depression. PMID:27512325

  20. Thought suppression and treatment outcome in late-life depression.

    PubMed

    Rosenthal, M Z; Cheavens, J S; Compton, J S; Thorp, S R; Lynch, T R

    2005-01-01

    This study examined severity of depression, age of onset, and thought suppression as predictors of treatment outcome. Measures were taken pre-treatment, post-treatment, and at six-month follow-up in 34 depressed older adults receiving the treatment protocol described in Lynch, Morse, Mendelson & Robins (Dialectical behavior therapy for depressed older adults, American Journal of Geriatric Psychiatry, 11, 33-45, 2003). Severity and chronicity of depression and higher levels of thought suppression were associated with higher depressive symptoms six months after treatment. Findings are consistent with research suggesting that severity and chronicity of depression predict poor clinical outcome. In addition, these results provide preliminary evidence that the tendency to cope with unwanted thoughts by deliberate attempts to not experience such thoughts may be an important pre-treatment predictor of outcome among depressed older adults. Larger studies are needed to explore whether thought suppression mediates long-term recovery from depression. PMID:15841830

  1. The Effects of Phosphatidylserine and Omega-3 Fatty Acid-Containing Supplement on Late Life Depression

    PubMed Central

    Komori, Teruhisa

    2015-01-01

    Late life depression is often associated with a poor response to antidepressants; therefore an alternative strategy for therapy is required. Although several studies have reported that phosphatidylserine (PS) may be effective for late life depression and that omega-3 fatty acids DHA and EPA have also proven beneficial for many higher mental functions, including depression, no concrete conclusion has been reached. This study was performed to clarify the effect of PS and omega-3 fatty acid-containing supplement for late life depression by not only clinical evaluation but also salivary cortisol levels. Eighteen elderly subjects with major depression were selected for the study. In all, insufficient improvement had been obtained by antidepressant therapy for at least 6 months. The exclusion criteria from prior brain magnetic resonance images (MRI) included the presence of structural MRI findings compatible with stroke or other gross brain lesions or malformations, but not white matter hypersensitivities. They took a supplement containing PS 100 mg, DHA 119 mg and EPA 70 mg three times a day for 12 weeks. The effects of the supplement were assessed using the 17-item Hamilton depression scale (HAM-D17) and the basal levels and circadian rhythm of salivary cortisol. The study adopted them as indices because: salivary cortisol levels are high in patients with depression, their circadian rhythm related to salivary cortisol is often irregular, and these symptoms are alleviated as depression improves. The mean HAM-D17 in all subjects taking the supplement was significantly improved after 12 weeks of taking the supplement. These subjects were divided into 10 non-responders and 8 responders. The basal levels and circadian rhythm of salivary cortisol were normalized in the responders while not in non-responders. PS and omega-3 fatty acids, or other elements of the supplement, may be effective for late life depression, associated with the correction of basal levels and circadian

  2. Mechanisms underlying the neuroprotective effect of brain reserve against late life depression.

    PubMed

    Freret, Thomas; Gaudreau, Pierrette; Schumann-Bard, Pascale; Billard, Jean-Marie; Popa-Wagner, Aurel

    2015-08-01

    Depression is common and medically relevant illness that has been associated to a state of "accelerated aging" and can significantly compromise successful aging. In recent years, the concept of "brain reserve" has emerged to describe some individuals having an increased "baseline adaptive neuroplasticity", providing greater dynamic capacity for adjusting and remodeling cortical circuits to various stressors. We hypothesize that brain reserve may have neuroprotective effects against late life depression. Here, we discuss the modulatory capacity of stress and corticosteroid hormones on hippocampal plasticity and neuronal viability in late life depression as well as the anti-depressive of ketamine and scopolamine mediated by stimulation of the mammalian target of rapamycin, increased inhibitory phosphorylation of GSK-3β, and increased synaptogenesis. This review shall shed light on complex neurobiological mechanisms that underpin late life depression and help to better understand neural correlates of resilience. Investigating how rat models of increased cognitive reserve mitigate a chronic mild stress-elicited depression will afford new insights in the search for new therapeutic targets to treat this neuropsychiatric disorder. PMID:24390152

  3. Amyloid Hypothesis: Is There a Role for Antiamyloid Treatment in Late-Life Depression?

    PubMed

    Mahgoub, Nahla; Alexopoulos, George S

    2016-03-01

    Antidepressants have modest efficacy in late-life depression (LLD), perhaps because various neurobiologic processes compromise frontolimbic networks required for antidepressant response. We propose that amyloid accumulation is an etiologic factor for frontolimbic compromise that predisposes to depression and increases treatment resistance in a subgroup of older adults. In patients without history of depression, amyloid accumulation during the preclinical phase of Alzheimer disease (AD) may result in the prodromal depression syndrome that precedes cognitive impairment. In patients with early-onset depression, pathophysiologic changes during recurrent episodes may promote amyloid accumulation, further compromise neurocircuitry required for antidepressant response, and increase treatment resistance during successive depressive episodes. The findings that support the amyloid hypothesis of LLD are (1) Depression is a risk factor, a prodrome, and a common behavioral manifestation of AD; (2) amyloid deposition occurs during a long predementia period when depression is prevalent; (3) patients with lifetime history of depression have significant amyloid accumulation in brain regions related to mood regulation; and (4) amyloid deposition leads to neurobiologic processes, including vascular damage, neurodegeneration, neuroinflammation, and disrupted functional connectivity, that impair networks implicated in depression. The amyloid hypothesis of LLD is timely because availability of ligands allows in vivo assessment of amyloid in the human brain, a number of antiamyloid agents are relatively safe, and there is evidence that some antidepressants may reduce amyloid production. A model of LLD introducing the role of amyloid may guide the design of studies aiming to identify novel antidepressant approaches and prevention strategies of AD. PMID:26946981

  4. Applying Interpersonal Psychotherapy to Bereavement-Related Depression Following Loss of a Spouse in Late Life

    PubMed Central

    MILLER, MARK D.; FRANK, ELLEN; CORNES, CLEON; IMBER, STANLEY D.; ANDERSON, BARBARA; EHRENPREIS, LIN; MALLOY, JULIE; SILBERMAN, REBECCA; WOLFSON, LEE; ZALTMAN, JEAN; REYNOLDS, CHARLES F.

    1994-01-01

    The efficacy of interpersonal psychotherapy (IPT) as a treatment for outpatients with major depression has been documented in several controlled trials. Recently, IPT has been adapted specifically for depression in late life. The authors report on their experience in applying IPT to geriatric patients whose depression is temporally linked to the loss of their spouses. Detailed treatment techniques are illustrated with case vignettes. Preliminary treatment outcomes are presented for 6 subjects who showed a mean change on the 17-item Hamilton Rating Scale for Depression from 18.5 ± 2.3 SD to 7.2 ± 4.6 after an average of 17 weekly IPT sessions. IPT appears to be an effective short-term treatment for bereavement-related depression in elderly subjects. PMID:22700188

  5. Being stuck in a vice: The process of coping with severe depression in late life

    PubMed Central

    Bjørkløf, Guro Hanevold; Kirkevold, Marit; Engedal, Knut; Selbæk, Geir; Helvik, Anne-Sofie

    2015-01-01

    Articles describing older persons’ experiences of coping with severe depression are, to our knowledge, lacking. This article is methodologically grounded in phenomenological hermeneutics, inspired by Paul Ricoeur, and applies a descriptive design with in-depth interviews for producing the data. We included 18 older persons, 13 women and 5 men, with a mean age of 77.9 years, depressed to a severe or moderate degree, 1–2 weeks after admission to a hospital for treatment of depression. We found the metaphor “being in a vice” to capture the essence of meaning from the participants’ stories, and can be understood as being stuck in an immensely painful existence entirely dominated by depression in late life. This is the first article where coping in older men and women experiencing the most severe phase of depression is explored. PMID:26119368

  6. Depression care management for late-life depression in China primary care: Protocol for a randomized controlled trial

    PubMed Central

    2011-01-01

    Background As a major public health issue in China and worldwide, late-life depression is associated with physical limitations, greater functional impairment, increased utilization and cost of health care, and suicide. Like other chronic diseases in elders such as hypertension and diabetes, depression is a chronic disease that the new National Health Policy of China indicates should be managed in primary care settings. Collaborative care, linking primary and mental health specialty care, has been shown to be effective for the treatment of late-life depression in primary care settings in Western countries. The primary aim of this project is to implement a depression care management (DCM) intervention, and examine its effectiveness on the depressive symptoms of older patients in Chinese primary care settings. Methods/Design The trial is a multi-site, primary clinic based randomized controlled trial design in Hangzhou, China. Sixteen primary care clinics will be enrolled in and randomly assigned to deliver either DCM or care as usual (CAU) (8 clinics each) to 320 patients (aged ≥ 60 years) with major depression (20/clinic; n = 160 in each treatment condition). In the DCM arm, primary care physicians (PCPs) will prescribe 16 weeks of antidepressant medication according to the treatment guideline protocol. Care managers monitor the progress of treatment and side effects, educate patients/family, and facilitate communication between providers; psychiatrists will provide weekly group psychiatric consultation and CM supervision. Patients in both DCM and CAU arms will be assessed by clinical research coordinators at baseline, 4, 8, 12, 18, and 24 months. Depressive symptoms, functional status, treatment stigma and clients' satisfaction will be used to assess patients' outcomes; and clinic practices, attitudes/knowledge, and satisfaction will be providers' outcomes. Discussion This will be the first trial of the effectiveness of a collaborative care intervention aiming to

  7. Late-life depression, mild cognitive impairment, and dementia: possible continuum?

    PubMed

    Panza, Francesco; Frisardi, Vincenza; Capurso, Cristiano; D'Introno, Alessia; Colacicco, Anna M; Imbimbo, Bruno P; Santamato, Andrea; Vendemiale, Gianluigi; Seripa, Davide; Pilotto, Alberto; Capurso, Antonio; Solfrizzi, Vincenzo

    2010-02-01

    Clinical and epidemiologic research has focused on the identification of risk factors that may be modified in predementia syndromes, at a preclinical and early clinical stage of dementing disorders, with specific attention to the role of depression. Our goal was to provide an overview of these studies and more specifically to describe the prevalence and incidence of depression in individuals with mild cognitive impairment (MCI), the possible impact of depressive symptoms on incident MCI, or its progression to dementia and the possible mechanisms behind the observed associations. Prevalence and incidence of depressive symptoms or syndromes in MCI vary as a result of different diagnostic criteria and different sampling and assessment procedures. The prevalence of depression in individuals with MCI was higher in hospital-based studies (median: 44.3%, range: 9%-83%) than in population-based studies (median: 15.7%, range: 3%-63%), reflecting different referral patterns and selection criteria. Incidence of depressive symptoms varied from 11.7 to 26.6/100 person-years in hospital-based and population-based studies. For depressed normal subjects and depressed patients with MCI, the findings on increased risk of incident MCI or its progression to dementia were conflicting. These contrasting findings suggested that the length of the follow-up period, the study design, the sample population, and methodological differences may be central for detecting an association between baseline depression and subsequent development of MCI or its progression to dementia. Assuming that MCI may be the earliest identifiable clinical stage of dementia, depressive symptoms may be an early manifestation rather than a risk factor for dementia and Alzheimer disease, arguing that the underlying neuropathological condition that causes MCI or dementia also causes depressive symptoms. In this scenario, at least in certain subsets of elderly patients, late-life depression, MCI, and dementia could

  8. Late-Life Depression and Cardiovascular Disease Burden: Examination of Reciprocal Relationship

    PubMed Central

    Choi, Namkee G.; Kim, Jinseok; Marti, C. Nathan; Chen, G. John

    2015-01-01

    Objectives Empirical studies of the relationship between depression and cardiovascular disease (CVD) tend to be limited to examination of one-way relationships. This study assessed both cross-sectional association and longitudinal reciprocal relationships between late-life depressive symptoms and CVD. Methods The National Health and Aging Trends Study waves 1 (T1) and 2 (T2, one year later) provided the data. The study sample (N = 5,414) represented Medicare beneficiaries aged 65 years or older. We fit structural equation models to examine: 1) cross-sectional association between depression and CVD at each wave; and 2) longitudinal reciprocal relationship between T1 depression and T2 CVD and between T1 CVD and T2 depression. Results At T1, 28.6% reported a CVD diagnosis, and at T2, 4.9% reported having had a new diagnosis or new episode of heart attack or heart disease and 2.2% reported having had a stroke since T1. In addition to significant cross-sectional relationships between depression and CVD, T1 CVD had significant impact on T2 depressive symptoms, and T1 depressive symptoms had significant impact on T2 CVD, with a 1-point increase in depressive symptom score increasing the odds of having a new CVD diagnosis or episode by 21%. Conclusions The care of older adults with CVD and/or depression needs to include interventions focusing on lifestyle and psychological factors that can reduce risks for both CVD and depression. Depression prevention and treatment also needs to be an integral part of CVD prevention and management. PMID:24856874

  9. BDNF promoter methylation and genetic variation in late-life depression.

    PubMed

    Januar, V; Ancelin, M-L; Ritchie, K; Saffery, R; Ryan, J

    2015-01-01

    The regulation of the brain-derived neurotrophic factor (BDNF) is important for depression pathophysiology and epigenetic regulation of the BDNF gene may be involved. This study investigated whether BDNF methylation is a marker of depression. One thousand and twenty-four participants were recruited as part of a longitudinal study of psychiatric disorders in general population elderly (age ⩾ 65). Clinical levels of depression were assessed using the Mini International Neuropsychiatric Interview for the diagnosis of major depressive disorder according to the Diagnostic and Statistical Manual of Mental Disorder IV criteria, and the Centre for Epidemiologic Studies Depression Scale (CES-D) for assessment of moderate to severe depressive symptoms. Buccal DNA methylation at the two most widely studied BDNF promoters, I and IV, was investigated using the Sequenom MassARRAY platform that allows high-throughput investigation of methylation at individual CpG sites within defined genomic regions. In multivariate linear regression analyses adjusted for a range of participant characteristics including antidepressant use, depression at baseline, as well as chronic late-life depression over the 12-year follow-up, were associated with overall higher BDNF methylation levels, with two sites showing significant associations (promoter I, Δ mean = 0.4%, P = 0.0002; promoter IV, Δ mean = 5.4%, P = 0.021). Three single-nucleotide polymorphisms (rs6265, rs7103411 and rs908867) were also found to modify the association between depression and promoter I methylation. As one of the largest epigenetic studies of depression, and the first investigating BDNF methylation in buccal tissue, our findings highlight the potential for buccal BDNF methylation to be a biomarker of depression. PMID:26285129

  10. Spouse health status, depressed affect, and resilience in mid and late life: a longitudinal study.

    PubMed

    Bookwala, Jamila

    2014-04-01

    This study used longitudinal data to examine the effects of spousal illness on depressive symptoms among middle-aged and older married individuals and the extent to which the adverse effects of illness in a spouse were mitigated by 2 psychological resources, mastery and self-esteem. Using 1,704 married participants who were 51 years of age on average, depressive symptoms were compared in 4 groups varying in their experience of spousal health transitions: those whose spouse remained ill at T1 and T2, those whose spouse declined in health from T1 to T2, those whose spouse's health improved from T1 to T2, and those whose spouse remained healthy at both time points. Mixed analyses of covariance showed that, as hypothesized, having a spouse who became or remained ill over time was linked to greater depressed affect by T2, whereas having a spouse improve in health was associated with a decline in depressive symptomatology. Moderated regression analyses indicated that while higher mastery and self-esteem were linked to lower depressed affect in general, these resources were especially protective against depressed affect for those whose spouse remained ill at both time points. These findings are at the intersection of life course theory and the stress process model highlighting the contextual forces in and the interconnectedness of individual development as well as the plasticity and resilience evident in adaptation to stress during mid and late life. PMID:24364828

  11. First evidence for glial pathology in late life minor depression: S100B is increased in males with minor depression

    PubMed Central

    Polyakova, Maryna; Sander, Christian; Arelin, Katrin; Lampe, Leonie; Luck, Tobias; Luppa, Melanie; Kratzsch, Jürgen; Hoffmann, Karl-Titus; Riedel-Heller, Steffi; Villringer, Arno; Schoenknecht, Peter; Schroeter, Matthias L.

    2015-01-01

    Minor depression is diagnosed when a patient suffers from 2 to 4 depressive symptoms for at least 2 weeks. Though minor depression is a widespread phenomenon, its pathophysiology has hardly been studied. To get a first insight into the pathophysiological mechanisms underlying this disorder we assessed serum levels of biomarkers for plasticity, glial and neuronal function: brain-derived neurotrophic factor (BDNF), S100B and neuron specific enolase (NSE). 27 subjects with minor depressive episode and 82 healthy subjects over 60 years of age were selected from the database of the Leipzig population-based study of civilization diseases (LIFE). Serum levels of BDNF, S100B and NSE were compared between groups, and correlated with age, body-mass index (BMI), and degree of white matter hyperintensities (score on Fazekas scale). S100B was significantly increased in males with minor depression in comparison to healthy males, whereas other biomarkers did not differ between groups (p = 0.10–0.66). NSE correlated with Fazekas score in patients with minor depression (rs = 0.436, p = 0.048) and in the whole sample (rs = 0.252, p = 0.019). S100B correlated with BMI (rs = 0.246, p = 0.031) and with age in healthy subjects (rs = 0.345, p = 0.002). Increased S100B in males with minor depression, without alterations in BDNF and NSE, supports the glial hypothesis of depression. Correlation between white matter hyperintensities and NSE underscores the vascular hypothesis of late life depression. PMID:26500502

  12. Diminished performance on neuropsychological testing in late life depression is correlated with microstructural white matter abnormalities

    PubMed Central

    Mettenburg, Joseph M; Benzinger, Tammie L.S.; Shimony, Joshua S; Snyder, Abraham Z.; Sheline, Yvette I

    2012-01-01

    Background Traditional T2 weighted MR imaging results are non-specific for the extent of underlying white matter structural abnormalities present in late life depression (LLD). Diffusion tensor imaging provides a unique opportunity to investigate the extent and nature of structural injury, but has been limited by examining only a subset of regions of interest (ROI) and by confounds common to the study of an elderly population, including comorbid vascular pathology. Furthermore, comprehensive correlation of diffusion tensor imaging (DTI) measurements, including axial and radial diffusivity measurements, has not been demonstrated in the late life depression population. Methods 51 depressed and 16 non-depressed, age- and cerebrovascular risk factor- matched elderly subjects underwent traditional anatomic T1 and T2 weight imaging, as well as DTI. The DTI data were skeletonized using tract based spatial statistics (TBSS), and both regional and global analyses were performed. Results Widespread structural abnormalities within white matter were detected in the LLD group, accounting for age, gender and education and matched for cerebrovascular risk factors and global T2 white matter hyperintensities (T2WMH). Regional differences were most prominent in uncinate and cingulate white matter and were generally characterized by an increase in radial diffusivity. Age-related changes particularly in the cingulate bundle were more advanced in individuals with LLD relative to controls. Regression analysis demonstrated significant correlations of regional fractional anisotropy and radial diffusivity with five different neuropsychological factor scores. TBSS analysis demonstrated a greater extent of white matter abnormalities in LLD not responsive to treatment, as compared to controls. Conclusions White matter integrity is compromised in late life depression, largely manifested by increased radial diffusivity in specific regions, suggesting underlying myelin injury. A possible

  13. A Review of Brain Stimulation Treatments for Late-Life Depression

    PubMed Central

    Hsu, Jonathan H.; Daskalakis, Zafiris J.

    2016-01-01

    Opinion Statement Recurrence, relapse and resistance to first-line therapies are common and pervasive issues in the treatment of depression in older adults. As a result, brain stimulation modalities are essential treatment options in this population. The majority of data for the effectiveness of brain stimulation modalities comes from electroconvulsive therapy (ECT) studies. Current ECT trials are focused on prolonging response after a successful course and mitigating the cognitive adverse effects. Newer forms of brain stimulation have emerged; unfortunately, as with most advances in medicine older adults have not been systematically included in clinical trials. Repetitive transcranial magnetic stimulation has demonstrated efficacy in younger adults and there is emerging data to support its use in late-life depression (LLD). It will be imperative that older adults be included in future transcranial direct current stimulation and magnetic seizure therapy clinical trials. Unclear efficacy results are a concern for both vagus nerve stimulation and deep brain stimulation. PMID:27398288

  14. Neuroanatomical correlates of late-life depression and associated cognitive changes.

    PubMed

    Lebedeva, Aleksandra; Borza, Tom; Håberg, Asta Kristine; Idland, Ane-Victoria; Dalaker, Turi Olene; Aarsland, Dag; Selbaek, Geir; Beyer, Mona K

    2015-11-01

    We compared cortical thickness between patients with late-life depression (LLD) and healthy controls and between patients with early-onset (EOD) and late-onset (LOD) depression. We also tested age effects on cortical thickness in LLD and controls and if cortical thickness and hippocampal volumes were associated with cognitive performance in LLD. Three-dimensional T1-weighted magnetic resonance images were obtained in 49 LLD and 49 matched hospital controls and processed using FreeSurfer. General linear model analysis was used as a statistical approach. LLD group had thinning in the left parahippocampal, fusiform, and inferior-parietal cortex compared with controls. Age correlated with cortical thinning in controls but not in LLD. Women in the LOD groups had extensive cortical thinning in the lateral prefrontal cortex bilaterally compared with EOD women. Absence of statistically significant changes observed in men should however be treated with caution because of the low number of men in the study. Mini-Mental Status Examination score correlated with lateral prefrontal cortical thickness bilaterally and hippocampal volume in the total group of LLD and in LOD but not EOD. LLD is associated with cortical thinning, which is associated with age at depression onset, gender, and level of cognitive functioning. PMID:26277679

  15. Structural Imaging in Late Life Depression: Association with Mood and Cognitive Responses to Antidepressant Treatment

    PubMed Central

    Marano, Christopher M.; Workman, Clifford I.; Lyman, Christopher H.; Munro, Cynthia A.; Kraut, Michael A.; Smith, Gwenn S.

    2014-01-01

    Objectives Recent positron emission tomography studies of cerebral glucose metabolism have identified the functional neural circuitry associated with mood and cognitive responses to antidepressant treatment in late life depression (LLD). The structural alterations in these networks are not well understood. The present study used magnetic resonance (MR) imaging and voxel-based morphometry (VBM) to evaluate the association between grey matter volumes and changes in mood symptoms and cognitive function with treatment with the antidepressant citalopram. Design Open label trial with baseline brain MR scan. Mood and cognitive assessments performed at baseline and during citalopram treatment. Setting Outpatient clinics of an academic medical center. Participants 17 previously unmedicated patients age 55 or older with a major depressive episode and 17 non-depressed comparison subjects. Intervention 12 week trial of flexibly dosed citalopram. Measurements Grey matter volumes, Hamilton Depression Rating Scale, California Verbal Learning Test, Delis–Kaplan Executive Function System™. Results In LLD, higher grey matter volumes in the cingulate gyrus, superior and middle frontal gyri, middle temporal gyrus and precuneus was associated with greater mood improvement. Higher grey matter volumes in primarily frontal areas were associated with greater improvement in verbal memory and verbal fluency performance. Conclusions Associations with antidepressant induced improvements in mood and cognition were observed in several brain regions previously correlated with normalization of glucose metabolism after citalopram treatment in LLD. Future studies will investigate molecular mechanisms underlying these associations (e.g. beta-amyloid, inflammation, glutamate). PMID:24238925

  16. Applications of magnetic resonance imaging for treatment-resistant late-life depression

    PubMed Central

    Agudelo, Christian; Aizenstein, Howard J.; Karp, Jordan F.; Reynolds III, Charles F.

    2015-01-01

    Late-life depression (LLD) is a growing public and global health concern with diverse clinical manifestations and etiology. This literature review summarizes neuroimaging findings associated with depression in older adults and treatment-response variability. LLD has been associated with cerebral atrophy, diminished myelin integrity, and cerebral lesions in frontostriatal-limbic regions. These associations help explain the depression-executive dysfunction syndrome observed in LLD, and support cerebrovascular burden as a pathogenic mechanism. Furthermore, this review suggests that neuroimaging determinants of treatment resistance also reflect cerebrovascular burden. Of the theoretical etiologies of LLD, cerebrovascular burden may mediate treatment resistance. This review proposes that neuroimaging has the potential for clinical translation. Controlled trials may identify neuroimaging biomarkers that may inform treatment by identifying depressed adults likely to remit with pharmacotherapy, identifying individualized therapeutic dose, and facilitating earlier treatment response measures. Neuroimaging also has the potential to similarly inform treatment response variability from treatment with aripiprazole (dopamine modulator) and buprenorphine (opiate modulator). PMID:26246790

  17. The Age-by-Disease Interaction Hypothesis of Late-Life Depression

    PubMed Central

    McKinney, Brandon Chad; Sibille, Etienne

    2012-01-01

    The phenomenological diagnosis of depression is successful in increasing diagnostic reliability, but it is a classification scheme without biological bases. One subtype of depression for which evidence suggests a unique biological basis is late-life depression (LLD), with first onset of symptoms after the age of 65. LLD is common and poses a significant burden on affected individuals, caretakers, and society. The pathophysiology of LLD includes disruptions of the neural network underlying mood, which can be conceptualized as the result of dysfunction in multiple underlying biological processes. Here, we briefly review current LLD hypotheses and then describe the characteristics of molecular brain aging and their overlap with disease processes. Further, we propose a new hypothesis for LLD, the Age-by-Disease Interaction hypothesis, which posits that the clinical presentation of LLD is the integrated output of specific biological processes that are pushed in LLD-promoting directions by changes in gene expression naturally occurring during brain aging, hence leading the brain to a physiological state that is more susceptible to LLD, since additional pushes by genetic, environmental and biochemical factors may now be sufficient to generate dysfunctional states that produce depressive symptoms. We put our propositions together into a decanalization model to aid in illustrating how age-related biological changes of the brain can shift the repertoire of available functional states in a pro-depression direction, and how additional factors can readily lead the system into distinct and stable maladaptive phenotypes, including LLD. This model brings together basic research on neuropsychiatric and neurodegenerative diseases more closely with the investigation of normal aging. Specifically, identifying biological processes affected during normal aging may inform the development of new interventions for the prevention and treatment of LLD. PMID:23570886

  18. Is Old Age Depressing? Growth Trajectories and Cohort Variations in Late-Life Depression

    ERIC Educational Resources Information Center

    Yang, Yang

    2007-01-01

    Findings in previous research on the association of old age and depression are inconsistent due to a confounding of age changes and cohort differences. Using data from an accelerated longitudinal design from the National Institute of Aging Established Populations for Epidemiologic Studies of the Elderly, this study addresses three questions: (1)…

  19. A multiple indicators multiple causes model of late-life depression in Latin American countries

    PubMed Central

    Brailean, Anamaria; Guerra, Mariella; Chua, Kia-Chong; Prince, Martin; Prina, Matthew A.

    2015-01-01

    Background The Euro-D depression scale consists of symptom clusters that may be differentially related to demographic and cognitive characteristics in older adults. This hypothesis needs further investigation and the role of measurement bias on substantive conclusions remains to be established. Method The study sample comprised 10,405 community-dwelling older adults from six Latin American countries. We applied a Multiple Indicators Multiple Causes (MIMIC) model for a concurrent investigation of measurement bias and of the association between Euro-D symptom clusters and background variables. Results The factorial validity of Euro-D, with a two-dimensional structure – affective suffering and motivation disturbance, was consistently supported in all countries. Although complete measurement invariance could not be assumed across countries, measurement bias was minor. Both Euro-D factors were unrelated to age, but related to gender, as well as to impairment in memory and verbal fluency. Gender differences were larger for affective suffering than for motivation disturbance, whereas differences in verbal fluency impairment were more strongly related to motivation disturbance. Limitations Our analytic strategies could only examine invariance at the level of indicator thresholds. The generalisability of current findings needs to be examined in clinical populations. A wider set of cognitive tests is needed. We did not examine the compositional factors that could have accounted for the variation in Euro-D scores across countries, as this was beyond the aims of the paper. Conclusion The current study adds evidence for the construct validity of Euro-D and for the possible differential association of depression symptom-clusters with gender and verbal fluency in older adults. An understanding of the heterogeneity of late-life depression may carry clinical implications for the diagnosis and treatment of depression in old age. PMID:26092097

  20. Cognitive Control, Reward Related Decision Making and Outcomes of Late-Life Depression Treated with an Antidepressant

    PubMed Central

    Alexopoulos, George S.; Manning, Kevin; Kanellopoulos, Dora; McGovern, Amanda; Seirup, Joanna K.; Banerjee, Samprit; Gunning, Faith

    2015-01-01

    Background Executive processes consist of at least two sets of functions: one concerned with cognitive control and the other with reward-related decision making. Abnormal performance in both sets occurs in late-life depression. This study tested the hypothesis that only abnormal performance in cognitive control tasks predicts poor outcomes of late-life depression treated with escitalopram. Methods We studied older subjects with major depression (N=53) and non-depressed subjects (N=30). Executive functions were tested with the Iowa Gambling Test (IGT), Stroop Color/Word test, Tower of London, and Dementia Rating Scale-Initiation/Perseveration Domain (DRS-IP). After a 2-week placebo washout, depressed subjects received escitalopram (target daily dose: 20 mg) for 12 weeks. Results There were no significant differences between depressed and non-depressed subjects on executive function tests. Hierarchical cluster analysis of depressed subjects identified a Cognitive Control Cluster (abnormal Stroop, Tower, DRS-IP), a Reward-Related Cluster (IGT), and an Executively Unimpaired Cluster. Decline in depression was greater in the Executively Unimpaired (t=−2.09, df=331, p=0.0375) and the Reward-Related Cluster (t=−2.33, df=331,p=0.0202) than the Cognitive Control Cluster. The Executively Unimpaired Cluster (t=2.17, df=331, p=0.03) and the Reward-Related Cluster (t=2.03, df=331, p=0.0433) had a higher probability of remission than the Cognitive Control Cluster. Conclusions Dysfunction of cognitive control functions, but not reward-related decision making, may influence the decline of symptoms and the probability of remission of late-life depression treated with escitalopram. If replicated, simple to administer cognitive control tests may be used to select depressed older patients at risk for poor outcomes to SSRIs who may require structured psychotherapy. PMID:26169527

  1. Association between Depressive Symptoms and Negative Dependent Life Events from Late Childhood to Adolescence

    ERIC Educational Resources Information Center

    Johnson, Daniel P.; Whisman, Mark A.; Corley, Robin P.; Hewitt, John K.; Rhee, Soo Hyun

    2012-01-01

    The association between stressful life events and depression has been consistently supported in the literature; however, studies of the developmental trajectories of these constructs and the nature of their association over time are limited. We examined trajectories of depressive symptoms and negative dependent life events and the associations…

  2. Relationship Between Hippocampal Volume, Serum BDNF, and Depression Severity Following Electroconvulsive Therapy in Late-Life Depression.

    PubMed

    Bouckaert, Filip; Dols, Annemiek; Emsell, Louise; De Winter, François-Laurent; Vansteelandt, Kristof; Claes, Lene; Sunaert, Stefan; Stek, Max; Sienaert, Pascal; Vandenbulcke, Mathieu

    2016-10-01

    Recent structural imaging studies have described hippocampal volume changes following electroconvulsive therapy (ECT). It has been proposed that serum brain-derived neurotrophic factor (sBDNF)-mediated neuroplasticity contributes critically to brain changes following antidepressant treatment. To date no studies have investigated the relationship between changes in hippocampal volume, mood, and sBDNF following ECT. Here, we combine these measurements in a longitudinal study of severe late-life unipolar depression (LLD). We treated 88 elderly patients with severe LLD twice weekly until remission (Montgomery-Åsberg Depression Rating Scale (MADRS) <10). sBDNF and MADRS were obtained before ECT (T0), after the sixth ECT (T1), 1 week after the last ECT (T2), 4 weeks after the last ECT (T3), and 6 months after the last ECT (T4). Hippocampal volumes were quantified by manual segmentation of 3T structural magnetic resonance images in 66 patients at T0 and T2 and in 23 patients at T0, T2, and T4. Linear mixed models (LMM) were used to examine the evolution of MADRS, sBDNF, and hippocampal volume over time. Following ECT, there was a significant decrease in MADRS scores and a significant increase in hippocampal volume. Hippocampal volume decreased back to baseline values at T4. Compared with T0, sBDNF levels remained unchanged at T1, T2, and T3. There was no coevolution between changes in MADRS scores, hippocampal volume, and sBDNF. Hippocampal volume increase following ECT is an independent neurobiological effect unrelated to sBDNF and depressive symptomatology, suggesting a complex mechanism of action of ECT in LLD. PMID:27272769

  3. Exploring the Relationship between Absolute and Relative Position and Late-Life Depression: Evidence from 10 European Countries

    ERIC Educational Resources Information Center

    Ladin, Keren; Daniels, Norman; Kawachi, Ichiro

    2010-01-01

    Purpose: Socioeconomic inequality has been associated with higher levels of morbidity and mortality. This study explores the role of absolute and relative deprivation in predicting late-life depression on both individual and country levels. Design and Methods: Country- and individual-level inequality indicators were used in multivariate logistic…

  4. Age-by-disease biological interactions: implications for late-life depression

    PubMed Central

    McKinney, Brandon C.; Oh, Hyunjung; Sibille, Etienne

    2012-01-01

    Onset of depressive symptoms after the age of 65, or late-life depression (LLD), is common and poses a significant burden on affected individuals, caretakers, and society. Evidence suggests a unique biological basis for LLD, but current hypotheses do not account for its pathophysiological complexity. Here we propose a novel etiological framework for LLD, the age-by-disease biological interaction hypothesis, based on the observations that the subset of genes that undergoes lifelong progressive changes in expression is restricted to a specific set of biological processes, and that a disproportionate number of these age-dependent genes have been previously and similarly implicated in neurodegenerative and neuropsychiatric disorders, including depression. The age-by-disease biological interaction hypothesis posits that age-dependent biological processes (i) are “pushed” in LLD-promoting directions by changes in gene expression naturally occurring during brain aging, which (ii) directly contribute to pathophysiological mechanisms of LLD, and (iii) that individual variability in rates of age-dependent changes determines risk or resiliency to develop age-related disorders, including LLD. We review observations supporting this hypothesis, including consistent and specific age-dependent changes in brain gene expression and their overlap with neuropsychiatric and neurodegenerative disease pathways. We then review preliminary reports supporting the genetic component of this hypothesis. Other potential biological mediators of age-dependent gene changes are proposed. We speculate that studies examining the relative contribution of these mechanisms to age-dependent changes and related disease mechanisms will not only provide critical information on the biology of normal aging of the human brain, but will inform our understanding of age-dependent diseases, in time fostering the development of new interventions for prevention and treatment of age-dependent diseases, including

  5. Men of the Cloth: African-American Clergy's Knowledge and Experience in Providing Pastoral Care to African-American Elders with Late-Life Depression

    ERIC Educational Resources Information Center

    Stansbury, Kim L.

