Caregiving Intensity and Depressive Symptoms Among Older Adults After Partners’ Onset of Dementia

Abstract Caring for a partner with Alzheimer’s disease or related dementia (ADRD) can create tremendous care burdens. However, the extent to which onset of ADRD in a partner impacts caregiving intensity and emotional health, the relationship of increased care intensity to emotional health, and whether relationships vary across the older adult population, are less clear. We used 9 waves (years 2000-2016) of the nationally representative Health and Retirement Study dataset to examine the number of weekly caregiving hours provided and depressive symptoms for older (ages ≥51) individuals after partners' ADRD onset (measured with the Telephone Cognitive Interview Survey). We compared changes in outcomes from before to after partners' ADRD onset using zero-inflated negative binomial regression models, overall and among sub-populations with potential vulnerability to excess care burdens – women and racial/ethnic minorities. In our sample of 2,186 older Americans with 10,120 unique observations, we observed a 215% increase (p<0.001) in weekly caregiving hours provided and 21% increase (p<0.001) in depressive symptoms reported by older respondents after partners' ADRD onset. Even larger impacts were observed for women and for non-Hispanic whites. Increased amounts of caregiving were associated with increases in depressive symptoms after a partner's ADRD onset. In all, ADRD has substantial impacts on family. Improved support mechanisms, including enriched community resources, clinician focus on dyadic needs, respite care, and policy efforts such as tax credits for caregivers, will be needed to meet the needs of couples increasingly affected by ADRD.

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Longitudinal relationship of diabetes and depressive symptoms in older adults from Mexico: a secondary data analysis

BMJ Open Diabetes Research & Care ◽

10.1136/bmjdrc-2020-001789 ◽

2020 ◽

Vol 8 (2) ◽

pp. e001789

Author(s):

Teresa Alvarez-Cisneros ◽

Paloma Roa-Rojas ◽

Carmen Garcia-Peña

Keyword(s):

Risk Factors ◽

Older Adults ◽

Depressive Symptoms ◽

Secondary Data ◽

Random Effects Models ◽

Health Factors ◽

Longitudinal Association ◽

Common Risk Factors ◽

Nationally Representative ◽

Relationship Of

IntroductionSeveral studies have argued a causal relationship between diabetes and depression, while others have highlighted that their association is a result of common risk factors. Because Mexico is a country with a high prevalence of diabetes, and diabetes and depression are a frequent comorbidity, we chose this country to investigate the longitudinal relationship of these two conditions, focusing on the influence of demographic, health, and socioeconomic factors which could act as common risk factors for both conditions.Research design and methodsUsing the harmonized Mexican Health and Aging Study, a nationally representative sample of adults older than 50 with a response rate of 93%, we analyzed the longitudinal relationship of diabetes and depressive symptoms using ‘between-within’ random-effects models, focusing on the effect of demographic, socioeconomic and health factors.ResultsWhile older adults with diabetes reported a higher prevalence of depressive symptoms in the four waves of the study, there was no causal longitudinal association between them once controlling for demographic, socioeconomic and health factors (between-effect OR=0.88, 95% CI 0.77 to 1.01; within-effect OR=0.87, 95% CI 0.69 to 1.11).ConclusionsThere is no causal longitudinal association between diabetes and depression; the higher prevalence of depression among older adults with diabetes seems a result of socioeconomic and health factors that are not exclusive to respondents with diabetes but are more frequent in this group. Our results highlight the importance of prevention and control of chronic conditions as well as the role of socioeconomic inequalities in mental health.

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Title I: Modernizing Definitions and Programs Under the Administration on Aging

Innovation in Aging ◽

10.1093/geroni/igaa057.2518 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 714-715

Author(s):

Marie Gualtieri

Keyword(s):

Title I ◽

Adult Population ◽

Term Care ◽

Older Americans ◽

Aging Society ◽

Program Adaptation ◽

Older Americans Act ◽

The Individual ◽

Older Adult Population

Abstract The recent reauthorization of the Older Americans Act adds language and definitions to current issues facing the aging population. Specifically, Title I includes definitions related to program adaptation and coordination, workforce and long-term care issues, nutrition and social isolation, as well as family caregivers. Different from the last authorization, these definitions span beyond the individual experience to include other entities impacted by an aging society, such as the workforce and families. Overall, the Title I reauthorization seeks to modernize policy to reflect the current influx of the older adult population and its consequences.

