scholarly journals Aetiology of late-life depression

1999 ◽  
Vol 5 (6) ◽  
pp. 435-442 ◽  
Author(s):  
Robert Baldwin
Keyword(s):  
Depressive Disorder ◽  
Old Age ◽  
Clinical Presentation ◽  
Late Onset ◽  
Adult Life ◽  
Later Life ◽  
Late Life Depression ◽  
Heterogeneous Condition ◽  
The Subject ◽  
New Research

Depressive disorder has no single cause. Arguably, in old age it is a more heterogeneous condition than in earlier adult life, in both clinical presentation and causation. A broad distinction is often made between early- and late-onset depression in later life. The aetiology of these may differ and is currently the subject of new research.

Late-life depression

2014 ◽  
Vol 29 (S3) ◽  
pp. 577-577 ◽  
Author(s):  
K. Ritchie
Keyword(s):  
Depressive Symptomatology ◽  
Late Onset ◽  
Late Life ◽  
Later Life ◽  
The Elderly ◽  
Conclusive Evidence ◽  
First Episode ◽  
Hormonal Changes ◽  
Late Life Depression ◽  
Incident Cases

Late-life depression is highly heterogeneous in clinical presentation, and is also commonly resistant to treatment. While some cases are a continuation of the chronic course of illness beginning in early adulthood, a large number of persons will have a first episode of depression in later life following alife-time of relatively good mental health. While incident cases of major depression tend to decrease with age, the number of persons with clinically significant depressive symptomatology rises. À distinction has often been made between early-onset and late-onset depression, however, there is no conclusive evidence to suggest these are distinct clinical entities. On the other hand observations from a fifteen year prospective population study of psychiatric disorder in the elderly (the ESPRIT Study) supports the alternative idea that depression may be divided into sub-types according to postulated aetiology; for example depression with a strong genetic component, related to hormonal changes, the consequence of trauma; the result of cerebrovascular insult. Exposure to these putative causes may be more common at different points in the life span, thus suggesting age-differences. Our research further suggests that even cases of depression appearing for the first time in late-life, may be initially triggered by risk factors occurring decades before. Our findings suggest, for example, that childhood events may lead to changes in the biology of stress management, which continue throughout life, increasing vulnerability to depression and persisting even after effective treatment of symptoms. Together these observations suggest it may be more meaningful to classify depression in the elderly according to probable principle precipitating factors rather than age.

Ego Functioning in Old Age: Early Adult Life Antecedents

1974 ◽  
Vol 5 (2) ◽  
pp. 157-179 ◽  
Author(s):  
Joseph A. Kuypers
Keyword(s):  
Socioeconomic Status ◽  
Old Age ◽  
Young Adulthood ◽  
Family Relations ◽  
Adult Life ◽  
Early Adult Life ◽  
Intellectual Capacity ◽  
Alternative Measures ◽  
The Subject ◽  
And Behavior

Do aspects of intelligence, health, socioeconomic status, personality, and family relations in young adulthood relate to adaptability in old age? Correlations are reported between three alternative measures of old age adaptability (coping, defense, and disorganization) and measures in five areas of status and behavior in young adulthood (representing a 40 year longitudinal analysis). Coping ability in old age is most associated with variations in intellectual capacity and socioeconomic status, especially for women. Ego disorganization in old age is most related to variations in socioeconomic status and family relations in young adulthood. The data suggest that adaptability in old age is associated with environments and behaviors early along the adult life course but that the strength of over-time connection varies according to the sex of the subject, the model of old age adaptability used, and the aspects of status and behavior considered in young adulthood.

A Descriptive Study of First Presentation Psychosis in Old Age

1999 ◽  
Vol 33 (6) ◽  
pp. 814-824 ◽  
Author(s):  
Anne Hassett
Keyword(s):  
Old Age ◽  
Cognitive Deficits ◽  
Late Onset ◽  
Descriptive Study ◽  
First Episode ◽  
Elderly Subjects ◽  
Openness To Change ◽  
Adult Personality ◽  
First Onset ◽  
The Subject

