Prevalence of and risk factors for minor and major depression among community-dwelling older adults in Taiwan

ABSTRACTBackground:This study was conducted to estimate prevalence rates and risk factors for late-life depression in a large nationwide representative sample from Taiwan.Methods:A total of 5,664, randomly sampled individuals aged ≥55 years were enrolled. Clinically, relevant depressive symptoms were classified using the Center for Epidemiological Studies Depression Scale (CES-D score ≥16), and major depression was confirmed using the Primary Care Evaluation of Mental Disorders. Individuals with clinically relevant depressive symptoms, who did not meet the strict diagnostic criteria for major depression, were considered to have minor depression. Multinomial logistic regression analyses were conducted to identify risk factors for major and minor depression, including socio-demographic characteristics, medical conditions, lifestyle behaviors, social support network, and life events.Results:The prevalence rates of minor and major depression were 3.7% and 1.5%, respectively. Major depression was associated with personal vulnerability factors, such as poor social support, cognitive impairment, comorbid pain conditions, and sleep disturbance. However, minor depression was more likely to be related to adverse life events, including increased burden on families, changes in health status, or relationship problem. Approximately, 20.0% of individuals with major depression received antidepressant treatment.Conclusions:Late-life depression was less prevalent among community-dwelling older adults in Taiwan than among populations in other countries. Our findings may aid the early detection and treatment of late-life depression and provide a basis for future investigations.

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Late life depression: a comparison of risk factors and symptoms according to age of onset in community dwelling older adults

International Journal of Geriatric Psychiatry ◽

10.1002/gps.2438 ◽

2009 ◽

Vol 25 (10) ◽

pp. 981-987 ◽

Cited By ~ 30

Author(s):

Damien Gallagher ◽

Aine Ni Mhaolain ◽

Elaine Greene ◽

Cathal Walsh ◽

Aisling Denihan ◽

...

Keyword(s):

Risk Factors ◽

Older Adults ◽

Age Of Onset ◽

Late Life ◽

Community Dwelling ◽

Late Life Depression ◽

Community Dwelling Older Adults

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On becoming depressed or anxious in late life: similar vulnerability factors but different effects of stressful life events

The British Journal of Psychiatry ◽

10.1192/bjp.179.5.426 ◽

2001 ◽

Vol 179 (5) ◽

pp. 426-431 ◽

Cited By ~ 65

Author(s):

Edwin De Beurs ◽

Aartjan Beekman ◽

Sandra Geerlings ◽

Dorly Deeg ◽

Richard Van Dyck ◽

...

Keyword(s):

Risk Factors ◽

Life Events ◽

Stressful Life Events ◽

Late Life ◽

Community Dwelling ◽

Self Report ◽

Stressful Life ◽

Depression And Anxiety ◽

Vulnerability Factors ◽

Risk Profiles

BackgroundLittle research has been done on the uniqueness of risk profiles for depression and anxiety in late life.AimsDelineating risk factors for the decline of mental health in older persons, comparing risk profiles for developing symptoms of pure depression, pure anxiety and both anxiety and depression in a prospective design.MethodSelf-Report data on depression and anxiety were collected from community-dwelling older respondents (⩾55 years) on two occasions, 3 years apart. Data from emotionally healthy respondents (n=1810) were used to investigate the effects of long-standing vulnerability factors and stressful life events.ResultsAfter 3 years 9% of the subjects had scored beyond the thresholds for symptoms. Vulnerability for depression and anxiety was quite similar, but life events differed: onset of depression was predicted by death of a partner or other relatives; onset of anxiety was best predicted by having a partner who developed a major illness. No support for moderator effects between vulnerability factors and stress was found; the effects were purely additive.ConclusionsDepression and anxiety have many risk factors in common, but specific risk factors also were found, especially in subjects developing both depression and anxiety.

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The association of late-life depression with all-cause and cardiovascular mortality among community-dwelling older adults: systematic review and meta-analysis

The British Journal of Psychiatry ◽

10.1192/bjp.2019.74 ◽

2019 ◽

Vol 215 (2) ◽

pp. 449-455 ◽

Cited By ~ 17

Author(s):

Jingkai Wei ◽

Ruixue Hou ◽

Xiaotao Zhang ◽

Huiwen Xu ◽

Liyang Xie ◽

...

