Pain and symptoms of depression in older adults living in community and in nursing homes: the role of activity restriction as a potential mediator and moderator

2014 ◽  
Vol 26 (10) ◽  
pp. 1679-1691 ◽  
Author(s):  
Almudena López-Lopez ◽  
José L. González ◽  
Miriam Alonso-Fernández ◽  
Noelia Cuidad ◽  
Borja Matías

ABSTRACTBackground:Chronic pain is likely to lead to depressive symptoms, but the nature of this relationship is not completely clear. The aim of the present study is to analyze the role of activity restriction in the pain-depression relationship in older people, and to test the hypothesis that this role is more relevant in community-dwelling older people than in nursing home residents.Method:Depressive symptoms, pain intensity, and activity restriction were measured in a sample of 208 older adults with osteoarthritis, 102 living in nursing homes (NH), and 106 in the community. Analyses were carried out using moderation and moderated mediation analyses approach, treating activity restriction as a confounder.Results:Results showed a significant confounding effect of activity restriction, interaction effect between pain intensity and activity restriction on depression, and modifying effect of pain intensity on depression by adding activity restriction into the model. These results suggest a potential mediating and moderating effects of activity restriction. Moreover, analyses suggest that, surprisingly, the strength of the mediation could be higher in nursing homes.Conclusions:Overall, it may be that what is really important to emotional well-being is not so much pain itself, but rather the way in which the pain alters older people's lives. The greater strength of the mediation in NH might be understood within the scope of self-determination theory. Generally speaking, the NH context has been considered as a coercive setting, promoting non-autonomous orientation. In this context, when events are objectively coercive, people may lack perceived autonomy and hence be at greater risk of depression.

Author(s):  
Katja Pynnönen ◽  
Katja Kokko ◽  
Milla Saajanaho ◽  
Timo Törmäkangas ◽  
Erja Portegijs ◽  
...  

Abstract Background Although depressive symptoms are more common among older than younger age groups, life satisfaction tends to remain stable over the life course, possibly because the underlying factors or processes differ. Aim To study whether the factors that increase the likelihood of high life satisfaction also decrease the likelihood of depressive symptoms among older people. Methods The data were a population-based probability sample drawn from community-dwelling people aged 75, 80, and 85 years (n = 1021). Participants’ life satisfaction was measured with the Satisfaction with Life Scale and depressive symptoms with the Centre for Epidemiologic Studies Depression Scale (CES-D). Physical performance, perceived financial situation, executive functions, loneliness, self-acceptance, and having interests in one’s life were studied as explanatory variables. The data were analyzed using cross-sectional bivariate linear modeling. Results Better physical performance, not perceiving loneliness, having special interests in one’s life, and higher self-acceptance were associated with higher life satisfaction and fewer depressive symptoms. Better financial situation was related only to life satisfaction. Executive functions were not associated with either of the outcomes. Discussion The opposite ends of the same factors underlie positive and negative dimensions of mental well-being. Conclusion Further studies are warranted to better understand how people maintain life satisfaction with aging when many resources may diminish and depressive symptoms become more prevalent.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 251-251
Author(s):  
Kheng Siang Ted Ng ◽  
Shu Cheng Wong ◽  
Glenn Wong ◽  
Ee Heok Kua ◽  
Anis Larbi ◽  
...  

Abstract Despite increasing emphasis on assessing the mental health of older adults, there has been inconclusive evidence on whether depression and psychological well-being (PWB) are fundamentally distinct constructs or representations of the opposite ends of the mental health spectrum. To instantiate either hypothesis, investigation of the associations between mental health scales and biomarkers have been proposed. First, we assessed depressive symptoms and PWB in community-dwelling older adults (N=59, mean age=67) using the Self-Rating Depression Scale (SDS) and Ryff’s Scale of PWB (comprising six sub-scales). We measured a wide range of immune markers employing ELISA and flow cytometry. Subsequently, we used principal component analysis (PCA) to aggregate and derived biomarker factor scores. Lastly, multiple linear regressions were performed to examine the associations between the scales and the derived biomarker factor scores, controlling for covariates. PCA extracted six biomarker factors. Biomarker factor score 1 was significantly associated with PWB (β=-0.029, p=0.035) and the PWB sub-scale, self-acceptance (β=-0.089, p=0.047), while biomarker factor score 4 was significantly associated with the PWB sub-scale, purpose in life (β=-0.087, p=0.025). On the other hand, biomarker factor 6 was significantly associated with SDS (β=-0.070, p=0.008). There were mutually- exclusive associations between the scales with biomarker factor scores, supporting the hypothesis of distinct constructs. Our findings expanded the biomarkers of depression and PWB, deepening understanding of the biological underpinnings of depressive symptoms and PWB. These findings have implications in field work, since researchers could not infer one construct from the other, the examination of both constructs are essential.


BMJ Open ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. e026744 ◽  
Author(s):  
Anne Heaven ◽  
Lesley Brown ◽  
John Young ◽  
Elizabeth Teale ◽  
Rebecca Hawkins ◽  
...  