    2011-01-01

    African-American clergy's ability to recognize late-life depression and their capacity to provide support with this illness have been neglected in the literature. Using a mental health literacy framework, the purpose of this research was to explore African-American clergy's knowledge of and treatments for late-life depression. In-depth interviews…

  6. Psychosocial Risk Factors for Cognitive Decline in Late-Life Depression: Findings from the MTLD-III Study

    PubMed Central

    Rej, Soham; Begley, Amy; Gildengers, Ariel; Dew, Mary Amanda; Reynolds, Charles F.; Butters, Meryl A.

    2015-01-01

    Background Cognitive impairment and depression frequently co-occur in late life. There remains a need to better characterize psychosocial risk factors of cognitive decline in older adults with depression. We hypothesized that certain psychosocial factors would be associated with higher risk of cognitive decline in individuals with late-life depression. Methods 130 individuals aged ≥ 65 years who had achieved remission from a major depressive episode were randomized to donepezil or placebo and then closely followed for two years. Using Cox proportional hazard models, we examined the association between baseline median household income, education level, race, marital status, and social support and cognitive decline over the follow-up. Results Lower interpersonal support (OR = 0.86 [0.74–0.99], p = .04) and lower baseline global neuropsychological score (OR = 0.56 [0.36–0.87], p = .001) predicted shorter time to conversion to MCI or dementia in univariate models. These exposures did not remain significant in multivariate analyses. Neither socioeconomic status nor other psychosocial factors independently predicted cognitive diagnostic conversion (p > .05). Conclusions We did not find reliable associations between cognitive outcome and any of the psychosocial factors examined. Future large-scale, epidemiological studies, ideally using well-validated subjective measures, should better characterize psychosocial risk factors for cognitive decline in late-life depression. PMID:26180559

  7. Are depression and frailty overlapping syndromes in mid- and late-life? A latent variable analysis

    PubMed Central

    Mezuk, Briana; Lohman, Matt; Dumenci, Levent; Lapane, Kate L.

    2012-01-01

    Background Depression and frailty both predict disability and morbidity in later life. However, it is unclear to what extent these common geriatric syndromes represent overlapping constructs. Objective To examine the joint relationship between the constructs of depression and frailty. Methods Data come from 2004/5 wave of the Baltimore Epidemiologic Catchment Area Study and analysis is limited to participants aged 40 and older with complete data on frailty and depression indicators (N = 683). Depression was measured using the Diagnostic Interview Schedule and frailty was indexed by modified Fried criteria. A series of confirmatory latent class analyses (LCA) were used to assess the degree to which depression and frailty syndromes identify the same populations. A latent Kappa coefficient (Кl) was also estimated between the constructs. Results Confirmatory LCA indicated that depression and frailty represent distinct syndromes rather than a single construct. The joint modeling of the two constructs supported a three class solution for depression and two class solution for frailty, with 2.9% categorized as severe depression, 19.4% as mild depression, and 77.7% as not depressed, and 21.1% categorized as frail and 78.9% as not frail. The chance-corrected agreement statistic indicated moderate correspondence between the depression and frailty constructs (Кl: 66, 95% CI: 0.58 – 0.74). Conclusions Results suggest that depression and frailty are interrelated concepts, yet their operational criteria identify substantively overlapping subpopulations. These findings have implications for understanding factors that contribute to the etiology and prognosis of depression and frailty in later life. PMID:23567406

  8. Role of the serotonin transporter gene locus in the response to SSRI treatment of major depressive disorder in late life.

    PubMed

    Seripa, Davide; Pilotto, Andrea; Paroni, Giulia; Fontana, Andrea; D'Onofrio, Grazia; Gravina, Carolina; Urbano, Maria; Cascavilla, Leandro; Paris, Francesco; Panza, Francesco; Padovani, Alessandro; Pilotto, Alberto

    2015-05-01

    It has been suggested that the serotonin or 5-hydroxytriptamine (5-HT) transporter (5-HTT) and its gene-linked polymorphic region (5-HTTLPR) are selective serotonin reuptake inhibitor (SSRI) response modulators in late-life depression (LLD), and particularly in late-life major depressive disorder (MDD). Previous studies differed in design and results. Our study aimed to investigate the solute carrier family 6 (neurotransmitter transporter and serotonin) member 4 (SLC6A4) gene locus, encoding 5-HTT and SSRI treatment response in late-life MDD. For a prospective cohort study, we enrolled 234 patients with late-life MDD to be treated with escitalopram, sertraline, paroxetine or citalopram for 6 months. The SLC6A4 polymorphisms rs4795541 (5-HTTLPR), rs140701 and rs3813034 genotypes spanning the SLC6A4 locus were investigated in blinded fashion. No placebo group was included. We assessed responder or non-responder phenotypes according to a reduction in the 21-item version of the Hamilton Depression Rating Scale (HDRS-21) score of ⩾ 50%. At follow-up, 30% of the late-life MDD patients were non-responders to SSRI treatment. No time-course of symptoms and responses was made. A poor response was associated with a higher baseline HDRS-21 score. We observed a significant over-representation of the rs4795541-S allele in the responder patients (0.436 versus 0.321; p = 0.023). The single S-allele dose-additive effect had OR = 1.74 (95% CI 1.12-2.69) in the additive regression model. Our findings suggested a possible influence of 5-HTTLPR on the SSRI response in patients with late-life MDD, which is potentially useful in identifying the subgroups of LLD patients whom need a different pharmacological approach. PMID:25827644

  9. Advancing the Screening of Fibromyalgia in Late-Life Depression: Practical Implications for Psychiatric Settings

    PubMed Central

    Jochum, John R.; Begley, Amy; Dew, Mary Amanda; Weiner, Debra K.; Karp, Jordan F.

    2015-01-01

    Background Fibromyalgia (FM) is common in older adults suffering from mood disorders. However, clinical diagnosis of FM is challenging, particularly in psychiatric settings. We examined the prevalence of FM and the sensitivity of three simple screeners for FM. Methods Using cross-sectional data, we evaluated three tests against the American College of Rheumatology (ACR) 1990 Criteria for the Classification of Fibromyalgia: a “Do you often feel like you hurt all over?” question, a pain map score, and the Pope and Hudson (PH) interview for FM. Participants: were 185 community-dwelling adults ≥ 60 years old with comorbid depression and chronic low back pain evaluated at a late-life mental health clinic. Results 53 of 185 subjects (29%) met the ACR 1990 FM criteria. Compared to those without FM, the FM group had more “yes” answers to the “hurt all over?” question and higher pain map scores. To reach a sensitivity of at least 0.90, the cut-off score for the pain map was 8. The sensitivity of the pain map, “hurt all over?” question, and PH criteria were 0.92 [95%CI 0.82–0.98], 0.91 [95%CI 0.79–0.97], and 0.94 [95%CI 0.843–0.99] respectively. Conclusions Nearly one in three older adults suffering from depression and chronic low back pain met ACR 1990 FM criteria. Three short screening tests showed high sensitivity when compared to the ACR 1990 FM criteria. Implementation of one of the simple screeners for FM in geriatric psychiatry settings may guide the need for further diagnostic evaluation. PMID:25907254

  10. A comparative cross-cultural study of the prevalence of late life depression in low and middle income countries

    PubMed Central

    Guerra, M.; Prina, A.M.; Ferri, C.P.; Acosta, D.; Gallardo, S.; Huang, Y.; Jacob, K.S.; Jimenez-Velazquez, I.Z.; Llibre Rodriguez, J.J.; Liu, Z.; Salas, A.; Sosa, A.L.; Williams, J.D.; Uwakwe, R.; Prince, M.

    2016-01-01

    Background Current estimates of the prevalence of depression in later life mostly arise from studies carried out in Europe, North America and Asia. In this study we aimed to measure the prevalence of depression using a standardised method in a number of low and middle income countries (LMIC). Methods A one-phase cross-sectional survey involving over 17,000 participants aged 65 years and over living in urban and rural catchment areas in 13 sites from 9 countries (Cuba, Dominican Republic, Puerto Rico, Mexico, Venezuela, Peru, China, India and Nigeria). Depression was assessed and compared using ICD-10 and EURO-D criteria. Results Depression prevalence varied across sites according to diagnostic criteria. The lowest prevalence was observed for ICD-10 depressive episode (0.3 to 13.8%). When using the EURO-D depression scale, the prevalence was higher and ranged from 1.0% to 38.6%. The crude prevalence was particularly high in the Dominican Republic and in rural India. ICD-10 depression was also associated with increased age and being female. Limitations Generalisability of findings outside of catchment areas is difficult to assess. Conclusions Late life depression is burdensome, and common in LMIC. However its prevalence varies from culture to culture; its diagnosis poses a significant challenge and requires proper recognition of its expression. PMID:26544620

  11. Coping with Health Stresses and Remission from Late-Life Depression in Primary Care: A Two-Year Prospective Study

    PubMed Central

    Wallace, Meredith L.; Dombrovski, Alexandre Y.; Morse, Jennifer Q.; Houck, Patricia R.; Frank, Ellen; Alexopoulos, George S.; Reynolds, Charles F.; Schulz, Richard

    2011-01-01

    OBJECTIVES Identifying predictors of late-life depression that are amenable to change may lead to interventions that result in better and faster remission. Thus, authors investigated the impact of two different strategies for coping with physical illness on depression in older, primary care patients. Health-oriented goal engagement strategies involve the investment of cognitive and behavioral resources to achieve health goals. Conversely, disengagement strategies involve the withdrawal of these resources from obsolete or unattainable health goals, combined with goal restructuring. METHODS Participants were 271 adults aged >59 who took part in a two-year randomized clinical trial for treating depression in the elderly (PROSPECT -- Prevention of Suicide in Primary Care Elderly: Collaborative Trial). The use of engagement and disengagement strategies, along with other risk factors for depression, were included in a tree-structured survival analysis to identify subgroups of individuals at risk for not achieving depression remission. RESULTS Greater use of disengagement strategies predicted earlier remission of depression, particularly among more severely depressed elderly. Use of engagement strategies did not predict earlier remission. CONCLUSION Interventions that encourage disengagement from unattainable health goals may promote remission from depression in older, primary care patients. PMID:21452177

  12. C-reactive protein gene variants: independent association with late-life depression and circulating protein levels.

    PubMed

    Ancelin, M-L; Farré, A; Carrière, I; Ritchie, K; Chaudieu, I; Ryan, J

    2015-01-01

    C-reactive protein (CRP) is a heritable biomarker of systemic inflammation that is commonly elevated in depressed patients. Variants in the CRP gene that influence protein levels could thus be associated with depression but this has seldom been examined, especially in the elderly. Depression was assessed in 990 people aged at least 65 years as part of the ESPRIT study. A clinical level of depression (DEP) was defined as having a score of ⩾16 on The Center for Epidemiologic Studies Depression scale or a diagnosis of current major depression based on the Mini-International Neuropsychiatric Interview and according to Diagnostic and Statistical Manual of Mental Disorders-IV criteria. Five single-nucleotide polymorphisms spanning the CRP gene were genotyped, and circulating levels of high-sensitivity CRP were determined. Multivariable analyses adjusted for socio-demographic characteristics, smoking, ischemic pathologies, cognitive impairment and inflammation-related chronic pathologies. The minor alleles of rs1130864 and rs1417938 were associated with a decreased risk of depression in women at Bonferroni-corrected significance levels (P=0.002). CRP gene variants were associated with serum levels in a gender-specific manner, but only rs1205 was found to be nominally associated with both an increased risk of DEP and lower circulating CRP levels in women. Variants of the CRP gene thus influence circulating CRP levels and appear as independent susceptibility factors for late-life depression. PMID:25603415

  13. Plasma Biosignature and Brain Pathology related to Persistent Cognitive Impairment in Late-Life Depression

    PubMed Central

    Diniz, Breno S.; Sibille, Etienne; Ding, Ying; Tseng, George; Aizenstein, Howard; Lotrich, Francis; Becker, James T.; Lopez, Oscar L.; Lotze, Michael T.; Klunk, William E.; Reynolds, Charles F.; Butters, Meryl A.

    2015-01-01

    Cognitive impairment is highly prevalent among individuals with late-life depression (LLD) and tends to persist even after successful treatment. The biological mechanisms underlying cognitive impairment in LLD are complex and likely involve abnormalities in multiple pathways, or “cascades,” reflected in specific biomarkers. Our aim was to evaluate peripheral (blood-based) evidence for biological pathways associated with cognitive impairment in older adults with LLD. To this end, we used a data-driven comprehensive proteomic analysis (multiplex immunoassay including 242 proteins), along with measures of structural brain abnormalities (gray matter atrophy and white matter hyperintensity volume via MRI), and brain amyloid-β (Aβ) deposition (PiB-PET). We analyzed data from 80 older adults with remitted major depression (36 with Mild Cognitive Impairment (LLD+MCI) and 44 with normal cognitive function (LLD+NC)). LLD+MCI was associated with differential expression of 24 proteins (p <0.05 and q-value <0.30) related mainly to the regulation of immune-inflammatory activity, intracellular signaling, cell survival, and protein and lipid homeostasis. Individuals with LLD+MCI also showed greater white matter hyperintensity burden compared with LLD+NC (p=0.015). We observed no differences in gray matter volume or brain Aβ deposition between groups. Machine learning analysis showed that a group of three proteins (Apo AI, IL-12, and stem cell factor) yielded accuracy of 81.3%, sensitivity of 75%, and specificity of 86.4% in discriminating participants with MCI from those with normal cognitive function (with an averaged cross-validation accuracy of 76.3%, sensitivity of 69.4% and specificity of 81.8% with nested cross-validation considering the model selection bias). Cognitive impairment in LLD seems to be related to greater cerebrovascular disease along with abnormalities in immune-inflammatory control, cell survival, intracellular signaling, protein and lipid homeostasis

  14. Depressive Symptoms and the Experience of Pleasure in Daily Life: An Exploration of Associations in Early and Late Adolescence.

    PubMed

    van Roekel, Eeske; Bennik, Elise C; Bastiaansen, Jojanneke A; Verhagen, Maaike; Ormel, Johan; Engels, Rutger C M E; Oldehinkel, Albertine J

    2016-07-01

    Although loss of pleasure (i.e., anhedonia) is one of the two core symptoms of depression, very little research has examined the relation between depressive symptoms and the experience of pleasure in daily life. This exploratory study in two population-based adolescent samples aimed to examine how depressive symptoms and anhedonia specifically were related to (1) the proportion and intensity of positive events, (2) mean and variability of positive affect (PA), (3) reactivity to positive events, and (4) reactivity to PA (i.e., whether PA elicits positive events). We used Experience Sampling to measure positive events and PA several times a day during 6 to 14 days in early (N = 284) and late (N = 74) adolescents. Results showed that depressive symptoms were related to a lower proportion and intensity of positive events, lower mean PA, and higher variability in PA regardless of sex and stage of adolescence. No clear evidence was found for differential reactivity to positive events or to PA. Anhedonia was not associated with most daily life experiences of pleasure. Our findings, though preliminary, suggest that although adolescents with many depressive symptoms experience less positive events and lower PA, they are able to enjoy pleasurable events to the same extent as individuals with fewer depressive symptoms. PMID:26496738

  15. Predicting 6-week treatment response to escitalopram pharmacotherapy in late-life major depressive disorder

    PubMed Central

    Saghafi, Ramin; Brown, Charlotte; Butters, Meryl A.; Cyranowski, Jill; Dew, Mary Amanda; Frank, Ellen; Gildengers, Ariel; Karp, Jordan F.; Lenze, Eric J.; Lotrich, Francis; Martire, Lynn; Mazumdar, Sati; Miller, Mark D.; Mulsant, Benoit H.; Weber, Elizabeth; Whyte, Ellen; Morse, Jennifer; Stack, Jacqueline; Houck, Patricia R.; Bensasi, Salem; Reynolds, Charles F.

    2013-01-01

    SUMMARY Objective Approximately half of older patients treated for major depressive disorder (MDD) do not achieve symptomatic remission and functional recovery with first-line pharmacotherapy. This study aims to characterize sociodemographic, clinical, and neuropsychologic correlates of full, partial, and non-response to escitalopram monotherapy of unipolar MDD in later life. Methods One hundred and seventy-five patients aged 60 and older were assessed at baseline on demographic variables, depression severity, hopelessness, anxiety, cognitive functioning, co-existing medical illness burden, social support, and quality of life (disability). Subjects received 10 mg/d of open-label escitalopram and were divided into full (n =55; 31%), partial (n =75; 42.9%), and non-responder (n =45; 25.7%) groups based on Hamilton depression scores at week 6. Univariate followed by multivariate analyses tested for differences between the three groups. Results Non-responders to treatment were found to be more severely depressed and anxious at baseline than both full and partial responders, more disabled, and with lower self-esteem than full responders. In general partial responders resembled full responders more than they resembled non-responders. In multivariate models, more severe anxiety symptoms (both psychological and somatic) and lower self-esteem predicted worse response status at 6 weeks. Conclusion Among treatment-seeking elderly persons with MDD, higher anxiety symptoms and lower self-esteem predict poorer response after six weeks of escitalopram treatment. PMID:17486678

  16. Neuroanatomy of Alzheimer's Disease and Late-Life Depression: A Coordinate-Based Meta-Analysis of MRI Studies.

    PubMed

    Boccia, Maddalena; Acierno, Mauro; Piccardi, Laura

    2015-01-01

    Depression and cognitive impairment are both common disorders in elderly people and frequently occur together. Due to the presence of a common set of behavioral and cognitive symptoms, differential diagnosis may become arduous. Neuroimaging may offer a good tool during diagnosis. We performed a coordinate-based meta-analysis to compare gray matter changes in Alzheimer's disease (AD) and late-life depression (LLD). AD and LLD led to brain atrophy in networks only partially overlapping. Both conditions are linked to a reduction of the bilateral hippocampal volume, but AD is correlated with great atrophy in the left anterior hippocampus and bilateral posterior cingulate cortex, while LLD is correlated with great atrophy in the precuneus, superior frontal gyrus, and ventromedial frontal cortex. Present results shed some light on neural underpinnings of AD and LLD and provide new useful evidence for differential diagnosis. PMID:25869784

  17. Serotonin-norepinephrine reuptake inhibitor therapy in late-life depression is associated with increased marker of bone resorption

    PubMed Central

    Shea, Marcie L.O.; Garfield, Lauren D.; Teitelbaum, Steven; Civitelli, Roberto; Mulsant, Benoit H.; Reynolds, Charles F.; Dixon, David; Doré, Peter; Lenze, Eric J.

    2014-01-01

    Purpose Antidepressants have been associated with increased bone loss and fractures in older adults in observational studies, but the mechanism is unclear. We examined the effects of a serotonin-norepinephrine reuptake inhibitor, venlafaxine, on biomarkers of bone turnover in a prospective treatment study of late-life depression. Methods 76 individuals aged 60 and older with current major depressive disorder received a 12-week course of venlafaxine XR 150-300mg daily. We measured serum C-terminal cross-linking telopeptide of type I collagen (β-CTX) and N-terminal propeptide of type I procollagen (P1NP), measures of bone resorption and formation, respectively, before and after treatment. We then analyzed the change in β-CTX and P1NP within each participant. Venlafaxine levels were measured at the end of the study. We assessed depression severity at baseline and remission status after treatment. Results After 12 weeks of venlafaxine, β-CTX increased significantly, whereas P1NP did not significantly change. The increase in β-CTX was significant only in participants whose depression did not remit (increase of 10% in non-remitters versus 4% in remitters). Change in β-CTX was not correlated with serum levels of venlafaxine or norvenlafaxine. Conclusion Our findings suggest that the primary effect of serotonergic antidepressants is to increase bone resorption. However, such an increase in bone resorption seemed to depend on whether or not participants’ depression remitted. Our results are in agreement with prior observational studies reporting increased bone loss in older adults taking serotonergic antidepressants. These negative effects on bone homeostasis could potentially contribute to increased fracture risk in older adults. PMID:23358607

  18. DIFFUSE MICROSTRUCTURAL ABNORMALITIES OF NORMAL APPEARING WHITE MATTER IN LATE LIFE DEPRESSION: A DIFFUSION TENSOR IMAGING STUDY

    PubMed Central

    Shimony, Joshua S.; Sheline, Yvette I.; D’Angelo, Gina; Epstein, Adrian A.; Benzinger, Tammie L.S.; Mintun, Mark A.; McKinstry, Robert C.; Snyder, Abraham Z.

    2009-01-01

    Many recent studies have identified white matter abnormalities in late life depression (LLD). These abnormalities include an increased volume of discrete white matter lesions (hyperintensities on T2-weighted imaging) and changes in the diffusion tensor properties of water. However, no study of LLD to date has examined the integrity of white matter outside of discrete lesions, i.e., in normal appearing white matter. We performed T1- and T2-weighted imaging as well as diffusion tensor imaging (DTI) in depressed elderly subjects (n=73) and non-depressed control subjects (n=23) matched for age and cerebrovascular risk factors. The structural images were segmented into white matter, gray matter, cerebrospinal fluid and discrete white matter lesions. DTI parameters were calculated in white matter regions of interest after excluding the white matter lesions. Widespread LLD vs. control group differences were found, particularly in prefrontal regions, where the DTI abnormalities correlated with cognitive processing speed. These results suggest that further investigation is warranted to determine the basic pathophysiology and potential reversibility of LLD. PMID:19375071

  19. Late-life depression and risk of vascular dementia and Alzheimer’s disease: systematic review and meta-analysis of community-based cohort studies

    PubMed Central

    Diniz, Breno S.; Butters, Meryl A.; Albert, Steven M.; Dew, Mary Amanda; Reynolds, Charles F.

    2013-01-01

    Background Late-life depression may increase the risk of incident dementia, in particular of Alzheimer’s disease and vascular dementia. Aims To conduct a systematic review and meta-analysis to evaluate the risk of incident all-cause dementia, Alzheimer’s disease and vascular dementia in individuals with late-life depression in population-based prospective studies. Method A total of 23 studies were included in the meta-analysis. We used the generic inverse variance method with a random-effects model to calculate the pooled risk of dementia, Alzheimer’s disease and vascular dementia in older adults with late-life depression. Results Late-life depression was associated with a significant risk of all-cause dementia (1.85, 95% CI 1.67-2.04, P<0.001), Alzheimer’s disease (1.65, 95% CI 1.42-1.92, P<0.001) and vascular dementia (2.52, 95% CI 1.77-3.59, P<0.001). Subgroup analysis, based on five studies, showed that the risk of vascular dementia was significantly higher than for Alzheimer’s disease (P = 0.03). Conclusions Late-life depression is associated with an increased risk for all-cause dementia, vascular dementia and Alzheimer’s disease. The present results suggest that it will be valuable to design clinical trials to investigate the effect of late-life depression prevention on risk of dementia, in particular vascular dementia and Alzheimer’s disease. PMID:23637108

  20. A Daily Diary Study of Co-Rumination, Stressful Life Events, and Depressed Mood in Late Adolescents

    ERIC Educational Resources Information Center

    White, Megan E.; Shih, Josephine H.

    2012-01-01

    The purpose of this study was to extend the research on co-rumination and depressed mood by examining the impact of co-rumination on depressed mood on a daily basis while controlling for the effects of daily stress events in a sample of late adolescents. Two-hundred and seventy-nine predominantly Caucasian college students (95 male, 184 female)…

  1. The temptation of suicide: striatal gray matter, discounting of delayed rewards, and suicide attempts in late-life depression

    PubMed Central

    Dombrovski, Alexandre Y.; Siegle, Greg J.; Szanto, Katalin; Clark, Luke; Reynolds, Charles F.; Aizenstein, Howard

    2012-01-01

    Background Converging evidence implicates basal ganglia alterations in impulsivity and suicidal behavior. For example, D2/D3 agonists and subthalamic nucleus stimulation in Parkinson’s disease trigger impulse control disorders and possibly suicidal behavior. Further, suicidal behavior has been associated with structural basal ganglia abnormalities. Finally, low-lethality, unplanned suicide attempts are associated with increased discounting of delayed rewards, a behavior dependent upon the striatum. Thus, we tested whether, in late-life depression, changes in the basal ganglia were associated with suicide attempts and with increased delay discounting. Methods Fifty-two persons aged ≥60 underwent extensive clinical and cognitive characterization: 33 with major depression (13 suicide attempters [SA], 20 non-suicidal depressed elderly), and 19 non-depressed controls. Participants had high-resolution T1-weighted MPRAGE MRI scans. Basal ganglia gray matter voxel counts were estimated using atlas-based segmentation, with a highly-deformable automated algorithm. Discounting of delayed rewards was assessed using the Monetary Choice Questionnaire, and delay aversion with the Cambridge Gamble Task. Results SA had lower putamen but not caudate or pallidum gray matter voxel counts, compared to the control groups. This difference persisted after accounting for substance use disorders and possible brain injury from suicide attempts. SA with lower putamen gray matter voxel counts displayed higher delay discounting on the MCQ, but not delay aversion on the CGT. Secondary analyses revealed that SA had lower voxel counts in associative and possibly ventral, but not sensorimotor striatum. Conclusions Our findings, while limited by small sample size and case-control design, suggest that striatal lesions could contribute to suicidal behavior by increasing impulsivity. PMID:21999930

  2. Brain-Derived neurotrophic factor levels in late-life depression and comorbid mild cognitive impairment: a longitudinal study

    PubMed Central

    Diniz, Breno Satler; Reynolds, Charles F.; Begley, Amy; Dew, Mary Amanda; Anderson, Stewart J.; Lotrich, Francis; Erickson, Kirk I.; Lopez, Oscar; Aizenstein, Howard; Sibille, Etienne L.; Butters, Meryl A.

    2014-01-01

    Changes in brain-derived neurotrophic factor (BDNF) level are implicated in the pathophysiology of cognitive decline in depression and neurodegenerative disorders in older adults. We aimed to evaluate the longitudinal association over two years between BDNF and persistent cognitive decline in individuals with remitted late-life depression and Mild Cognitive Impairment (LLD+MCI) compared to either individuals with remitted LLD and no cognitive decline (LLD+NCD) or never-depressed, cognitively normal, elderly control participants. We additionally evaluated the effect of double-blind, placebo-controlled donepezil treatment on BDNF levels in all of the remitted LLD participants (across the levels of cognitive function). We included 160 elderly participants in this study (72 LLD+NCD, 55 LLD+MCI and 33 never-depressed cognitively normal elderly participants). At the same visits, cognitive assessments were conducted and blood sampling to determine serum BDNF levels were collected at baseline assessment and after one and two years of follow-up. We utilized repeated measure, mixed effect models to assess: (1) the effects of diagnosis (LLD+MCI, LLD+NCD, and controls), time, and their interaction on BDNF levels; and (2) the effects of donepezil treatment (donepezil vs. placebo), time, baseline diagnosis (LLD+MCI vs. LLD+NCD), and interactions between these contrasts on BDNF levels. We found a significant effect of time on BDNF level (p=0.02) and a significant decline in BDNF levels over 2 years of follow-up in participants with LLD+MCI (p=0.004) and controls (p=0.04). We found no effect of donepezil treatment on BDNF level. The present results suggest that aging is an important factor related to decline in BDNF level. PMID:24290367

  3. Does Cognition Predict Treatment Response and Remission in Psychotherapy for Late-Life Depression?

    PubMed Central

    Beaudreau, Sherry A.; Rideaux, Tiffany; O'Hara, Ruth; Arean, Patricia

    2014-01-01

    Objectives To identify cognitive predictors of geriatric depression treatment outcome. Method Older participants completed baseline measures of memory and executive function, health, and baseline and posttreatment Hamilton Depression Scales (HAM-D) in a 12-week trial comparing psychotherapies (problem-solving vs. supportive; n = 46). We examined cognitive predictors to identify treatment responders, i.e., HAM-D scores reduced by ≥50%, and remitters, i.e., posttreatment HAM-D score ≤ 10. Results Empirically-derived decision trees identified poorer performance on switching (i.e. Trails B), with a cut-score of ≥82” predicting psychotherapy responders. No other cognitive or health variables predicted psychotherapy outcomes in the decision trees. Conclusions Psychotherapies that support or improve the executive skill of switching may augment treatment response for older patients exhibiting executive dysfunction in depression. If replicated, Trails B has potential as a brief cognitive tool for clinical decision-making in geriatric depression. PMID:25441055

  4. The MMSE is not an adequate screening cognitive instrument in studies of late-life depression

    PubMed Central

    Rajji, Tarek K.; Miranda, Dielle; Mulsant, Benoit H.; Lotz, Meredith; Houck, Patricia; Zmuda, Michelle D.; Bensasi, Salem; Reynolds, Charles F.; Butters, Meryl A.