Keyword(s):

Systematic Review ◽

Older Adults ◽

Cardiovascular Mortality ◽

Meta Analysis ◽

Late Life ◽

Community Dwelling ◽

Late Life Depression ◽

Prospective Cohort Studies ◽

Community Dwelling Older Adults

BackgroundLate-life depression has become an important public health problem. Available evidence suggests that late-life depression is associated with all-cause and cardiovascular mortality among older adults living in the community, although the associations have not been comprehensively reviewed and quantified.AimTo estimate the pooled association of late-life depression with all-cause and cardiovascular mortality among community-dwelling older adults.MethodWe conducted a systematic review and meta-analysis of prospective cohort studies that examine the associations of late-life depression with all-cause and cardiovascular mortality in community settings.ResultsA total of 61 prospective cohort studies from 53 cohorts with 198 589 participants were included in the systematic review and meta-analysis. A total of 49 cohorts reported all-cause mortality and 15 cohorts reported cardiovascular mortality. Late-life depression was associated with increased risk of all-cause (risk ratio 1.34; 95% CI 1.27, 1.42) and cardiovascular mortality (risk ratio 1.31; 95% CI 1.20, 1.43). There was heterogeneity in results across studies and the magnitude of associations differed by age, gender, study location, follow-up duration and methods used to assess depression. The associations existed in different subgroups by age, gender, regions of studies, follow-up periods and assessment methods of late-life depression.ConclusionLate-life depression is associated with higher risk of both all-cause and cardiovascular mortality among community-dwelling elderly people. Future studies need to test the effectiveness of preventing depression among older adults as a way of reducing mortality in this population. Optimal treatment of late-life depression and its impact on mortality require further investigation.Declaration of interestNone.

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Psychiatry: life events and social support in late life depression

Clinics ◽

10.1590/s1807-59322011000200009 ◽

2011 ◽

Vol 66 (2) ◽

pp. 233-238 ◽

Cited By ~ 24

Author(s):

Clóvis Alexandrino-Silva ◽

Tânia Ferraz Alves ◽

Luís Fernando Tófoli ◽

Yuan-Pang Wang ◽

Laura Helena Andrade

Keyword(s):

Social Support ◽

Life Events ◽

Late Life ◽

Late Life Depression

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Validating Psychosocial Pathways of Risk Between Neuroticism and Late Life Depression Using a Polygenic Score Approach

10.31219/osf.io/2xkqc ◽

2018 ◽

Author(s):

James Janford Li ◽

Emily C. Hilton ◽

Qiongshi Lu ◽

Jinkuk Hong ◽

Jan S. Greenberg ◽

...

Keyword(s):

Social Support ◽

Life Events ◽

Indirect Effects ◽

Stressful Life Events ◽

Late Life ◽

Stressful Life ◽

Direct And Indirect Effects ◽

Late Life Depression ◽

Polygenic Score ◽

Study Results

Neuroticism is a stable and heritable personality trait that is strongly linked to depression. Yet, little is known about its association with late life depression, as well as how neuroticism eventuates into depression. This study used data from the Wisconsin Longitudinal Study (WLS; N=4,877) to examine the direct and indirect effects of neuroticism on late life depression at three points in the life course – ages 53, 64, and 71 – via stressful life events (i.e., independent and dependent) and social supports measured across adulthood and into later life. Neuroticism was rigorously assayed using multiple methods, including self-report measures and a polygenic score informed by a meta-analytic genome-wide association study. Results indicated that the association between self-reported neuroticism and late life depression was partially mediated via the effects of dependent stressful life events experienced after the age of 53 and by age 64 (T2) social support. There were no specific indirect effects of self-reported neuroticism on depression through the effects of age 53 social support (T1), age 71 social support (T3), adult dependent stressful life events (experienced between age 19 and 52), and adult and late life independent stressful life events. These associations were replicated when we examined the direct and indirect effects of the polygenic score for neuroticism on late life depression, providing key evidence that our findings are robust. Results are consistent with previous findings that individuals with high neuroticism may be vulnerable to late life depression through psychosocial risk factors that are, in part, attributable to their own personality.

