Gender Differences in the Relationship between Living alone and Depressive Symptoms in Elderly Korean Adults

Author(s):  
Young Bum KIM ◽  
Seung Hee LEE

Background: This study examined gender differences in the relationship between living alone and depressive symptoms in elderly Korean adults and the variables that influence this relationship. Methods: We conducted a secondary analysis using fourth-wave data from adults 65 yr of age or older who participated in the Korean Longitudinal Study of Aging. Depressive symptoms were measured using the 10-item short-form of the Center for Epidemiological Studies Depression Scale. Multiple logistic regression analyses were used. Results: After controlling for the factors of formal and informal social activities, financial support from children, employment, activities of daily living, instrumental activities of daily living, self-rated health, frequency of meals, and gender, living alone (AOR=1.45, 95% CI =1.09-1.93, P=0.010) was an independent risk factor that contributed to depressive symptoms in late life. Living alone was more likely to elevate depressive symptoms in older women but not in older men. Conclusion: Gender differences in the depressive effect of living alone in late life may differ across diverse cultures.

2012 ◽  
pp. 261-268
Author(s):  
Salvatore La Carrubba ◽  
Loredana Manna ◽  
Carmelina Rinollo ◽  
Antonino Mazzone ◽  
Gualberto Gussoni ◽  
...  

Introduction: There are few data on the prevalence of depression among acute patients with comorbidities. The current study aimed to determine the prevalence of depressive symptoms in hospitalized patients admitted to Internal Medicine Units and the correlation between these symptoms and comorbidities and disability indexes. Materials and methods: All consecutive patients admitted to 26 Internal Medicine Units of the Italian National Public Health System in Sicily, Italy, from September 2001 to March 2002 were screened. Within 24 hours of admission, patients were administered the Geriatric Depression Scale (GDS), Mini-Mental State Examination, Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADL) and Charlson’s Comorbidity Index. Results: 1,947 subjects were included in the analyses. Of the patients, 509 (26.1%) showed depressive symptoms (indicated by GDS score > 15). Depression was significantly associated (univariate analyses) with hypertension (OR 1.45; CI 95% 1.18-1.79), diabetes (OR 1.48, CI 95% 1.17-1.87), cerebrovascular disease (OR 1.50, CI 95% 1.08-2.07), cirrhosis (OR 1.49, CI 95% 1.01- 2.19), ADL score (OR 0.72: CI 95% 0.63-0.82), and IADL score (OR 0.83; CI 95% 0.78-0.87), but not with Charlson’s Comorbidity Index (OR 1.04; CI 95% 0.98-1.10). Multivariate analysis showed that independent predictive factors for depression were age (OR 1.02, CI 95% 1.01-1.02), female gender (OR 2.29, CI 95% 1.83 - 2.87), and IADL score (OR 0.86, CI 95% 0.81 - 0.93). Conclusions: The data suggest that depressive symptoms are not linked to worse clinical conditions but are associated with the loss of autonomy in Instrumental Activities of Daily Living.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Anup K. Mishra ◽  
Marjorie Skubic ◽  
Mihail Popescu ◽  
Kari Lane ◽  
Marilyn Rantz ◽  
...  

Abstract Background Higher levels of functional health in older adults leads to higher quality of life and improves the ability to age-in-place. Tracking functional health objectively could help clinicians to make decisions for interventions in case of health deterioration. Even though several geriatric assessments capture several aspects of functional health, there is limited research in longitudinally tracking personalized functional health of older adults using a combination of these assessments. Methods We used geriatric assessment data collected from 150 older adults to develop and validate a functional health prediction model based on risks associated with falls, hospitalizations, emergency visits, and death. We used mixed effects logistic regression to construct the model. The geriatric assessments included were Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADL), Mini-Mental State Examination (MMSE), Geriatric Depression Scale (GDS), and Short Form 12 (SF12). Construct validators such as fall risks associated with model predictions, and case studies with functional health trajectories were used to validate the model. Results The model is shown to separate samples with and without adverse health event outcomes with an area under the receiver operating characteristic curve (AUC) of > 0.85. The model could predict emergency visit or hospitalization with an AUC of 0.72 (95% CI 0.65–0.79), fall with an AUC of 0.86 (95% CI 0.83–0.89), fall with hospitalization with an AUC of 0.89 (95% CI 0.85–0.92), and mortality with an AUC of 0.93 (95% CI 0.88–0.97). Multiple comparisons of means using Turkey HSD test show that model prediction means for samples with no adverse health events versus samples with fall, hospitalization, and death were statistically significant (p < 0.001). Case studies for individual residents using predicted functional health trajectories show that changes in model predictions over time correspond to critical health changes in older adults. Conclusions The personalized functional health tracking may provide clinicians with a longitudinal view of overall functional health in older adults to help address the early detection of deterioration trends and decide appropriate interventions. It can also help older adults and family members take proactive steps to improve functional health.


2017 ◽  
Vol 11 (1) ◽  
pp. 54-61 ◽  
Author(s):  
Christina Martins Borges Lima ◽  
Heloisa Veiga Dias Alves ◽  
Daniel Correa Mograbi ◽  
Flávia Furtado Pereira ◽  
Jesus Landeira Fernandez ◽  
...  