    2009-01-01

    Background The Mini Mental State Examination (MMSE) is frequently used to assess cognition in studies of late-life depression (LLD). However, its sensitivity and specificity in this population are largely unknown. We undertook an analysis of subjects with LLD and hypothesized that: (1) at the traditional cutoff of 24, the MMSE would have low sensitivity in the detection of cognitive impairment; (2) increasing the cutoff score would improve this sensitivity at the expense of a minimal reduction in specificity. Methods We analyzed the MMSE scores of 447 non-demented subjects with LLD using the Dementia Rating Scale (DRS) as the gold standard for cognitive function. Results Using the DRS raw total cutoff of 132 as the “gold standard”, the MMSE at a cutoff of 24 has a sensitivity of 8.0% and a specificity of 99.4% in detecting “cognitively impaired” depressed elders. A receiver operating characteristic curve demonstrates that with an MMSE cutoff of 27 instead of 24, its sensitivity more than quadruples and increases to 37.5% while its specificity decreases minimally from 99.4% to 91.3%. Conclusions In our sample almost all of those classified as cognitively impaired by the DRS are mislabelled as “cognitively intact” by the MMSE. By using a higher cutoff score, the sensitivity can be increased with a minimal reduction in specificity. Our findings have significant implications for those who study or treat persons with LLD or other neuropsychiatric disorders. PMID:18644607

  5. Grey matter volume increase following electroconvulsive therapy in patients with late life depression: a longitudinal MRI study

    PubMed Central

    Bouckaert, Filip; De Winter, François-Laurent; Emsell, Louise; Dols, Annemieke; Rhebergen, Didi; Wampers, Martien; Sunaert, Stefan; Stek, Max; Sienaert, Pascal; Vandenbulcke, Mathieu

    2016-01-01

    Background The evidence on the mechanisms of action of electroconvulsive therapy (ECT) has grown over the past decades. Recent studies show an ECT-related increase in hippocampal, amygdala and subgenual cortex volume. We examined grey matter volume changes following ECT using voxel-based morphometry (VBM) whole brain analysis in patients with severe late life depression (LLD). Methods Elderly patients with unipolar depression were treated twice weekly with right unilateral ECT until remission on the Montgomery–Åsberg Depression Rating Scale (MADRS) was achieved. Cognition (Mini Mental State Examination) and psychomotor changes (CORE Assessment) were monitored at baseline and 1 week after the last session of ECT. We performed 3 T structural MRI at both time points. We used the VBM8 toolbox in SPM8 to study grey matter volume changes. Paired t tests were used to compare pre- and post-ECT grey matter volume (voxel-level family-wise error threshold p < 0.05) and to assess clinical response. Results Twenty-eight patients (mean age 71.9 ± 7.8 yr, 8 men) participated in our study. Patients received a mean of 11.2 ± 4 sessions of ECT. The remission rate was 78.6%. Cognition, psychomotor agitation and psychomotor retardation improved significantly (p < 0.001). Right- hemispheric grey matter volume was increased in the caudate nucleus, medial temporal lobe (including hippocampus and amygdala), insula and posterior superior temporal regions but did not correlate with MADRS score. Grey matter volume increase in the caudate nucleus region correlated significantly with total CORE Assessment score (r = 0.63; p < 0.001). Limitations Not all participants were medication-free. Conclusion Electroconvulsive therapy in patients with LLD is associated with significant grey matter volume increase, which is most pronounced ipsilateral to the stimulation side. PMID:26395813

  6. Spouse Health Status, Depressed Affect, and Resilience in Mid and Late Life: A Longitudinal Study

    ERIC Educational Resources Information Center

    Bookwala, Jamila

    2014-01-01

    This study used longitudinal data to examine the effects of spousal illness on depressive symptoms among middle-aged and older married individuals and the extent to which the adverse effects of illness in a spouse were mitigated by 2 psychological resources, mastery and self-esteem. Using 1,704 married participants who were 51 years of age on…

  7. Reward signals, attempted suicide, and impulsivity in late-life depression.

    PubMed

    Dombrovski, Alexandre Y; Szanto, Katalin; Clark, Luke; Reynolds, Charles F; Siegle, Greg J

    2013-10-01

    IMPORTANCE—Suicide can be viewed as an escape from unendurable punishment at the cost of any future rewards. Could faulty estimation of these outcomes predispose to suicidal behavior? In behavioral studies, many of those who have attempted suicide misestimate expected rewards on gambling and probabilistic learning tasks.OBJECTIVES—To describe the neural circuit abnormalities that underlie disadvantageous choices in people at risk for suicide and to relate these abnormalities to impulsivity, which is one of the components of vulnerability to suicide.DESIGN—Case-control functional magnetic resonance imaging study of reward learning using are inforcement learning model.SETTING—University hospital and outpatient clinic.PATIENTS—Fifty-three participants 60 years or older, including 15 depressed patients who had attempted suicide, 18 depressed patients who had never attempted suicide (depressed control subjects), and 20 psychiatrically healthy controls.MAIN OUTCOMES AND MEASURES—Components of the cortical blood oxygenation level–dependent response tracking expected and unpredicted rewards.RESULTS—Depressed elderly participants displayed 2 distinct disruptions of control over reward-guided behavior. First, impulsivity and a history of suicide attempts (particularly poorly planned ones) were associated with a weakened expected reward signal in the paralimbic cortex,which in turn predicted the behavioral insensitivity to contingency change. Second, depression was associated with disrupted corticostriatothalamic encoding of unpredicted rewards, which in turn predicted the behavioral over sensitivity to punishment. These results were robust to the effects of possible brain damage from suicide attempts, depressive severity, co-occurring substance use and anxiety disorders, antidepressant and anticholinergic exposure, lifetime exposure to electroconvulsive therapy, vascular illness, and incipient dementia.CONCLUSIONS AND RELEVANCE—Altered paralimbic reward

  8. Antidepressants differentially related to 1,25-(OH)2 vitamin D3 and 25-(OH) vitamin D3 in late-life depression

    PubMed Central

    Oude Voshaar, R C; Derks, W J; Comijs, H C; Schoevers, R A; de Borst, M H; Marijnissen, R M

    2014-01-01

    A low plasma 25-OH vitamin D3 level is a universal risk factor for a wide range of diseases and has also been implicated in late-life depression. It is currently unknown whether the biologically active form of vitamin D, that is, 1,25-(OH)2 vitamin D3, is also decreased in late-life depression, or whether vitamin D levels correlate with specific depression characteristics. We determined plasma 25-OH vitamin D3, 1,25-(OH)2 vitamin D3 and parathormone levels in 355 depressed older persons and 124 non-depressed comparison subjects (age⩾60 years). Psychopathology was established with the Composite International Diagnostic Interview 2.1, together with potential confounders and depression characteristics (severity, symptom profile, age of onset, recurrence, chronicity and antidepressant drug use). Adjusted for confounders, depressed patients had significantly lower levels of 25-OH vitamin D33 (Cohen's d =0.28 (95% confidence interval: 0.07–0.49), P=0.033) as well as 1,25-(OH)2 vitamin D3 (Cohen's d =0.48 (95% confidence interval: 0.27–0.70), P<0.001) than comparison subjects. Of all depression characteristics tested, only the use of tricyclic antidepressants (TCAs) was significantly correlated with lower 1,25-(OH)2 vitamin D3 levels (Cohen's d =0.86 (95% confidence interval: 0.53–1.19), P<0.001), but not its often measured precursor 25-OH vitamin D3. As vitamin D levels were significantly lower after adjustment for confounders, vitamin D might have an aetiological role in late-life depression. Differences between depressed and non-depressed subjects were largest for the biologically active form of vitamin D. The differential impact of TCAs on 25-OH vitamin D3 and 1,25-(OH)2 vitamin D3 levels suggests modulation of 1-α-hydroxylase and/or 24-hydroxylase, which may in turn have clinical implications for biological ageing mechanisms in late-life depression. PMID:24736799

  9. Parental Religious Socialization Practices, Connectedness With Others, and Depressive Symptoms in Late Life

    PubMed Central

    2012-01-01

    This purpose of this study is to examine two constructs that have been largely overlooked in the study of religious involvement among older people: parental religious socialization practices and feelings of connectedness with others. The data are from an ongoing nationwide survey of older people. Findings from a latent variable model that was designed to examine the two focal constructs provides support for the following relationships:(1) older people whose parents encouraged them to become more involved in religion are more likely to attend worship services; (2) older people whose parents promoted religious involvement and older individuals who attend church more often are more likely to report that they see a fundamental connection among all human beings; (3) older adults who feel more closely connected to others will be more likely to forgive people for the things they have done; and (4) older people who are more forgiving are likely to experience fewer symptoms of depression over time. PMID:22468116

  10. Models of Care for Late-Life Depression of the Medically Ill: Examples from COPD and Stroke

    PubMed Central

    Avari, Jimmy N.; Alexopoulos, George S.

    2014-01-01

    Depression worsens most treatment outcomes in medically ill older adults. Chronic medical illnesses weaken and demoralize patients and compromise their ability to adhere to treatments requiring consistency and effort. Acute medical illnesses create a psychosocial storm that finds patients and their ecosystem unprepared. We describe two intervention models that can be used to target and personalize treatment in depressed, chronically or acutely medically ill older adults. Personalized Adherence Intervention for Depression and COPD (PID-C) is a model intervention for depressed patients with chronic medical illnesses. It targets patient-specific barriers to treatment engagement and aims to shift the balance in favor of treatment participation. PID-C led to higher remission rates of depression, reduction in depressive symptoms, and reduction in dyspnea-related disability. Addition of problem solving training enables patients to utilize resources available to them and hopefully improve their outcomes. Ecosystem Focused Therapy (EFT) is a model intervention for depression developing in the context of an acute medical event. It was developed for patients with post-stroke depression (PSD) and targets five areas, part of the “psychosocial storm” originating from the patient’s sudden disability and the resulting change in the patient’s needs and family’s life. A preliminary study suggests that EFT is feasible and efficacious in reducing depressive symptoms and signs and disability in PSD. PMID:25028344

  11. Models of care for late-life depression of the medically ill: examples from chronic obstructive pulmonary disease and stroke.

    PubMed

    Avari, Jimmy N; Alexopoulos, George S

    2015-05-01

    Depression worsens most treatment outcomes in medically ill older adults. Chronic medical illnesses weaken and demoralize patients and compromise their ability to adhere to treatments requiring consistency and effort. Acute medical illnesses create a psychosocial storm that finds patients and their ecosystem unprepared. We describe two intervention models that can be used to target and personalize treatment in depressed, chronically, or acutely medically ill older adults. The Personalized Adherence Intervention for Depression and COPD (PID-C) is a model intervention for depressed patients with chronic medical illnesses. It targets patient-specific barriers to treatment engagement and aims to shift the balance in favor of treatment participation. PID-C led to higher remission rates of depression, reduction in depressive symptoms, and reduction in dyspnea-related disability. The addition of problem-solving training enables patients to use resources available to them and hopefully improve their outcomes. Ecosystem-focused therapy (EFT) is a model intervention for depression developing in the context of an acute medical event. It was developed for patients with poststroke depression (PSD) and targets five areas, part of the "psychosocial storm" originating from the patient's sudden disability and the resulting change in the patient's needs and family's life. A preliminary study suggests that EFT is feasible and efficacious in reducing depressive symptoms and signs and disability in PSD. PMID:25028344

  12. Interpersonal psychotherapy (IPT) for late-life depression in general practice: uptake and satisfaction by patients, therapists and physicians

    PubMed Central

    van Schaik, Digna JF; van Marwijk, Harm WJ; Beekman, Aartjan TF; de Haan, Marten; van Dyck, Richard

    2007-01-01

    Background Interpersonal Psychotherapy (IPT) is recommended in most depression treatment guidelines and proved to be a suitable treatment for elderly depressed patients. Despite the favorable results of IPT in research populations, the dissemination to general practice is surprisingly limited. Little is known about uptake and satisfaction when this therapy is introduced into real-life general practice. Methods Motivation and evaluation of patients, GPs and therapists were recorded and organizational barriers described alongside a randomized controlled trial. IPT, given by mental health workers, was compared with usual general practitioner (GP) care. Included were patients (≥55 years) who met the DSM-IV criteria for major depressive disorder. Results Patients were motivated for the psychotherapy intervention: of the 205 eligible patients, 143 (70%) entered the study, and of the 69 patients who were offered IPT, 77% complied with the treatment. IPT proved to be an attractive therapy for patients as well as for therapists from mental health organizations. General practitioners evaluated the intervention positively afterwards, mainly because of the time-limited and structured approach. Organizational barriers: no IPT therapists were available; an IPT trainer and supervisor had to be trained and training materials had to be developed and translated. Additionally, there was a lack of office space in some general practices; for therapists from private practices it was not feasible to participate because of financial reasons. IPT was superior to usual care in patients with moderate to severe depression. Conclusion As we succeeded in delivering IPT in primary care practice, and as IPT was superior to usual care, there are grounds to support the implementation of IPT for depressed elderly patients within general practice, as long as the practices have room for the therapists and financial barriers can be overcome. Consolidation may be achieved by making this intervention

  13. Ethics of palliative care in late-stage cancer management and end-of-life issues in a depressed economy.

    PubMed

    Chukwuneke, F N

    2015-12-01

    The Hippocratic Oath has often been referred to as the ethical foundation of medical practice with the key restriction "cause no harm" which is also the principle of benevolence in bioethics. In medical profession, the Oath still exemplifies the key virtues of a doctor in its emphasis on the obligations toward the well-being of the individual patient. In management of end-stage cancer in a depressed economy such as Nigeria, we frequently encounter a wide range of ethical issues that arise in the provision of palliative care mostly due to the prevailing economic situation and cultural setting. Since most of these patients came from a lower economic class of the society, with little or no formal education and lived at a subsistence level, they often find it difficult to provide the medications needed. In a poor setting where health inequity is rife, and ignorance and poverty are commonplace, a good understanding of medical ethics with a good model of health care system will contribute to the health professional's decision-making that will be in the best interest of the patients. Physicians must protect the lives of their patients and should never hasten their death. In end-stage cancer management, we have to relieve suffering and pains, promote palliative care, and give psychological support but never abandoning the patient or initiate terminating their life. This presentation is a clinical analysis of the ethical issues regarding the management of end-stage cancer patients in a poor economy with a critical overview of end-of-life issues in African perspective. PMID:26620617

  14. Cross-National Comparisons of Gender Differences in Late-Life Depressive Symptoms in Japan and the United States

    PubMed Central

    2013-01-01

    Objectives. This study compared changes in self-reported depressive symptoms in the United States and Japan across 2 points in time. The investigation focused on the gendered processes of intergenerational coresidence and support as the primary distinctions between nations. Methods. Fixed-effects models were fit to examine the covariates of depressive symptoms in the Health and Retirement Study (HRS) and the Nihon University Japanese Longitudinal Study of Aging. Results. Gender differences in depressive symptoms persisted across survey waves in both nations, with Japanese men reporting sharper increases by Time 2 than Japanese women. Getting older was associated with more depressive symptoms among Japanese men, whereas income provided a slight buffering effect. Coresiding with daughters also appeared to protect Japanese men and women with functional limitations from depressive symptoms. HRS data demonstrated that changes in marital status and physical health were correlated with increased depressive symptoms for men and women in the United States. Discussion. The analyses revealed more variety in Center for Epidemiologic Studies Depression scale reports by gender in Japan than in the United States. Future research should consider the diversity of contemporary Japanese households, reflecting new interpretations of traditional family support relationships. PMID:23591572

  15. Shared Decision-Making in the Primary Care Treatment of Late-Life Major Depression: A Needed New Intervention?

    PubMed Central

    Raue, Patrick J.; Schulberg, Herbert C.; Lewis-Fernandez, Roberto; Boutin-Foster, Carla; Hoffman, Amy S.; Bruce, Martha L.

    2010-01-01

    Objective We suggest that clinicians consider models of shared decision-making for their potential ability to improve the treatment of major depression in the primary care setting and overcome limitations of collaborative care and other interventions. Methods We explore the characteristics and techniques of patient-clinician shared decision-making, with particular emphasis on this model’s relevance to the unique treatment concerns of depressed older adults. Results We describe a shared decision-making intervention to engage older adults in depression treatment in the primary care sector. Conclusions It is timely to examine shared decision-making models for elderly depressed primary care patients given their potential ability to improve treatment adherence and clinical outcomes. PMID:19946872

  16. Management of anxiety in late life.

    PubMed

    Flint, A J

    1998-01-01

    Epidemiologic data are used as a framework to discuss the pharmacologic and cognitive-behavioral management of anxiety disorders in late life. Generalized anxiety disorder (GAD) and phobias account for most cases of anxiety in late life. The high level of comorbidity between GAD and major depression, and the observation that the anxiety usually arises secondarily to the depression, suggests that antidepressant medication should be the primary pharmacologic treatment for many older people with GAD. Most individuals with late-onset agoraphobia do not have a history of panic attacks and the illness often starts after a traumatic event. Exposure therapy is the treatment of choice for agoraphobia without panic. It is uncommon for obsessive-compulsive disorder (OCD) and panic disorder to start for the first time in old age, but these disorders can persist from younger years into late life. Case reports and uncontrolled case series suggest that elderly people with OCD or panic disorder can benefit from pharmacologic and cognitive-behavioral treatments that are known to be effective in younger patients. However, it is not known whether the rate of response among elderly patients is adversely affected by the chronicity of these disorders. The prevalence and incidence of post-traumatic stress disorder in late life are not known. Uncontrolled data support the use of selective serotonin reuptake inhibitors in war veterans with chronic symptoms of post-traumatic stress disorder; other treatments for this condition await evaluation in the elderly. PMID:10230998

  17. [Late-onset depression : Pathophysiology, diagnostics and treatment].

    PubMed

    Notzon, S; Alferink, J; Arolt, V

    2016-09-01

    Late-onset depression (LOD) is defined as depression manifesting for the first time in later life. Up to now, there has been no exact definition of the lower age limit for LOD. Psychopathological symptoms of LOD do not fundamentally differ from depression in other phases of life; however, cognitive deficits are typically more pronounced. The LOD is associated with an increased risk of developing dementia. Imaging studies show reduction in gray matter volume and white matter lesions caused by vascular diseases. The occurrence of depression with vascular lesions of the brain is also referred to as "vascular depression". The diagnostic procedure includes a detailed medical history and the observation of psychopathological changes, physical examination, laboratory tests, electroencephalograph (EEG), electrocardiograph (ECG) and magnetic resonance imaging (MRI) of the head and neuropsychological tests to measure cognitive deficits. Psychotherapy is an effective treatment option. Selective serotonin reuptake inhibitors are the first-line pharmacological therapy. PMID:27531211

  18. Advantages and Challenges of A Village Doctor-Based Cognitive Behavioral Therapy for Late-Life Depression in Rural China: A Qualitative Study

    PubMed Central

    Tang, Tan; Yang, Xuemei; Zhang, Weijun; Wang, Xiaohua; Ji, Li; Xiao, Yun; Ma, Kun; Wang, Ying; Kong, Xianglei; Wang, Jianping; Liu, Jun; Xu, Qian; Tian, Donghua; Qu, Zhiyong

    2015-01-01

    Background The delivery of mental health services in rural China has been notably limited due to lack of qualified mental health professionals among other impeding factors. A village doctor-based cognitive behavioral therapy intervention may be one way of improving accessibility. The purpose of this study was to explore the advantages and challenges of implementing this intervention, as delivered by trained village doctors, to treat late-life depression in rural China. Methods We conducted one focus group discussion with 10 village doctors, 10 individual interviews with each of the village doctors, and individual interviews with 19 older adults. The topic guides were advantages and challenges of the intervention program from the perspective of the village doctors and older adults. Interviews were audio-recorded, transcribed, coded using NVivo 8, and analyzed using thematic analysis. Results The village doctors stressed the importance of role-playing and using instructive manuals in the training. Proper supervision was also a key component of the program. The benefits received from the intervention for the village doctors and the elders were positive such that both the doctors and the older adults were willing to implement/receive this intervention. Cultural and political factors (renqing and perceived policy consideration) facilitated the elders’ access to mental health services. Challenges included a lack of real therapy (in contrast to role-playing) demonstrated in the training and lack of a step-by-step manual based on different types of problems encountered. Other impediments to the successful implementation of the intervention included the time constraints of village doctors and the presence of other people when conducting the intervention. Conclusions The present study has demonstrated that the intervention program is likely to be an acceptable geriatric depression intervention in rural China if several challenges are appropriately addressed. PMID:26371473

  19. Late pregnancy thyroid-binding globulin predicts perinatal depression.

    PubMed

    Pedersen, Cort; Leserman, Jane; Garcia, Nacire; Stansbury, Melissa; Meltzer-Brody, Samantha; Johnson, Jacqueline

    2016-03-01

    Previously we found that late pregnancy total and free thyroxine (TT4, FT4) concentrations were negatively related to greater pre and/or postpartum depressive symptoms. In a much larger cohort, the current study examined whether these thyroid indices measured earlier in the third trimester (31-33 weeks) predict subsequent perinatal depression and anxiety ratings as well as syndromal depression. Thyroid-binding globulin (TBG) concentrations increase markedly during pregnancy and may be an index of sensitivity to elevated estrogen levels. TBG was examined in this study because prior findings suggest that postpartum depression is related to sensitivity to mood destabilization by elevated sex hormone concentrations during pregnancy. Our cohort was 199 euthyroid women recruited from a public health obstetrics clinic (63.8% Hispanic, 21.6% Black). After screening and blood draws for hormone measures at pregnancy weeks 31-33, subjects were evaluated during home visits at pregnancy weeks 35-36 as well as postpartum weeks 6 and 12. Evaluations included psychiatric interviews for current and life-time DSM-IV psychiatric history (M.I.N.I.-Plus), subject self-ratings and interviewer ratings for depression and anxiety (Edinburgh Postnatal Depression Scale, Montgomery-Ǻsberg Depression Rating Scale; Spielberger State-Trait Anxiety Inventory, Hamilton Anxiety Inventory), as well as a standardized interview to obtain life-time trauma history. Numerous covariates were included in all regression analyses. Trauma and major depression history were robustly significant predictors of depression and anxiety ratings over the study period when these variables were analyzed individually or in a combined model including FT4 or TBG (p<.001). When analyzed alone, FT4 levels were a less strong but still significant predictor of all depression and anxiety ratings (p<.05) while TBG levels was a significant or nearly significant predictor of most ratings. FT4, TBG and trauma history, but not

  20. Differences Between Early and Late Onset Adult Depression

    PubMed Central

    Bukh, Jens Drachmann; Bock, Camilla; Vinberg, Maj; Gether, Ulrik; Kessing, Lars Vedel

    2011-01-01

    Background: It is unclear, whether age-of-onset identifies subgroups of depression. Aim: To assess the clinical presentation of depression with onset in the early adult age (18-30 years) as compared to depression with later onset (31-70 years). Method: A total number of 301 patients with first episode depression were systematically recruited. Characteristics including psychiatric co-morbidity, personality disorders and traits, stressful life events prior to onset, family history, and treatment outcome were assessed by structured interviews and compared by chi-square tests for categorical data, t-tests for continuous parametric data and Mann-Whitney U-test for continuous nonparametric data. Logistic and multiple regression analyses were used to adjust the analyses for potentially confounding variables. Results: Patients with early onset of depression were characterised by a higher prevalence of co-morbid personality disorders, higher levels of neuroticism, and a lower prevalence of stressful life events preceding onset compared to patients with later age-of-onset. There were no differences in severity of the depressive episode, treatment outcome or family loading of psychiatric illness. Conclusion: Early adult onset of depression is associated with co-morbid personality deviances, whereas late onset is associated with environmental risk factors. PMID:21866230

  1. Depression in Later Life: Recognition and Treatment.

    ERIC Educational Resources Information Center

    Schmall, Vicki L.; And Others

    This guide is designed to help readers understand depression and factors related to its onset in later life; recognize signs of depression and potential suicide; and know actions they can take if they suspect an older family member or friend may be depressed or contemplating suicide. Following a brief introduction, a chapter on depression…

  2. Sodium Butyrate, a Histone Deacetylase Inhibitor, Reverses Behavioral and Mitochondrial Alterations in Animal Models of Depression Induced by Early- or Late-life Stress.

    PubMed

    Valvassori, Samira S; Resende, Wilson R; Budni, Josiane; Dal-Pont, Gustavo C; Bavaresco, Daniela V; Réus, Gislaine Z; Carvalho, André F; Gonçalves, Cinara L; Furlanetto, Camila B; Streck, Emilio L; Quevedo, João

    2015-01-01

    The aim of the present study was to evaluate the effects of sodium butyrate on depressive-like behavior and mitochondrial alteration parameters in animal models of depression induced by maternal deprivation or chronic mild stress in Wistar rats. maternal deprivation was established by separating pups from their mothers for 3 h daily from postnatal day 1 to day 10. Chronic mild stress was established by water deprivation, food deprivation, restraint stress, isolation and flashing lights. Sodium butyrate or saline was administered twice a day for 7 days before the behavioral tests. Depressive behavior was evaluated using the forced swim test. The activity of tricarboxylic acid cycle enzymes (succinate dehydrogenase and malate dehydrogenase) and of mitochondrial chain complexes (I, II, II-III and IV) was measured in the striatum of rats. From these analyses it can be observed that sodium butyrate reversed the depressive-like behavior observed in both animal models of depression. Additionally, maternal deprivation and chronic mild stress inhibited mitochondrial respiratory chain complexes and increased the activity of tricarboxylic acid cycle enzymes. Sodium butyrate treatment reversed -maternal deprivation and chronic mild stress- induced dysfunction in the striatum of rats. In conclusion, sodium butyrate showed antidepressant effects in maternal deprivation and chronic mild stress-treated rats, and this effect can be attributed to its action on the neurochemical pathways related to depression. PMID:26216027

  3. [Disaster psychiatry in late life].

    PubMed

    Awata, Shuichi

    2013-10-01

    Disaster preparedness in geriatric psychiatry was proposed on the basis of experience of the Great East Japan Earthquake. 1) Frail or demented elderly should be considered as a special population at risk for disaster victims and addressed in local disaster prevention programs. 2) To response to various psychiatric symptoms(delirium, BPSD, depression, anxiety, insomnia, and posttraumatic stress disorder) caused by medical conditions and rapid environmental changes due to disaster, linkage and coordination systems between psychiatric and medical sections should be established. 3) As a medium- and long-term support for the elderly who lost the community familiar to them, creation of a new community should be promoted in order to prevent depression, alcohol dependence, BPSD, and suicide. PMID:24261221

  4. Depression, Life Events and Somatic Symptoms.

    ERIC Educational Resources Information Center

    Rozzini, Renzo; And Others

    1988-01-01

    Investigated the relationship between somatic symptoms, depression, and life events (health status, function, social satisfaction, income) in a population of 1,201 elderly persons living at home. Found depression was the most important factor in the appearance of somatic complaints; however, life events were important cofactors in defining…

  5. Mild cognitive impairment, poor episodic memory, and late-life depression are associated with cerebral cortical thinning and increased white matter hyperintensities

    PubMed Central

    Fujishima, Motonobu; Maikusa, Norihide; Nakamura, Kei; Nakatsuka, Masahiro; Matsuda, Hiroshi; Meguro, Kenichi

    2014-01-01

    In various independent studies to date, cerebral cortical thickness and white matter hyperintensity (WMH) volume have been associated with episodic memory, depression, and mild cognitive impairment (MCI). The aim of this study was to uncover variations in cortical thickness and WMH volume in association with episodic memory, depressive state, and the presence of MCI simultaneously in a single study population. The participants were 186 individuals with MCI (clinical dementia rating [CDR] of 0.5) and 136 healthy elderly controls (HCs; CDR of 0) drawn from two community-based cohort studies in northern Japan. We computed cerebral cortical thickness and WMH volume by using MR scans and statistically analyzed differences in these indices between HCs and MCI participants. We also assessed the associations of these indices with memory performance and depressive state in participants with MCI. Compared with HCs, MCI participants exhibited thinner cortices in the temporal and inferior parietal lobes and greater WMH volumes in the corona radiata and semioval center. In MCI participants, poor episodic memory was associated with thinner cortices in the left entorhinal region and increased WMH volume in the posterior periventricular regions. Compared with non-depressed MCI participants, depressed MCI participants showed reduced cortical thickness in the anterior medial temporal lobe and gyrus adjacent to the amygdala bilaterally, as well as greater WMH volume as a percentage of the total intracranial volume (WMHr). A higher WMHr was associated with cortical thinning in the frontal, temporal, and parietal regions in MCI participants. These results demonstrate that episodic memory and depression are associated with both cortical thickness and WMH volume in MCI participants. Additional longitudinal studies are needed to clarify the dynamic associations and interactions among these indices. PMID:25426066

  6. Bereaved Elders: Transformative Learning in Late Life

    ERIC Educational Resources Information Center

    Moon, Paul J.

    2011-01-01

    This qualitative study sought to understand older adults' (elders) transformative learning through bereavement in late life. Nine bereaved elders were engaged through in-depth interviews. Data analysis via the constant comparative method indicated deep changes in views of death-related issues as well as ongoing life-related issues. The process of…

  7. Eating Disorders in Late-life

    PubMed Central

    Luca, Antonina; Luca, Maria; Calandra2, Carmela

    2015-01-01

    Eating disorders are a heterogeneous group of complex psychiatric disorders characterized by abnormal eating behaviours that lead to a high rate of morbidity, or even death, if underestimated and untreated. The main disorders enlisted in the chapter of the Diagnostic and Statistic Manual of Mental Disorders-5 dedicated to “Feeding and Eating Disorders” are: anorexia nervosa, bulimia nervosa and binge eating disorder. Even though these abnormal behaviours are mostly diagnosed during childhood, interesting cases of late-life eating disorders have been reported in literature. In this review, these eating disorders are discussed, with particular attention to the diagnosis and management of those cases occurring in late-life. PMID:25657852

  8. Obsessive-Compulsive Disorder in Late Life

    ERIC Educational Resources Information Center

    Calamari, John E.; Pontarelli, Noelle K.; Armstrong, Kerrie M.; Salstrom, Seoka A.

    2012-01-01

    Although obsessive-compulsive disorder (OCD) has received increasing attention, the study and treatment of OCD in late life has been neglected. The obsessions and compulsions seen with older adults do not appear to differ from the symptoms experienced by other age groups, although developmental issues might influence symptom focus (e.g., memory…

  9. Alcohol abuse: medical effects of heavy drinking in late life.

    PubMed

    Gambert, S R

    1997-06-01

    As many as 15% of community-dwelling older persons are heavy drinkers, but their alcoholism is often hidden from their physicians. Depression, loneliness, and lack of social support are the most frequently cited antecedents to drinking for older alcoholics. Clinically, the same amount of alcohol once consumed with impunity may cause clinical symptoms in late life. Physiologic changes in volume of distribution make older patients susceptible to acute alcohol toxicity, with its CNS effects and metabolic disturbances. Liver disease, nutritional deficiencies, and impotence are consequences of chronic alcohol abuse. PMID:9194788

  10. Midlife Eriksonian psychosocial development: Setting the stage for late-life cognitive and emotional health.

    PubMed

    Malone, Johanna C; Liu, Sabrina R; Vaillant, George E; Rentz, Dorene M; Waldinger, Robert J

    2016-03-01

    Erikson's (1950) model of adult psychosocial development outlines the significance of successful involvement within one's relationships, work, and community for healthy aging. He theorized that the consequences of not meeting developmental challenges included stagnation and emotional despair. Drawing on this model, the present study uses prospective longitudinal data to examine how the quality of assessed Eriksonian psychosocial development in midlife relates to late-life cognitive and emotional functioning. In particular we were interested to see whether late-life depression mediated the relationship between Eriksonian development and specific domains of cognitive functioning (i.e., executive functioning and memory). Participants were 159 men from the over-75 year longitudinal Study of Adult Development. The sample was comprised of men from both higher and lower socioeconomic strata. Eriksonian psychosocial development was coded from men's narrative responses to interviews between the ages of 30-47 (Vaillant & Milofsky, 1980). In late life (ages 75-85) men completed a performance-based neuropsychological assessment measuring global cognitive status, executive functioning, and memory. In addition depressive symptomatology was assessed using the Geriatric Depression Scale. Our results indicated that higher midlife Eriksonian psychosocial development was associated with stronger global cognitive functioning and executive functioning, and lower levels of depression 3 to 4 decades later. There was no significant association between Eriksonian development and late-life memory. Late-life depression mediated the relationship between Eriksonian development and both global cognition and executive functioning. All of these results controlled for highest level of education and adolescent intelligence. Findings have important implications for understanding the lasting benefits of psychosocial engagement in mid-adulthood for late-life cognitive and emotional health. In addition

  11. Musical Training and Late-Life Cognition

    PubMed Central

    Gooding, Lori F; Abner, Erin L; Jicha, Gregory A; Kryscio, Richard J; Schmitt, Fredrick A

    2014-01-01

    This study investigated effects of early- to mid-life musical training on cognition in older adults. A Musical Training Survey examined self-reported musical experience and objective knowledge in 237 cognitively intact participants. Responses were classified into Low, Medium, and High knowledge groups. Linear mixed models compared the groups’ longitudinal performance on the Animal Naming Test (ANT; semantic verbal fluency) and Logical Memory Story A Immediate Recall (LMI; episodic memory) controlling for baseline age, time since baseline, education, sex, and full-scale IQ. Results indicate that High knowledge participants had significantly higher LMI scores at baseline and over time compared to Low knowledge participants. ANT scores did not differ among the groups. Ability to read music was associated with higher mean scores for both ANT and LMI over time. Early-to mid-life musical training may be associated with improved late-life episodic and semantic memory as well as a useful marker of cognitive reserve. PMID:24375575

  12. Midlife migraine and late-life parkinsonism

    PubMed Central

    Ross, G. Webster; Sigurdsson, Sigurdur; Garcia, Melissa; Gudmundsson, Larus S.; Sveinbjörnsdóttir, Sigurlaug; Wagner, Amy K.; Gudnason, Vilmundur; Launer, Lenore J.

    2014-01-01

    Objective: In the present study, we tested the hypothesis that having migraine in middle age is related to late-life parkinsonism and a related disorder, restless legs syndrome (RLS), also known as Willis-Ekbom disease (WED). Methods: The AGES-Reykjavik cohort (born 1907–1935) has been followed since 1967. Headaches were classified based on symptoms assessed in middle age. From 2002 to 2006, 5,764 participants were reexamined to assess symptoms of parkinsonism, diagnosis of Parkinson disease (PD), family history of PD, and RLS/WED. Results: Subjects with midlife migraine, particularly migraine with aura (MA), were in later life more likely than others to report parkinsonian symptoms (odds ratio [OR]MA = 3.6 [95% CI 2.7–4.8]) and diagnosed PD (ORMA = 2.5 [95% CI 1.2–5.2]). Women with MA were more likely than others to have a parent (ORMA = 2.26 [95% CI 1.3–4.0]) or sibling (ORMA = 1.78 [95% CI 1.1–2.9]) with PD. Late-life RLS/WED was increased for headache generally. Associations were independent of cardiovascular disease and MRI-evident presumed ischemic lesions. Conclusions: These findings suggest there may be a common vulnerability to, or consequences of, migraine and multiple indicators of parkinsonism. Additional genetic and longitudinal observational studies are needed to identify candidate pathways that may account for the comorbid constellation of symptoms. PMID:25230997

  13. Quality of Life, Health Status, and Depression

    PubMed Central

    Pike, Nancy A.; Evangelista, Lorraine S.; Doering, Lynn V.; Eastwood, Jo-Ann; Lewis, Alan B.; Child, John S.