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PERCEIVED NEIGHBORHOOD SOCIAL DISORDER, FRIENDS’ SUPPORT, AND DEPRESSIVE SYMPTOMATOLOGY OF NON-MARRIED OLDER WOMEN

Innovation in Aging ◽

10.1093/geroni/igz038.1142 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S312-S312

Author(s):

Seungjong Cho ◽

Aloen Townsend

Keyword(s):

Depressive Symptoms ◽

Older Women ◽

Negative Binomial ◽

Depressive Symptomatology ◽

Negative Binomial Regression ◽

Negative Binomial Regression Model ◽

Social Disorder ◽

Stress Buffering ◽

Buffering Effect ◽

Negative Perceptions

Abstract This study examined whether perceived neighborhood social disorder predicted depressive symptoms among non-married older women (N = 823) drawn from the 2016 Health and Retirement Study. It also tested the stress buffering effect of friends support. A negative binomial regression model showed that higher perceived neighborhood social disorder was associated with higher depressive symptoms. Presence of good friends in the same neighborhood and number of close friends were protective factors, but no stress buffering effect of friends support was identified. This study highlights the adverse effect of negative perceptions of the neighborhood social environment on non-married older women’s depressive symptoms.

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Racial–Ethnic Differences in Turnover Intent Among Home Health Aides

Journal of Applied Gerontology ◽

10.1177/0733464819827806 ◽

2019 ◽

Vol 39 (5) ◽

pp. 490-501 ◽

Cited By ~ 2

Author(s):

Scott D. Landes ◽

Suzie S. Weng

Keyword(s):

Adult Population ◽

The United States ◽

Home Health ◽

Turnover Intent ◽

Advancement Opportunities ◽

Home Health Aides ◽

Home Based ◽

Nationally Representative ◽

Older Adult Population ◽

Racial Ethnic

Home health aides are crucial to ensuring quality services for the growing older adult population needing home-based care in the United States. We utilize data from the nationally representative 2007 National Home Health Aide Survey ( N = 3,344) to analyze racial–ethnic disparity in turnover intent. Non-Hispanic Black and non-Hispanic Other home health aides had higher all-cause turnover intent than Non-Hispanic Whites. Cause-specific turnover intent varied by race–ethnicity. Compared with non-Hispanic White home health aides, (a) non-Hispanic Black home health aides were more likely to leave due to low pay and educational/advancement opportunities; (b) Hispanic home health aides were more likely to leave due to a perceived lack of respect or difficulty with their supervisor/agency; and (c) non-Hispanic home health aides were more likely to leave due to an impending move. Findings suggest that efforts to address high levels of turnover intent among home health aides should account for differences in race–ethnic groups.

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Setting-Specific and Symptom-Specific Association between Secondhand Smoke Exposure and Depressive Symptoms

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16071249 ◽

2019 ◽

Vol 16 (7) ◽

pp. 1249

Author(s):

Xiaohua Ye ◽

Jingya Huang ◽

Liang Xia ◽

Xiaojun Xu ◽

Xiao Gong ◽

...