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Predictors of change in anxiety symptoms of older persons: results from the Longitudinal Aging Study Amsterdam

Psychological Medicine ◽

10.1017/s0033291799001956 ◽

2000 ◽

Vol 30 (3) ◽

pp. 515-527 ◽

Cited By ~ 60

Author(s):

E. DE BEURS ◽

A. T. F. BEEKMAN ◽

D. J. H. DEEG ◽

R. VAN DYCK ◽

W. VAN TILBURG

Keyword(s):

Risk Factors ◽

Life Events ◽

Older Persons ◽

Late Life ◽

Anxiety Symptoms ◽

Community Dwelling ◽

Stressful Event ◽

Stress Model ◽

Vulnerability Factors ◽

Logistic Regression Models

Background. Data on the course of anxiety in late life are scarce. The present study sets out to investigate the course of anxiety, as measured by the HADS-A (Zigmond & Snaith, 1983) in community dwelling older persons, and to evaluate predictive factors for change over 3 years in anxiety symptoms following the vulnerability/stress model.Method. Based on the first anxiety assessment, two cohorts were formed: subjects with and subjects without anxiety symptoms. In the non-anxious cohort (N = 1602) we studied risk factors for the development of anxiety symptoms; in the anxious cohort (N = 563) the same factors were evaluated on their predictive value for restitution of symptoms. Risk factors included vulnerability factors (demographics, health status, personality characteristics and social resources) and stressors (life events occurring in between both anxiety assessments). Logistic regression models estimated the effects of vulnerability factors, stress and their interaction on the likelihood of becoming anxious and chronicity of anxiety symptoms.Results. It was indicated that the best predictors for becoming anxious were being female, high neuroticism, hearing/eyesight problems and life-events. Female sex and neuroticism also increased the likelihood of chronicity of anxiety symptoms in older adults, but life events were not related to chronicity. The main stressful event in late life associated with anxiety was death of one's partner. Vulnerability factors and stress added on to each other rather than their interaction being associated with development or chronicity of anxiety.Conclusion. The vulnerability/stress model offers a useful framework for organizing risk factors for development and chronicity of anxiety symptoms in older persons, but no support was attained for the hypothesis that vulnerability and stress amplify each others effects. Finally, the results indicate to whom preventive efforts should be directed: persons high in neuroticism, women, and those who experience distressing life events.

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Cross-Country Differences and Similarities in Undernutrition Prevalence and Risk as Measured by SCREEN II in Community-Dwelling Older Adults

Healthcare ◽

10.3390/healthcare8020151 ◽

2020 ◽

Vol 8 (2) ◽

pp. 151

Author(s):

Jos W. Borkent ◽

Heather Keller ◽

Carol Wham ◽

Fleur Wijers ◽

Marian A. E. de van der Schueren

Keyword(s):

Risk Factors ◽

Older Adults ◽

Community Dwelling ◽

Nutritional Risk ◽

Sensitivity Analyses ◽

Data Sampling ◽

Prevalence Rates ◽

Nutrition Risk ◽

Screen Ii ◽

Community Dwelling Older Adults

Undernutrition is highly prevalent among community-dwelling older adults. Early identification of nutrition risk is important to prevent or treat undernutrition. This study describes the prevalence rates of nutrition risk in community-dwelling older adults (aged ≥ 65) using the same validated tool across different countries and aims to identify differences in nutritional risk factors. Cross-sectional data was obtained from three datasets including participants from the Netherlands (NL), Canada (CA) and New Zealand (NZ). Seniors in the Community Risk Evaluation for Eating and Nutrition II (SCREEN II) was used to assess nutritional risk factors and prevalence of risk. Differences between countries were tested with logistic and linear regression. Sensitivity analyses were conducted to test the influence of sampling strategy. A total of 13,340 participants were included, and 66.3% were found to be at high nutrition risk. After stratifying the data for method of data sampling, prevalence rates showed some differences across countries (NL: 61.5%, NZ: 68.2%, CA: 70.1%). Risk factor items that contributed to nutrition risk also differed among countries: NZ and CA participants scored higher for weight change, skipping meals, problems with meal preparation, use of meal replacements, problems with biting and chewing, low fluid intake and problems with doing groceries, as compared to participants in NL. Low intake of fruits and vegetables and meat were more prevalent in NL. In conclusion: nutrition risk is a worldwide, highly prevalent problem among community-dwelling older adults, but risk factors contributing to nutrition risk differ by country.

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