Antidepressant use and mortality in very old people

2016 ◽  
Vol 28 (7) ◽  
pp. 1201-1210 ◽  
Author(s):  
Gustaf Boström ◽  
Carl Hörnsten ◽  
Jon Brännström ◽  
Mia Conradsson ◽  
Peter Nordström ◽  
...  
Keyword(s):  
Mortality Risk ◽  
Antidepressant Treatment ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Community Dwelling ◽  
Old People ◽  
Very Old ◽  
Risk Of Death ◽  
Antidepressant Use ◽  
Cox Proportional Hazard Regression

ABSTRACTBackground:Antidepressant treatment may increase the risk of death. The association between antidepressants and mortality has been evaluated in community-dwelling older people, but not in representative samples of very old people, among whom dementia, multimorbidity, and disability are common.Methods:Umeå 85+/GERDA study participants (n = 992) aged 85, 90, and ≥95 years were followed for up to five years. Cox proportional hazard regression models were used to analyze mortality risk associated with baseline antidepressant treatment, adjusted for potential confounders.Results:Mean age was 89 years; 27% of participants had dementia, 20% had stroke histories, 29% had heart failure, and 16% used antidepressants. In age- and sex-adjusted analyses, antidepressant use was associated with a 76% increased mortality risk (hazard ratio [HR] = 1.76; 95% confidence interval [CI], 1.41–2.19). Adding adjustment for Geriatric Depression Scale score, HR was 1.62 (95% CI, 1.29–2.03). The association was not significant when adjusting for additional confounding factors (HR = 1.08; 95% CI, 0.85–1.38). Interaction analyses in the fully adjusted model revealed a significant interaction between sex and antidepressant use (HR: 1.76; 95% CI, 1.05–2.94). Among male and female antidepressant users, the HRs for death were 0.76 (95% CI, 0.47–1.24) and 1.28 (95% CI, 0.97–1.70), respectively.Conclusion:Among very old people, baseline antidepressant treatment does not seem to be independently associated with increased mortality risk. However, the risk may be different in men and women. This difference and the potential risk of initial treatment require further investigation in future cohort studies of very old people.

scholarly journals Usefulness of the Geriatric Depression Scale 15-item version among very old people with and without cognitive impairment

2013 ◽  
Vol 17 (5) ◽  
pp. 638-645 ◽  
Author(s):  
Mia Conradsson ◽  
Erik Rosendahl ◽  
Håkan Littbrand ◽  
Yngve Gustafson ◽  
Birgitta Olofsson ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Geriatric Depression ◽  
Old People ◽  
Very Old

scholarly journals Disability, Frailty and Depression in the community-dwelling older adults with Osteosarcopenia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ki-Soo Park ◽  
Gyeong-Ye Lee ◽  
Young-Mi Seo ◽  
Sung-Hyo Seo ◽  
Jun-Il Yoo
Keyword(s):  
Older Adults ◽  
Short Form ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Community Dwelling ◽  
Normal Group ◽  
World Health ◽  
Common Disease ◽  
Using Data ◽  
Health Organization

Abstract Background The purpose of this study was to investigate the prevalence of osteosarcopenia in the over 60-year-old community and to evaluate whether osteosarcopenia is associated with disability, frailty and depression. Methods This study was performed using the baseline data of Namgaram-2, among the 1010 surveyed subjects, 885 study subjects who were 60 years or older and had all necessary tests performed were selected. The Kaigo-Yobo checklist (frailty), World Health Organization Disability Assessment Schedule (WHODAS) and Geriatric Depression Scale-Short Form-Korean (GDSSF-K) were used. The Asian Working Group for Sarcopenia (AWGS 2019) were applied in this study. Osteopenia was measured using data from dual energy X-ray absorptiometry (DEXA) and osteopenia was diagnosed when the T-score was less than − 1.0. The study subjects were divided into four groups: the normal group, in which both sarcopenia and osteopenia were undiagnosed, osteopenia only, sarcopenia only and the osteosarcopenia group, which was diagnosed with both sarcopenia and osteopenia. Results Of the 885 subjects over 60 years old evaluated, the normal group comprised 34.0%, the only osteopenia group 33.7%, the only sarcopenia group 13.1%, and the osteosarcopenia group 19.2%. WHODAS (17.5, 95% CI: 14.8-20.1), Kaigo-Yobo (3.0, 95% CI: 2.6-3.4), and GDSSF mean score (4.6, 95% CI: 3.9-5.4) were statistically significantly higher in the osteosarcopenia group compared the other groups. Partial eta squared (ηp2) of WHODAS (0.199) and Kaigo-Yobo (0.148) values ​​according to Osteosarcopenia were large, and GDSSF (0.096) was medium Conclusions Osteosarcopenia is a relatively common disease group in the older adults community that may cause deterioration of health outcomes. Therefore, when evaluating osteopenia or sarcopenia in the older adults, management of those in both disease groups should occur together.