Keyword(s):

Depressive Symptoms ◽

Dose Response ◽

Secondhand Smoke ◽

Negative Binomial ◽

Negative Binomial Regression ◽

Response Relationship ◽

Dose Response Relationship ◽

Cross Sectional ◽

Shs Exposure ◽

The Impact

Few studies have focused on the potential relationship between secondhand smoke (SHS) exposure and depressive symptoms. This study aimed to explore the potential association between SHS exposure and depressive symptoms and differentiate this association in setting-specific exposure and symptom-specific outcomes. A cross-sectional study was conducted in Guangdong province of China from September to December 2010 using a multistage sampling method to randomly sample adults aged 18 years and older. SHS exposure was defined as inhalation by non-smokers of the smoke exhaled from smokers for at least 1 day a week in the past 30 days. Depressive symptoms were measured using the nine-item Patient Health Questionnaire. The zero-inflate negative binomial regression models were used to explore the associations between SHS exposure and depressive symptoms. A total of 2771 non-smokers were included in this study, with mean age of 49.6 ± 14.0 years and 70.3% of females. The prevalence of depressive symptoms was significantly higher in participants with SHS exposure than in those without exposure (incidence rate ratio (IRR) = 1.32, 95% confidence interval (CI) 1.16–1.51), and there were similar positive associations for SHS exposure in medical facilities (IRR = 1.37, 95% CI 1.17–1.61) and in schools (IRR = 1.46, 95% CI 1.20–1.77). Notably, there was a monotonically increasing dose-response relationship between frequency of SHS exposure and depressive symptoms. When differentiating this relationship by the dimensions of depressive symptoms, there were similar dose-response relationships for cognitive-affective and somatic symptoms. When differentiating this relationship by sex, only females showed a significant dose-response relationship. Our findings suggest dose-response relationships between SHS exposure and depressive symptoms in sex-specific and symptom-specific manners. Future longitudinal studies are needed to establish the biological mechanisms of the impact of SHS exposure.

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Predictors of functional limitation trajectories after injury in a nationally representative U.S. older adult population

Annals of Epidemiology ◽

10.1016/j.annepidem.2015.08.012 ◽

2015 ◽

Vol 25 (12) ◽

pp. 894-900 ◽

Cited By ~ 4

Author(s):

Teresa M. Bell ◽

Junling Wang ◽

Robert Nolly ◽

Esra Ozdenerol ◽

George Relyea ◽

...

Keyword(s):

Older Adult ◽

Adult Population ◽

Functional Limitation ◽

Nationally Representative ◽

Older Adult Population

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The Association between Age and Depressive Symptoms among Older Men and Women in Europe. Findings from SHARE

Comparative Population Studies ◽

10.12765/cpos-2011-02 ◽

2011 ◽

Vol 36 (1) ◽

Cited By ~ 3

Author(s):

Isabella Buber ◽

Henriette Engelhardt

Keyword(s):

Mental Health ◽

Depressive Symptoms ◽

Negative Binomial ◽

Explanatory Power ◽

Negative Binomial Regression ◽

Negative Binomial Regression Model ◽

Negative Effects ◽

Symptoms Of Depression ◽

Binomial Regression ◽

Older Men And Women

Empirical evidence of the effects of age on depressive symptoms is mixed, ranging from positive to zero to negative effects, depending on the modelling of the age-depression profile. This paper uses internationally comparative data to analyse the association between age and the prevalence of symptoms of depression, controlling for well-known determinants of mental health. Based on the first wave of the Survey of Health, Ageing and Retirement in Europe (SHARE), depressive symptoms of 28,538 persons aged 50 to 89 from eleven European countries and Israel are analysed using a negative binomial regression model. The results indicate that the number of depressive symptoms measured by EURO-D scores increase with age and are higher among women than among men. When including socio-demographic characteristics, health conditions and economic strains, the association between depressive symptoms and age vanishes for men, and even reverses for women. Thus, the association between age and mental health is mediated by the health and living conditions of older persons; age by itself has no explanatory power.