    2012-01-01

    Background Quality of life (QOL) in adolescents and adults who have undergone the Fontan procedure and are living with only 1 ventricle is presumed to be diminished. Objectives This study aimed to compare QOL, health status, and prevalence of depression in adolescents/adults after the Fontan procedure with healthy counterparts and to identify predictors of QOL in the Fontan group. Methods Using a comparative, cross-sectional design, 54 adolescents and adults with single ventricle congenital heart disease who have undergone the Fontan procedure were compared with 66 age-matched healthy counterparts. Quality of life, health status, depression, and social support were measured using the Satisfaction With Life Scale, Short Form Survey Version 2, Patient Health Questionnaire Depression Module, and Multidimensional Scale of Perceived Social Support. Clinical variables were abstracted from medical records. Predictors of QOL were determined using multiple linear regression. Results Adolescents and adults in the Fontan group reported lower physical health status (mean [SD] = 46.5 [9.3] vs mean [SD] = 55.9 [5.1], P < .001) and were more depressed (mean [SD] = 7.3 [5.9] vs mean [SD] = 4.5 [4.3], P < .004) than their healthy counterparts. There were no differences in QOL, mental health status, or social support between the 2 groups. Functional status (New York Heart Association class), depression, and social support accounted for 55% of the variance in QOL in the Fontan group. Conclusions Despite lower levels of physical health, the QOL of Fontan patients was comparable with that of their healthy counterparts; this finding contradicts previous proxy reports, self-reports, and assumptions that QOL is lower in patients with complex single ventricle congenital heart disease. However, because Fontan patients were more depressed than their healthy counterparts, the need for early screening and detection is warranted. PMID:21912272

  14. Witnessing Violence across the Life Course, Depressive Symptoms, and Alcohol Use among Older Persons

    ERIC Educational Resources Information Center

    Colbert, Sha Juan; Krause, Neal

    2009-01-01

    The purpose of this study is to see whether witnessing a very violent act at any point in the life course is associated with depressive symptoms and alcohol use in late life. The data come from a nationwide probability sample of older adults (N = 1,498). The findings reveal that witnessing violence is associated with more symptoms of depression…

  15. Musical Training and Late-Life Cognition.

    PubMed

    Gooding, Lori F; Abner, Erin L; Jicha, Gregory A; Kryscio, Richard J; Schmitt, Fredrick A

    2014-06-01

    This study investigated the effects of early- to midlife musical training on cognition in older adults. A musical training survey examined self-reported musical experience and objective knowledge in 237 cognitively intact participants. Responses were classified into low-, medium-, and high-knowledge groups. Linear mixed models compared the groups' longitudinal performance on the Animal Naming Test (ANT; semantic verbal fluency) and Logical Memory Story A Immediate Recall (LMI; episodic memory) controlling for baseline age, time since baseline, education, sex, and full-scale IQ. Results indicate that high-knowledge participants had significantly higher LMI scores at baseline and over time compared to low-knowledge participants. The ANT scores did not differ among the groups. Ability to read music was associated with higher mean scores for both ANT and LMI over time. Early- to midlife musical training may be associated with improved late-life episodic and semantic memory as well as a useful marker of cognitive reserve. PMID:24375575

  16. Relationship Between Quality of Life and Depression in Pregnant Women

    PubMed Central

    Abbaszadeh, Fatemeh; Kafaei Atrian, Mahboobe; Masoudi Alavi, Negin; Bagheri, Azam; Sadat, Zohreh; Karimian, Zahra

    2013-01-01

    Background: Quality of life differs for different people in different situations and is related to one's self-satisfaction with life. Quality of life is affected by health status. Objectives: The current study examined the relationship between quality of life and depression in pregnant women in Kashan city. Patients and Methods: A Case - control study was performed on 112 depressed pregnant women (Case Group) and 353 Non-depressed pregnant women (Control Group) who referred to the prenatal health care centers of Kashan University of Medical Sciences .They completed Short Form 36 Health Survey (SF-36) to assess the quality of life and the Beck Depression Inventory to assess the level of depressive symptoms. T-test, chi-square and Pearson correlation coefficient statistical tests were used for data analysis. Results: The findings showed that there was an inverse relationship between quality of life and depression in pregnancy (P = 0.0001). Average scores in all eight domains of quality of life were significantly lower in depressed pregnant women compared to non- depressed women. The strongest relationship was observed between depression and vitality (r =-0.52, P = 0.0001), mental health (r = -0.50, P = 0.001) and social functioning (r =-0.38, P = 0.001). Conclusion: Depressed pregnant women had a lower quality of life. The proper management of depression during pregnancy can improve the quality of life in women. It is recommended that antenatal services integrate screening for depression into routine antenatal care. PMID:25414858

  17. Eszopiclone for late-life insomnia

    PubMed Central

    McCrae, Christina S; Ross, Amanda; Stripling, Ashley; Dautovich, Natalie D

    2007-01-01

    Insomnia, the most common sleep disturbance in later life, affects 20%–50% of older adults. Eszopiclone, a short-acting nonbenzodiazepine hypnotic agent developed for the treatment of insomnia, has been available in Europe since 1992 and in the US since 2005. Although not yet evaluated for transient insomnia in older adults, eszopiclone has been shown to be safe and efficacious for short-term treatment (2 weeks) of chronic, primary insomnia in older adults (64–91 years). Clinical studies in younger adults (mean = 44 years) have shown eszopiclone can be used for 6–12 months without evidence of problems. Because the oldest participant in these longer-term trials was 69, it not known whether eszopiclone is effective for older adults [particularly the old old (75–84 years) and oldest old (85+)] when used over longer periods. This is unfortunate, because older individuals frequently suffer from chronic insomnia. Cognitive-behavioral therapy for insomnia, which effectively targets the behavioral factors that maintain chronic insomnia, represents an attractive treatment alternative or adjuvant to eszopiclone for older adults. To date, no studies have compared eszopiclone to other hypnotic medications or to nonpharmacological interventions, such as cognitive-behavioral therapy for insomnia, in older adults. All of the clinical trials reported herein were funded by Sepracor. This paper provides an overview of the literature on eszopiclone with special emphasis on its use for the treatment of late-life insomnia. Specific topics covered include pharmacology, pharmacodynamics, pharmacokinetics, clinical trial data, adverse events, drug interactions, tolerance/dependence, and economics/cost considerations for older adults. PMID:18044182

  18. The influence of pubertal timing and stressful life events on depression and delinquency among Chinese adolescents.

    PubMed

    Chen, Jie; Yu, Jing; Wu, Yun; Zhang, Jianxin

    2015-06-01

    This study aimed to investigate the influences of pubertal timing and stressful life events on Chinese adolescents' depression and delinquency. Sex differences in these influences were also examined. A large sample with 4,228 participants aged 12-15 years (53% girls) was recruited in Beijing, China. Participants' pubertal development, stressful life events, depressive symptoms, and delinquency were measured using self-reported questionnaires. Both early maturing girls and boys displayed more delinquency than their same-sex on-time and late maturing peers. Early maturing girls displayed more depressive symptoms than on-time and late maturing girls, but boys in the three maturation groups showed similar levels of depressive symptoms. The interactive effects between early pubertal timing and stressful life events were significant in predicting depression and delinquency, particularly for girls. Early pubertal maturation is an important risk factor for Chinese adolescents' depression and delinquency. Stressful life events intensified the detrimental effects of early pubertal maturation on adolescents' depression and delinquency, particularly for girls. PMID:26261908

  19. Measuring Depression at the End of Life: Is the Hamilton Depression Rating Scale a Valid Instrument?

    ERIC Educational Resources Information Center

    Olden, Megan; Rosenfeld, Barry; Pessin, Hayley; Breitbart, William

    2009-01-01

    Depression at the end of life is a common mental health issue with serious implications for quality of life and decision making. This study investigated the reliability and validity of one of the most frequently used measures of depression, the Hamilton Depression Rating Scale (HAM-D) in 422 patients with terminal cancer admitted to a palliative…

  20. Depression in patients with early versus late onset of Parkinson's disease.

    PubMed

    Starkstein, S E; Berthier, M L; Bolduc, P L; Preziosi, T J; Robinson, R G

    1989-11-01

    We examined correlates of depression in patients whose onset of Parkinson's disease (PD) began before age 55 (early-onset group) compared with patients whose onset was after age 55 (late-onset group). The early-onset group showed a significantly higher frequency of depression than the late-onset group. When both groups were matched for duration of the disease, the early-onset group still showed a significantly higher frequency of depression, whereas tremor, akinesia, and rigidity were significantly more severe in the late-onset group. A stepwise regression analysis showed that in the early-onset group, depression scores were significantly correlated with scores of cognitive impairment and duration of the disease, while in the late-onset group, depression scores were significantly correlated with impairments in activities of daily living. These data suggest that depression in patients with early-onset PD may have a different etiology than in patients with late-onset PD. PMID:2812320

  1. Life stress and family history for depression: the moderating role of past depressive episodes.

    PubMed

    Monroe, Scott M; Slavich, George M; Gotlib, Ian H

    2014-02-01

    Three of the most consistently reported and powerful predictors of depression are a recent major life event, a positive family history for depression, and a personal history of past depressive episodes. Little research, however, has evaluated the inter-relations among these predictors in depressed samples. Such information is descriptively valuable and potentially etiologically informative. In the present article we summarize the existing literature and test four predictions in a sample of 62 clinically depressed individuals: (1) participants who experienced a major life event prior to onset would be less likely than participants who did not experience a major life event to have a positive family history for depression; (2) participants with a recent major life event would have fewer lifetime episodes of depression than would participants without; (3) participants with a positive family history for depression would have more lifetime episodes of depression than would participants with a negative family history for depression; and (4) we would obtain a 3-way interaction in which participants with a positive family history and without a major life event would have the most lifetime episodes, whereas participants with a negative family history and a major life event would have the fewest lifetime episodes. The first three predictions were confirmed, and the fourth prediction partially confirmed. These novel findings begin to elucidate the complex relations among these three prominent risk factors for depression, and point to avenues of research that may help illuminate the origins of depressive episodes. PMID:24308926

  2. Unipolar Depression, Life Context Vulnerabilities, and Drinking to Cope

    ERIC Educational Resources Information Center

    Holahan, Charles J.; Moos, Rudolf H.; Holahan, Carole K.; Cronkite, Ruth C.; Randall, Patrick K.

    2004-01-01

    This study followed baseline samples of 424 unipolar depressed patients and 424 community controls across 10 years to investigate the association between depression and alcohol-related coping and to examine how life context vulnerabilities underlie the risk for depressed individuals to rely on drinking to cope. Findings supported all hypotheses.…

  3. Life expectancy without depression increases among Brazilian older adults

    PubMed Central

    Andrade, Flávia Cristina Drumond; Wu, Fan; Lebrão, Maria Lúcia; Duarte, Yeda Aparecida de Oliveira

    2016-01-01

    ABSTRACT OBJECTIVE To estimate life expectancy with and without depressive symptoms in older adults for the years 2000 and 2010. METHODS We evaluated individuals aged 60 years or older (n = 1,862 in 2000 and n = 1,280 in 2010), participants of the Saúde, Bem-Estar e Envelhecimento (SABE – Health, Wellbeing and Aging) study in in Sao Paulo, Southeastern Brazil. Depression was measured using the shorter version of the Geriatric Depression Scale (GDS-15); respondents scoring ≥ 6 were classified as having depression. Estimates of life expectancy with and without depression were obtained using the Sullivan method. RESULTS Data from 2000 indicate that 60-year-old men could expect to live, on average, 14.7 years without depression and 60-year-old women could expect to live 16.5 years without depression. By 2010, life expectancy without depression had increased to 16.7 years for men and 17.8 years for women. Expected length of life with depression differed by sex, with women expected to live more years with depression than men. CONCLUSIONS Between 2000 and 2010, life expectancy without depression in Sao Paulo increased. However, older adults in Brazil, especially older women, still face a serious burden of mental illness. PMID:27143612

  4. Suicide Ideation, Depression, and Stressful Life Events among Gifted Adolescents.

    ERIC Educational Resources Information Center

    Metha, Arlene; McWhirter, Ellen Hawley

    1997-01-01

    Differences in life-change events, life stress, depression, and suicide ideation were investigated in a mixed-ethnic sample of 34 gifted and 38 nongifted urban junior high school students. Suicide ideation was significantly and positively correlated both with level of depression and with levels of past and recent stress. Recent stress and use of…

  5. Quality of life in young- compared with late-onset Parkinson's disease.

    PubMed

    Knipe, M Duleeka W; Wickremaratchi, Mirdhu M; Wyatt-Haines, Emma; Morris, Huw R; Ben-Shlomo, Yoav

    2011-09-01

    The impact of Parkinson's disease on quality of life may vary depending on age at onset. We investigated the effect of age at onset on quality of life in a large Parkinson's disease population (n = 426) using a disease-specific rating scale (PDQ-39) and with careful adjustment for confounding and intermediary factors. We also explored the relationship between depression and excessive daytime sleepiness by age at onset and compared this with the general population. We found that a younger age at onset was significantly associated with worse overall quality of life scores (odds ratio, 2.66; 95% confidence interval, 1.39-5.09; P = .003), but this was attenuated by adjustment for depression as an intermediary factor (odds ratio, 1.86; 95% confidence interval, 0.84-4.11; P = .13). Younger onset was also a risk factor for poor emotional well-being independent of depression status. Risk of depression and excessive daytime sleepiness were elevated in patients with Parkinson's disease compared with controls (odds ratio, 2.99; 95% confidence interval, 1.93-4.65; P < .001; and odds ratio, 3.84; 95% confidence interval, 2.56-5.75; P < .001, respectively), with similar findings seen in both early- and late-onset groups. Our study highlights the need for accurate diagnosis and treatment of depression in younger-onset patients in order to improve quality of life. PMID:21574185

  6. Security of attachment to spouses in late life: Concurrent and prospective links with cognitive and emotional wellbeing

    PubMed Central

    Waldinger, Robert J.; Cohen, Shiri; Schulz, Marc S.; Crowell, Judith A.

    2014-01-01

    Social ties are powerful predictors of late-life health and wellbeing. Although many adults maintain intimate partnerships into late life, little is known about mental models of attachment to spouses and how they influence aging. Eighty-one elderly heterosexual couples (162 individuals) were interviewed to examine the structure of attachment security to their partners and completed measures of cognition and wellbeing concurrently and 2.5 years later. Factor analysis revealed a single factor for security of attachment. Higher security was linked concurrently with greater marital satisfaction, fewer depressive symptoms, better mood, and less frequent marital conflicts. Greater security predicted lower levels of negative affect, less depression, and greater life satisfaction 2.5 years later. For women, greater security predicted better memory 2.5 years later and attenuated the link between frequency of marital conflict and memory deficits. Late in life, mental models of attachment to partners are linked to wellbeing concurrently and over time. PMID:26413428

  7. Cognitive function, functional performance and severity of depression in Chinese older persons with late-onset depression.

    PubMed

    Tam, C W C; Lam, L C W

    2012-03-01

    OBJECTIVES. The relationship between cognitive status and depressive symptoms and their liability to cause functional decline are of clinical and public health importance as it appears to be common, frequently coexists, and may be treatable. This study examined the relationship of depression severity and cognitive performance and the impact of such an interaction on functional ability in Chinese elderly subjects with late-onset depression. METHODS. A total of 105 non-demented elderly patients with late-onset depression were recruited. Impairment in instrumental activities of daily living and severity of depression were respectively assessed with the Disability Assessment for Dementia scale and the 24-item Hamilton Depression Rating Scale. Various cognitive domains were assessed including global cognitive function, delayed episodic memory, and executive functions. The relationship between specific cognitive impairment and mood symptom severity was assessed. The clinical correlates of functional performance were also examined. RESULTS. Increasingly severe depression was associated with lower scores in the Mini-Mental State Examination, delayed recall, and poorer performance in the Trail Making Test-Part A (after adjusting for the effect of age and education). The severity of apathy correlated negatively with the Mini-Mental State Examination scores only. Among the depressed subjects, greater levels of depression and apathy, poorer performance in Trail Making Test-Part B, and mild parkinsonian signs were associated with lower functional scores. CONCLUSIONS. Lack of interest and motivation, depressive mood, compounded by behavioural abnormalities resulting from executive dysfunction, accounted for functional disability in elderly subjects with late-onset depression. These relationships may provide the background for developing interventions targeting functional deficits associated with specific cognitive dysfunctions and depression. PMID:22447800

  8. Pathways to Childlessness and Late-Life Outcomes

    ERIC Educational Resources Information Center

    Dykstra, Pearl A.; Wagner, Michael

    2007-01-01

    Via a simultaneous analysis of different life course pathways (marital, occupational, and childbearing histories) and different outcomes, this article addresses the question When does childlessness matter in late life and how? Survey data from Amsterdam (N = 661) and Berlin, Germany (N = 516) are used. Lifelong childlessness results in smaller…

  9. Factors Influencing Adjustment to Late-Life Divorce.

    ERIC Educational Resources Information Center

    Wilson, Keren Brown; DeShane, Michael R.

    Although the rate of divorce among older Americans has increased steadily, little attention has been paid to late life divorce. To describe the role of age and other factors which might influence adjustment to divorce in later life, data from a larger pilot study were used: 81 divorced persons over the age of 60 completed in-depth, structured…

  10. Depression and suicidality in modern life.

    PubMed

    Stranieri, Giuseppe; Carabetta, Carmelo

    2012-09-01

    This paper describes the relationship between depression and the difficulties experienced in the postmodern world for human beings who must reconcile their consciousness of their own death and the feelings of powerlessness in the face of inevitable consequences. Depression and suicide are closely linked, and the consequences in terms of philosophy and psychology are described. PMID:22945196

  11. Maternal infection during late pregnancy increases anxiety- and depression-like behaviors with increasing age in male offspring.

    PubMed

    Enayati, Mohsen; Solati, Jalal; Hosseini, Mohammad-Hassan; Shahi, Hamid-Reza; Saki, Golshid; Salari, Ali-Akbar

    2012-02-10

    Scientific reports suggest that the exposure to long-term stressors throughout or during late gestation increase anxiety- and depression-like behaviors of offspring in their later life. Moreover, several studies concluded that increasing age correlates with increased anxiety behaviors in humans and rodents. In the present study, we assessed the effects of prenatally administration of equal lipopolysaccharide (LPS) doses in various points of late gestation (days 15, 16, and 17) period, on neuroendocrine and immunological responses of pregnant mice, and subsequent long-lasting consequences of anxiety and depression with increasing age in male offspring at postnatal days (PD) 40 and 80. Four hours after the LPS injection, levels of corticosterone (COR) and pro-inflammatory cytokines (PIC) in pregnant mice, as compared to the control dams, were increased significantly. Furthermore, maternal inflammation raised the levels of COR, anxiety- and depression-like behaviors with increasing age in male offspring in comparison with saline male offspring. These data support other studies demonstrating that maternal stress increases the levels of anxiety and depression in offspring. Additionally, our data confirm other findings indicating that increasing age correlates with increased anxiety or depression behaviors in humans and rodents. Findings of this study suggest that time course of an inflammation response or stressor application during various stages of gestation and ages of offspring are important factors for assessing neuropsychiatric disorders. PMID:21893170

  12. Continuity and Discontinuity of Depression from Late Adolescence to Young Adulthood: The Mediating and Moderating Effects of Young Adults’ Socioeconomic Attainment

    PubMed Central

    Wickrama, K. A. S.; Conger, Rand D.; Lorenz, Federick O.; Martin, Monica

    2011-01-01

    Using prospective, longitudinal data from 467 youth over a 13-year period (late adolescence and young adulthood), the present study investigates three research questions: (1) to what extent do elevations in depressed mood continue (homotypic continuity) from adolescence to young adulthood, (2) to what extent do young adults’ socioeconomic attainments and failures sustain the depressed mood from adolescence to young adulthood and (3) to what extent do young adults’ socioeconomic attainments or failures mediate the continuity and discontinuity of depressive symptoms across this period? The results from our structural equation modeling (SEM) analyses suggest that continuity of depressive symptoms from late adolescence to young adulthood is mediated in part by economic and work achievements or failures of young adults after controlling for adolescent conduct disorder/antisocial behavior, parents’ psychopathology and family adversity. Additionally, the results indicate that the continuity of depressed mood across the early life course is conditioned (stabilized or disrupted) by young adult socioeconomic achievements or failures. PMID:21925725

  13. Urban neighbourhood unemployment history and depressive symptoms over time among late middle age and older adults

    PubMed Central

    Wight, Richard G; Aneshensel, Carol S; Barrett, Christopher; Ko, Michelle; Chodosh, Joshua; Karlamangla, Arun S

    2013-01-01

    Background Little is known about how a neighbourhood’s unemployment history may set the stage for depressive symptomatology. This study examines the effects of urban neighbourhood unemployment history on current depressive symptoms and subsequent symptom trajectories among residentially stable late middle age and older adults. Contingent effects between neighbourhood unemployment and individual-level employment status (ie, cross-level interactions) are also assessed. Methods Individual-level survey data are from four waves (2000, 2002, 2004 and 2006) of the original cohort of the nationally representative US Health and Retirement Study. Neighbourhoods are operationalised with US Census tracts for which historical average proportion unemployed between 1990 and 2000 and change in proportion unemployed between 1990 and 2000 are used to characterise the neighbourhood’s unemployment history. Hierarchical linear regressions estimate three-level (time, individual and neighbourhood) growth models. Results Symptoms in 2000 are highest among those residing in neighbourhoods characterised by high historical average unemployment beginning in 1990 and increasing unemployment between 1990 and 2000, net of a wide range of socio-demographic controls including individual-level employment status. These neighbourhood unemployment effects are not contingent upon individual-level employment status in 2000. 6-year trajectories of depressive symptoms decrease over time on average but are not significantly influenced by the neighbourhood’s unemployment history. Conclusions Given the current US recession, future studies that do not consider historical employment conditions may underestimate the mental health impact of urban neighbourhood context. The findings suggest that exposure to neighbourhood unemployment earlier in life may be consequential to mental health later in life. PMID:22918896

  14. Cognitive and functional impairment in Chinese elderly with late-onset depression.

    PubMed

    Tam, C W C; Lam, L C W

    2012-03-01

    OBJECTIVES. To investigate cognitive and functional impairment in Chinese elderly subjects with late-onset depression. METHODS. Subjects with late-onset depression and who were clinically non-demented were recruited. Their cognitive and functional scores were compared with those of cognitively normal elderly controls and elderly persons with mild cognitive impairment. Functional ability was assessed by the Disability Assessment for Dementia score. Various cognitive domains were assessed including global cognitive function, delayed episodic memory, working memory, and categorical verbal fluency test. RESULTS. A total of 105 depressed subjects and 324 non-depressed controls (149 normal elderly controls and 175 with mild cognitive impairment) were recruited. The depression group had significantly poorer performance in all cognitive assessments compared to the normal elderly control group. The depression group had a similar cognitive profile to those with mild cognitive impairment, except that its subjects had slightly better performance in the Categorical Verbal Fluency Test, delayed recall testing, and the Chinese version of the Alzheimer's Disease Assessment Scale-Cognitive subscale test. Depressed subjects had significantly lower functional scores in instrumental activities of daily living than the non-depressed, normal elderly controls, and those with mild cognitive impairment. CONCLUSIONS. Our results demonstrate that Chinese elderly with late-onset depression had cognitive impairments in multiple domains similar to those encountered in the age- and sex-matched non-depressed controls with mild cognitive impairment. However, their functional performance was significantly poorer than that in these controls. This study provided extensive characterisation of the range and depth of cognitive and functional impairments in elderly patients with late-onset depression. PMID:22447802

  15. Vietnamese women immigrants' life adaptation, social support, and depression.

    PubMed

    Lin, Li-Hua; Hung, Chich-Hsiu

    2007-12-01

    The purpose of this study was to explore the relationships between life adaptation, social support, and depression among migrant Vietnamese women living in Meinong Township, Kaohsiung County. With a cross-sectional study design, 143 participants were recruited by purposive sampling. Structured questionnaires including Demographic Inventory Scale, Life Adaptation Scale, Social Support Scale, and Beck Depression Inventory Scale were used. Data were analyzed with Pearson's correlation and One-way ANOVA. The results showed that Vietnamese women's social support was significantly correlated with the length of time living in Taiwan, the length of marriage, and their husbands' age. Women's social support was significantly different with languages in common, the way of acquaintance with her husband, and family members living together. Depression was significantly different with family income. Life adaptation was also significantly different with family income. Moreover, there was a significantly positive correlation between Vietnamese women's social support and life adaptation, and significantly negative correlations between Vietnamese women's social support and depression, and between their life adaptation and depression. The study findings could be used as references for health professionals and government agencies to institute strategies and policies for promoting migrant Vietnamese women's life adaptation. PMID:18080969

  16. Financial Conflicts Facing Late-Life Remarried Alzheimer's Disease Caregivers

    ERIC Educational Resources Information Center

    Sherman, Carey Wexler; Bauer, Jean W.

    2008-01-01

    This qualitative study explores financial conflicts faced by late-life remarried wives providing care for their husbands with Alzheimer's disease. Interviews with 9 women identified intergenerational secrets and tensions regarding financial and inheritance decisions. Participants' remarried spouse status, underlying family boundary ambiguities,…

  17. Personality, Stressful Life Events, and Treatment Response in Major Depression

    ERIC Educational Resources Information Center

    Bulmash, Eric; Harkness, Kate L.; Stewart, Jeremy G.; Bagby, R. Michael

    2009-01-01

    The current study examined whether the personality traits of self-criticism or dependency moderated the effect of stressful life events on treatment response. Depressed outpatients (N = 113) were randomized to 16 weeks of cognitive-behavioral therapy, interpersonal psychotherapy, or antidepressant medication (ADM). Stressful life events were…

  18. Cognitive and Life Event Correlates of Depressive Symptoms in Children.

    ERIC Educational Resources Information Center

    Mullins, Larry L.; And Others

    The present study examines the relationship of various cognitive and life event variables to depressive symptoms in children. The variables studied are locus of control, interpersonal and impersonal problem-solving ability, and objective and subjective life stress. Subjects were 47 students in the fourth grade, 58 students in the fifth grade, and…

  19. [Late-onset depression and a new psychometric scale for its clinical evaluation].

    PubMed

    Ivanets, N N; Kinkul'kina, M A; Avdeeva, T I

    2012-01-01

    The most of existed psychometric scales for depression have some shortcomings hampering their use in old patients. The authors worked out the original scale for clinical evaluation of symptoms of late-onset depression. The list of symptoms was made up basing on literature data. The most significant symptoms that characterized the structure and severity of depression in old patients were singled out. According to results of factor analyses they were combined in the groups forming the corresponding items of the scale. In addition, some symptoms with particular clinical significance for late-onset depression (suicidal thoughts, senesto-hypochondriac symptoms, insight) were singled out. The scale comprises 13 items with scores from -6 to +6. It can be implemented for symptom screening, clinical diagnosis and rating, including dynamics of depression in elderly patients. PMID:23235407

  20. Depression and life satisfaction among European and Confucian adolescents.

    PubMed

    Stankov, Lazar

    2013-12-01

    The purpose of this study was to compare adolescents from Europe and Confucian Asia on measures of psychological constructs that reflect either maladjustment or positive outlook on life. Empirical findings are reported based on N = 7,167 secondary school students (15 years old) from Confucian Asia (Hong Kong, Singapore, South Korea, and Taiwan) and from Europe (Denmark, Finland, Netherlands, Serbia, and Latvia with 2 nationalities-Latvian and Russian). Participants' responses were used to assess several aspects of personality and psychopathology, in addition to well-being, social attitudes, and parental styles. Exploratory factor analysis of these measures produced 4 factors: Depression, Life Satisfaction, Toughness and Modesty. Adolescents from Confucian countries show higher levels of Depression and lower levels of Life Satisfaction in comparison to their European counterparts. The most potent influences on Depression and Life Satisfaction were found to be Toughness and Parental Warmth variables, both of which are, in turn, linked to differences between regions/cultures. PMID:23914959

  1. The relationship of sleep problems to life quality and depression

    PubMed Central

    Sarıarslan, Hacı A.; Gulhan, Yıldırım B.; Unalan, Demet; Basturk, Mustafa; Delibas, Senol

    2015-01-01

    Objective: To identify the level of depression, the level of life quality, and the relationship between these, in patients applying to sleep centers for various sleep problems. Methods: This cross-sectional study included 229 patients who applied for polysomnography at sleeping centers under supervision of the Neurology and Chest Diseases Clinics of Kayseri Education and Research Hospital, Kayseri, Turkey between June and August 2013. The data collection tools were a socio-demographical data form, Beck Depression Inventory (BDI), Pittsburgh Sleep Quality Index (PSQI), and the World Health Organization Quality of Life Scale (WHOQOL-BREF). For statistical analyses, the Student t-test, Kruskal-Wallis-variant analysis, and chi-square tests were used. Significance level was considered as p<0.05. Results: In our study, patients who were older aged, married, not working, and who had a chronic disease, and a severe depressive symptom were observed to have significantly poorer sleep quality. While patients with any chronic disease had significantly higher scores for total PSQI and depression, their physical, mental, and social WHOQOL-BREF scores were significantly lower. The PSQI total scores, and depression scores of the smoking patients were significantly higher for physical, mental, and social WHOQOL-BREF fields. There was a positive correlation between PSQI scores and BDI scores while there was a negative correlation among BDI, PSQI, and WHOQOL-BREF life quality sub-scale scores. Conclusions: Sleep quality was significantly poorer in patients who were older aged, married, not working, and who had a chronic disease, and a severe depressive symptom. There was a significantly negative correlation among depression, sleep quality, and life quality, while there was a significantly positive correlation between life quality and depression. PMID:26166591

  2. Early Life Course Pathways of Adult Depression and Chronic Pain

    PubMed Central

    Goosby, Bridget J.

    2013-01-01

    Applying cumulative inequality theory, this study examines the extent to which childhood socioeconomic disadvantage and maternal depression increase the risk of major depression and chronic pain in U.S. working-aged adults. Further, I assess whether low socioeconomic status amplifies the risk of adult depression and/or pain. Using data from the 2003 National Comorbidity Survey Replication (N=4339), I find that socioeconomic disadvantage and maternal depression during youth increases the risk of adult depression and/or chronic pain. The probability of having chronic pain increases in magnitude over the life course for adults whose parents have lower educational attainment relative to those with more highly educated parents. Childhood socioeconomic circumstances are not completely explained by adulthood socioeconomic status indicators. These findings help illustrate the far-reaching influence of childhood context on adult physical and mental health. PMID:23426854

  3. Self-disclosure and marital satisfaction in mid-life and late-life remarriages.

    PubMed

    Bograd, R; Spilka, B

    1996-01-01

    Self-disclosure and marital satisfaction were studied among 125 males and females who were in their first remarriage. Essentially equal numbers had remarried in mid-life (ages 30-45) and late-life (ages 60-75). The multidimensional Wheeless self-disclosure scales and Locke-Wallace measure of marital satisfaction were employed. Mid-life versus late-life differences were evident for the amount, and depth of disclosure, but not for intentionality, valence or honesty of disclosure. No gender differences were manifested in self-disclosure. Marital satisfaction was greatest for late-life remarriages, and this was due to the high level of male satisfaction in this age group. PMID:8805081

  4. Loneliness, Depression, and Epistemological Relativity in Early and Late Adolescence.

    ERIC Educational Resources Information Center

    Lapsley, Daniel K.; And Others

    Epistemological loneliness refers to the isolation adolescents may experience as the result of cognitive relativism, ushered in by the emergence of formal operational thought. To examine the relationship between cognitive relativity, epistemological loneliness, and depression in adolescence, 108 adolescents (29 seventh graders, 29 ninth graders,…

  5. New Wine in Old Bottle: Late-Life Psychosis

    PubMed Central

    Iglewicz, Alana; Meeks, Thomas W.; Jeste, Dilip V.

    2011-01-01

    Psychosis is common in late life and exacts enormous costs to society, affected individuals, and their caregivers. A multitude of etiologies for late-life psychosis exist, the two most prototypical being schizophrenia and psychosis of Alzheimer’s Disease (AD). As such, this review will focus on the non-affective, neuropsychiatric causes of chronic psychosis in the elderly, specifically schizophrenia, delusional disorder, and the psychosis of AD and other dementias. As evidenced in this review, the current research regarding the onset and course of late-life schizophrenia reflects a more favorable prognosis than that painted by the Kraepelinian notion of schizoprenia as “dementia praecox.” Antipsychotics are useful in controlling the symptoms of late-life schizophrenia, but their use among older adults warrants increased vigilance because of older adults’ increased proclivity to side effects. Psychosocial interventions can be effective, usually in conjunction with medication. Meanwhile, psychosis of AD occurs in nearly half of people with AD and is associated with increased hospitalizations, institutionalization, caregiver distress, and mortality. Despite the profound consequences of psychotic symptoms associated with dementias, the extant literature does not afford clinicians clear, consistent guidance on how to provide optimal treatment to specific patients. Second generation antipsychotics are usually the choice treatment for psychosis, but the black box warning regarding their associated 1–2% increased absolute risk in stroke and overall mortality in patients with dementia complicates their use. Using second generation antipsychotics in low doses for brief periods and discontinuing them when possible is the best clinical practice for dementia-related psychosis. Psychosocial interventions for the treatment of psychosis with AD appear promising in empirical research, but more rigorous study is needed. PMID:21536160

  6. Modifiable Midlife Risk Factors for Late-Life Cognitive Impairment and Dementia

    PubMed Central

    Hughes, Tiffany F.; Ganguli, Mary

    2009-01-01

    The baby boom generation is approaching the age of greatest risk for cognitive impairment and dementia. There is growing interest in strategies to modify the environment in midlife to increase the probability of maintaining cognitive health in late life. Several potentially modifiable risk factors have been studied in relation to cognitive impairment and dementia in late life, but methodological limitations of observational research have resulted in some inconsistencies across studies. The most promising strategies are maintaining cardiovascular health, engagement in mental, physical, and social activities, using alcohol in moderation, abstaining from tobacco use, and following a heart-healthy diet. Other factors that may influence cognitive health are occupational attainment, depression, personality, exposure to general anesthesia, head injury, postmenopausal hormone therapy, non-steroidal anti-inflammatory medications, and nutritional supplements such as antioxidants. Some long-term observational studies initiated in midlife or earlier, and some randomized controlled trials, have examined the effects of specific cognitive health promotion behaviors in midlife on the risk of cognitive impairment in late life. Overall, these studies provide limited support for risk reduction at this time. Recommendations and challenges for developing effective strategies to reduce the burden of cognitive impairment and dementia in the future are discussed. PMID:19946443

  7. Improving Quality of Life and Depression After Stroke Through Telerehabilitation

    PubMed Central

    Linder, Susan M.; Rosenfeldt, Anson B.; Bay, R. Curtis; Sahu, Komal; Wolf, Steven L.