Reliability, Validity, and Factor Structure of the Geriatric Depression Scale in Turkish Elderly: Are There Different Factor Structures for Different Cultures?

2000 ◽  
Vol 12 (2) ◽  
pp. 163-172 ◽  
Author(s):  
Turan Ertan ◽  
Engin Eker
Keyword(s):  
Factor Structure ◽  
Internal Consistency ◽  
Discriminant Validity ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Principal Component ◽  
Community Dwelling ◽  
Geriatric Depression ◽  
Reasonable Time ◽  
Positive Form

The purpose of this study was to examine the Geriatric Depression Scale (GDS) translated into Turkish for its reliability, discriminant validity, and factor structure in a sample of 276 community-dwelling elderly and 30 patients with major depression. One item (Item 5) was discovered to have conceptual difficulty for Turkish elderly and was transformed to negative form. Item 2 was transformed to positive form to keep the number of positive and negative items equal to that in the original GDS. A reasonable time stability with 1-week interval (r:.74) and a high level of internal consistency (α = .91) were observed. Student's t test resulted in a significant discriminant validity for the scale total score. Factor study with principal component analysis and varimax rotation gave rise to a structure with seven factors. Results of the same analysis with two factors were found to be easier to interpret. The first factor was composed of 19 items reflecting “depressive affect and thought content.” The other 11 items representing “decrease in motivation and cognitive functions” loaded in the second factor. In conclusion, the Turkish GDS was found to have reasonable time reliability, high internal consistency, and discriminant validity for Turkish elderly. Its two-factor structure can be used as an informative instrument for epidemiological studies, reflecting two main dimensions of depression in the elderly.

scholarly journals The Joint Effects of Loneliness and Depression on Mortality: Does Gender Matter?

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 323-323
Author(s):  
Ted Kheng Siang Ng ◽  
Abhijit Visaria ◽  
Angelique W M Chan ◽  
Kheng Siang Ted Ng
Keyword(s):  
Los Angeles ◽  
Mortality Risk ◽  
Proportional Hazards ◽  
Depression Scale ◽  
Well Being ◽  
Joint Effect ◽  
Epidemiologic Studies ◽  
Cox Proportional Hazards ◽  
Community Dwelling ◽  
Increased Risk

Abstract Loneliness and depression are both associated with an increased risk of all-cause mortality among older adults. However, the evidence on the joint effect of loneliness and depression is scarce. Furthermore, previous research has rarely examined the modifying effects of gender. We investigated these questions using the Panel on Health and Aging of Singaporean Elderly, a nationally-representative cohort study of community-dwelling older Singaporean adults aged 60 and above, conducted in 2009 with two follow-up waves in 2011 and 2015 (N=4536). We operationalized six groups based on three categories of loneliness measured using the 3-item University of California, Los Angeles (UCLA) loneliness scale: always lonely, sometimes lonely, and never lonely; Two categories of depressive symptom scores were measured using the 11-item Center for Epidemiologic Studies Depression Scale (CES-D) scale: depressed and not depressed. Cox proportional hazards models were employed to estimate the mortality risks for each group, with an extensive set of covariates. Due to significant differences in the prevalence of loneliness and depression in different genders, we conducted gender-stratified analyses. Compared to being not depressed and never lonely, women who were depressed and sometimes lonely and who were not depressed but always lonely had a higher mortality risk. Men who were not depressed but sometimes lonely had a higher mortality risk. We conclude that loneliness appears to be the predominant construct in conferring excess mortality risk. Health policies and interventions addressing the factors common and unique to each gender may improve psychological well-being at older ages, thereby extending the lifespan.

scholarly journals Applicability of a cognitive questionnaire in the elderly and proxy

2008 ◽  
Vol 2 (3) ◽  
pp. 228-232 ◽  
Author(s):  
Renata Areza Fegyveres ◽  
Ana Paula Formigoni ◽  
Cláudia Sellitto Porto ◽  
Maria Teresa Carthery Goulart ◽  
Mirna Lie Hosogi Senaha ◽  
...  
Keyword(s):  
Geriatric Depression Scale ◽  
Depression Scale ◽  
The Elderly ◽  
Community Dwelling ◽  
Geriatric Depression ◽  
Community Group ◽  
Proxy Report ◽  
Proxy Responses ◽  
The Mean ◽  
State Examination