Objective: This report describes the characteristics of a sample of elderly subjects presenting with their first episode of psychosis in old age. Method: Forty-six (38 females and eight males) patients were assessed on a variety of cognitive, psychopathological and personality measures. Results: Female preponderance, social isolation and early cognitive deficits were findings of this study which have been replicated by other studies of late-onset psychosis. In contrast, hearing loss was not overly represented in this sample. Personality style differed significantly from accepted norms of adult personality traits, with lower scores for dimensional ratings of neuroticism, extraversion and openness to change. Conclusions: The descriptive findings in this study suggest that psychosocial factors require further investigation in patients presenting with late-onset psychosis. Comparison with younger first-onset psychotic subjects will be the subject of a later report.

scholarly journals Schizophrenia and delusional disorders with onset in later life

2002 ◽  
Vol 24 (suppl 1) ◽  
pp. 81-86 ◽  
Author(s):  
Anne Hassett
Keyword(s):  
Clinical Presentation ◽  
Late Onset ◽  
Early Adulthood ◽  
Treatment Strategies ◽  
Later Life ◽  
Psychotic Symptoms ◽  
Sensory Impairment ◽  
Schizophrenia Spectrum ◽  
History Of ◽  
First Time

Schizophrenia-spectrum illness is most commonly associated with an onset in early adulthood. When non-affective psychotic symptoms emerge for the first time in later life, the clinical presentation has both similarities and differences with earlier-onset syndromes. This situation has resulted in continuing debate about the nosological status of late-onset psychosis, and whether there are particular risk factors associated with this late-life peak in incidence. Although early cognitive decline is frequently identified in these patients, studies, to date, have not established if there is a relationship with the dementing illnesses of old age. Sensory impairment, social isolation, and a family history of schizophrenia have been associated with late-onset psychosis, but appear to exert a nonspecific influence on vulnerability. While diagnostic issues remain unresolved, clinicians need to formulate treatment strategies that most appropriately address the constellation of symptoms in the clinical presentation of their psychotic elderly patients.

Is 70 the new 60? Extending American women’s and men’s working lives

2017 ◽  
Author(s):  
Debra Street ◽  
Joanne Tompkins
Keyword(s):  
Old Age ◽  
Older Workers ◽  
Critical Role ◽  
Adult Life ◽  
Later Life ◽  
Unpaid Care ◽  
Global Recession ◽  
Working Lives ◽  
The Us ◽  
Time Work

Although the United States economy rebounded relatively quickly from the global recession, older workers wanting or needing to work longer confront similar limitations to those in other countries. The critical role of Social Security for shaping patterns of later life work is considered, alongside the US neoliberal stance that minimizes family-friendly policies that would support more equal gender outcomes for work and retirement. Instead, the structure of employment markets, persistent gender gaps in pay, raced and gendered outcomes related to sources and amounts of retirement income, and increasing retirement ages that compel some of the most vulnerable Americans to work longer are considered. The concept of extended working life is considered at both ends of the adult life course, taking into account the challenges of both young and older workers given the realities of the US labour market, underscoring the importance of taking both labour supply and demand into account to fully understand the implications of extended working lives. Although women bear a disproportionate burden of unpaid care, few compensatory policies exist to ensure their income adequacy in old age. That, combined with ageism in the American workplace, make older women who have interrupted work histories or lifetimes of low paid or part time work very vulnerable to experiencing precarious employment, or low incomes/poverty in old age.

scholarly journals Neurological findings in late-onset depressive disorder: comparison of individuals with and without depression

2005 ◽  
Vol 186 (4) ◽  
pp. 308-313 ◽  
Author(s):  
Robert Baldwin ◽  
Suzanne Jeffries ◽  
Alan Jackson ◽  
Caroline Sutcliffe ◽  
Neil Thacker ◽  
...  
Keyword(s):  
Depressive Disorder ◽  
Rating Scale ◽  
Late Onset ◽  
Late Life ◽  
Brain Dysfunction ◽  
Late Life Depression ◽  
Neurological Signs ◽  
Complex Motor ◽  
Organic Brain ◽  
Control Study

BackgroundOrganic factors are thought to be important in late-life depressive disorder but there have been few studies specifically of neurological signs.AimsTo compare neurological signs in a group of patients with late-onset depression and in healthy controls.MethodA case–control study comparing 50 patients with depression and 35 controls on three measures of central nervous system (CNS) signs: a structured CNS examination, the Neurological Evaluation Scale (NES) and the Webster rating scale for parkinsonism.ResultsAfter adjusting for major depression at the time of evaluation and prescription of tranquillisers, ratings on two of the NES sub-scales (complex motor sequencing and ‘other’ signs) and on the Webster scale were significantly higher (more impaired) in patients compared with controls (P <0.05). With logistic regression, the NES was the main measure predictive of group outcome. There were no differences in scores of vascular risk or white matter but patients had more atrophy.ConclusionsThe findings add to the evidence that late-life depression is associated with organic brain dysfunction, perhaps mediated by neurodegeneration or subtle vascular impairment. The use of the NES in subjects with depression should be replicated.