    2015-01-01

    OBJECTIVE. The aim of this study was to determine the effects of home-based robot-assisted rehabilitation coupled with a home exercise program compared with a home exercise program alone on depression and quality of life in people after stroke. METHOD. A multisite randomized controlled clinical trial was completed with 99 people <6 mo after stroke who had limited access to formal therapy. Participants were randomized into one of two groups, (1) a home exercise program or (2) a robot-assisted therapy + home exercise program, and participated in an 8-wk home intervention. RESULTS. We observed statistically significant changes in all but one domain on the Stroke Impact Scale and the Center for Epidemiologic Studies Depression Scale for both groups. CONCLUSION. A robot-assisted intervention coupled with a home exercise program and a home exercise program alone administered using a telerehabilitation model may be valuable approaches to improving quality of life and depression in people after stroke. PMID:26122686

  8. A Longitudinal Study of the Relationship between Attributional Style, Life Events, and Depression in Japanese Undergraduates.

    ERIC Educational Resources Information Center

    Sakamoto, Shinji; Kambara, Masahiko

    1998-01-01

    Investigates relationships among attributional style, life events, and depression in 143 Japanese undergraduates. Results indicate that negative experiences and depressogenic attributional styles increase the likelihood of depression, while positive experiences and enhancing attributional styles decrease the likelihood of depression. Suggests…

  9. Do Late Adolescent Fathers Have More Depressive Symptoms than Older Fathers?

    ERIC Educational Resources Information Center

    Lee, Yookyong; Fagan, Jay; Chen, Wan-Yi

    2012-01-01

    Although fathers are increasingly a focus of attention in research, there is a dearth of research on depressive symptoms among fathers, especially young fathers with toddlers. This study used longitudinal data to examine what risk factors, including the age status of fathers (e.g., late adolescence, emerging adulthood, and adulthood), may be…

  10. History of Depression and Frontostriatal Connectivity during Reward Processing in Late Adolescent Boys

    PubMed Central

    Morgan, Judith K.; Shaw, Daniel S.; Olino, Thomas M.; Musselman, Samuel C.; Kurapati, Nikhil T.; Forbes, Erika E.

    2015-01-01

    Objective Given that depression in men is associated with risk for seriously adverse consequences, evaluating how putative neural mechanisms of depression—such as reward-related frontostriatal connectivity—may be altered in late adolescent boys with a history of depression is an important research aim. Adolescents and adults with depression have been demonstrated to show blunted striatal response and heightened medial prefrontal cortex (mPFC) activation to winning reward. Function in reward circuits appears to be best understood as coordination of regions within frontostriatal circuitry, and alterations to this circuitry could occur in those with a history of depression. Method The current study evaluated functional connectivity between the nucleus accumbens and mPFC in a sample of 166 ethnically-diverse boys with and without a history of depression. Participants completed an fMRI monetary reward paradigm at age 20. Lifetime history of depression and other psychiatric illnesses was measured prospectively and longitudinally, using structured clinical interviews at 7 time points from ages 8 to 20. Results Boys with a history of depression showed heightened positive connectivity between the nucleus accumbens and the mPFC relative to boys with no psychiatric history when winning rewards relative to losing rewards. This altered frontostriatal connectivity pattern was also associated with greater number of depressive episodes in the boys’ lifetime. Conclusions History of depression in late adolescent boys may be associated with altered coordination between the nucleus accumbens and mPFC when winning reward. This coordination could reflect over-signaling of the mPFC to dampen typical VS response or enhance weak VS response. PMID:25915469

  11. Comparison of Clock Test Deficits Between Elderly Patients With Early and Late Onset Depression.

    PubMed

    Klein, Lisa; Saur, Ralf; Müller, Stephan; Leyhe, Thomas

    2015-12-01

    To compare clock test deficits in elderly patients with early onset depression (EOD) and late onset depression (LOD), we assessed 32 elderly healthy controls (HCs), 26 patients with EOD, and 27 patients with LOD with the clock drawing test (CDT), clock setting test, clock reading test, and the Tübingen Clock Questionnaire testing semantic memory about clock times. There was no significant difference in depression severity between patients with EOD and LOD. Patients with LOD had significantly lower scores on the CDT than patients with EOD and HCs. Semantic memory impairment concerning minute hand functionality was highly correlated with CDT performance and was significantly different between the EOD and the LOD groups. It can be suggested that significant differences in cognitive impairment severity between patients with EOD and LOD can be detected with CDT. Semantic memory impairment concerning minute hand functionality might affect CDT test results in elderly patients with depression. PMID:26047634

  12. The Cumulative Impact of Nonsevere Life Events Predicts Depression Recurrence during Maintenance Treatment with Interpersonal Psychotherapy

    ERIC Educational Resources Information Center

    Lenze, Shannon N.; Cyranowski, Jill M.; Thompson, Wesley K.; Anderson, Barbara; Frank, Ellen

    2008-01-01

    Although much research has focused on the role of severe life events as risk factors for depression onset, less is known about the relationship between nonsevere life events and depression recurrence. The current study examined the cumulative effects of nonsevere and positive life events on depression recurrence in an outpatient sample of…

  13. Depression from childhood into late adolescence: Influence of gender, development, genetic susceptibility, and peer stress.

    PubMed

    Hankin, Benjamin L; Young, Jami F; Abela, John R Z; Smolen, Andrew; Jenness, Jessica L; Gulley, Lauren D; Technow, Jessica R; Gottlieb, Andrea Barrocas; Cohen, Joseph R; Oppenheimer, Caroline W

    2015-11-01

    Depression is a debilitating mental illness with clear developmental patterns from childhood through late adolescence. Here, we present data from the Gene Environment Mood (GEM) study, which used an accelerated longitudinal cohort design with youth (N = 665) starting in 3rd, 6th, and 9th grades, and a caretaker, who were recruited from the general community, and were then assessed repeatedly through semistructured diagnostic interviews every 6 months over 3 years (7 waves of data) to establish and then predict trajectories of depression from age 8 to 18. First, we demonstrated that overall prevalence rates of depression over time, by age, gender, and pubertal status, in the GEM study closely match those trajectories previously obtained in past developmental epidemiological research. Second, we tested whether a genetic vulnerability-stress model involving 5-HTTLPR and chronic peer stress was moderated by developmental factors. Results showed that older aged adolescents with SS/SL genotype, who experienced higher peer chronic stress over 3 years, were the most likely to be diagnosed with a depressive episode over time. Girls experiencing greater peer chronic stress were the most likely to develop depression. This study used repeated assessments of diagnostic interviewing in a moderately large sample of youth over 3 years to show that depression rates increase in middle to late adolescence, or postpubertally, and that the gender difference in depression emerges earlier in adolescence (age 12.5), or postpubertally. Additionally, genetically susceptible older adolescents who experience chronic peer stress were the most likely to become depressed over time. PMID:26595469

  14. [Occupational complexity and late-life memory and reasoning abilities].

    PubMed

    Ishioka, Yoshiko; Gondo, Yasuyuki; Masui, Yukie; Nakagawa, Takeshi; Tabuchi, Megumi; Ogawa, Madoka; Kamide, Kei; Ikebe, Kazunori; Arai, Yasumichi; Ishizaki, Tatsuro; Takahashi, Ryutaro

    2015-08-01

    This study examined the associations between the complexity of an individual's primary lifetime occupation and his or her late-life memory and reasoning performance, using data from 824 community-dwelling participants aged 69-72 years. The complexity of work with data, people, and things was evaluated based on the Japanese job complexity score. The associations between occupational complexity and participant's memory and reasoning abilities were examined in multiple regression analyses. An association was found between more comple work with people and higher memory performance, as well as between more complex work with data and higher reasoning performance, after having controlled for gender, school records, and education. Further, an interaction effect was observed between gender and complexity of work with data in relation to reasoning performance: work involving a high degree of complexity with data was associated with high reasoning performance in men. These findings suggest the need to consider late-life cognitive functioning within the context of adulthood experiences, specifically those related to occupation and gender. PMID:26402953

  15. What Are the Causes of Late-Life Depression?

    PubMed Central

    Aziz, Rehan; Steffens, David C.

    2014-01-01

    Overview The rapid increase in the numbers of older adults worldwide makes a focus on mental disorders and aging both timely and imperative. According to the 2010 census, in the United States, there were 40.3 million adults aged 65 years and older. This number represented an increase of 5.3 million over the 2000 census. Between 2000 and 2010, the number of elders increased at a faster rate (15.1%) than the total US population (9.7%).1 These numbers are projected to continue to diverge, and the disparity between age groups will widen further as a consequence. By 2050, an estimated 20.2% of the population will be 65 years of age and older.2 PMID:24229653

  16. Late-life depression: a model for medical classification.

    PubMed

    Alexopoulos, George S; Schultz, Susan K; Lebowitz, Barry D

    2005-08-15

    Geriatric psychiatric syndromes might serve as the starting point for a medical classification of psychiatric disorders, because their medical and neurological comorbidity and their clinical, neuropsychological, and neuroimaging features often reflect specific brain abnormalities. Geriatric syndromes, however, consist of complex behaviors that are unlikely to be caused by single lesions. We propose a model in which aging-related changes in specific brain structures increase the propensity for the development of certain psychiatric syndromes. The predisposing factors are distinct from the mechanisms mediating the expression of a syndromic state, much like hypertension is distinct from stroke, but constitutes a morbid vulnerability. We argue that research seeking to identify both brain abnormalities conferring vulnerability as well as the mediating mechanisms of symptomatology has the potential to lead to a medical classification of psychiatric disorders. In addition, a medical classification can guide the effort to improve treatment and prevention of psychiatric disorders as it can direct therapeutic efforts to the underlying predisposing abnormalities, the syndrome-mediating mechanisms, and to development of behavioral skills needed for coping with adversity and disability. PMID:16026764

  17. Life in conflict: Characteristics of Depression in Kashmir

    PubMed Central

    Amin, Syed; Khan, A.W.

    2009-01-01

    Background: Mental, physical and social health, are vital strands of life that are closely interwoven and deeply interdependent. Mental disorders affect people of all countries and societies, individuals at all ages, women and men, the rich and the poor, from urban and rural environments. Depression is more likely following particular classes of experience – those involving conflict, disruption, losses and experiences of humiliation or entrapment. Many people living amidst the rages of conflict suffer from post-traumatic stress disorder. Objective: To determine the characteristics of depression in the population in Kashmir where a low-intensity-conflict has been going on for the last seventeen years. Methods: The non-combatant civilian population was surveyed. The Centre for Epidemiological Studies Depression (CES-D) Scale was used to measure symptoms of depression in community populations. Results: Due to continuing conflict in Kashmir during the last 18 years there has been a phenomenal increase in psychiatric morbidity. The results reveal that the prevalence of depression is 55.72%. The prevalence is highest (66.67%) in the 15 to 25 years age group, followed by 65.33% in the 26 to 35 years age group. The difference in the prevalence of depression among males and females is significant. Depression is much higher in rural areas (84.73%) as compared to urban areas (15.26%). In rural areas the prevalence of depression among females is higher (93.10 %) as compared to males (6.8%). Conclusion: Mental health is an integral part of overall health and quality of life. Effective evidence-based programs and policies are available to promote mental health, enhance resilience, reduce risk factors, increase protective factors, and prevent mental and behavioural disorders. Innovative community-based health programmes which are culturally and gender appropriate and reaches out to all segments of the population need to be developed. Substantial and sustainable improvements can

  18. Buldir Depression - A Late Tertiary graben on the Aleutian Ridge, Alaska

    USGS Publications Warehouse

    Marlow, M. S.; Scholl, D. W.; Buffington, E.C.; Boyce, R.E.; Alpha, T.R.; Smith, P.J.; Shipek, C.J.

    1970-01-01

    Buldir Depression is a large, rectilinear basin that lies on the northern edge of the Aleutian Ridge and is aligned with the arcuate chain of active volcanoes on the ridge crest. The depression appears to be a volcanic-tectonic feature, which began to form in Late Tertiary time and which is still forming. It is a graben formed by extensional rifting and accompanied by contemporaneous volcanism on the Aleutian Ridge. Subsidence rates for the depression are estimated at 20-70 cm/1,000 years. Sediments in the depression are 300 m thick and are probably pelagic and turbidite deposits of Pleistocene age. The turbidites were apparently derived from the plateau area of the Aleutian Ridge surrounding the depression. Older sediments on the northern slope of the Aleutian Ridge have a maximum thickness of 550 m and are deformed and slumped toward the Bering Sea. These sediments are postulated to overlie a mid-flank terrace on the northern Aleutian Ridge that titled to the north during the formation of Buldir Depression. ?? 1970.

  19. Late-life homicide-suicide: a national case series in New Zealand.

    PubMed

    Cheung, Gary; Hatters Friedman, Susan; Sundram, Frederick

    2016-01-01

    Homicide-suicide is a rare event, but it has a significant impact on the family and community of the perpetrator and victim(s). The phenomenon of late-life homicide-suicide has not been previously studied in New Zealand, and there is only limited data in the international literature. The aim of this study is to systematically review coroners' records of late-life homicide-suicides in New Zealand. After ethics approval was granted, the Coronial Services of New Zealand was approached to provide records of all closed cases with a suicide verdict (age 65+) over a five-year period (July 2007-December 2012). Of the 225 suicides, 4 cases of homicide-suicide were identified (an estimated incidence of 0.12 per 100,000 per persons year). All four perpetrators were men; three had been farmers. Their ages ranged from 65 to 82. One case occurred in the context of an underlying psychiatric illness (psychotic depression in bipolar disorder). Firearms were used in three cases. Two cases were categorized as spousal/consortial subtype, one case as filicide-suicide, and one case as siblicide-suicide. The prospect of major social upheaval in the form of losing their homes was present in all four cases. The findings of this case series were consistent with the limited existing literature on homicide-suicide. Age-related biopsychosocial issues were highlighted in this case series of late-life homicide-suicide. Additionally, evaluating firearm licences in high-risk groups may represent a prevention strategy. PMID:25735608

  20. Measuring Meaning: Searching For and Making Sense of Spousal Loss in Late-Life

    PubMed Central

    Coleman, Rachel A.; Neimeyer, Robert A.

    2010-01-01

    Despite much recent theorizing, evidence regarding the temporal relationship of sense-making to adjustment following bereavement remains relatively sparse. This study examined the role of searching for and making sense of loss in late-life spousal bereavement, using prospective, longitudinal data from the Changing Lives of Older Couples1 (CLOC) project (N=250). Searching at 6 and 18 months post-loss predicted both contemporaneous and subsequent grief. Sense-making was not related to grief for this sample. In contrast, sense-making at 6 months and 18 months predicted positive affect at 48 months, while searching had no prospective effect on this outcome. Searching at 6 months predicted depression at 18 months. Results are interpreted in terms of meaning-oriented theories of bereavement and processes promoting both adaptive and maladaptive outcomes. PMID:24482851

  1. Quality of Life, Coping and Depression in Systemic Lupus Erythematosus.

    PubMed

    Abu-Shakra, Mahmoud

    2016-01-01

    Physical, mental and social well-being are important outcomes in patients with chronic rheumatic diseases, including systemic lupus erythematosus (SLE). The MOS SF-36 and the WHO QoL Bref are appropriate for assessing quality of life (QoL) in patients with SLE. The QoL of patients with SLE is impaired compared with that of controls. Fibromyalgia adversely affects the QoL of SLE patients. Women with SLE had significantly lower scores on subscales of the sense of coherence (SoC) compared with matched controls. This reduced SoC in SLE women represents impaired adaptive coping and is independently associated with reduced QoL in women with SLE. Depression and anxiety are common among SLE patients, and the frequency is similar to that in patients with rheumatoid arthritis. A reciprocal longitudinal relationship between depression and illness intrusiveness was found in patients with SLE. Disease activity and damage are not associated with depression. The subjective experience, not the illness per se, causes depression. PMID:27228629

  2. Life Stress and the Accuracy of Cognitive Appraisals in Depressed Youth

    ERIC Educational Resources Information Center

    Krackow, Elisa; Rudolph, Karen D.

    2008-01-01

    This study investigated the accuracy of depressed youths' appraisals of naturally occurring life events. Participants (49% girls; M age = 12.44 years) with clinical diagnoses of depression (n = 24), subsyndromal symptoms of depression (n = 29), and no symptoms of psychopathology (n = 36) completed semi-structured interviews of life stress. As…

  3. Long-term course of severe depression: late remission and recurrence may be found in a follow-up after 38–53 years

    PubMed Central

    Crona, Lisa; Brådvik, Louise

    2012-01-01

    This study is a follow-up of inpatients diagnosed with severe depression/melancholia between 1956 and 1969. During this period, all inpatients at the Department of Psychiatry, University Hospital, Lund, were rated on a multidimensional diagnostic schedule on discharge. There were 471 patients born from 1920 onward. In the present follow-up, 2006 to 2010, 169 survivors could be traced. They were asked to participate in the study involving a telephone interview, in which a structured life chart was used. Of the patients contacted, 16 were ill or confused and 3 did not remember ever being depressed, leaving 150 who could participate. Seventy-five of these agreed to participate in the study. Long-term course of depression was evaluated by cluster analysis and compared to background variables, such as heredity for depression, perceived parental rearing behaviour, and treatment of index depressive episode. Using a cluster analysis the patients could be separated into six clusters describing the course: i) single or few episodes followed by long-lasting remission; ii) single or few episodes followed by long-lasting remission, although shorter; iii) single or few episodes followed by late recurrence; iv) single or few episodes, but more frequently ill, followed by late recurrence; v) several episodes followed by lasting remission; vi) chronic course of episodes. Remission or recurrence could therefore occur even after more than a decade. In summary, there was a short-term course with or without recurrence or a chronic course with or without late remission. Heredity for depression was significantly related to a chronic course with or without late remission. PMID:25478118

  4. The Game of Late Life: A Novel Education Activity for the Psychology of Ageing

    ERIC Educational Resources Information Center

    Brinker, Jay K.; Roberts, Pamela; Radnidge, Belinda

    2014-01-01

    This article describes the development and evaluation of The Game of Late Life--a novel education activity for the psychology of ageing. The game was designed to provide transformational learning where students imagine themselves as older adults and move through late life via a game board, encountering various life events along the way. One of the…

  5. Late-life brain volume: a life-course approach. The AGES-Reykjavik study.

    PubMed

    Muller, Majon; Sigurdsson, Sigurdur; Kjartansson, Olafur; Gunnarsdottir, Ingibjorg; Thorsdottir, Inga; Harris, Tamara B; van Buchem, Mark; Gudnason, Vilmundur; Launer, Lenore J

    2016-05-01

    The "fetal-origins-of-adult-disease" hypothesis proposes that an unfavorable intrauterine environment, estimated from small birth size, may induce permanent changes in fetal organs, including the brain. These changes in combination with effects of (cardiovascular) exposures during adult life may condition the later risk of brain atrophy. We investigated the combined effect of small birth size and mid-life cardiovascular risk on late-life brain volumes. Archived birth records of weight and height were abstracted for 1348 participants of the age, gene/environment susceptibility-Reykjavik study (RS; 2002-2006) population-based cohort, who participated in the original cohort of the RS (baseline 1967). Mid-life cardiovascular risk factors (CVRF) were collected in the RS. As a part of the late-life age, gene/environment susceptibility-RS examination, a brain magnetic resonance imaging was acquired and from it, volumes of total brain, gray matter, white matter, and white matter lesions were estimated. Adjusting for intracranial volume, demographics, and education showed small birth size (low ponderal index [PI]) and increased mid-life cardiovascular risk had an additive effect on having smaller late-life brain volumes. Compared with the reference group (high PI/absence of mid-life CVRF), participants with lower PI/presence of mid-life CVRF (body mass index >25 kg/m(2), hypertension, diabetes, "ever smokers") had smaller total brain volume later in life; B (95% confidence interval) were -10.9 mL (-21.0 to -0.9), -10.9 mL (-20.4 to -1.4), -20.9 mL (-46.9 to 5.2), and -10.8 mL (-19.3 to -2.2), respectively. These results suggest that exposure to an unfavorable intrauterine environment contributes to the trajectory toward smaller brain volume, adding to the atrophy that may be associated with mid-life cardiovascular risk. PMID:27103521

  6. Depression from childhood into late adolescence: Influence of gender, development, genetic susceptibility, and peer stress

    PubMed Central

    Hankin, Benjamin L.; Young, Jami F.; Abela, John R. Z.; Smolen, Andrew; Jenness, Jessica L.; Gulley, Lauren D.; Technow, Jessica R.; Gottlieb, Andrea Barrocas; Cohen, Joseph R.; Oppenheimer, Caroline W.

    2015-01-01

    Depression is a debilitating mental illness with clear developmental patterns from childhood through late adolescence. Here, we present data from the Gene Environment Mood (GEM) study, which used an accelerated longitudinal cohort design with youth (N = 665) starting in 3rd, 6th, and 9th grades, and a caretaker, who were recruited from the general community, and were then assessed repeatedly via semi-structured diagnostic interviews every 6-months over 3 years (7 waves of data) to establish and then predict trajectories of depression from age 8 to 18. First, we demonstrated that overall prevalence rates of depression over time, by age, gender, and pubertal status, in the GEM study closely match those trajectories previously obtained in past developmental epidemiological research. Second, we tested whether a genetic vulnerability-stress model involving 5-HTTLPR and chronic peer stress was moderated by developmental factors. Results showed that older aged adolescents with SS/SL genotype, who experienced higher peer chronic stress over 3 years, were the most likely to be diagnosed with a depressive episode over time. Girls experiencing greater peer chronic stress were the most likely to develop depression. PMID:26595469

  7. Late life gambling: the attitudes and behaviors of older adults.

    PubMed

    McNeilly, D P; Burke, W J

    2000-01-01

    For a significant number of retired older adults (aged 65+), gambling has become a new form of recreation and entertainment. While prevalence studies have examined the incidence of problem gambling in other age groups, little research attention has been paid to the impact of gambling on older adults since the increase in availability and accessibility of legalized gambling within the last ten years. This study investigated the prevalence of problem gambling behaviors (SOGS-R), depression (GDS-15), levels of life satisfaction (SWLS), and motivations for gambling among older adults. A total of 315 older adults completed the study questionnaire and were grouped and analyzed according to those sampled from gambling venues and those from within the community. Results of the study found the most frequent accession and spending on several types of gambling occurred among older adults who were sampled at gambling venues. Older adults who were sampled at gambling venues were also found more likely to have higher levels of disordered gambling than older adults from the community, as measured by the SOGS-R. Relaxation, boredom, passing time, and getting away for the day were also the most likely reported motivations for the older adults who were gambling patrons. These findings provide an initial profile of older adults and their attitudes, motivations and gambling behaviors. PMID:14634305

  8. Maternal Depression and Mother-Child Interaction Patterns: Association with Toddler Problems and Continuity of Effects to Late Childhood

    ERIC Educational Resources Information Center

    Leckman-Westin, Emily; Cohen, Patricia R.; Stueve, Ann

    2009-01-01

    Objective: Increased behavior problems have been reported in offspring of mothers with depression. In-home observations link maternal depressive symptoms (MDS) and mother-child interaction patterns with toddler behavior problems and examine their persistence into late childhood. Method: Maternal characteristics (N = 153) and behaviors of…

  9. Do Afterlife Beliefs Affect Psychological Adjustment to Late-Life Spousal Loss?

    PubMed Central

    2014-01-01

    Objectives. We explore whether beliefs about the existence and nature of an afterlife affect 5 psychological symptoms (anxiety, anger, depression, intrusive thoughts, and yearning) among recently bereaved older spouses. Method. We conduct multivariate regression analyses using data from the Changing Lives of Older Couples (CLOC), a prospective study of spousal loss. The CLOC obtained data from bereaved persons prior to loss and both 6 and 18 months postloss. All analyses are adjusted for health, sociodemographic characteristics, and preloss marital quality. Results. Bleak or uncertain views about the afterlife are associated with multiple aspects of distress postloss. Uncertainty about the existence of an afterlife is associated with elevated intrusive thoughts, a symptom similar to posttraumatic distress. Widowed persons who do not expect to be reunited with loved ones in the afterlife report significantly more depressive symptoms, anger, and intrusive thoughts at both 6 and 18 months postloss. Discussion. Beliefs in an afterlife may be maladaptive for coping with late-life spousal loss, particularly if one is uncertain about its existence or holds a pessimistic view of what the afterlife entails. Our findings are broadly consistent with recent work suggesting that “continuing bonds” with the decedent may not be adaptive for older bereaved spouses. PMID:23811692

  10. The Relationship among Negative Life Events, Cognitions, and Depression within Three Generations.

    ERIC Educational Resources Information Center

    Nacoste, Denise R. Barnes; Wise, Erica H.

    1991-01-01

    Investigated extent to which cognitions mediate relationship between negative life events and depression. College students and their same-sex parents and grandparents (n=171) completed measures of stressful life events, automatic thoughts, dysfunctional attitudes, and depression. Found interaction between negative life events and cognition for…

  11. Reported causal antecedents of discrete emotions in late life.

    PubMed

    Chipperfield, Judith G; Perry, Raymond P; Weiner, Bernard; Newall, Nancy E

    2009-01-01

    Valuable insights about emotional well-being can be learned from studying older adults who have wrestled with differentiating and regulating their emotions while they navigate through the many joys and traumas of a lifetime. Our objective was to document the underlying reasons for older adults' (n = 353, ages 72 -99) emotional experiences. Using a phenomenological approach, we identified participants' reported reasons (i.e., antecedents) for a broad variety of positive and negative emotions, classifying them into thematic categories through a content analysis. The array of thematic categories that emerged for some emotions was more differentiated than for others. For example, 14 antecedent categories were required to account for the emotion of happiness; whereas, only 4 categories were needed to capture all antecedents for anger. Our analysis provided a rich description of what older adults report as the causes of their emotions, showing that later life is characterized as a time when the loss of love ones elicits sadness, self-limitations elicit frustration, and others' transgressions elicit anger. Yet, our data show that old age can be portrayed even more so as a time when a variety of positive emotions are elicited by social factors (interactions and relationships), achievements, and personal attributes. Finally, in an analysis of the most common antecedents for pride (accomplishments) and anger (other's transgression), we suggest that pride over accomplishments is most likely elicited by internal attributions to skill and effort; whereas, anger over others' transgressions is most likely elicited by controllable attributions to the transgressor's inconsiderate or offensive behavior. Overall, this shows the utility of applying Weiner's attributional framework (Weiner, 1985) to an analysis of emotion antecedents in late life. PMID:19522180

  12. Inbreeding depression in an insect with maternal care: influences of family interactions, life stage and offspring sex.

    PubMed

    Meunier, J; Kölliker, M

    2013-10-01

    Although inbreeding is commonly known to depress individual fitness, the severity of inbreeding depression varies considerably across species. Among the factors contributing to this variation, family interactions, life stage and sex of offspring have been proposed, but their joint influence on inbreeding depression remains poorly understood. Here, we demonstrate that these three factors jointly shape inbreeding depression in the European earwig, Forficula auricularia. Using a series of cross-breeding, split-clutch and brood size manipulation experiments conducted over two generations, we first showed that sib mating (leading to inbred offspring) did not influence the reproductive success of earwig parents. Second, the presence of tending mothers and the strength of sibling competition (i.e. brood size) did not influence the expression of inbreeding depression in the inbred offspring. By contrast, our results revealed that inbreeding dramatically depressed the reproductive success of inbred adult male offspring, but only had little effect on the reproductive success of inbred adult female offspring. Overall, this study demonstrates limited effects of family interactions on inbreeding depression in this species and emphasizes the importance of disentangling effects of sib mating early and late during development to better understand the evolution of mating systems and population dynamics. PMID:23981229

  13. Clinical and cognitive diversity of psychotic states arising in late life (late paraphrenia).

    PubMed

    Almeida, O P; Howard, R J; Levy, R; David, A S; Morris, R G; Sahakian, B J

    1995-07-01

    This study aimed to explore the heterogeneity of paranoid psychosis with onset in late life by using cognitive factors in a centroid method of cluster analysis. Forty-seven subjects were allocated to two different clusters, the first with 24 (51.1%) and the second with 23 (48.9%) patients. Their cognitive attainment was evaluated against the performance of 33 elderly controls, all groups being matched for age, sex, and the numbers of years of education. Patients in cluster 2 showed a pattern of widespread cognitive impairment, which involved general measures of cognitive performance (MMSE, CAMCOG, WAIS-R verbal and performance scores), memory (digit and spatial span, delayed matching-to-sample, recognition memory for words and faces), and executive functions (verbal fluency, extra and intra-dimensional shift ability, spatial working memory, and planning). In contrast, patients in cluster 1 were only impaired on their extra-dimensional set shift and planning abilities, suggesting a more specific and restricted executive functioning deficit. We also analysed the impact that the use of antipsychotic medication could have had on patients' cognitive performance, which was shown to be negligible. In addition, there was no difference between the clusters with regard to the number of patients using neuroleptics, suggesting that the medication was unlikely to have introduced a performance bias in the two patient clusters. The validity of the subdivision of these patients into two separate groups was further supported by other clinical findings. Patients in cluster 1 exhibited more severe psychotic symptoms, as measured by the SAPS, than their counterparts in cluster 2, and were also more likely to display first-rank symptoms of Schneider. Conversely, cluster 2 membership was strongly associated with the presence of neurological signs and negative symptoms. We suggest that psychotic states arising in late life are a heterogeneous condition that may be best divided in two

  14. Alleles that modulate late life hearing in genetically heterogeneous mice

    PubMed Central

    Schacht, Jochen; Altschuler, Richard; Burke, David T.; Chen, Shu; Dolan, David; Galecki, Andrzej T.; Kohrman, David; Miller, Richard A.

    2012-01-01

    A genetically heterogeneous population of mice was tested for hearing at 8, 18 and 22 months by auditory brainstem response (ABR), and genotyped at 128 markers to identify loci that modulate late life hearing loss. Half of the test mice were exposed to noise for 2 hr at age 20 months. Polymorphisms affecting hearing at 18 months were noted on chromosomes 2, 3, 7, 10, and 15. Most of these loci had effects only on responses to 48 kHz stimuli, but a subset also influenced the ABR at lower frequencies. Loci on chromosomes 4, 10, 12, and 14 had significant effects on hearing at 22 months in noise-exposed mice, and loci on chromosomes 10 and 11 had effects on mice not exposed to noise. Outer hair cell loss was modulated by polymorphisms on chromosomes 10, 11, 12, 17, and 19. Resistance to age-related hearing loss is thus modulated by a set of genetic effects, some age-specific, some frequency specific, some dependent on prior exposure to noise, and some of which compromise survival of cochlear hair cells. PMID:22305187

  15. Evidence on early-life income and late-life health from America's Dust Bowl era.

    PubMed

    Cutler, David M; Miller, Grant; Norton, Douglas M

    2007-08-14

    In recent decades, elderly Americans have enjoyed enormous gains in longevity and reductions in disability. The causes of this progress remain unclear, however. This paper investigates the role of fetal programming, exploring how economic progress early in the 20th century might be related to declining disability today. Specifically, we match sudden unexpected economic changes experienced in utero in America's Dust Bowl during the Great Depression to unusually detailed individual-level information about old-age disability and chronic disease. We are unable to detect any meaningful relationship between early life factors and outcomes in later life. We conclude that, if such a relationship exists in the United States, it is most likely not a quantitatively important explanation for declining disability today. PMID:17686988

  16. Evidence on early-life income and late-life health from America's Dust Bowl era

    PubMed Central

    Cutler, David M.; Miller, Grant; Norton, Douglas M.

    2007-01-01

    In recent decades, elderly Americans have enjoyed enormous gains in longevity and reductions in disability. The causes of this progress remain unclear, however. This paper investigates the role of fetal programming, exploring how economic progress early in the 20th century might be related to declining disability today. Specifically, we match sudden unexpected economic changes experienced in utero in America's Dust Bowl during the Great Depression to unusually detailed individual-level information about old-age disability and chronic disease. We are unable to detect any meaningful relationship between early life factors and outcomes in later life. We conclude that, if such a relationship exists in the United States, it is most likely not a quantitatively important explanation for declining disability today. PMID:17686988

  17. [Events of life and links with severe depression at different ages].

    PubMed

    Gourion, D

    2009-12-01

    Major depression is a common, severe, chronic, and often life-threatening illness. There is a growing body of evidence that, far from being a disease with purely psychological manifestations, major depression is a systemic disease with deleterious effects on multiple organ systems. Stressful life events have a substantial causal association with depression, and there is now compelling evidence that even early life stress constitutes a major risk factor for the subsequent development of depression. This review will focus on the association between severity of depression and diachronic vulnerability across the life-span, in terms of events of life, stress, and hormonal modulation, with a special focus on depression in young adults, women during postpartum and in depression in ederly people. Given the high prevalence of depressive disorders, the significant burden and the severity of disease in adolescents and young adults experiencing their first episode, they represent a group at high risk of relapse, recurrence, comorbidity and suicide to whom early intervention and prevention efforts should be targeted. Females exhibit different stress sensitivities than males which might contribute to their increased vulnerability for depression and the disease exhibit a prevalence among women which is 2-3x higher than in men. The postpartum period is considered the time of greatest risk for women to develop major depression and postpartum depression affects approximately 15% of women. In old age, depression mainly affects those with chronic medical illness, severe disability or mental decline. Depression in elderly worsens the outcomes of many medical illness and increases mortality. Environmental factors, such as isolation, caregiving and bereavement, contribute to further increase susceptibility to depression or triggering depression in already vulnerable elderly people. Suitable treatment of depression in elderly reduces the symptoms, prevents suicidal ideation, improves

  18. Adolescent Depression and Negative Life Events, the Mediating Role of Cognitive Emotion Regulation

    PubMed Central

    Stikkelbroek, Yvonne; Bodden, Denise H. M.; Kleinjan, Marloes; Reijnders, Mirjam; van Baar, Anneloes L.