Abstract The Informant Questionnaire on Cognitive Decline in the Elderly with the Proxy (IQCODE) was developed as a screening tool for cognition alterations. Objectives: 1) To verify the applicability of IQCODE in the elderly with limited schooling, 2) To verify the reliability of the responses supplied by the aged and their proxies. Methods: Individuals of a Community Group were evaluated using the Mini-Mental State Examination (MMSE), IQCODE and Geriatric Depression Scale (GDS). The IQCODE was applied to informants and proxies. Results: We analyzed 44 individuals, aged between 58-82 years (M=66.8, SD=5.97) with mean elderly-schooling level of 3.75, SD=2.82 and 44 proxies aged 44.5 (SD=13.3), with mean schooling level of 8.25 (SD=4.3). The mean GDS was 8.22, SD=4.90 and 13 participants presented a score suggestive of depressive symptoms. The mean elderly IQCODE score was 3.26, SD=0.69 and 3.21, SD=0.65, for proxy responses. There was no statistical difference between these means. On the MMSE, the mean score was 24.20, SD=4.14 and 18 participants presented scores below the cut-off. The IQCODE answers by the elderly in this latter group were more congruent with MMSE than the answers of proxies. Conclusions: The applicability of the IQCODE in a population with little schooling was verified in that the proxy-report was similar to the elderly report. We can affirm that the elderly answers were more accurate than the proxies, as they were closer to MMSE score. The inclusion of a greater number of participants from community-dwelling settings is necessary to confirm the results obtained in this study.

scholarly journals Physical activity and depressive symptoms in community-dwelling elders from southern Brazil

2011 ◽  
Vol 33 (2) ◽  
pp. 165-170 ◽  
Author(s):  
César L. Reichert ◽  
César L. Diogo ◽  
José L. Vieira ◽  
Roberta R. Dalacorte
Keyword(s):  
Physical Activity ◽  
Depressive Symptoms ◽  
Linear Trend ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Population Based ◽  
Community Dwelling ◽  
Active Group ◽  
Lower Prevalence ◽  
Cross Sectional

OBJECTIVE: To determine the existence of a relationship between physical activity and depressive symptoms in community-dwelling elders. METHOD: This is a cross-sectional, population-based study, which included 379 community-dwelling elders from Novo Hamburgo, state of RS, Brazil. The level of physical activity was estimated using the International Physical Activity Questionnaire and depressive symptoms were diagnosed according to the Yesavage Geriatric Depression Scale. The association between the level of physical activity and depressive symptoms was analyzed by logistic regression. RESULTS: A tendency towards a lower prevalence of depressive symptoms was observed in individuals with higher levels of physical activity, both in the sample as a whole as well as among men, but not among women (p for linear trend 0.04, 0.03 and 0.36, respectively). The odds ratio of the presence of depressive symptoms in the very active group, as compared against that of the insufficiently active group was 0.32 (95% CI: 0.12-0.86) for men and 0.76 (95% CI: 0.39-1.46) for women. CONCLUSION: In this population of aged individuals, more intense physical activity is related to a lower prevalence of depressive symptoms. As shown by gender stratification, physical activity is inversely related to depressive symptoms in men, albeit not in women.

scholarly journals Brief version of Zarit Burden Interview (ZBI) for burden assessment in older caregivers

2019 ◽  
Vol 13 (1) ◽  
pp. 122-129 ◽  
Author(s):  
Aline Cristina Martins Gratão ◽  
Allan Gustavo Brigola ◽  
Ana Carolina Ottaviani ◽  
Bruna Moretti Luchesi ◽  
Érica Nestor Souza ◽  
...  
Keyword(s):  
Psychological Health ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Negative Influence ◽  
Community Dwelling ◽  
Zarit Burden Interview ◽  
Scale Scores ◽  
Physical And Psychological Health ◽  
Older Caregivers ◽  
Efficient Option