scholarly journals THE RELATION OF APICAL TUBERCULOSIS OF ADULTS TO THE FOCAL TUBERCULOSIS OF CHILDREN

1917 ◽  
Vol 26 (2) ◽  
pp. 263-277 ◽  
Author(s):  
Eugene L. Opie
Keyword(s):  
Pulmonary Tuberculosis ◽  
Old Age ◽  
Adult Life ◽  
Later Life ◽  
The Body ◽  
Common Belief ◽  
Focal Lesions ◽  
Tuberculous Lesion ◽  
Apical Lesions ◽  
Chronic Course

The age incidence of focal tuberculous lesions of the lungs demonstrates that they have their origin in most instances in childhood. Focal lesions which heal have been found at all ages after the 2nd year of life, but in more than half of all individuals these lesions are acquired between the ages of 10 and 18 years. In the period between 18 and 30 years at least 85 per cent of all individuals have 'acquired focal tuberculous lesions. The occurrence of tuberculous infection in the lungs, in regional lymphatic nodes, or in some other organs of the body such as the gastrointestinal tract and its lymphatic system, is nearly universal but doubtless a few individuals escape. That focal tuberculous lesions of the lung are occasionally acquired during adult life is shown by the slight increase in the proportion of those with these lesions as age increases from 18 years to old age. Apical lesions of the lung make their appearance in later childhood and occur with increasing frequency from adolescence to old age (50 per cent). After the 2nd year of life focal tuberculous lesions occurring in situations other than the apices of the lungs tend to heal and after the 10th year focal lesions are almost invariably encapsulated and latent or healed. Fatal tuberculosis after the 10th year is with few exceptions apical in origin. The apices are not only more susceptible to infection in later life but once infected afford less resistance to the extension of the lesion. The present series of cases has furnished opportunity to observe the character of the apical lesion in lungs of individuals previously infected with tuberculosis. With one exception the apical lesion (in eight instances) has pursued a chronic course and, encapsulated by fibrous tissue, has remained limited to the extreme apex of the lung. In one instance in a woman with advanced malignant disease chronic pulmonary tuberculosis has been progressive. Tuberculosis of the apices in those who have previously acquired a focal tuberculous lesion has pursued a chronic course and in most instances has remained latent or has completely healed. A very small group of instances of fatal pulmonary tuberculosis suggests that apical lesions in those who have not undergone previous infection may assume an unusually severe character. One instance of apical tuberculosis unaccompanied by focal lesions and followed by tuberculosis of the thoracic duct and disseminated miliary tuberculosis has been especially significant. Apical tuberculosis unaccompanied by evidence of preexisting tuberculosis may be accompanied by tuberculosis of the regional lymphatic nodes, whereas apical tuberculosis in an individual with a preexistent focal tuberculous lesion is not followed by tuberculosis of adjacent lymphatic nodes. It is well known that tuberculosis in previously uninfected animals is followed by tuberculosis of adjacent lymphatic nodes, whereas a second infection fails to implicate the regional lymphatic nodes. This relation has been well illustrated by the lungs of a monkey which acquired in confinement acute tuberculous pneumonia limited to the left lung; the lymphatic nodes on this side were greatly enlarged and caseous. The following observations indicate that apical tuberculosis of adults is not the result of infantile tuberculosis but is caused by subsequent infection: (a) Apical tuberculosis does not have its highest incidence, in accordance with common belief, in early adult life when focal infections acquired in childhood are relatively fresh and active but is more common in later life when the focal lesions of childhood have in most instances completely healed. It is noteworthy that most of these apical lesions of later life pursue a chronic course and are discovered at autopsy in individuals who have died from other causes. (b) The well characterized lesions of tuberculosis acquired in childhood and found in adults with apical lesions are almost invariably calcified and healed. The apical lesion is in most instances relatively fresh and caseous whereas the focal pulmonary lesion and associated lesions of regional lymphatic nodes exhibit no evidence of activity. (c) In a large proportion of instances of associated focal and apical tuberculosis the focal lesion is in one lung, whereas the apical lesion is limited to the opposite apex. This relation affords no support to the view that tuberculous lesions may be transmitted to the apex by way of the lymphatics.