    2016-01-01

    Background Depression during adolescence is a serious mental health problem. Difficulties in regulating evoked emotions after stressful life events are considered to lead to depression. This study examined if depressive symptoms were mediated by various cognitive emotion regulation strategies after stressful life events, more specifically, the loss of a loved one, health threats or relational challenges. Methods We used a sample of 398 adolescents (Mage = 16.94, SD = 2.90), including 52 depressed outpatients, who all reported stressful life event(s). Path analyses in Mplus were used to test mediation, for the whole sample as well as separately for participants scoring high versus low on depression, using multigroup analyses. Results Health threats and relational challenging stressful life events were associated with depressive symptoms, while loss was not. More frequent use of maladaptive strategies was related to more depressive symptoms. More frequent use of adaptive strategies was related to less depressive symptoms. Specific life events were associated with specific emotion regulation strategies. The relationship between challenging, stressful life events and depressive symptoms in the whole group was mediated by maladaptive strategies (self-blame, catastrophizing and rumination). No mediation effect was found for adaptive strategies. Conclusion The association between relational challenging, stressful life events and depressive symptoms was mediated by maladaptive, cognitive emotion regulation strategies. PMID:27571274

  19. Making Sense of Intimate Partner Violence in Late Life: Comments from Online News Readers

    ERIC Educational Resources Information Center

    Brossoie, Nancy; Roberto, Karen A.; Barrow, Katie M.

    2012-01-01

    Purpose: The purpose of this study was to gain insight into public awareness of intimate partner violence (IPV) in late life by how individuals respond to incidents of IPV reported in the newspaper. Design and Methods: Using grounded theory techniques, online news items covering 24 incidents of IPV in late life, and the reader comments posted to…

  20. Life Course Socioeconomic Position and Mid-Late Life Cognitive Function in Eastern Europe

    PubMed Central

    2014-01-01

    Objectives. To investigate whether the positive relation between socioeconomic position (SEP) across the life course and later life cognitive function observed in Western populations exists in former communist countries with apparently smaller income inequalities. Method. Structural equation modeling analysis of cross-sectional data on 30,846 participants aged 45–78 years in four Central and Eastern European centers: Novosibirsk (Russia), Krakow (Poland), Kaunas (Lithuania), and six Czech towns from the HAPIEE (Health, Alcohol, and Psychosocial factors In Eastern Europe) study. SEP was measured using self-reported childhood (maternal education, household amenities), adult (education), and older adult (current material circumstances) indicators. Latent variable for cognition was constructed from word recall, animal naming, and letter search. Results. Associations between SEP measures over the life course and cognition were similar across study centers. Education had the strongest direct association with cognition, followed by current material circumstances. Indirect path from education to cognition, mediated by current SEP, was small. Direct path from mother’s education to cognition was significant but modest, and partially mediated by later SEP measures, particularly education. Discussion. In these Eastern European populations, late life cognition reflected life course socioeconomic trajectories similarly to findings in Western countries. PMID:24598045

  1. Serum lipid levels and cognitive change in late life

    PubMed Central

    Reynolds, Chandra A.; Gatz, Margaret; Prince, Jonathan A.; Berg, Stig; Pedersen, Nancy L.

    2010-01-01

    Objectives To assess the importance of lipids and lipoproteins on longitudinal cognitive performance and cognitive health in late life and to consider moderating factors such as age and sex which may clarify conflicting prior evidence. Design A 16-year prospective cohort study of health and cognitive aging. Participants 819 adults from the Swedish Adoption Twin Study of Aging (SATSA), 50 years and older at the first cognitive testing, including 21 twin pairs discordant for dementia. Measurements Up to five occasions of cognitive measurements encompassing verbal, spatial, memory and perceptual speed domains across a 16-year span. Baseline serum lipids and lipoproteins including HDL, apoA1, apoB, total serum cholesterol, and triglycerides. Results The effect of lipids on cognitive change was most evident prior to age 65. In women higher HDL and lower apoB and triglycerides predicted better maintenance of cognitive abilities over age, particularly verbal ability and perceptual speed. Lipid values were less predictive of cognitive trajectories in men and, where observed, were in the contrary direction: i.e., higher total cholesterol and apoB values predicted better perceptual speed performance though faster rates of decline. In twin pairs discordant for dementia, higher total cholesterol and apoB levels were observed in the twin who subsequently developed dementia. Conclusions Elevated lipids may constitute a more important risk factor for cognitive health before age 65 than after. Findings for women are consistent with clinical recommendations, while for men the findings correspond with earlier age-associated shifts in lipid profiles and the importance of lipid homeostasis to cognitive health. PMID:20398119

  2. Late-Life Risk Factors for All-Cause Dementia and Differential Dementia Diagnoses in Women

    PubMed Central

    Neergaard, Jesper Skov; Dragsbæk, Katrine; Hansen, Henrik Bo; Henriksen, Kim; Christiansen, Claus; Karsdal, Morten Asser

    2016-01-01

    Abstract Since the first evidence of a decline in dementia incidence was reported in 2011, the focus on modifiable risk factors has increased. The possibility of risk factor intervention as a prevention strategy has been widely discussed; however, further evidence in relation to risk factors is still needed. The Prospective Epidemiologic Risk Factor (PERF I) study was an observational prospective study of postmenopausal Danish women who were initially examined between 1999 and 2001 (n = 5855). Follow-up data on diagnosis and survival as of December 31, 2014 was retrieved from the National Danish Patient Registry and the National Danish Causes of Death Registry. Cox proportional hazards regression model was applied to calculate adjusted hazard ratios (HR) for selected risk factors for dementia. Of 5512 eligible subjects, 592 developed dementia within the follow-up period of maximum 15 years. The independent factors associated with increased risk of all-cause dementia were depression (HR = 1.75 [95% CI 1.32–2.34]) and impaired fasting glucose levels. A dose–response relationship was observed between fasting glucose level and risk of dementia with HRs of 1.25 [1.05–1.49] and 1.45 [1.03–2.06] for impaired (5.6–6.9 mmol/L) and hyperglycemic (≥7.0 mmol/L) glucose levels, respectively. The factors associated with a decreased risk of dementia were overweight in late-life (HR = 0.75 [0. 62–0.89]) and physical activity at least once weekly (HR = 0.77 [0.61–0.96]). The identified risk factors for dementia in women in late-life are all considered modifiable. This supports the notion that prevention strategies may improve the poor future prospects for dementias in the ageing population. PMID:26986157

  3. Blood Transcriptomic Markers in Patients with Late-Onset Major Depressive Disorder

    PubMed Central

    Miyata, Shigeo; Kurachi, Masashi; Okano, Yoshiko; Sakurai, Noriko; Kobayashi, Ayumi; Harada, Kenichiro; Yamagata, Hirotaka; Matsuo, Koji; Takahashi, Keisuke; Narita, Kosuke; Fukuda, Masato; Ishizaki, Yasuki; Mikuni, Masahiko

    2016-01-01

    We investigated transcriptomic markers of late-onset major depressive disorder (LOD; onset age of first depressive episode ≥ 50 years) from the genes expressed in blood cells and identified state-dependent transcriptomic markers in these patients. We assessed the genes expressed in blood cells by microarray and found that the expression levels of 3,066 probes were state-dependently changed in the blood cells of patients with LOD. To select potential candidates from those probes, we assessed the genes expressed in the blood of an animal model of depression, ovariectomized female mice exposed to chronic ultra-mild stress, by microarray and cross-matched the differentially expressed genes between the patients and the model mice. We identified 14 differentially expressed genes that were similarly changed in both patients and the model mice. By assessing statistical significance using real-time quantitative PCR (RT-qPCR), the following 4 genes were selected as candidates: cell death-inducing DFFA-like effector c (CIDEC), ribonuclease 1 (RNASE1), solute carrier family 36 member-1 (SLC36A1), and serine/threonine/tyrosine interacting-like 1 (STYXL1). The discriminating ability of these 4 candidate genes was evaluated in an independent cohort that was validated. Among them, CIDEC showed the greatest discriminant validity (sensitivity 91.3% and specificity 87.5%). Thus, these 4 biomarkers should be helpful for properly diagnosing LOD. PMID:26926397

  4. Cognitive Distortions as Mediators between Life Stress and Depression in Adolescents.

    ERIC Educational Resources Information Center

    Deal, Saundra L.; Williams, John E.

    1988-01-01

    Administered measures of cognitive distortion, life stress, and depressive tendencies to 103 high school students. Findings were consistent with predictions that measures of cognitive distortion would be better predictors of depressive tendencies than were measures of life stress; cognitive distortions would affect perceived stressfulness of life…

  5. Life Stress and the Long-Term Treatment Course of Recurrent Depression: III. Nonsevere Life Events Predict Recurrence for Medicated Patients over 3 Years

    ERIC Educational Resources Information Center

    Monroe, Scott M.; Torres, Leandro D.; Guillaumot, Julien; Harkness, Kate L.; Roberts, John E.; Frank, Ellen; Kupfer, David

    2006-01-01

    Research has consistently documented the significance of severe life events for onset of major depression. Theory, however, suggests other forms of stress are relevant for depression's recurrence. Nonsevere life events were tested in relation to depression for 126 patients with recurrent depression in a 3-year randomized maintenance protocol. Life…

  6. The Role of Early-Life Educational Quality and Literacy in Explaining Racial Disparities in Cognition in Late Life

    PubMed Central

    Gross, Alden L.; Shih, Regina A.; Sachs, Bonnie C.; Glymour, M. Maria; Bangen, Katherine J.; Benitez, Andreana; Skinner, Jeannine; Schneider, Brooke C.; Manly, Jennifer J.

    2015-01-01

    Objectives. Racial disparities in late-life cognition persist even after accounting for educational attainment. We examined whether early-life educational quality and literacy in later life help explain these disparities. Method. We used longitudinal data from the Washington Heights-Inwood Columbia Aging Project (WHICAP). Educational quality (percent white students; urban/rural school; combined grades in classroom) was operationalized using canonical correlation analysis. Late-life literacy (reading comprehension and ability, writing) was operationalized using confirmatory factor analysis. We examined whether these factors attenuated race-related differences in late-life cognition. Results. The sample consisted of 1,679U.S.-born, non-Hispanic, community-living adults aged 65–102 (71% black, 29% white; 70% women). Accounting for educational quality and literacy reduced disparities by 29% for general cognitive functioning, 26% for memory, and 32% for executive functioning but did not predict differences in rate of cognitive change. Discussion. Early-life educational quality and literacy in late life explain a substantial portion of race-related disparities in late-life cognitive function. PMID:24584038

  7. Aging differently: diet- and sex-dependent late-life mortality patterns in Drosophila melanogaster.

    PubMed

    Zajitschek, Felix; Jin, Tuo; Colchero, Fernando; Maklakov, Alexei A

    2014-06-01

    Diet effects on age-dependent mortality patterns are well documented in a large number of animal species, but studies that look at the effects of nutrient availability on late-life mortality plateaus are lacking. Here, we focus on the effect of dietary protein content (low, intermediate, and high) on mortality trajectories in late life in the fruit fly Drosophila melanogaster. According to the two theories that are mainly implicated in explaining the deceleration of mortality rate in late life (the heterogeneity/frailty theory and the Hamiltonian theory), we predict, in general, the occurrence of late-life mortality deceleration under most circumstances, independent of sex and dietary regime. However, the heterogeneity theory of late life is more flexible in allowing no mortality deceleration to occur under certain circumstances compared with the Hamiltonian theory. We applied a novel statistical approach based on Bayesian inference of age-specific mortality rates and found a deceleration of late-life mortality rates on all diets in males but only on the intermediate (standard) diet in females. The difference in mortality rate deceleration between males and females on extreme diets suggests that the existence of mortality plateaus in late life is sex and diet dependent and, therefore, not a universal characteristic of large enough cohorts. PMID:24170671

  8. Prevalence, work-loss days and quality of life of community dwelling subjects with depressive symptoms.

    PubMed

    Sohn, Jee Hoon; Ahn, Seung Hee; Seong, Su Jeong; Ryu, Ji Min; Cho, Maeng Je

    2013-02-01

    The nationwide prevalence of major depressive disorder in Korea is lower than most countries, despite the high suicide rate. To explain this unexpectedly low prevalence, we examined the functional disability and quality of life in community-dwelling subjects with significant depressive symptoms not diagnosable as depressive disorder. A total of 1,029 subjects, randomly chosen from catchment areas, were interviewed with the Center for Epidemiologic Studies Depression scale, Mini International Neuropsychiatric Interview, WHO Quality of Life scale, and the WHO Disability Assessment Schedule. Those with scores over 21 on the depression scale were interviewed by a psychiatrist for diagnostic confirmation. Among community-dwelling subjects, the 1-month prevalence of major depressive disorder was 2.2%, but the 1-month prevalence of depressive symptoms not diagnosable as depressive disorder was 14.1%. Depressive disorders were the cause of 24.7% of work loss days, while depressive symptoms not diagnosable as depressive disorder were the cause of 17.2% of work loss days. These findings support the dimensional or spectrum approach to depressive disorder in the community and might be the missing link between the apparent low prevalence of depressive disorder and high suicide rate in Korea. PMID:23399785

  9. Prevalence, Work-Loss Days and Quality of Life of Community Dwelling Subjects with Depressive Symptoms

    PubMed Central

    Sohn, Jee Hoon; Ahn, Seung Hee; Seong, Su Jeong; Ryu, Ji Min

    2013-01-01

    The nationwide prevalence of major depressive disorder in Korea is lower than most countries, despite the high suicide rate. To explain this unexpectedly low prevalence, we examined the functional disability and quality of life in community-dwelling subjects with significant depressive symptoms not diagnosable as depressive disorder. A total of 1,029 subjects, randomly chosen from catchment areas, were interviewed with the Center for Epidemiologic Studies Depression scale, Mini International Neuropsychiatric Interview, WHO Quality of Life scale, and the WHO Disability Assessment Schedule. Those with scores over 21 on the depression scale were interviewed by a psychiatrist for diagnostic confirmation. Among community-dwelling subjects, the 1-month prevalence of major depressive disorder was 2.2%, but the 1-month prevalence of depressive symptoms not diagnosable as depressive disorder was 14.1%. Depressive disorders were the cause of 24.7% of work loss days, while depressive symptoms not diagnosable as depressive disorder were the cause of 17.2% of work loss days. These findings support the dimensional or spectrum approach to depressive disorder in the community and might be the missing link between the apparent low prevalence of depressive disorder and high suicide rate in Korea. PMID:23399785

  10. Early life stress affects limited regional brain activity in depression

    PubMed Central

    Du, Lian; Wang, Jingjie; Meng, Ben; Yong, Na; Yang, Xiangying; Huang, Qingling; Zhang, Yan; Yang, Lingling; Qu, Yuan; Chen, Zhu; Li, Yongmei; Lv, Fajin; Hu, Hua

    2016-01-01

    Early life stress (ELS) can alter brain function and increases the risk of major depressive disorder (MDD) in later life. This study investigated whether ELS contributes to differences in regional brain activity between MDD patients and healthy controls (HC), as measured by amplitude of low-frequency fluctuation (ALFF)/fractional (f)ALFF. Eighteen first-episode, treatment-naïve MDD patients and HC were assessed with the Childhood Trauma Questionnaire and resting-state functional magnetic resonance imaging. We compared ALFF/fALFF between MDD patients and HC, with or without controlling for ELS, and determined whether ELS level was correlated with regional brain activity in each group. After regressing out ELS, we found that ALFF increased in bilateral amygdala and left orbital/cerebellum, while fALFF decreased in left inferior temporal and right middle frontal gyri in MDD patients relative to controls. ELS positively correlated with regional activity in the left cerebellum in MDD and in the right post-central/inferior temporal/superior frontal cingulate, inferior frontal gyrus and bilateral cerebellum in HC. Our findings indicate that there is only very limited region showing correlation between ELS and brain activity in MDD, while diverse areas in HC, suggesting ELS has few impacts on MDD patients. PMID:27138376

  11. Prefrontal activation predicts social functioning improvement after initial treatment in late-onset depression.

    PubMed

    Pu, Shenghong; Nakagome, Kazuyuki; Yamada, Takeshi; Yokoyama, Katsutoshi; Matsumura, Hiroshi; Nagata, Izumi; Kaneko, Koichi

    2015-03-01

    The activation of oxygenated hemoglobin (oxy-Hb) has been shown to be lacking in the prefrontal cortex (PFC) of patients with late-onset depression (LOD), in verbal fluency task (VFT)-related near-infrared spectroscopy (NIRS). In our previous studies, we have emphasized the connection between the lack of activation in the frontopolar cortex and social functioning disorder in patients with LOD. In this study, we investigated whether the responsiveness to medical treatment of untreated patients with LOD, particularly social functioning improvements, could be predicted by NIRS findings at the initial examination. The subjects were 29 patients with LOD who were diagnosed with major depression at 65 years or older at the initial examination (mean age ± standard deviation, 72.4 ± 5.71 years). We measured the changes in hemoglobin concentration in the prefrontal and temporal cortex regions during a VFT by using 52-channel NIRS. In addition, depression status and social functioning were evaluated with the Hamilton Depression Rating Scale and the Social Adaptation Self-evaluation Scale, respectively, at the initial examination and 8 weeks after the treatment. A negative correlation was found between the NIRS activation in the right ventrolateral PFC region before treatment and the improvement in social functioning. These results suggested that the social functioning improvements were greater in LOD with initially lower NIRS activation in the right ventrolateral PFC region. NIRS is a simple technique that can be used before treatment to evaluate the social functioning levels of patients with LOD, and predict social functioning improvement after treatment. PMID:25659188

  12. Early Life Socioeconomic Circumstance and Late Life Brain Hyperintensities – A Population Based Cohort Study

    PubMed Central

    Murray, Alison D.; McNeil, Christopher J.; Salarirad, Sima; Whalley, Lawrence J.; Staff, Roger T.

    2014-01-01

    Context There have been many reports confirming the association between lower childhood socioeconomic circumstance and cardiovascular disease but evidence for links with cerebrovascular disease is contradictory. Hyperintensities on brain magnetic resonance imaging are associated with vascular risk factors, cognitive decline, dementia and death. However, the relationship between childhood socioeconomic circumstance and these lesions is unclear. Objective To test the hypothesis that childhood socioeconomic circumstance is associated with late life hyperintensity burden and that neither adult socioeconomic circumstance nor change in socioeconomic circumstance during life influence this effect. Design Cohort study Setting Community Participants 227 community dwelling members of the 1936 Aberdeen Birth Cohort aged 68 years, who were free from dementia. Main Outcome Measures Relationship between early life socioeconomic circumstance (paternal occupation) and abundance of late life brain hyperintensities. Results We find significant negative correlations between childhood socioeconomic circumstance and white matter hyperintensities (ρ = −0.18, P<0.01), and periventricular hyperintensities (ρ = −0.15, P<0.05), between educational attainment and white matter hyperintensities (ρ = −0.15, P<0.05) and periventricular hyperintensities (ρ = −0.17, P<0.05), and between childhood intelligence and periventricular hyperintensities (ρ = −0.14, P<0.05). The relationship is strongest for childhood socioeconomic circumstance and regional white matter hyperintensities, where there is a step change in increased burden from paternal occupation grades equivalent to a shift from “white collar” to “blue collar” paternal occupation. Significant correlations were also found between hypertension and hyperintensity burden in all brain regions (ρ = 0.15–0.24, P<0.05). In models that include hypertension, the magnitude of the effect of childhood

  13. Late Life Immigration and Quality of Life among Asian Indian Older Adults.

    PubMed

    Mukherjee, Anita J; Diwan, Sadhna

    2016-09-01

    Late-life immigration among seniors for purposes of family reunification is a growing phenomenon in developed countries. Using the World Health Organization's Quality of Life instrument short form (WHOQOL-BREF) and other psychosocial measures related to the political/legal context of immigration, and personal and environmental autonomy (mastery, immigration status, access to transportation, and language barrier), this study examined quality of life (QoL) in Asian Indian seniors (N = 109), who immigrated to the United States to reunite with their adult children. The sample scores on Overall QoL and QoL domains (physical and psychological health, social relationships, and environment) were similar to established norms. Although all QoL domains correlated significantly with Overall QoL at the bivariate level, multivariate analysis showed that only environmental domain contributed significantly to Overall QoL. Linear regressions indicated: Mastery contributed significantly to Overall QoL and all QoL domains; access to transport contributed to Overall QoL, physical health, and environmental QoL; immigration status (a proxy for political/legal context) contributed to environmental QoL whereas language barrier contributed to none. Implications for improving perceptions of QoL, mastery, access to transport and other services are discussed. PMID:27245988

  14. Life stress and the accuracy of cognitive appraisals in depressed youth.

    PubMed

    Krackow, Elisa; Rudolph, Karen D

    2008-04-01

    This study investigated the accuracy of depressed youths' appraisals of naturally occurring life events. Participants (49% girls; M age = 12.44 years) with clinical diagnoses of depression (n = 24), subsyndromal symptoms of depression (n = 29), and no symptoms of psychopathology (n = 36) completed semi-structured interviews of life stress. As predicted, depressed youth experienced more independent and self-generated interpersonal stress than did nonsymptomatic youth. Consistent with a cognitive bias, clinically depressed youth overestimated the stressfulness of events and overestimated their contribution to events relative to nonsymptomatic youth. Youth with subsyndromal symptoms demonstrated similar, although typically less severe, impairment than those with clinical depression. Results contribute to cognitive-interpersonal models of depression by illustrating the need to consider both realistic interpersonal difficulties and biased appraisals of experiences. PMID:18470774

  15. Evaluation of the late life disability instrument in the Lifestyle Interventions and Independence for Elders Pilot (LIFE-P) study

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The late life disability instrument (LLDI) was developed to assess limitations in instrumental and management roles using a small and restricted sample. In this paper we examine the measurement properties of the LLDI using data from the Lifestyle Interventions and Independence for Elders Pilot (LIFE...

  16. Stressful Life Events and Depression Symptoms: The Effect of Childhood Emotional Abuse on Stress Reactivity

    PubMed Central

    Shapero, Benjamin G.; Black, Shimrit K.; Liu, Richard T.; Klugman, Joshua; Bender, Rachel E.; Abramson, Lyn Y.; Alloy, Lauren B.

    2013-01-01

    Objective Stressful life events are associated with an increase in depressive symptoms and the onset of major depression. Importantly, research has shown that the role of stress changes over the course of depression. The present study extends the current literature by examining the effects of early life stress on emotional reactivity to current stressors. Method In a multiwave study (N = 281, mean age = 18.76; 68% female), we investigated the proximal changes that occur in depressive symptoms when individuals are faced with life stress and whether a history of childhood emotional abuse moderates this relationship. Results Results support the stress sensitivity hypothesis for early emotional abuse history. Individuals with greater childhood emotional abuse severity experienced greater increases in depressive symptoms when confronted with current dependent stressors, controlling for childhood physical and sexual abuse. Conclusions This study highlights the importance of emotional abuse as an indicator for reactivity to stressful life events. PMID:23800893

  17. Racial and Ethnic Differences in Prenatal Life Stress and Postpartum Depression Symptoms.

    PubMed

    Liu, Cindy H; Giallo, Rebecca; Doan, Stacey N; Seidman, Larry J; Tronick, Ed

    2016-02-01

    This study determined the risk of core depression symptoms based on life stress domains during pregnancy and whether stressors varied by race/ethnicity. The sample consisted of 2,344 White, African American, Hispanic, and Asian/Pacific Islander (API) Massachusetts women who recently gave birth. African Americans and Hispanics who endorsed high relational and high financial stress were more likely to report high depressed mood and loss of interest; high physical stress was associated with high depressed mood among API. Screening based on life stress domains may be informative in determining risk for core depression symptoms during the postpartum period especially for minority groups. PMID:26804495

  18. Motivation in Late Life: The Personal Need for Challenge.

    ERIC Educational Resources Information Center

    Wolf, Mary Alice

    Older adults attend continuing education courses for a variety of reasons. Some, like Wuschko K., seek to make sense of their early life experiences. Wuschko is a Polish immigrant who wanted to go on with his education in early life but was prevented from doing so by poverty and war. He spent years in a concentration camp, then became a carpenter…

  19. Explaining Late Life Urban vs. Rural Health Discrepancies in Beijing

    ERIC Educational Resources Information Center

    Zimmer, Zachary; Kaneda, Toshiko; Tang, Zhe; Fang, Xianghua

    2010-01-01

    Social characteristics that differ by place of residence are consequential for health. To study implications of this among older adults in rural vs. urban China, this study employs data from the Beijing municipality, a region that has witnessed growth and gaps in development. Life and active life expectancy is assessed using a multistate life…

  20. Personality Predicts Health Declines Through Stressful Life Events During Late Mid-Life.

    PubMed

    Iacovino, Juliette M; Bogdan, Ryan; Oltmanns, Thomas F

    2016-08-01

    Personality predicts the occurrence of dependent stressful life events (SLE; i.e., events reliant, at least in part, on an individual's behavior). This process, termed stress generation, contributes to psychiatric outcomes, but its role in physical health is unknown. Data were included from 998 participants (aged 55-64) in the St. Louis Personality and Aging Network (SPAN) study. Assessments occurred every 6 months for 18 months. Neuroticism, impulsivity, and agreeableness were measured with the Revised NEO Personality Inventory. Dependent (e.g., divorce) and independent (e.g., family death) SLE occurring within 6 months following baseline were assessed with the List of Threatening Experiences and confirmed by interviews. Health problems occurring within a year after SLE were the outcome. Analyses examined whether neuroticism, impulsivity, and agreeableness indirectly predict the onset of new health problems through exposure to dependent SLE. Each personality trait was associated with dependent, but not independent, SLE. Only dependent SLE predicted new health problems. Each personality trait indirectly predicted the onset of new health problems through dependent SLE. Findings suggest that personality-driven stress generation influences physical health during late mid-life. Addressing personality in interventions may reduce the occurrence of SLE, in turn decreasing health risks. PMID:25929195

  1. Depression and frailty in later life: a systematic review.

    PubMed

    Vaughan, Leslie; Corbin, Akeesha L; Goveas, Joseph S

    2015-01-01

    Frailty and depression are important issues affecting older adults. Depressive syndrome may be difficult to clinically disambiguate from frailty in advanced old age. Current reviews on the topic include studies with wide methodological variation. This review examined the published literature on cross-sectional and longitudinal associations between frailty and depressive symptomatology with either syndrome as the outcome, moderators of this relationship, construct overlap, and related medical and behavioral interventions. Prevalence of both was reported. A systematic review of studies published from 2000 to 2015 was conducted in PubMed, the Cochrane Database of Systematic Reviews, and PsychInfo. Key search terms were "frailty", "frail", "frail elderly", "depressive", "depressive disorder", and "depression". Participants of included studies were ≥ 55 years old and community dwelling. Included studies used an explicit biological definition of frailty based on Fried et al's criteria and a screening measure to identify depressive symptomatology. Fourteen studies met the inclusion/exclusion criteria. The prevalence of depressive symptomatology, frailty, or their co-occurrence was greater than 10% in older adults ≥ 55 years old, and these rates varied widely, but less in large epidemiological studies of incident frailty. The prospective relationship between depressive symptomatology and increased risk of incident frailty was robust, while the opposite relationship was less conclusive. The presence of comorbidities that interact with depressive symptomatology increased incident frailty risk. Measurement variability of depressive symptomatology and inclusion of older adults who are severely depressed, have cognitive impairment or dementia, or stroke may confound the frailty syndrome with single disease outcomes, accounting for a substantial proportion of shared variance in the syndromes. Further study is needed to identify medical and behavioral interventions for

  2. Adolescent depression. Epidemiology, nosology, life stress and social network. Minireview based on a doctoral thesis.

    PubMed

    Olsson, G

    1998-01-01

    The study engaged a total population of 16-17-year-old urban high-school students and 2300 (93%) were screened for depression and previous suicide attempts. Adolescents with high depression scores in self-evaluation (12.3%) or reporting previous suicide attempts (2.4%) were diagnostically interviewed together with one control for each, matched for gender and educational program. After the interview self-ratings were completed regarding social network, family climate, and life events. Major depression was prevalent during the last year in 5.8% and during life time in 11.4%, 4 girls for every boy. A depression with remaining symptoms for a year or more was the most common type. Dysthymia without major depressive episodes was diagnosed in 1.1%, two girls for every boy. Short hypomanic episodes had been experienced by 13.2% of those with major depressive disorder. Anxiety disorder was comorbid to depression in one half and conduct disorder in one forth of the depressed adolescents. Alcohol was abused by 6.5% and used regularly by another 12%. Other drugs were used by 6.5% of depressed adolescents and not at all by controls. The depressed used tobacco twice as frequently as non-depressed. Social network and family climate were compared within the originally matched pairs. Adolescents with long-lasting depressions had a smaller and unsatisfying social network. They also had experienced many stressful life events related to family adversities, while those with shorter depressive episodes had stress related to the peer group. Depressed adolescents with comorbid conduct disorder reported insufficient support from the close network and a more negative family climate. PMID:9923068

  3. Comparison of severe life stress in depressed mothers and non-mothers: do children matter?

    PubMed

    Feske, U; Shear, M K; Anderson, B; Cyranowski, J; Strassburger, M; Matty, M; Luther, J; Frank, E

    2001-01-01

    Given the high rates of maladjustment among children of depressed mothers, parenting is likely to cause significant life stress in this population, potentially worsening the course of mothers' depression. The present study is a comparison of severe life stress in 38 mothers and 62 non-mothers receiving treatment for recurrent major depression. Life stress was assessed using the Life Events and Difficulties Schedule [Brown and Harris, 1978a]. We hypothesized that mothers would evidence a greater number of severe life events and marked difficulties both in the year prior to the onset of their depressive index episode and in the time period following the onset of their current depressive episode. Prior to depression onset, mothers reported a significantly greater number of entrapping difficulties, but not marked difficulties, severe events, entrapping events, or humiliating events. However, following the onset of depression, mothers experienced a significantly greater number of severe events, entrapping events, marked difficulties, and entrapping difficulties, but not humiliating events. Mothers' elevated levels of stress were attributable to child-related stress, predominantly related to children's psychological and behavioral problems. Our findings suggest that comprehensive treatment for mothers with major depression needs to address their parenting style and any psychological problems experienced by their children. PMID:11387730

  4. The Vascular Depression Hypothesis: Mechanisms Linking Vascular Disease with Depression

    PubMed Central

    Taylor, Warren D.; Aizenstein, Howard J.; Alexopoulos, George S.

    2013-01-01

    The ‘Vascular Depression’ hypothesis posits that cerebrovascular disease may predispose, precipitate, or perpetuate some geriatric depressive syndromes. This hypothesis stimulated much research that has improved our understanding of the complex relationships between late-life depression (LLD), vascular risk factors, and cognition. Succinctly, there are well-established relationships between late-life depression, vascular risk factors, and cerebral hyperintensities, the radiological hallmark of vascular depression. Cognitive dysfunction is common in late-life depression, particularly executive dysfunction, a finding predictive of poor antidepressant response. Over time, progression of hyperintensities and cognitive deficits predicts a poor course of depression and may reflect underlying worsening of vascular disease. This work laid the foundation for examining the mechanisms by which vascular disease influences brain circuits and influences the development and course of depression. We review data testing the vascular depression hypothesis with a focus on identifying potential underlying vascular mechanisms. We propose a disconnection hypothesis, wherein focal vascular damage and white matter lesion location is a crucial factor influencing neural connectivity that contributes to clinical symptomatology. We also propose inflammatory and hypoperfusion hypotheses, concepts that link underlying vascular processes with adverse effects on brain function that influence the development of depression. Testing such hypotheses will not only inform the relationship between vascular disease and depression but also provide guidance on the potential repurposing of pharmacological agents that may improve late-life depression outcomes. PMID:23439482

  5. Early dysautonomia detected by heart rate variability predicts late depression in female patients following mild traumatic brain injury.