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Aging: Public Policy

Encyclopedia of Social Work ◽

10.1093/acrefore/9780199975839.013.511 ◽

2013 ◽

Author(s):

Jeanette C. Takamura

Keyword(s):

Public Policy ◽

Population Policy ◽

Personal Responsibility ◽

Adult Population ◽

The United States ◽

Older Americans ◽

Health Security ◽

Conservative Policy ◽

Older Adult Population ◽

The U.S

Public policy advances in the field of aging in the United States have lagged compared to the growth of the older adult population. Policy adjustments have been driven by ideological perspectives and have been largely incremental. In recent years, conservative policy makers have sought through various legislative vehicles to eliminate or curb entitlement programs, proposing private sector solutions and touting the importance of an “ownership society” in which individual citizens assume personal responsibility for their economic and health security. The election of a Democratic majority in the U.S. House and the slim margin of votes held by Democrats in the U.S. Senate may mean a shift in aging policy directions that strengthens Social Security, Medicare, and Medicaid, if the newly elected members are able to maintain their seats over time. The results of the 2008 presidential election will also determine how the social, economic, and other policy concerns will be addressed as the baby boomers join the ranks of older Americans.

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Understanding Socioenvironmental Contributors to Racial and Ethnic Disparities in Disability Among Older Americans

Research on Aging ◽

10.1177/0164027516681165 ◽

2016 ◽

Vol 40 (2) ◽

pp. 103-130 ◽

Cited By ~ 9

Author(s):

Allison B. Brenner ◽

Philippa J. Clarke

Keyword(s):

Socioeconomic Factors ◽

Home Environment ◽

Negative Binomial ◽

Ethnic Disparities ◽

Negative Binomial Regression ◽

Physical Impairment ◽

Older Americans ◽

Binomial Regression ◽

Racial Ethnic

Our understanding of the mechanisms through which racial/ethnic disparities in disability in older adults develop and are maintained is limited. We examined the role of physical impairment, socioeconomic factors and health for racial/ethnic disparities in activities of daily living (ADL), and the modifying role of the indoor home environment. Data come from the National Health and Aging Trends Study ( N = 5,640), and negative binomial regression models were specified separately for men and women. Blacks and Hispanics reported more ADL difficulty than Whites. Living in homes with clutter was associated with higher rates of ADL difficulty, but it was not related to racial/ethnic disparities. Racial/ethnic differences were explained by physical impairment for men, but not for women. Socioeconomic factors and health accounted for remaining disparities for Black, but not for Hispanic women. Attention to individual and environmental factors is necessary to fully understand and address race/ethnic disparities in disability in older Americans.

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Association between serum uric acid and depressive symptoms stratified by low-grade inflammation status

Scientific Reports ◽

10.1038/s41598-021-99312-x ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Sang Jin Rhee ◽

Hyunju Lee ◽

Yong Min Ahn

Keyword(s):

Uric Acid ◽

Depressive Symptoms ◽

Serum Uric Acid ◽

Negative Binomial ◽

Negative Binomial Regression ◽

Low Grade ◽

Cross Sectional ◽

Patient Health ◽

Hs Crp ◽

Low Grade Inflammation

AbstractDespite increasing evidence for an association between circulating uric acid (UA) and depression, the directionality of this association remains unclear and is potentially moderated by low-grade inflammation. Thus, the present study aimed to investigate the cross-sectional association between serum UA concentration and depressive symptoms in Korean individuals with and without low-grade inflammation, as measured using serum high-specific C-reactive protein (hs-CRP) levels. The final study sample comprised 4188 participants, aged 19–79 years, from the Korea National Health and Nutrition Examination Study 2016. Data on serum uric acid (UA) concentrations, serum hs-CRP levels, Patient Health Questionnaire-9 (PHQ-9) scores, and relative covariates were retrieved. Negative binomial regression with adjustment for the complex sample design was used to analyze the associations. After adjusting for covariates, log-transformed serum UA concentrations and total PHQ-9 scores were positively associated (incidence rate ratio [IRR] = 1.34 [95% confidence interval [CI] = 1.09–1.66]) for participants without low-grade inflammation and inversely associated (IRR = 0.64 [95% CI = 0.45–0.92]) for participants with low-grade inflammation. In conclusion, the direction of the association between serum UA and depressive symptoms was the opposite in participants with and without low-grade inflammation. The study has the limitation of potential uncontrolled confounders.

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