Depressive Symptoms and Frailty Among the Oldest Old: Evidence From the Multicenter Prospective AgeCoDe-AgeQualiDe Study

Introduction: Due to the strong association between old age and the need for long-term care, the number of individuals in need for care is projected to increase noticeably. The aim of this study was to examine the determinants of institutionalization among the oldest old longitudinally. Methods: Longitudinal data (follow-up [FU] wave 7–9) were gathered from a multicenter prospective cohort study (“Study on needs, health service use, costs and health-related quality of life in a large sample of oldest old primary care patients [85+],” AgeQualiDe). At FU wave 7, in 2014, complete measures were available for 763 individuals. The average age was 88.9 (standard deviation 2.9) years (range 85–100), and 68% were female. Sociodemographic and health-related independent variables (e.g., depressive symptoms or functioning) were included in the regression model. Institutionalization (admission to assisted living home or nursing home) was used as an outcome measure. Logistic random-effects models were used. Results: Regressions revealed that among oldest old, the odds of being institutionalized were lower for men (odds ratio [OR] = 0.03; 95% confidence interval [CI] 0.00–0.16). Institutionalization was associated with an increased age (OR = 1.27; 95% CI 1.04–1.55). Additionally, widowed individuals (ref. non-widowed) had higher odds of being institutionalized (OR = 8.95; 95% CI 1.61–49.81). Institutionalization was also associated with functional decline (OR = 0.16; 95% CI 0.11–0.23), whereas it was not significantly associated with cognitive decline, depressive symptoms, and social support. Conclusion: Our findings stress the importance of gender, age, widowhood, and functional decline for institutionalization among the oldest old. Preventing or at least postponing functional decline might help to delay institutionalization as far as possible.

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Do the GDS and the GDS-15 adequately capture the range of depressive symptoms among older residents in congregate housing?

International Psychogeriatrics ◽

10.1017/s1041610210002425 ◽

2011 ◽

Vol 23 (6) ◽

pp. 950-960 ◽

Cited By ~ 1

Author(s):

Kathryn Betts Adams

Keyword(s):

Older Adults ◽

Depressive Symptoms ◽

Oldest Old ◽

Geriatric Depression Scale ◽

Depression Scale ◽

Diagnostic Interview ◽

Geriatric Depression ◽

Roc Curve Analysis ◽

Cut Points ◽

Hit Rates

ABSTRACTBackground: In light of inconsistencies in cut points for identifying non-major depression, this study examined the classification efficiency of the Geriatric Depression Scale (GDS and GDS-15) total scores and individual items, and four additional depressive symptoms for identification of subthreshold, minor, or criterion depression among 166 vulnerable residents of congregate housing.Methods: Depression (combined categories of major depressive episode, minor, or subthreshold depression) was determined by the Mini-International Neuropsychiatric Interview (MINI) diagnostic interview depression module administered by telephone to 166 older residents of congregate housing facilities who also completed the 30-item GDS and four other yes/no potential indicators of geriatric depression. Classification agreement and ROC curve analysis for the full and 15-item GDS scale scores were calculated. Individual item hit rates for MINI criterion were calculated for GDS items and four new items.Results: GDS and GDS-15 at standard cut points had 70–75% agreement with MINI. Best sensitivity and specificity were obtained at lower than standard cut points. Some GDS Withdrawal, Apathy, lack of Vigor (WAV) and cognitive items obtained very low hit rates. New items “I just don't feel like myself” and “I feel I am a burden to others” better discriminated MINI depression than most GDS items and had good item-to-total correlations with the GDS.Conclusions: Diagnostic criteria and GDS screen had partial agreement. Some GDS items did not adequately represent depression among functionally impaired or oldest old older adults. Feeling one is a burden and the sense of feeling “different” from usual may be useful indicators of depression among vulnerable older adults.

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Worries, psychosocial resources, and depressive symptoms among the South Korean oldest old

Aging & Mental Health ◽

10.1080/13607860903420997 ◽

2010 ◽

Vol 14 (1) ◽

pp. 57-66 ◽

Cited By ~ 15

Author(s):

Injeong Lee ◽

Ruth E. Dunkle

Keyword(s):

Depressive Symptoms ◽

Oldest Old ◽

Psychosocial Resources ◽

The South ◽

South Korean

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Bereavement in Very Old Age: Impact on Health and Relationships of the Loss of a Spouse, a Child, a Sibling, or a Close Friend

OMEGA - Journal of Death and Dying ◽

10.2190/om.60.4.a ◽

2010 ◽

Vol 60 (4) ◽

pp. 301-325 ◽

Cited By ~ 28

Author(s):

Christian J. Lalive d'Epinay ◽

Stefano Cavalli ◽

Luc A. Guillet

Keyword(s):

Depressive Symptoms ◽

Functional Status ◽

Old Age ◽

Oldest Old ◽

Great Majority ◽

Close Friend ◽

Short Term ◽

Very Old ◽

Very Old Age

This article deals with the following two questions: In very old age, which are the main sources of bereavement? And what are the consequences of such losses on health and on relationships? The findings are based on the complete set of data compiled in the course of the Swiss Interdisciplinary Longitudinal Study on the Oldest Old (SWILSOO), which provided a 10-year follow-up of a first cohort (1994–2004) and a 5-year follow-up of a second (1999–2004). The data revealed that, in very old age, the great majority of the dear ones who died were either siblings or close friends. Taken as a whole, the bereaved suffered a marked and lasting increase in depressive symptoms, together with a short-term deterioration in their functional status; those bereft of a spouse or a child saw their functional status worsen and exhibited enduring depressive symptoms but they also benefited from support in the form of increased interaction; those bereft of siblings only suffered from a mild, short-term deterioration in functional status; those who had lost a close friend suffered a very significant increase in depressive symptoms. In the medium term, most of these effects disappeared, lending weight to the claim that the survivors manage to cope with the misfortunes of life.

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