    PubMed

    Sung, Chih-Wei; Lee, Hsin-Chien; Chiang, Yung-Hsiao; Chiu, Wen-Ta; Chu, Shu-Fen; Ou, Ju-Chi; Tsai, Shin-Han; Liao, Kuo-Hsing; Lin, Chien-Min; Lin, Jia-Wei; Chen, Gunng-Shinng; Li, Wei-Jiun; Wang, Jia-Yi

    2016-04-01

    Depression is one of the frequent complications following a mild traumatic brain injury (mTBI). Recent research indicated that abnormalities in the autonomic nervous system (ANS) can be evaluated by a noninvasive power spectral analysis of the heart rate variability (HRV). In this study, we investigated whether a frequency-domain analysis of HRV was correlated with late depression in mTBI patients. In total, 181 patients diagnosed with mTBI and 83 volunteers as healthy controls were recruited in 2010-2014. Beck Depression Inventory (BDI) scores were used to evaluate depression in the 1st week of assessment and at 1.5-, 3-, 6-, 12-, and 18-month follow-ups. Correlation and logistic regression analyses of the 1st week HRV parameters with BDI scores at 18 months were performed in individual female mTBI patients. Female mTBI patients were more vulnerable to depression accompanied by reduced HRV compared to healthy controls. Over time, depression was aggravated in female mTBI patients but was alleviated in male mTBI patients. A significantly lower parasympathetic proportion of the ANS was noted at 18 months with respect to the 1st week in female mTBI patients. In addition, depression in female mTBI patients at 18 months after injury was significantly correlated with a decrease in the parasympathetic proportion of the ANS in the 1st week (ρ = -0.411; p < .05). Dysautonomia resulted in higher risks of depression in female mTBI patients. We concluded that early dysautonomia following an mTBI contributes to late depression in female mTBI patients. PMID:26560198

  6. Type and Intensity of Negative Life Events Are Associated With Depression in Adults With Intellectual Disabilities.

    PubMed

    Hove, Oddbjørn; Assmus, Jörg; Havik, Odd E

    2016-09-01

    This study investigated the associations between types and intensity of life events and symptoms of depression among adults with intellectual disabilities. A community sample (N = 593) was screened for current depression and exposure to life events (i.e., loss, illness, change, and bullying) during the previous 12 months. Symptoms of depression were measured using the Psychopathology Checklists for Adults With Intellectual Disabilities. Exposure to three of the four types of life events studied (loss, illness, and bullying) and the intensity of the events were associated with depression, particularly in the cases of loss of relatives and bullying. Quality of care moderated the association between bullying and depression and may buffer the adverse consequences of bullying. PMID:27611352

  7. Depression and frailty in later life: a systematic review

    PubMed Central

    Vaughan, Leslie; Corbin, Akeesha L; Goveas, Joseph S

    2015-01-01

    Frailty and depression are important issues affecting older adults. Depressive syndrome may be difficult to clinically disambiguate from frailty in advanced old age. Current reviews on the topic include studies with wide methodological variation. This review examined the published literature on cross-sectional and longitudinal associations between frailty and depressive symptomatology with either syndrome as the outcome, moderators of this relationship, construct overlap, and related medical and behavioral interventions. Prevalence of both was reported. A systematic review of studies published from 2000 to 2015 was conducted in PubMed, the Cochrane Database of Systematic Reviews, and PsychInfo. Key search terms were “frailty”, “frail”, “frail elderly”, “depressive”, “depressive disorder”, and “depression”. Participants of included studies were ≥55 years old and community dwelling. Included studies used an explicit biological definition of frailty based on Fried et al’s criteria and a screening measure to identify depressive symptomatology. Fourteen studies met the inclusion/exclusion criteria. The prevalence of depressive symptomatology, frailty, or their co-occurrence was greater than 10% in older adults ≥55 years old, and these rates varied widely, but less in large epidemiological studies of incident frailty. The prospective relationship between depressive symptomatology and increased risk of incident frailty was robust, while the opposite relationship was less conclusive. The presence of comorbidities that interact with depressive symptomatology increased incident frailty risk. Measurement variability of depressive symptomatology and inclusion of older adults who are severely depressed, have cognitive impairment or dementia, or stroke may confound the frailty syndrome with single disease outcomes, accounting for a substantial proportion of shared variance in the syndromes. Further study is needed to identify medical and behavioral

  8. Orthognathic surgery improves quality of life and depression, but not anxiety, and patients with higher preoperative depression scores improve less.

    PubMed

    Brunault, P; Battini, J; Potard, C; Jonas, C; Zagala-Bouquillon, B; Chabut, A; Mercier, J-M; Bedhet, N; Réveillère, C; Goga, D; Courtois, R

    2016-01-01

    This study assessed quality of life (QoL), depression, and anxiety before and after orthognathic surgery and identified risk factors for poorer postoperative outcome. This multicentre prospective study included 140 patients from five French medical centres. We assessed patients before surgery (T1), 3 months after surgery (T2), and 12 months after surgery (T3). We assessed the severity of the orofacial deformity, physical, psychological, social, and environmental QoL (WHOQOL-BREF), and depression and anxiety (GHQ-28). Risk factors for poorer outcome were identified using linear mixed models. Between baseline and 12 months, there was significant improvement in psychological and social QoL and in depression (although below the norms reported in the general population), but not in anxiety. Physical QoL was poorer in patients who were younger, who had a mild orofacial deformity, and who were depressed. Psychological QoL was poorer in younger patients and in depressed patients. Social QoL was poorer in patients who were single, who had a mild orofacial deformity, and who were depressed. Although orthognathic surgery provides a moderate improvement in psychological and social QoL, the systematic screening and treatment of depression could further improve QoL after surgery because it is a major predictor of poor QoL in this population. PMID:26359548

  9. Irrational Beliefs as Moderators of the Life Stress-Depression Relationship.

    ERIC Educational Resources Information Center

    Kelly, Lily M.; Lahey, Benjamin

    Considerable research and theory have focused on the concept of life stress, defined as major changes occurring in an individual's life, such as divorce, loss of employment, or the death of a significant other. To examine the role of irrational beliefs in the life stress-depression relationship, 286 college students completed the Beck Depression…

  10. Teenage Childbearing, Marital Status, and Depressive Symptoms in Later Life.

    ERIC Educational Resources Information Center

    Kalil, Ariel; Kunz, James

    2002-01-01

    This longitudinal study tested the contribution of age and marital status at first birth to depressive symptomatology in early adulthood. Findings indicated that unmarried teenage childbearers displayed higher levels of depressive symptoms than women who first gave birth as married adults. The psychological health of married teenage mothers in…

  11. Brooding and reflection as explanatory of depressive symptoms in adolescents experiencing stressful life events.

    PubMed

    Young, Cara Calloway; Dietrich, Mary S; Lutenbacher, Melanie

    2014-03-01

    Delineating etiologic mechanisms of adolescent-onset depressive disorders has implications for advances in depression recognition and prevention. Two cognitive processes, namely brooding and reflection, may be instrumental in the development of depressive symptoms. Study aims were to (1) examine the relationships among brooding, reflection, dysfunctional attitudes, negative inferential style, stressful life events, and depressive symptoms and (2) determine the unique contributions of brooding and reflection to depressive symptoms in adolescents who are experiencing stressful life events. A secondary data analysis was conducted using cross-sectional data gathered via a web-based survey (N = 111) of 12-15 year olds. Descriptive statistics, Pearson's correlations, and hierarchical linear regression modeling were used to evaluate study aims. The final regression model explained approximately 73% of the variance in depressive symptoms (Multiple R = 0.85, p < .001). After controlling for each of the study variables, both brooding (beta = .48, p < .001) and reflection (beta = .33, p < .001) demonstrated unique contributions to the prevalence of depressive symptoms. Our findings suggest that brooding and reflection are significant contributors to depressive symptoms in young adolescents experiencing stressful life events. With this knowledge, nurses are better equipped to identify adolescents at high risk for depressive symptoms and implement appropriate levels of intervention. PMID:24597582

  12. Influence of Serotonin Transporter Gene Polymorphisms and Adverse Life Events on Depressive Symptoms in the Elderly: A Population-Based Study

    PubMed Central

    Davin, Annalisa; Monti, Maria Cristina; Polito, Letizia; Vaccaro, Roberta; Abbondanza, Simona; Gnesi, Marco; Villani, Simona; Guaita, Antonio

    2015-01-01

    Background Depression is common in the elderly. The role of genetic and environmental factors in modulating depressive symptoms is not clear. Methods We evaluated the influence of serotonin transporter gene polymorphisms and recent adverse life events on depressive symptoms in an elderly Italian population. We used data from “InveCe.Ab”, a population-based study of 1321 subjects aged 70–74 years. We used the 15-item Geriatric Depression Scale (GDS) to assess depressive symptoms–a GDS score ≥5 points (GDS≥5) indicated the presence of clinically relevant symptoms–and performed 5-HTTLPR and rs25531 genotyping to obtain the triallelic polymorphism of the serotonin transporter. We used the Geriatric Adverse Life Events Scale to measure adverse life events, and logistic regression models to evaluate the role of genotype and recent adverse life events in depressive symptoms, controlling for potential confounders and independent predictors. Results Two hundred subjects (15.76%) had a GDS≥5. The 5-HTTLPR triallelic polymorphism was significantly associated with GDS≥5. Only S′S′ carriers showed an increased risk of depressive symptoms (ORadj = 1.81, p = .022); one extra adverse life event increased this risk by 14% (p = .061) independently of genotype. Other factors significantly related to GDS≥5 were: female gender (ORadj = 2.49, p < .001), age (ORadj = 1.19, p = .007), a history of depression (ORadj = 4.73, p < .001), and comorbidity (ORadj = 1.23, p = .001). One extra adverse life event increased the risk of depressive symptoms by 57% (p = .005) only in the L′L′ carriers, while antidepressant intake was directly related to GDS≥5 in the L′S′ carriers (ORadj = 2.46, p = .036) and borderline significant in the S′S′ carriers (ORadj = 2.41, p = .081). Discussion The S′S′ genotype and recent exposure to adverse life events were independently associated with depressive symptoms. The S′S′ genotype, compared with the environment

  13. Positive Psychology Intervention to Alleviate Child Depression and Increase Life Satisfaction: A Randomized Clinical Trial

    ERIC Educational Resources Information Center

    Kwok, Sylvia Y. C. L.; Gu, Minmin; Kit, Katrina Tong Kai

    2016-01-01

    Purpose: The study aims to examine the effectiveness of a positive psychology group-based intervention program, incorporating elements of hope and gratitude, in decreasing depression and increasing life satisfaction among primary school students in Hong Kong. Method: A total of 68 children, with the Depression score of Chinese Hospital Anxiety and…

  14. Relations of Parenting and Negative Life Events to Cognitive Diatheses for Depression in Children

    ERIC Educational Resources Information Center

    Bruce, Alanna E.; Cole, David A.; Dallaire, Danielle H.; Jacquez, Farrah M.; Pineda, Ashley Q.; LaGrange, Beth

    2006-01-01

    In a sample of 299 children (grades 2, 4, and 6), we examined parenting and negative life events as predictors of depressive cognitions, specifically low self-perceived competence, depressive cognitive schemas, and depressogenic attributional style. We also examined developmental trends in these relations. Children completed measures of parenting,…

  15. Functioning and Quality of Life in the Treatment for Adolescents with Depression Study (TADS)

    ERIC Educational Resources Information Center

    Vitiello, Benedetto; Rohde, Paul; Silva, Susan; Wells, Karen; Casat, Charles; Waslick, Bruce; Simons, Anne; Reinecke, Mark; Weller, Elizabeth; Kratochvil, Christopher; Walkup, John; Pathak, Sanjeev; Robins, Michele; March, John

    2006-01-01

    Obective: To test whether 12-week treatment of major depression improved the level of functioning, global health, and quality of life of adolescents. Method: The Treatment for Adolescents With Depression Study was a multisite, randomized clinical trial of fluoxetine, cognitive-behavioral therapy (CBT), their combination (COMB), or clinical…

  16. Adaptive and Maladaptive Perfectionism as Mediators of Adult Attachment Styles and Depression, Hopelessness, and Life Satisfaction

    ERIC Educational Resources Information Center

    Gnilka, Philip B.; Ashby, Jeffrey S.; Noble, Christina M.

    2013-01-01

    This study examined the relationships between adaptive and maladaptive perfectionism, anxious and avoidant adult attachment styles, depression, hopelessness, and life satisfaction among a sample of 180 undergraduate students. Maladaptive perfectionism mediated the relationship between both forms of adult attachment and depression, hopelessness,…

  17. Relationships among Social Support, Perceived Control, and Psychological Distress in Late Life

    ERIC Educational Resources Information Center

    Nemeroff, Robin; Midlarsky, Elizabeth; Meyer, Joseph F.

    2010-01-01

    Social support has been shown to buffer the relationship between life stress and psychological distress in late life. However, little attention has been paid to personality variables that are associated with the capacity to effectively utilize social support. Although the buffering effects of social support were replicated in our sample of 134…

  18. Difficulties, Disagreements, and Disappointments in Late-Life Marriages

    ERIC Educational Resources Information Center

    Henry, Ryan G.; Miller, Richard B.; Giarrusso, Roseann

    2005-01-01

    Although research has examined marital satisfaction in later life, little is known about the specific relationship challenges that older couples experience. Thus, the objective of the study was to explore the challenges older couples face. Data came from the USC Longitudinal Study of Generations. Qualitative analysis was conducted on 105 older…

  19. Late-Life Divorce: Its Impact on Family Rituals.

    ERIC Educational Resources Information Center

    Pett, Marjorie A.; And Others

    1992-01-01

    Examined perceived changes in specific family celebrations, traditions, important life cycle events, and day-to-day family contact that occurred for 115 adult children whose parents had divorced after long-term marriage. Found strong positive correlation between perceived disruptiveness of parental divorce and changes in family rituals,…

  20. Trajectories of Social Engagement and Limitations in Late Life

    ERIC Educational Resources Information Center

    Thomas, Patricia A.

    2011-01-01

    Although studies have established important links between social relations and health, much of this research does not take into account the dynamic nature of both social relations and health over time. The present study combines person-centered and variable-centered approaches and uses social integration theory within the life course framework to…

  1. Social Support Buffers the Impact of Depressive Symptoms on Life Satisfaction in Old Age

    PubMed Central

    Adams, Tangeria R.; Rabin, Laura A.; Da Silva, Valdiva G.; Katz, Mindy J.; Fogel, Joshua; Lipton, Richard B.

    2015-01-01

    Objectives Life satisfaction is an important component of overall well-being. Decline in life satisfaction is related to many adverse health outcomes including mortality. Methods We investigate the association of various psychosocial and health-related factors to life satisfaction in 237 non-demented community-dwelling older adults. Results Lower levels of depressive symptoms, less perceived stress, higher levels of social support, and better self-perceived general health were significantly associated with higher life satisfaction. Social support buffered the adverse impact of depressive symptoms on life satisfaction where more depressive symptoms were associated with much lower life satisfaction at low levels of social support than at high levels of social support. Discussion We discuss study implications, future research directions, and possible interventions that involve boosting social support in at-risk older adults. PMID:27418714

  2. Abnormal Functional Connectivity of Amygdala in Late-Onset Depression Was Associated with Cognitive Deficits

    PubMed Central

    Yue, Yingying; Yuan, Yonggui; Hou, Zhenghua; Jiang, Wenhao; Bai, Feng; Zhang, Zhijun

    2013-01-01

    Background Major depressive disorder (MDD) is associated with decreased function of cortico-limbic circuits, which play important roles in the pathogenesis of MDD. Abnormal functional connectivity (FC) with the amygdala, which is involved in cortico-limbic circuits, has also been observed in MDD. However, little is known about connectivity alterations in late-onset depression (LOD) or whether disrupted connectivity is correlated with cognitive impairment in LOD. Methods and Results A total of twenty-two LOD patients and twenty-two matched healthy controls (HC) underwent neuropsychological tests and resting state functional magnetic resonance imaging (rs-fMRI). Regional homogeneity (ReHo) and FC with bilateral amygdala seeds were used to analyze blood oxygen level-dependent fMRI data between two groups. Compared with HC, LOD patients showed decreased ReHo in the right middle frontal gyrus and left superior frontal gyrus. In the LOD group, the left amygdala had decreased FC with the right middle frontal gyrus and the left superior frontal gyrus in the amygdala positive network, and it had increased FC with the right post-central gyrus in the amygdala negative network. However, significantly reduced FC with the right amygdala was observed in the right middle occipital gyrus in the amygdala negative network. Further correlative analyses revealed that decreased FC between the amygdala and the right middle occipital gyrus was negatively correlated with the verbal fluency test (VFT, r = −0.485, P = 0.022) and the digit span test (DST, r = −0.561, P = 0.007). Conclusions Our findings of reduced activity of the prefrontal gyrus and abnormal FC with the bilateral amygdala may be key markers of cognitive dysfunction in LOD patients. PMID:24040385

  3. Depression, anxiety, and religious life: a search for mediators.

    PubMed

    Sternthal, Michelle J; Williams, David R; Musick, Marc A; Buck, Anna C

    2010-09-01

    We examine several potential mechanisms linking religious involvement to depressive symptoms, major depression, and anxiety. Logistic and OLS regression estimations test five sets of potential psychosocial religion mediators: perceived attitudes toward and motivations for attendance; positive and negative religious coping; religious attitudes, beliefs, and spirituality; congregational support and criticism; and interpersonal and self-forgiveness. Compared to attending services less than once a month or never, attending services once a week but no more is associated with fewer depressive symptoms and anxiety symptoms. Hypothesized mediators, including meaning, interpersonal and self-forgiveness, congregational criticism, social attendance beliefs, and negative coping are independently associated with one or more mental health outcomes. PMID:20943594

  4. Predicting first onset of depression in young girls: Interaction of diurnal cortisol and negative life events.

    PubMed

    LeMoult, Joelle; Ordaz, Sarah J; Kircanski, Katharina; Singh, Manpreet K; Gotlib, Ian H

    2015-11-01

    Interactions between biological vulnerability and environmental adversity are central to the pathophysiology of depression. Given evidence that the hypothalamic-pituitary-adrenal (HPA) axis influences biological responses to environmental events, in the current longitudinal study the authors examined HPA-axis functioning, negative life events, and their interaction as predictors of the first onset of depression. At baseline, girls ages 9 to 14 years provided saliva samples to assess levels of diurnal cortisol production, quantified by total cortisol production (area under the curve with respect to ground; AUCg) and the cortisol awakening response (CAR). The authors then followed these participants until they reached age 18 in order to assess their subsequent experience of negative life events and the onset of a depressive episode. They found that the influence of negative life events on the subsequent onset of depression depended on HPA-axis functioning at baseline. Specifically, negative life events predicted the onset of depression in girls with higher levels of AUCg, but not in girls with lower levels of AUCg. In contrast, CAR did not predict the onset of depression either alone or in interaction with negative life events. These findings suggest that elevated total cortisol production in daily life potentiates susceptibility to environmental adversity and signals the need for early intervention. PMID:26595472

  5. Predicting First Onset of Depression in Young Girls: Interaction of Diurnal Cortisol and Negative Life Events

    PubMed Central

    LeMoult, Joelle; Ordaz, Sarah J.; Kircanski, Katharina; Singh, Manpreet K.; Gotlib, Ian H.

    2015-01-01

    Interactions between biological vulnerability and environmental adversity are central to the pathophysiology of depression. Given evidence that the hypothalamic-pituitary-adrenal (HPA) axis influences biological responses to environmental events, in the current longitudinal study we examined HPA-axis functioning, negative life events, and their interaction as predictors of the first onset of depression. At baseline, girls ages 9 to 14 years provided saliva samples to assess levels of diurnal cortisol production, quantified by total cortisol production (area under the curve with respect to ground; AUCg) and the cortisol awakening response (CAR). We then followed these participants until they reached age 18 in order to assess their subsequent experience of negative life events and the onset of a depressive episode. We found that the influence of negative life events on the subsequent onset of depression depended on HPA-axis functioning at baseline. Specifically, negative life events predicted the onset of depression in girls with higher levels AUCg, but not in girls with lower levels of AUCg. In contrast, CAR did not predict the onset of depression either alone or in interaction with negative life events. These findings suggest that elevated total cortisol production in daily life potentiates susceptibility to environmental adversity and signals the need for early intervention. PMID:26595472

  6. Sexual Dysfunction, Depression and Quality of Life in Patients With HIV Infection

    PubMed Central

    Amini Lari, Mahmood; Faramarzi, Hosain; Shams, Mesbah; Marzban, Maryam; Joulaei, Hasan

    2013-01-01

    Objective: In Iran, psychological aspect of HIV infection is poorly understood. The purposes of this study were to evaluate sexual dysfunction, depression rate and health-related quality of life and evaluate the association between sexual dysfunction, depression and quality of life in a group of HIV+ subjects in Shiraz, Iran. Methods: In this cross-sectional study, 278 male HIV-positive patients who had referred to voluntary counseling and testing and methadone maintenance therapy centers were recruited based on convenience sampling from May to October 2010. The purpose of the study was explained and interested individuals provided informed consent and completed validated questionnaires [Medical Outcomes Study Short Form-36 (SF-36(, Brief Male Sexual Function Inventory (BMSFI), Beck Depression Inventory-short form(BDI)] to assess overall health related quality of life (HRQOL), sexual function, and depression. Results: Average age of the participants was 34.9 ± 10.7 years and 37.5% were severely depressed. Ordinal logistic regression indicated that sexual drive (-0.15; CI: -0.28 to -0.027), ejaculation (-1.91, CI: -2.71 to -1.12), and problem assessment (-0.098, CI: -0.17 to -0.02) had significant effect on depression type. Depression was significantly correlated with poorer quality of life in all domains. Pearson’s correlation coefficients between the BMSFI and the domains of SF-36 indicated that sexual drive (r= 0.215), ejaculation (r= 0.297) and problem assessment (r= 0.213) were significantly correlated with emotional wellbeing. Conclusion: Sexual function and depression showed association with quality of life. Effective treatment of depression and sexual function may improve the quality of life of HIV-infected person. Declaration of interest: None. PMID:24644501

  7. Assessment of Menopausal Symptoms among Early and Late Menopausal Midlife Bangladeshi Women and Their Impact on the Quality of Life

    PubMed Central

    Jahan, Papia; Nadia, Israt; Ahmed, Farzana; Abdullah-Al-Emran

    2016-01-01

    Objectives Every physical abnormal criterion has an impact on the health. Late menopause causes different physiological problems which alike early menopause. The research interest is associated with both early and late menopausal women of Bangladesh as only few menopausal studies available in South East Asia especially in Bangladesh. The aims of this study are not only to assess the symptoms of menopausal abnormality but also to determine the impact of these symptoms on the quality of life (QOL) of the female society in Bangladesh. Methods Data mining techniques are used to rank the 22 factors (conducted with questionnaire) commonly associated with menopause. Among the participants menstruation that stops before 45 years was considered as early menopausal status and after 50 years as late menopausal. The mean of age and mean length of time in years, since menopause for all participants were 61.55±10.7 and 14.13±11.17, respectively. Recorded data indicated 67% were early menopausal women and 33% were late menopausal women. Results Results indicated that feeling tired or lacking in energy and dizziness (83%) and depression (82%) have worst impact on QOL among all factors, respectively. The next prevalent symptoms included hot flashes (64%), osteoporosis (72%), sweating at night (63%), concentration problem (75%), irritability (63%), feeling tense (77%), headache (66%). However, less frequent factors included breathing problems (33%), loss of feeling (31%), coherent heart disease (13%) and type2 diabetics (9%). Conclusion Our study indicates that early menopausal women are facing more physiological problems than the late menopausal women on their QOL. PMID:27152312

  8. Why ageing stops: heterogeneity explains late-life mortality deceleration in nematodes

    PubMed Central

    Chen, Hwei-yen; Zajitschek, Felix; Maklakov, Alexei A.

    2013-01-01

    While ageing is commonly associated with exponential increase in mortality with age, mortality rates paradoxically decelerate late in life resulting in distinct mortality plateaus. Late-life mortality plateaus have been discovered in a broad variety of taxa, including humans, but their origin is hotly debated. One hypothesis argues that deceleration occurs because the individual probability of death stops increasing at very old ages, predicting the evolution of earlier onset of mortality plateaus under increased rate of extrinsic mortality. By contrast, heterogeneity theory suggests that mortality deceleration arises from individual differences in intrinsic lifelong robustness and predicts that variation in robustness between populations will result in differences in mortality deceleration. We used experimental evolution to directly test these predictions by independently manipulating extrinsic mortality rate (high or low) and mortality source (random death or condition-dependent) to create replicate populations of nematodes, Caenorhabditis remanei that differ in the strength of selection in late-life and in the level of lifelong robustness. Late-life mortality deceleration evolved in response to differences in mortality source when mortality rate was held constant, while there was no consistent response to differences in mortality rate. These results provide direct experimental support for the heterogeneity theory of late-life mortality deceleration. PMID:24088560

  9. Depression among adults with neurofibromatosis type 1: prevalence and impact on quality of life.

    PubMed

    Cohen, J S; Levy, H P; Sloan, J; Dariotis, J; Biesecker, B B

    2015-11-01

    Neurofibromatosis type 1 (NF1) carries a significant psychosocial burden for affected individuals. The objective of this study was to measure the prevalence of depressive symptoms among a large sample of adults with NF1 and to quantify the impact of depressive symptoms on quality of life (QoL). This cross-sectional study used an Internet-based questionnaire to collect data from 498 adults who self-reported as having NF1. Using the Center for Epidemiologic Studies Depression (CESD) scale, 55% of all participants (61% of females and 43% of males) scored above 16, indicating a high likelihood of clinical depression. In a multivariate regression model controlling for demographics and potential confounders, depressive symptoms accounted for 32% of the variance in QoL as measured by the Quality of Life Index. This study is the largest to date and found the highest prevalence of depression compared to prior studies. Our data provide more compelling evidence that individuals with NF1 are at increased risk for psychiatric morbidity and suggest that this population should be routinely screened for depression. Because depression was found to be strongly associated with QoL and accounted for nearly one-third of the variance in QoL, it is likely that effectively treating depression may significantly enhance QoL for individuals with NF1. PMID:25534182

  10. Depression in Older Adults

    PubMed Central

    Fiske, Amy; Wetherell, Julie Loebach; Gatz, Margaret

    2010-01-01

    Depression is less prevalent among older adults than among younger adults but can have serious consequences. Over half of cases represent a first onset in later life. Although suicide rates in the elderly are declining, they are still higher than in younger adults and more closely associated with depression. Depressed older adults are less likely to endorse affective symptoms and more likely to display cognitive changes, somatic symptoms, and loss of interest than are younger adults. Risk factors leading to the development of late life depression likely comprise complex interactions among genetic vulnerabilities, cognitive diathesis, age-associated neurobiological changes, and stressful events. Insomnia is an often overlooked risk factor for late life depression. We suggest that a common pathway to depression in older adults, regardless of which predisposing risks are most prominent, may be curtailment of daily activities. Accompanying self-critical thinking may exacerbate and maintain a depressed state. Offsetting the increasing prevalence of certain risk factors in late life are age-related increases in psychological resilience. Other protective factors include higher education and socioeconomic status, engagement in valued activities, and religious or spiritual involvement. Treatments including behavioral therapy, cognitive behavioral therapy, cognitive bibliotherapy, problem-solving therapy, brief psychodynamic therapy, and life review/reminiscence therapy are effective but too infrequently used with older adults. Preventive interventions including education for individuals with chronic illness, behavioral activation, cognitive restructuring, problem-solving skills training, group support, and life review have also received support. PMID:19327033

  11. Jungian spirituality: a developmental context for late-life growth.

    PubMed

    Patton, Julie F

    2006-01-01

    Ira Byock's "opportunities for growth" at the end of life have become defining features of the hospice and palliative care movement and create a strong moral imperative against futile and distracting treatment for the terminally ill. This article examines a larger developmental and cultural context that includes the work of Carl Jung and others who describe similar growth as characteristic of the midlife transition and the movement toward "gerotranscendence" in later life. The author suggests that in developmental terms, gerotranscendence forms a bridge between the work of Jung and that of Byock. She examines archetypal concepts and practices that facilitate psychospiritual growth and argues that these may be used with terminally ill patients to help them engage the process of "dying well." She notes that these modern findings lie within a long and cross-cultural humanistic tradition that anticipates the development of wisdom for those whose aging occurs within a spiritual framework that involves identifying with the soul rather than with the body. PMID:17060294

  12. Frequency-Dependent Amplitude Alterations of Resting-State Spontaneous Fluctuations in Late-Onset Depression

    PubMed Central

    Yue, Yingying; Jia, Xize; Hou, Zhenghua; Zang, Yufeng; Yuan, Yonggui

    2015-01-01

    There is limited amplitude of low-frequency fluctuation (ALFF) of resting-state functional magnetic resonance imaging (fMRI) studies in late-onset depression (LOD) but reported different results. This may be due to the impact of different frequency bands. In this study, we examined the ALFF in five different frequency bands (slow-6: 0–0.01 Hz; slow-5: 0.01–0.027 Hz; slow-4: 0.027–0.073 Hz; slow-3: 0.073–0.167 Hz, and slow-2: 0.167–0.25 Hz) within the whole brain during resting-state fMRI in 16 LOD patients and 16 normal control (NC) subjects. The ALFF of primary effect of disease was widely distributed over left cerebellum anterior lobe, left cerebellum posterior lobe, left middle orbitofrontal gyrus, left superior occipital, and right superior parietal, while the interaction effect of disease and frequency was distributed over right superior frontal gyrus. Further relationship analysis findings suggest these abnormal ALFF may relate to cognitive dysfunction of LOD. Therefore, our data show that LOD patients have widespread abnormalities in intrinsic brain activity, which is dependent on the frequency band, and suggest that future studies should take the frequency bands into account when measuring intrinsic brain activity. PMID:25705666

  13. Depression, stressful life events, social support, and self-esteem in middle class African American women.

    PubMed

    Warren, B J

    1997-06-01

    African American women, are at risk for development of depression because they are a racial minority and female, and often have multiple roles which affect their social supports and self-esteem. An exploratory study was conducted that examined relationships between depression, stressful life events, social support, and self-esteem in 100 middle class African American women aged 20 to 35 years. The conceptual framework for the study was derived from Beeber's (1987) model. Correlational analysis revealed a positive relationship between depression and stressful life events and a negative relationship between depression and social support. Regression analysis revealed that stressful life events and social support added significantly to the model whereas self-esteem did not. PMID:9193115

  14. Neighborhood Socioeconomic Status and Cognitive Function in Late Life.

    PubMed

    Rosso, Andrea L; Flatt, Jason D; Carlson, Michelle C; Lovasi, Gina S; Rosano, Caterina; Brown, Arleen F; Matthews, Karen A; Gianaros, Peter J

    2016-06-15

    Neighborhood socioeconomic status (NSES) is associated with cognitive function, independently of individual demographic, health, and socioeconomic characteristics. However, research has been largely cross-sectional, and mechanisms of the association are unknown. In 1992-1993, Cardiovascular Health Study participants (n = 3,595; mean age = 74.8 years; 15.7% black) underwent cognitive testing and magnetic resonance imaging of white matter hyperintensities (WMH), and their addresses were geocoded. NSES was calculated using 1990 US Census data (block groups; 6 measures of wealth, education, and occupation). The Modified Mini-Mental State Examination (3MS) was used to assess general cognition, and the Digit Symbol Substitution Test (DSST) was used to assess speed of processing annually for 6 years. Associations of race-specific NSES tertiles with 3MS, DSST, and WMH were estimated using linear mixed-effects models accounting for geographic clustering, stratified by race, and adjusted for demographic, health, and individual socioeconomic status (education, income, lifetime occupational status) variables. In fully adjusted models, higher NSES was associated with higher 3MS scores in blacks (mean difference between highest and lowest NSES = 2.4 points; P = 0.004) and whites (mean difference = 0.7 points; P = 0.02) at baseline but not with changes in 3MS over time. NSES was marginally associated with DSST and was not associated with WMH. Adjustment for WMH did not attenuate NSES-3MS associations. Associations of NSES with cognition in late adulthood differ by race, are not explained by WMH, and are evident only at baseline. PMID:27257114

  15. Life Events as Predictors of Mania and Depression in Bipolar I Disorder

    PubMed Central

    Johnson, Sheri L.; Cueller, Amy K.; Ruggero, Camilo; Winett-Perlman, Carol; Goodnick, Paul; White, Richard; Miller, Ivan

    2010-01-01

    To date, few prospective studies of life events and bipolar disorder are available, and even fewer have separately examined the role of life events in depression and mania. The goal of this study was to prospectively examine the role of negative and goal-attainment life events as predictors of the course of bipolar disorder. One hundred twenty-five individuals with bipolar I disorder were interviewed monthly for an average of 27 months. Negative and goal-attainment life events were assessed with the Life Events and Difficulties Schedule. Changes in symptoms were evaluated using the Modified Hamilton Rating Scale for Depression and the Bech-Rafaelsen Mania Scale. The clearest results were obtained for goal-attainment life events, which predicted increases in manic symptoms over time. Negative life events predicted increases in depressive symptoms within regression models but were not predictive within multilevel modeling of changes in depressive symptoms. Given different patterns for goal attainment and negative life events, it appears important to consider specific forms of life events in models of bipolar disorder. PMID:18489203

  16. Psychological obstacles to job or career change in late life.

    PubMed

    Bailey, L L; Hansson, R O

    1995-11-01

    Four studies involving middle-aged and older workers were conducted to (a) explore perceived obstacles to adaptive job or career changes in later-life, and (b) develop an instrument with which to identify older adults who might be more sensitive to such obstacles. A reliable instrument was developed which reflected three broad categories of perceived risk: (a) age-inappropriateness of the change, (b) potential for age-discrimination, and (c) risk of hastened obsolescence. As evidence for the convergent validity of the instrument, the results indicated a heightened sensitivity to job change obstacles among respondents with: (a) age-sensitized concerns about job and financial security, (b) poorer psychological adjustment to a plateaued career, and (c) poorer psychological and social adjustment to their own aging. PMID:7583807

  17. Religious Music and Health in Late Life: A Longitudinal Investigation

    PubMed Central

    Krause, Neal; Hayward, R. David

    2013-01-01

    Listening to religious music is often an important part of religious life. Yet there has been little empirical research on it. The purpose of this study is to test a conceptual model that specifies one way in which religious music may be associated with change in health over time. This model contains the following core relationships: (1) people who attend worship services more often will have stronger emotional reactions to religious music; (2) individuals who are more emotionally involved in religious music will be more likely to feel a close sense of connectedness with other people; (3) people who feel more closely connected with others will be more hopeful about the future; and (4) individuals who feel more hopeful will be more likely to rate their health in a favorably over time. The data provide support for each of these relationships. Significant variations by race were also observed in the findings. PMID:24363543

  18. Late-Life and Life History Predictors of Older Adults of High-Risk Alcohol Consumption and Drinking Problems

    PubMed Central

    Moos, Rudolf H.; Schutte, Kathleen K.; Brennan, Penny L.; Moos, Bernice S.