ABSTRACT. The degree of burden related to the demands of daily care provided to a dependent older adult is important to evaluate due to the negative influence exerted on caregivers’ physical and psychological health. Objective: To analyze the validity of the 12-item version of the Zarit Burden Interview administered to older caregivers of community-dwelling older dependent individuals and suggest a cut-off score based on quartiles. Methods: Three hundred and forty-one older caregivers (mean age: 69.6±7.1 years; 76.8% women) registered with primary healthcare centers were evaluated using the ZBI-12. Additional evaluations addressed stress (Perceived Stress Scale [PSS]), depressive symptoms (Geriatric Depression Scale [GDS]) in the older caregivers and the degree of dependence of the older care recipients (Lawton and Brody [L&B]). Results: Cronbach’s alpha demonstrated very good internal consistency (α=0.81). Correlations were found between all ZBI-12 items and overall score on the PSS (r=0.53; p<0.01). GDS (r=0.43; p<0.01) and L&B (r= -0.23; p<0.01) scale scores. The PSS demonstrated the strongest correlation with ZBI-12 score and proved to be the standard reference. Based on caregivers with a higher degree of stress considering the PSS score quartiles, a cut-off score of 13 points on the ZBI-12 is suggested for screening burden in community-dwelling older caregivers, but should not be assumed as normative data. Conclusion: The ZBI-12 can be considered valid for evaluation of burden in clinical practice and research as a fast, efficient option for screening burden among older caregivers of community-dwelling older adults.

scholarly journals DO PERSONALITY TRAITS INFLUENCE PERCEPTIONS OF COGNITIVE CHANGE IN COMMUNITY DWELLING OLDER ADULTS?

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S893-S894
Author(s):  
Thomas M Meuser ◽  
Regula H Robnett
Keyword(s):  
Personality Traits ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Cognitive Change ◽  
Community Dwelling ◽  
Self Report ◽  
Sample Population ◽  
Big Five Personality ◽  
Cognitive Screening ◽  
Influence Perceptions

Abstract Recent research has linked personality traits and risk for cognitive impairment in advancing age. Associations with neuroticism are particularly robust. Both longstanding and recent elevations may predict dementia. Other traits – conscientiousness and openness to experience – also show unique associations. These findings derive mainly from large sample population studies and smaller clinical investigations. Relevance to the general population is unclear. We investigated the “big five” personality traits and cognition in 232 community-dwelling adults (73% female, 97% Caucasian, mean age 72 years). Scores on a self-report screen for dementia – the AD8 – framed the sample: 77% scored 0 points, no dementia; 23% scored 2+, possible dementia. Age and personality were independent variables in a binary logistic regression with AD8 status as dependent. All predictors but one, extraversion, were significant (p &lt; .05), suggesting that personality traits may influence perceptions of cognitive change. Higher agreeableness and neuroticism predicted possible dementia status on the AD8, whereas higher openness and conscientiousness predicted normal cognition. Interestingly, most in the AD8 positive group (70%) denied having “more problems with memory than most” on the Geriatric Depression Scale. These perceptions would seem incompatible, especially for true positive cases. Our findings suggest that the role of personality in dementia screening (and, perhaps, diagnosis) may be more nuanced than indicated in other studies. Longstanding traits and present perceptions are both elements of the evaluative process, as much as test scores and reported history. Our findings speak to the value of a person-centered, context-aware approach in cognitive screening.

scholarly journals Identifying the Factors Related to Depressive Symptoms Amongst Community-Dwelling Older Adults with Mild Cognitive Impairment

2019 ◽  
Vol 16 (18) ◽  
pp. 3449 ◽  
Author(s):  
Dan Song ◽  
Doris S.F. Yu ◽  
Polly W.C. Li ◽  
Qiuhua Sun
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Depressive Symptoms ◽  
Mild Cognitive Impairment ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Community Dwelling ◽  
Cross Sectional ◽  
Increased Risk ◽  
Community Dwelling Older Adults

High-level depressive symptoms have been reported in individuals with mild cognitive impairment (MCI), resulting in increased risk of progression to dementia. However, studies investigating the correlates of depressive symptoms among this population are scarce. This study aimed to investigate the significant socio-demographic, lifestyle-related and disease-related correlates of depressive symptoms among this cohort. Cross-sectional data were obtained from a sample of 154 Chinese community-dwelling older adults with MCI. MCI subjects were screened by the Montreal Cognitive Assessment. Depressive symptoms were measured by the Geriatric Depression Scale. Possible correlates of depressive symptoms in individuals with MCI were explored by multiple linear regressions. The prevalence of depressive symptoms among Chinese older adults with MCI was 31.8%. In multiple regression analysis, poor perceived positive social interaction, small social network, low level of physical activity, poor functional status, subjective memory complaint, and poor health perception were correlated with depressive symptoms. The findings highlight that depressive symptoms are sufficient to warrant evaluation and management in older adults with MCI. Addressing social isolation, assisting this vulnerable group in functional and physical activities, and cultivating a positive perception towards cognitive and physical health are highly prioritized treatment targets among individuals with MCI.

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