The impact of frailty on depressive disorder in later life: Findings from the Netherlands Study of depression in older persons

2017 ◽  
Vol 43 ◽  
pp. 66-72 ◽  
Author(s):  
R.M. Collard ◽  
M.H.L. Arts ◽  
A.H. Schene ◽  
P. Naarding ◽  
R.C. Oude Voshaar ◽  
...  
Keyword(s):  
Depressive Disorder ◽  
Older Persons ◽  
Psychiatric Treatment ◽  
Depressive Symptomatology ◽  
Later Life ◽  
Prognostic Impact ◽  
Late Life Depression ◽  
Physical Frailty ◽  
Frailty Phenotype ◽  
The Impact

AbstractBackground:Physical frailty and depressive symptoms are reciprocally related in community-based studies, but its prognostic impact on depressive disorder remains unknown.Methods:A cohort of 378 older persons (≥ 60 years) suffering from a depressive disorder (DSM-IV criteria) was reassessed at two-year follow-up. Depressive symptom severity was assessed every six months with the Inventory of Depressive Symptomatology, including a mood, motivational, and somatic subscale. Frailty was assessed according to the physical frailty phenotype at the baseline examination.Results:For each additional frailty component, the odds of non-remission was 1.24 [95% CI = 1.01–1.52] (P = 040). Linear mixed models showed that only improvement of the motivational (P < 001) subscale and the somatic subscale (P = 003) of the IDS over time were dependent on the frailty severity.Conclusions:Physical frailty negatively impacts the course of late-life depression. Since only improvement of mood symptoms was independent of frailty severity, one may hypothesize that frailty and residual depression are easily mixed-up in psychiatric treatment.

Images of Aging in the Psychotherapeutic Context

GeroPsych ◽  
2015 ◽  
Vol 28 (2) ◽  
pp. 47-55 ◽  
Author(s):  
Eva-Marie Kessler ◽  
Catherine E. Bowen
Keyword(s):  
Old Age ◽  
Diagnostic Tests ◽  
Aging Process ◽  
Developmental Psychology ◽  
Mental Representations ◽  
Later Life ◽  
Future Research ◽  
Psychotherapeutic Process ◽  
Images Of Aging ◽  
Client Communication

Both psychotherapists and their clients have mental representations of old age and the aging process. In this conceptual review, we draw on available research from gerontology, social and developmental psychology, and communication science to consider how these “images of aging” may affect the psychotherapeutic process with older clients. On the basis of selected empirical findings we hypothesize that such images may affect the pathways to psychotherapy in later life, therapist-client communication, client performance on diagnostic tests as well as how therapists select and apply a therapeutic method. We posit that interventions to help both older clients and therapists to reflect on their own images of aging may increase the likelihood of successful treatment. We conclude by making suggestions for future research.

Performance Management Transformation

2020 ◽  
Keyword(s):  
Organizational Performance ◽  
Performance Management ◽  
High Performance ◽  
Best Practice ◽  
Call To Action ◽  
Daily Work ◽  
The Past ◽  
Great Debate ◽  
The Subject ◽  
New Research

No other talent process has been the subject of such great debate and emotion as performance management (PM). For decades, different strategies have been tried to improve PM processes, yielding an endless cycle of reform to capture the next “flavor-of-the-day” PM trend. The past 5 years, however, have brought novel thinking that is different from past trends. Companies are reducing their formal processes, driving performance-based cultures, and embedding effective PM behavior into daily work rather than relying on annual reviews to drive these. Through case studies provided from leading organizations, this book illustrates the range of PM processes that companies are using today. These show a shift away from adopting someone else’s best practice; instead, companies are designing bespoke PM processes that fit their specific strategy, climate, and needs. Leading PM thought leaders offer their views about the state of PM today, what we have learned and where we need to focus future efforts, including provocative new research that shows what matters most in driving high performance. This book is a call to action for talent management professionals to go beyond traditional best practice and provide thought leadership in designing PM processes and systems that will enhance both individual and organizational performance.

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