    2009-01-01

    Aims This prospective, longitudinal study focused on late-life and life history predictors of high-risk alcohol consumption and drinking problems during a 20-year interval as adults matured from age 55–65 to age 75–85. Design, Setting, Participants A sample of older community residents (N=719) who had consumed alcohol in the past year or shortly before was surveyed at baseline and 10 years and 20 years later. Measurements At each contact point, participants completed an inventory that assessed their alcohol consumption, drinking problems, and personal and life context factors. Participants also provided information about their life history of drinking and help-seeking. Results Older adults who, at baseline, had more friends who approved of drinking, relied on substances for tension reduction, and had more financial resources were more likely to engage in high-risk alcohol consumption and to incur drinking problems at 10-year and 20-year follow-ups. With respect to life history factors, drinking problems by age 50 were associated with a higher likelihood of late-life high-risk alcohol consumption and drinking problems; having tried to cut down on drinking and participation in Alcoholics Anonymous were associated with a lower likelihood of high-risk consumption and problems. Conclusion Specific late-life and life history factors can identify older adults likely to engage in excessive alcohol consumption 10 and 20 years later. Targeted screening that considers current alcohol consumption and life context, and history of drinking problems and help-seeking, could help identify older adults at higher risk for excessive or problematic drinking. PMID:19969428

  19. Quality of Life, Family Support, and Comorbidities in Institutionalized Elders With and Without Symptoms of Depression.

    PubMed

    de Araújo, Aurigena Antunes; Rebouças Barbosa, Rosa Angélica Silveira; de Menezes, Marília Stefani Souza; de Medeiros, Ingrid Iana Fernandes; de Araújo, Raimundo Fernandes; de Medeiros, Caroline Addison Carvalho Xavier

    2016-06-01

    The institutionalization of elders can decrease the health status and quality of life in this population. The aim of this study was to analyze the socio-demographic, quality of life, family support, and comorbidities variables in institutionalized elders with and without symptoms of depression. This was a cross-sectional study in institutions for long permanence for the elderly in the State of Rio Grande do Norte, Brazil. Two institutionalized elderly groups were compared (138 elders: 69 with and 69 without depressive symptoms). The instruments used were: mini-mental state examination, geriatric depression scale in the reduced version, socio-demographic questionnaire, quality of life (World Health Organization Quality of Life abbreviated-WHOQOL-bref), and inventory of perception of family support. Elders with depressive symptoms had inferior quality of life than those without depressive symptoms. Other factors that negatively influenced the quality of life in this population include: low economic conditions, occurrence of comorbidities, and deficient family assistance. These results have important implications in the decision making process with regard to strategies for improving the health status of institutionalized elders. PMID:26195233

  20. Loneliness and depressive symptoms among older adults: The moderating role of subjective life expectancy.

    PubMed

    Bodner, Ehud; Bergman, Yoav S

    2016-03-30

    Loneliness and depressive symptoms are closely related, and both are indicators of reduced physical and mental well-being in old age. In recent years, the subjective perception of how long an individual expects to live (subjective life expectancy) has gained importance as a significant predictor of future psychological functioning, as well as of physical health. The current study examined whether subjective life expectancy moderates the connection between loneliness and depressive symptoms in a representative sample of older adults. Data was collected from the Israeli component of the fifth wave of the Survey of Health, Ageing and Retirement in Europe (SHARE-Israel). Participants (n=2210; mean age=70.35) completed measures of loneliness, depressive symptoms, and life expectancy target age. A hierarchical regression analysis predicting depressive symptoms yielded a significant interaction of loneliness and subjective life expectancy. Further analyses demonstrated that low subjective life expectancy mitigated the loneliness-depressive symptoms connection. Findings are discussed in light of the potential burden of higher subjective life expectancy for lonesome older adults, and practical implications are suggested. PMID:26921056

  1. Conservative Christianity, partnership, hormones, and sex in late life.

    PubMed

    Das, Aniruddha; Nairn, Stephanie

    2014-10-01

    Using nationally representative data from the 2005-2006 U.S. National Social Life, Health, and Aging Project, this study queried relationship, sexual, and sex hormone patterns among married evangelical women and men aged 57-85, relative to those in other religions. Results suggested that despite potentially more unequal gender roles, evangelical older women may have better marital quality, perhaps due to the recent transformation of their male counterparts into authoritative, yet-supportive, "soft patriarchs." Correspondingly, these women, especially those with greater subjective religiosity or more support from a spouse, reported consistently better sexual outcomes than their counterparts in other religions. In addition, they also had lower estradiol, whether due to psychobiological effects of their better relationships or self-selection of those with differential hormone levels into particular partnership patterns. While older men in these communities also experienced more satisfactory marriages, and had lower androgens (testosterone, DHEA), their relational assets were less uniformly matched by better sexual outcomes, perhaps reflecting a gender disparity in the linkage between these factors. PMID:24595917

  2. A Community-Based Study of Quality of Life and Depression among Older Adults.

    PubMed

    Cao, Wenjun; Guo, Chongzheng; Ping, Weiwei; Tan, Zhijun; Guo, Ying; Zheng, Jianzhong

    2016-01-01

    The goal of the study was to assess the quality of life (QOL) and depression and provide further insights into the relationship between QOL and depression among community-dwelling elderly Chinese people. Baseline data were collected from 1168 older adults (aged ≥ 60) in a large, prospective cohort study on measurement and evaluation of health-promoting and health-protecting behaviors intervention on chronic disease in different community-dwelling age groups. QOL was assessed using the 26-item, World Health Organization Quality of Life, brief version (WHOQOL-BREF) and depression was assessed using the 30-item Geriatric Depression Scale (GDS). The mean WHOQOL-BREF score for all dimensions was approximately 60, with the highest mean value (61.92) observed for social relationships, followed by environment, physical health, and psychological health domains. In this cohort, 26.1% of elderly urban adults met GDS criteria for depression. There were negative correlations between physical health (Odds Ratio (OR) = 0.928, 95% Confidence Interval (CI): 0.910-0.946), psychological health (OR = 0.906, 95% CI: 0.879-0.934), environment (OR = 0.966, 95% CI: 0.944-0.989) and depression among elderly people. Those with depression were older, less educated, had a lower monthly income, and were more likely to report insomnia. All WHOQOL-BREF domains, with the exception of the social domain were negatively correlated with depression. PMID:27409627

  3. A Community-Based Study of Quality of Life and Depression among Older Adults

    PubMed Central

    Cao, Wenjun; Guo, Chongzheng; Ping, Weiwei; Tan, Zhijun; Guo, Ying; Zheng, Jianzhong

    2016-01-01

    The goal of the study was to assess the quality of life (QOL) and depression and provide further insights into the relationship between QOL and depression among community-dwelling elderly Chinese people. Baseline data were collected from 1168 older adults (aged ≥ 60) in a large, prospective cohort study on measurement and evaluation of health-promoting and health-protecting behaviors intervention on chronic disease in different community-dwelling age groups. QOL was assessed using the 26-item, World Health Organization Quality of Life, brief version (WHOQOL-BREF) and depression was assessed using the 30-item Geriatric Depression Scale (GDS). The mean WHOQOL-BREF score for all dimensions was approximately 60, with the highest mean value (61.92) observed for social relationships, followed by environment, physical health, and psychological health domains. In this cohort, 26.1% of elderly urban adults met GDS criteria for depression. There were negative correlations between physical health (Odds Ratio (OR) = 0.928, 95% Confidence Interval (CI): 0.910–0.946), psychological health (OR = 0.906, 95% CI: 0.879–0.934), environment (OR = 0.966, 95% CI: 0.944–0.989) and depression among elderly people. Those with depression were older, less educated, had a lower monthly income, and were more likely to report insomnia. All WHOQOL-BREF domains, with the exception of the social domain were negatively correlated with depression. PMID:27409627

  4. Early-late life trade-offs and the evolution of ageing in the wild

    PubMed Central

    Lemaître, Jean-François; Berger, Vérane; Bonenfant, Christophe; Douhard, Mathieu; Gamelon, Marlène; Plard, Floriane; Gaillard, Jean-Michel

    2015-01-01

    Empirical evidence for declines in fitness components (survival and reproductive performance) with age has recently accumulated in wild populations, highlighting that the process of senescence is nearly ubiquitous in the living world. Senescence patterns are highly variable among species and current evolutionary theories of ageing propose that such variation can be accounted for by differences in allocation to growth and reproduction during early life. Here, we compiled 26 studies of free-ranging vertebrate populations that explicitly tested for a trade-off between performance in early and late life. Our review brings overall support for the presence of early-late life trade-offs, suggesting that the limitation of available resources leads individuals to trade somatic maintenance later in life for high allocation to reproduction early in life. We discuss our results in the light of two closely related theories of ageing—the disposable soma and the antagonistic pleiotropy theories—and propose that the principle of energy allocation roots the ageing process in the evolution of life-history strategies. Finally, we outline research topics that should be investigated in future studies, including the importance of natal environmental conditions in the study of trade-offs between early- and late-life performance and the evolution of sex-differences in ageing patterns. PMID:25833848

  5. Early-late life trade-offs and the evolution of ageing in the wild.

    PubMed

    Lemaître, Jean-François; Berger, Vérane; Bonenfant, Christophe; Douhard, Mathieu; Gamelon, Marlène; Plard, Floriane; Gaillard, Jean-Michel

    2015-05-01

    Empirical evidence for declines in fitness components (survival and reproductive performance) with age has recently accumulated in wild populations, highlighting that the process of senescence is nearly ubiquitous in the living world. Senescence patterns are highly variable among species and current evolutionary theories of ageing propose that such variation can be accounted for by differences in allocation to growth and reproduction during early life. Here, we compiled 26 studies of free-ranging vertebrate populations that explicitly tested for a trade-off between performance in early and late life. Our review brings overall support for the presence of early-late life trade-offs, suggesting that the limitation of available resources leads individuals to trade somatic maintenance later in life for high allocation to reproduction early in life. We discuss our results in the light of two closely related theories of ageing-the disposable soma and the antagonistic pleiotropy theories-and propose that the principle of energy allocation roots the ageing process in the evolution of life-history strategies. Finally, we outline research topics that should be investigated in future studies, including the importance of natal environmental conditions in the study of trade-offs between early- and late-life performance and the evolution of sex-differences in ageing patterns. PMID:25833848

  6. The Effect of Group Logotherapy on Meaning in Life and Depression Levels of Iranian Students

    ERIC Educational Resources Information Center

    Robatmili, Somaye; Sohrabi, Faramarz; Shahrak, Mohammad Ali; Talepasand, Siavash; Nokani, Mostafa; Hasani, Mohaddese

    2015-01-01

    This paper identifies the effectiveness of group logotherapy in reducing depression and increasing meaning in life levels of university students in Iran. A randomized controlled trial was conducted with a pre- post- and follow-up test design. The instruments used were the "Purpose in Life" (PIL) test and the "Beck Depression…

  7. Alcohol Problems and Depression in Later Life: Development of Two Knowledge Quizzes.

    ERIC Educational Resources Information Center

    Pratt, Clara C.; And Others

    1992-01-01

    Notes that effective measures of knowledge about mental health in later life are valuable in needs assessments and educational program evaluations. Describes development of two short, true/false quizzes, one on alcohol problems, other on depression and suicide in later life. Discusses usefulness of quizzes in planning and evaluating community…

  8. The Association between Child Autism Symptomatology, Maternal Quality of Life, and Risk for Depression

    ERIC Educational Resources Information Center

    Zablotsky, Benjamin; Anderson, Connie; Law, Paul

    2013-01-01

    Parents raising children with autism spectrum disorders (ASDs) have been shown to experience high levels of stress and report a lower quality of life. The current study examined the association between child autism symptomatology, mother's quality of life, and mother's risk for depression in a sample of 1,110 mothers recruited from a…

  9. A Prospective Analysis of Life Events, Problem Behaviours and Depression in Adults with Intellectual Disability

    ERIC Educational Resources Information Center

    Esbensen, A. J.; Benson, B. A.

    2006-01-01

    Background: Life events have consistently been found to be associated with behaviour problems and depression among individuals with intellectual disability (ID). However, prior findings have typically been based on correlational or retrospective analyses of case files. The current study attempted to replicate prior findings from life events with…

  10. First-Generation Undergraduate Students' Social Support, Depression, and Life Satisfaction

    ERIC Educational Resources Information Center

    Jenkins, Sharon Rae; Belanger, Aimee; Connally, Melissa Londono; Boals, Adriel; Duron, Kelly M.

    2013-01-01

    First-generation undergraduate students face challenging cross-socioeconomic cultural transitions into college life. The authors compared first- and non-first-generation undergraduate students' social support, posttraumatic stress, depression symptoms, and life satisfaction. First-generation participants reported less social support from…

  11. Depression symptoms and stressful life events among college students in Puerto Rico

    PubMed Central

    Reyes-Rodríguez, Mae Lynn; Rivera-Medina, Carmen L.; Cámara-Fuentes, Luis; Suárez-Torres, Alba; Bernal, Guillermo

    2012-01-01

    Background The transition from adolescence to adulthood is associated with stressful adaptation experiences that may increase symptoms of depression. We explored the prevalence and sex differences of depressive symptoms and suicidal ideation in freshmen Latino college students in Puerto Rico, and identified stressful life events that could contribute to symptoms of depression. Methods Two thousand one hundred sixty-three freshmen college students from the University of Puerto Rico (UPR) public education system were assessed for depression symptoms using the Beck Depression Inventory (BDI) and stressful life events using open questions. Results Nine percent of the sample reported depression symptoms at a moderate or severe level (BDI ≥ 20). Chi square analyses revealed a significantly higher prevalence for three of the stressful life events in females than males: relocation (10.2% females vs. 7.3% males; X2 (1) = 4.13, p=.042), break-up of a significant relationship (25.3% females vs. 17.8% males; X2 (1) = 13.76, p<.001), and illness (11.2% females vs. 7.3% males; X2 (1) = 7.23, p=.007). The model that best explained the variance of BDI scores among females was the presence of suicide risk, relationship break-up, illness, and relocation for college, whereas for males a similar model without the relationship break-up variable resulted in a better fit. Conclusions Freshmen college students present a broad range of depression symptoms and certain stressful life events are associated with an increased prevalence of depression symptoms. Early detection of depression and tailored prevention programs should be developed to improve both mental health and academic performance among the college population. PMID:22939390

  12. Health disparities in mid-to-late life: the role of earlier life family and neighborhood socioeconomic conditions.

    PubMed

    Johnson, Rucker C; Schoeni, Robert F; Rogowski, Jeannette A

    2012-02-01

    The relationship between neighborhoods of residence in young adulthood and health in mid-to-late life in the United States are examined using the 1968-2005 waves of the Panel Study of Income Dynamics (PSID). The sample consists of persons who were aged 20-30 in 1968 and are followed for a period of 38 years (N=2730). Four-level hierarchical random effects models of self-assessed general health status as a function of individual, family, and neighborhood factors are estimated. Using the original sampling design of the PSID, we analyze adult health trajectories of married couples and neighbors followed from young adulthood through elderly ages to assess the magnitudes of the possible causal effects of family and neighborhood characteristics in young adulthood on health in mid-to-late life. Estimates suggest disparities in neighborhood conditions in young adulthood account for one-quarter of the variation in mid-to-late life health. Living in poor neighborhoods during young adulthood is strongly associated with negative health outcomes in later-life. This result is robust even in the presence of a reasonably large amount of potential unobservable individual and family factors that may significantly affect both neighborhood of residence and subsequent health status. Racial differences in health status in mid-to-late life are also associated with family and neighborhood socioeconomic conditions earlier in life. Three quarters of the black-white gap in health status at ages over 55 can be accounted for by differences in childhood socioeconomic status and neighborhood and family factors in young adulthood. PMID:22212443

  13. Health Disparities in Mid-to-Late Life: The Role of Earlier Life Family and Neighborhood Socioeconomic Conditions

    PubMed Central

    Johnson, Rucker C.; Schoeni, Robert F.; Rogowski, Jeannette A.

    2012-01-01

    The relationship between neighborhoods of residence in young adulthood and health in mid to late life in the United States are examined using the 1968-2005 waves of the Panel Study of Income Dynamics (PSID). The sample consists of persons who were aged 20-30 in 1968 and are followed for a period of 38 years (N=2,730). Four-level hierarchical random effects models of self-assessed general health status as a function of individual, family, and neighborhood factors are estimated. Using the original sampling design of the PSID, we analyze adult health trajectories of married couples and neighbors followed from young adulthood through elderly ages to assess the magnitudes of the possible causal effects of family and neighborhood characteristics in young adulthood on health in mid to late life. Estimates suggest disparities in neighborhood conditions in young adulthood account for one-quarter of the variation in mid-to-late-life health. Living in poor neighborhoods during young adulthood is strongly associated with negative health outcomes in later life. This result is robust even in the presence of a reasonably large amount of potential unobservable individual and family factors that may significantly affect both neighborhood of residence and subsequent health status. Racial differences in health status in mid to late life are also associated with family and neighborhood socioeconomic conditions earlier in life. Three quarters of the black-white gap in health status at ages over 55 can be accounted for by differences in childhood socioeconomic status and neighborhood and family factors in young adulthood. PMID:22212443

  14. Late-in-life childbearing (kōrei shussan) in contemporary Japan.

    PubMed

    Castro-Vázquez, Genaro

    2015-01-01

    This paper draws on interviews with a group of 27 Japanese women who were classified as late-in-life-childbearing mothers, or kōrei shussan--women who had had their first delivery at 35 years of age or over. In making sense of the significance, symbolism and consequences of late-life motherhood, the paper utilises a symbolic interactionist perspective to shed light on the cultural, structural, interpersonal and intrapsychic dimensions underpinning the experiences of this group of mothers. The paper highlights the relevance of social interaction and everyday life that make pregnancy an 'obligation' for these women. Grounded in the Foucauldian notion of normalisation, the analysis suggests that the experience of late-in-life childbearing can be understood as the result of three forms of pressure: biological, homosocial and work. The late-in-life-childbearing mother largely stems from governmental economic neoliberalism imbued with traditional conservatism and the pervasive influence of the Assisted Reproduction Treatments industry. PMID:26043906

  15. Reducing depression among community-dwelling older adults using life-story review: a pilot study.

    PubMed

    Chan, Moon Fai; Leong, Katherine S P; Heng, Boon Ling; Mathew, Blessy Koottappal; Khan, Sher Banu A L; Lourdusamy, Sumathi Sagayamary; Nagapan, Mina; Woo, Sook Fan; Chee, Wai Yan; Ho, Roger C M; Taylor, Beverley Joan

    2014-01-01

    A life-story review can serve as an effective intervention to express one's inner feelings and provide emotional catharsis. The research aim was to examine the effects of life-story review on depression levels in community-dwelling older adults in Singapore. This pilot experimental pre-post-follow-up study was conducted from July 2012 to February 2013. Twenty-nine older Malays aged 60 and above, with mild to moderate depression, were randomly allocated to the life-story review (intervention) group (n = 15) or the non life-story review (control) group (n = 14). Depressive symptoms were measured by the Geriatric Depression Scale-15 and collected five times over eight weeks. Generalized estimating equations were used to examine the effects of the intervention on the elders' depression levels, controlled for age, gender, medication use, existence of chronic disease, and diary writing experience. Reductions in depression scores were found in the intervention group from week 1 (Mean ± SD 5.9 ± 2.3) to week 8 (1.9 ± 1.6) compared with the control group (week 1: 5.0 ± 1.3; week 8: 3.5 ± 1.5). At week 8, the intervention group showed a significantly lower level of depression than the control group (χ(2) = 14.61, p < 0.001). This study adds to prior research supporting the use of life story review in improving depression levels in cognitively intact community dwelling older adults. PMID:24246689

  16. Depression and Quality of Life in Patients With Type 2 Diabetes

    PubMed Central

    Derakhshanpour, Firooze; Vakili, Mohammad Ali; Farsinia, Maryam; Mirkarimi, Kamal

    2015-01-01

    Background: Frequency of mood disorders in patients with chronic diseases, especially diabetes and its effects on life quality are dramatically increasing. Objectives: This study aimed to investigate the relation between depression and quality of life in patients with diabetes. Patients and Methods: This is a cross sectional survey. Subjects were selected from 330 eligible people referred to the only diabetes clinic in Gorgan City during 6 months, using systematic random sampling. Beak Depression questionnaire and the brief questioner with 26 questions recommended by the World Health Organization (WHOQOL-BREF) were used to measure depression and quality of life, respectively. Data were analyzed through descriptive methods, Chi-square, Independent t test and linear regression model using SPSS16; moreover, P value < 0.05 was considered as significant. Results: In total, 330 patients with diabetes (35.5 % male and 64.5% women) were studied. The mean and standard deviation of their age and years involved with diabetes were 50.6 ± 9.0 and 5.4 ± 4.5 years, respectively. Range of age was 25 - 75 years, as well. The prevalence of depression in all patients with diabetes was 58.2% (124 mild, 56 medium, and 12 with severe depression). Hypertension was 13.9% more in diabetic patients with depression (P value < 0.001) and physical activity in 24.7% of the cases was less with a meaningful difference (P value = 0.01). The mean and standard deviation of quality of life in diabetic patients with and without depression was 50.7 ± 14 and 60.5 ± 13.3, respectively that was significant in two groups (P < 0.0001). Conclusions: The prevalence of depression is high in patients with diabetes and has a considerable impact on the consequences of diabetes and quality of life too. PMID:26082854

  17. Stress, Alcohol Use, and Depressive Symptoms in Later Life.

    ERIC Educational Resources Information Center

    Krause, Neal

    1995-01-01

    Uses social identity theory in order to evaluate whether alcohol use buffers the effects of stress on depressive symptoms in older adults. Results supported the hypothesis that alcohol effects reduce the negative impact of events arising in social roles that are not highly valued by study participants, and that alcohol consumption exacerbates the…

  18. Reconceptualizing Early- and Late-Onset: A Life Course Analysis of Older Heroin Users

    PubMed Central

    Boeri, Miriam Williams; Sterk, Claire E.; Elifson, Kirk W.

    2013-01-01

    Purpose Our knowledge regarding older users of illicit drugs is limited despite their increasing numbers. In this paper we apply a life course perspective to gain a further understanding of older adult drug use, specifically contrasting early- and late-onset heroin users. Design and Methods Qualitative data were collected from 29 older heroin users. Life course analysis focused on the users’ experiences across the life span. Results The findings suggest that those aging-into heroin use (late-onset) are disadvantaged compared to those who are maturing-in (early-onset) except in areas of health. Implications We propose that conceptualizing the use of heroin and other illicit drugs among older adults based on their life course trajectory will provide insights for social and health services, including drug treatment. PMID:18981280

  19. Physical functioning among mid-life women: associations with trajectory of depressive symptoms

    PubMed Central

    Sowers, MaryFran R; Harlow, Sioban; Jannausch, Mary; Zheng, Huiyong; Bromberger, Joyce

    2010-01-01

    During midlife, physical functioning limitations emerge and depressive symptoms are highly prevalent. We examined the relationship between physical functioning and depressive symptoms in the Michigan Study of Women's Health Across the Nation (SWAN) cohort of midlife women (n=377). Seven performance-based physical functioning measures quantifying strength, balance, coordination, flexibility and range of motion and perceived physical functioning, assessed with the SF-36 physical functioning sub-score, were included. The Center for Epidemiological Studies Depression Scale (CES-D) identified concurrent depressive symptom trajectory from 2000/01 through 2005/06 and history of depressive symptoms from 1996/7 through 1999/00. Longitudinal mixed-effects regression modeling was used to evaluate relationships. Median age of participants was 50 years. As age increased, higher CES-D scores were associated with performance-based functions including slower timed walk sit-to-stand, and stair climb after adjusting for five-year history of depressive symptoms and relevant covariates. As age increased, those with higher CES-D scores were more likely to have perceived limitations in physical functioning, though the association was weak. History of depressive symptoms was not significant in any model. These findings suggest that higher concurrent depressive symptoms are modestly associated with slower movement and a perception of poorer functioning. In contrast, history of depressive symptoms played little or no role in current physical functioning of mid-life women. When evaluating physical function, women's current mental health status should be considered. PMID:20692082

  20. Preventing Depression in Later Life: Translation From Concept to Experimental Design and Implementation

    PubMed Central

    Sriwattanakomen, Roy; Ford, Angela F.; Thomas, Stephen B.; Miller, Mark D.; Stack, Jacqueline A.; Morse, Jennifer Q.; Kasckow, John; Brown, Charlotte; Reynolds, Charles F.

    2009-01-01

    Objective The authors detail the public health need for depression prevention research and the decisions made in designing an experiment testing problem solving therapy as “indicated” preventive intervention for high-risk older adults with subsyndromal depression. Special attention is given to the recruitment of African Americans because of well-documented inequalities in mental health services and depression treatment outcomes between races. Methods A total of 306 subjects (half white, half African American) with scores of 16 or higher on the Center for Epidemiological Studies of Depression Scale, but with no history of major depressive disorder in the past 12 months, are being recruited and randomly assigned to either problem solving therapy-primary care or to a dietary education control condition. Time to, and rate of, incident episodes of major depressive disorder are to be modeled using survival analysis. Level of depressive symptoms will be analyzed via a mixed models approach. Results Twenty-two subjects have been recruited into the study, and to date eight have completed the randomly assigned intervention and postintervention assessment. Four of 22 have exited after developing major depressive episodes. None have complained about study procedures or demands. Implementation in a variety of community settings is going well. Conclusion The data collected to date support the feasibility of translating from epidemiology to RCT design and implementation of empirical depression prevention research in later life. PMID:18515690

  1. Stressful Life Events Prior to Depression Onset and the Cortisol Response to Stress in Youth with First Onset Versus Recurrent Depression.

    PubMed

    Mazurka, R; Wynne-Edwards, K E; Harkness, K L

    2016-08-01

    The strongest proximal predictors of depression onset in adolescence are stressful life events (SLEs). Changes in the hypothalamic-pituitary-adrenal (HPA) axis response to stress are theorized to mediate the etiological effect of SLEs on depression onset. The goal of the current study was to examine differences in the cortisol response to a laboratory-induced stressor between youth with versus without at least one SLE in the etiologically-central 3-month period prior to depression onset. One hundred adolescents (24 first-onset depression, 18 recurrent depression, and 58 non-depressed controls) had five salivary cortisol samples collected over the course of the Trier Social Stress Test (TSST). SLEs were assessed using a rigorous contextual interview and rating system. Among those with an SLE, youth on their first onset of depression had a flatter cortisol reactivity slope relative to non-depressed adolescents, and youth on a recurrent episode of depression had a steeper recovery slope relative to first-onsets and non-depressed adolescents. In contrast, no between-group differences were found among those with no SLE prior to onset. These results suggest that differences in the HPA axis response pattern may represent a neurobiological mechanism that distinguishes depressed and non-depressed groups but only for adolescents whose depression is precipitated by SLEs. Further, this neurobiological mechanism may play a different role in the very first episode of depression than it does in recurrent episodes. PMID:26610671

  2. Physical Sequelae and Depressive Symptoms in Gynecologic Cancer Survivors: Meaning in Life as a Mediator

    PubMed Central

    Simonelli, Laura E.; Fowler, Jeffrey; Maxwell, G. Larry

    2009-01-01

    Background Continuing symptoms and poor health following cancer treatments may alter meaning in life for cancer survivors. Gynecologic cancer survivors are particularly troubled with physical sequelae. In addition, for the most common sites of disease, such as breast and gynecologic cancers, the prevalence of depression is also high. Purpose This study tests meaning in life as a mechanism for the relationship between physical symptoms and depressive symptoms. Methods Gynecologic cancer survivors (N=260) participated. Measures of physical sequelae (nurse rated symptoms/signs, patient-reported gynecologic symptoms), meaning in life (harmony, life purpose, spirituality, and conversely, confusion and loss), and depressive symptoms were obtained at the time of a routine clinical follow-up visit 2–10 years following the completion of treatment. Latent variables were defined, and structural equation modeling tested a mediator model. Results Analyses support partial mediation. That is, survivors with more physical sequelae also reported lower levels of meaning in life, which was associated with higher levels of depressive symptoms. Conclusions Gynecologic cancer patients have been neglected in psychosocial research, and findings highlight the importance of existential issues in their lives. While many adjust well, those with persistent physical functioning deficits may experience depressive symptoms. By appreciating the role of meaning in their experience, we may help survivors foster their own growth and perspectives important for their future. PMID:18386113

  3. Depression, psychosocial variables and occurrence of life events among patients with cancer.

    PubMed

    Grassi, L; Malacarne, P; Maestri, A; Ramelli, E

    1997-06-01

    Depressive disorders and psychosocial related factors were investigated in 113 patients one year after the diagnosis of cancer. Patients with an ICD-10 diagnosis of depression (31% of the sample) showed higher external locus of control, poorer social support, higher incidence of undesirable and/or uncontrollable events than non-depressed patients. They also differed in reporting more frequently a life-time history of emotional disorders, inability to adjust to the diagnosis of cancer and in having a lower score on the performance status. Of these factors, past psychiatric history, early maladjustment to cancer, poor social support and low performance status were predictors of depressive symptoms. However, because of the cross-sectional nature of the study, no conclusion regarding a causal relationship between depression and psychosocial variables is possible. PMID:9186799

  4. Reconceptualizing Early and Late Onset: A Life Course Analysis of Older Heroin Users

    ERIC Educational Resources Information Center

    Boeri, Miriam Williams; Sterk, Claire E.; Elifson, Kirk W.

    2008-01-01

    Purpose: Researchers' knowledge regarding older users of illicit drugs is limited despite the increasing numbers of users. In this article, we apply a life course perspective to gain a further understanding of older adult drug use, specifically contrasting early- and late-onset heroin users. Design and Methods: We collected qualitative data from…

  5. Making Sense of Intimate Partner Violence in Late Life: Comments From Online News Readers

    PubMed Central

    Brossoie, Nancy; Roberto, Karen A.; Barrow, Katie M.

    2012-01-01

    Purpose: The purpose of this study was to gain insight into public awareness of intimate partner violence (IPV) in late life by how individuals respond to incidents of IPV reported in the newspaper. Design and Methods: Using grounded theory techniques, online news items covering 24 incidents of IPV in late life, and the reader comments posted to them were analyzed. The news items were examined for incident details, story framing, and reporting style. An open coding process (Charmaz, K. [2006]. Constructing grounded theory: A practical guide through qualitative analysis. Thousand Oaks, CA: Sage Publications.) was used to generate a comprehensive understanding of themes and patterns in the comments posted by readers. Results: Few posters indicated that incidents were episodes of IPV. As many posters struggled to make sense of incidents, they attempted to remove guilt from the perpetrator by assigning blame elsewhere. Comments were influenced by personal assumptions and perspectives about IPV, relationships, and old age; reporting style of the news items; and comments posted by other posters. Implications: Altering public views of IPV in late life requires raising awareness through education, reframing the ways in which information is presented, and placing greater emphasis on the context of the violence. By engaging interactive news media, reporters, participatory journalists, and policymakers can enhance public recognition and understanding of IPV in late life. PMID:22547086

  6. Integrating Religion and Spirituality into Treatment for Late-Life Anxiety: Three Case Studies

    ERIC Educational Resources Information Center

    Barrera, Terri L.; Zeno, Darrell; Bush, Amber L.; Barber, Catherine R.; Stanley, Melinda A.

    2012-01-01

    Generalized anxiety disorder (GAD) is common in older adults and, although cognitive behavioral therapy (CBT) is an efficacious treatment for late-life GAD, effect sizes are only moderate and attrition rates are high. One way to increase treatment acceptability and enhance current cognitive behavioral treatments for GAD in older adults might be to…

  7. Alcohol Abuse and the Elderly: Comparison of Early & Late-Life Onset.

    ERIC Educational Resources Information Center

    Schonfeld, Lawrence; And Others

    Two types of elderly alcohol abusers are described. Early onset or long-term alcohol abusers are abusers with long-standing behavioral problems considered well known to the social service delivery system. Late-life onset elderly alcohol abusers are those whose drinking problems began in the later years, after age 50, often in response to stresses…

  8. Grandparents Going to College: Late-Life Students. ASHE Annual Meeting Paper.

    ERIC Educational Resources Information Center

    Little, Chloe D.

    In seeking to explore theorists' claims that learning, education, and development in old age are linked, this qualitative study investigated how seeking a graduate or undergraduate degree functions in late-life development. Sixteen participants, ages 70 to 84, enrolled in higher education, were interviewed with a view to exploring their major…

  9. Measuring Meaning: Searching for and Making Sense of Spousal Loss in Late-Life

    ERIC Educational Resources Information Center

    Coleman, Rachel A.; Neimeyer, Robert A.

    2010-01-01

    Despite much recent theorizing, evidence regarding the temporal relationship of sense-making to adjustment following bereavement remains relatively sparse. This study examined the role of searching for and making sense of loss in late-life spousal bereavement, using prospective, longitudinal data from the Changing Lives of Older Couples (CLOC)…

  10. The Identification and Assessment of Late-Life ADHD in Memory Clinics

    ERIC Educational Resources Information Center

    Fischer, Barbara L.; Gunter-Hunt, Gail; Steinhafel, Courtney Holm; Howell, Timothy

    2012-01-01

    Objective: Little data exist about ADHD in late life. While evaluating patients' memory problems, the memory clinic staff has periodically identified ADHD in previously undiagnosed older adults. The authors conducted a survey to assess the extent to which other memory clinics view ADHD as a relevant clinical issue. Method: The authors developed…