IntroductionThe Community Ageing Research 75+ Study (CARE75+) is a longitudinal cohort study collecting an extensive range of health, social and economic data, with a focus on frailty, independence and quality of life in older age. CARE75+ is the first international experimental frailty research cohort designed using Trial within Cohorts (TwiCs) methodology, to align applied epidemiological research with clinical trial evaluation of interventions to improve the health and well-being of older people living with frailty.Methods and analysisProspective cohort study using a TwiCs design. One thousand community-dwelling older people (≥75 years) will be recruited from UK general practices. Nursing home residents, those with an estimated life expectancy of 3 months or less and people receiving palliative care will be excluded. Data collection assessments will be face to face in the person’s home at baseline, 6 months, 12 months, 24 months and 48 months, including assessments of frailty, cognition, mood, health-related quality of life, comorbidity, medications, resilience, loneliness, pain and self-efficacy. A modified protocol for follow-up by telephone or web based will be offered at 6 months. Consent will be sought for data linkage and invitations to additional studies, including intervention studies using the TwiCs design. A blood sample biobank will be established for future basic science studies.Ethics and disseminationCARE75+ was approved by the NRES Committee Yorkshire and the Humber—Bradford Leeds 10 October 2014 (14/YH/1120). Formal written consent is sought if an individual is willing to participate and has capacity to provide informed consent. Consultee assent is sought if an individual lacks capacity.Study results will be disseminated in peer-reviewed scientific journals and scientific conferences. Key study results will be summarised and disseminated to all study participants via newsletters, local older people’s publications and local engagement events. Results will be reported on a bespoke CARE75+ website.Trial registration numberISRCTN16588124;Results stage


Author(s):  
Ehud Bodner ◽  
Amit Shrira ◽  
Yaakov Hoffman ◽  
Yoav S Bergman

Abstract Objectives Evidence of daily fluctuations in subjective age and their association with older adults’ well-being was recently obtained. Yet, neither the simultaneous tracking of two daily views on aging (i.e., daily subjective age and daily ageist attitudes) nor their interactive effect on mental health (i.e., depressive symptoms) has been explored. We hypothesized that (a) at days on which older adults feel older or report high ageist attitudes they would report higher depressive symptoms, (b) combined older subjective age and high ageist attitudes will be associated with the highest daily depressive symptoms. Method Community-dwelling older adults (N = 134, mean age = 69.66) completed measures of subjective age, ageist attitudes, and depressive symptoms for 10 consecutive days. Results Daily older subjective age and higher ageist attitudes were related to higher depressive symptoms, but there was no combined effect of both on depressive symptoms. There was a significant three-way interaction between subjective age, ageist attitudes, and chronological age, demonstrating the interactive effect of subjective age and ageist attitudes on depressive symptoms only among the old-old respondents. Time-lagged analyses further showed that ageist attitudes during previous days predicted feeling older and more depressed on following days, but not vice versa. Discussion Results suggest that old-old individuals are more susceptible to a combination of negative views on aging on daily basis. Findings further support a daily assimilation process, whereby previous-day stereotypes are assimilated and manifested into one’s identity and mental health, so that one feels older and more depressed on subsequent days.


Assessment ◽  
2017 ◽  
Vol 25 (3) ◽  
pp. 302-309
Author(s):  
Ineke Demeyer ◽  
Nuria Romero ◽  
Rudi De Raedt

The interplay between actual and ideal self-esteem may be a key component in emotional disorders. Since automatic self-evaluations are not always consciously accessible, assessment through implicit measures is necessary. Given the lack of implicit self-esteem measures in late life, we aimed to identify a reliable measure and to clarify the role of actual and ideal self-esteem in mood and depressive symptoms in older adults. Forty-nine older adults completed two adapted Go/No go Association tasks measuring implicit actual and ideal self-esteem and measures of mood and depressive symptoms. The two Go/No go Association tasks showed satisfactory internal consistency. Moderation analyses revealed that lower actual self-esteem in older adults is related to higher levels of sad mood when ideal self-esteem is high. Moreover, lower actual self-esteem is related to more anxious mood. Given the role of self-esteem in emotional well-being, a reliable measure for older adults is crucial to improve age-appropriate diagnostics and treatment.


2016 ◽  
Vol 29 (7) ◽  
pp. 1251-1267 ◽  
Author(s):  
Jeong Eun Lee ◽  
Lynn M. Martire ◽  
Steve H. Zarit ◽  
Michael J. Rovine

Objective: The present study aimed to clarify the circumstances under which activity restriction (AR) is associated with depressive symptoms among patients with osteoarthritis (OA) and their spouses. Method: A total of 220 older adults with OA and their caregiving spouses participated in the study. The actor–partner interdependence model (APIM) was used to examine the associations between AR stemming from patients’ OA and the depressive symptoms of patients and spouses. The potential moderating role of marital satisfaction also was examined. Results: After accounting for pain severity, health, and life stress of both patients with OA and spouses, higher AR was associated with more depressive symptoms for both patients and spouses. In regard to partner effects, patients whose spouse had higher AR reported more depressive symptoms. In addition, the association of spouses’ and patients’ AR and their own depressive symptoms was moderated by their marital satisfaction. For both patients and spouses, the associations between their own AR and depressive symptoms were weaker for those with higher levels of marital satisfaction compared with those with lower levels of marital satisfaction. Discussion: This pattern of findings highlights the dyadic implications of AR and the vital role of marital satisfaction in the context of chronic illness.


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