ABSTRACT Objective: To describe the performance on basic cognitive tasks, instrumental activities of daily living, and depressive symptoms of a community-based sample of elderly adults in Rio de Janeiro (Brazil) who participated in multiple physical, social, and cognitive activities at government-run community centers. Methods: A total of 264 educated older adults (> 60 years of age of both genders) were evaluated by the Brief Cognitive Screening Battery (BCSB), Lawton's and Pfeffer's activities of daily living indexes, and the Geriatric Depressive Scale (GDS) . Results: The mean age of the sample was 75.7 years. The participants had a mean of 9.3 years of formal education. With the exception of the Clock Drawing Test (CDT), mean scores on the cognitive tests were consistent with the values in the literature. Only 6.4% of the sample had some kind of dependence for activities of daily living. The results of the Geriatric Depression Scale (GDS-15) indicated mild symptoms of depression in 16.8% of the sample. Conclusion: This study provided important demographic, cognitive, and functional characteristics of a specific community-based sample of elderly adults in Rio de Janeiro, Brazil.


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Ching-Fu Weng ◽  
Kun-Pei Lin ◽  
Feng-Ping Lu ◽  
Jen-Hau Chen ◽  
Chiung-Jung Wen ◽  
...  

Abstract Background The three geriatric conditions, depression, dementia and delirium (3D’s), are common among hospitalized older patients and often lead to impairments of activities of daily living. The aim of this study is to explore the impact of depression, dementia and delirium on activities of daily living (ADLs) during and after hospitalization. Methods A prospective cohort study was conducted between 2012 and 2013 in a tertiary medical center in Taiwan. Patients who aged over 65 years and admitted to the geriatric ward were invited to this study. Geriatric Depression Scale Short Form, Mini-Mental State and Confusion Assessment Method were used to identify patients with depression, dementia and delirium on admission, respectively. Barthel Index (BI) was used to evaluate patients’ functional status on admission, at discharge, 30-day, 90-day and 180-day after discharge. Generalized Estimating Equation (GEE) was used to calculate the associations between 3 D’s and BI. Results One-hundred-and-forty-nine patients were included in this study. Twenty-seven patients (18.1%) had depression, 37 (24.8%) had dementia, and 85 (57.0%) had delirium. The study demonstrated that all the geriatric patients with functional decline presented gradual improvements of physical function up to 180 days after discharge. Whether depression exists did not substantially affect functional recovery after discharge, whilst either dementia or delirium could impede elder people functional status. The recovery of functional improvement in delirium or dementia was relatively irreversible when comparing with depression. Once delirium or dementia was diagnosed, poorer functional restore was expected. In brief, intensive work and strategies on modifying delirium or dementia should be put more effort as early as possible. Conclusions Old hospitalized patients with depression can recover well after adequate intervention. We emphasize that early detection of dementia and delirium is imperative in subsequent functional outcome, even if at or before admission. Comprehensive plan must be implemented timely.


2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii1-iii16
Author(s):  
Robert Briggs ◽  
Anne Buckley ◽  
Silvin Knight ◽  
Jim Meaney ◽  
Sean Kennelly ◽  
...  

Abstract Background Cerebral white matter hyperintensity (WMH) burden is a key biological risk factor underpinning late life depression (LLD) and cerebral hypoperfusion has been identified as an important cause of WMH. The aim of this study therefore is to clarify if orthostatic hypotension (OH) and lower systemic blood pressure (BP), both of which cause reduced cerebral blood flow, modify the relationship between depression and cerebral white matter disease in a cohort of community-dwelling older people aged ≥70 years. Methods This study uses data from wave 3 of TILDA. Participants were included if they were aged ≥70 years and had undergone assessment for depressive symptoms, brain MRI and cardiovascular measures. Depressive symptoms were measured using the 8-item Centre for Epidemiological Studies Depression Scale. Scheltens Score was used by a trained radiologist to calculate overall WMH burden. Orthostatic BP was measured by active stand. OH was defined as a drop in Systolic BP≥20 mmHg or drop in diastolic BP≥10 mmHg at 30, 60 or 90 seconds post standing. Results Participants with depressive symptoms (8%, 16/202) had a significantly higher burden of WMH measured by Scheltens Score (14.6 (95% CI:11.0–18.2) vs. 11.0 (95% CI:10.1–11.8); p=0.0211). Two-way interaction models demonstrated that the association between depressive symptoms and WMH burden is significant only in those with co-existing OH. Similarly, the two-way interaction between depressive symptoms and systolic BP shows that this association remains statistically significant only in those with both depressive symptoms and lower BP, i.e. <130 mm Hg. Conclusion This study demonstrates that depressive symptoms are associated with cerebral WMH in a cohort of community-dwelling people aged ≥70 years but this relationship is modified by co-existing OH or lower BP. Identifying the processes that lead to WMH accumulation and progression in depression is crucial in order to inform strategies aimed at preventing and ameliorating LLD.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
T. Muhammad ◽  
Trupti Meher

Abstract Background Late-life depression (LLD) is considered as a prodrome to dementia and plays a major role in the development of long-term cognitive disabilities. We aimed to estimate the prevalence and correlates of LLD and cognitive impairment and to explore their associations among older adults in India. Methods Data for this study was derived from the Longitudinal Ageing Study in India (LASI) Wave 1 (2017-18). The total sample included 31,464 (15,098 male and 16,366 female) older individuals aged 60 years and above. Cognitive impairment measured from various domains derived from the cognitive module of the Health and Retirement Study (HRS), and major depression measured by the CIDI-SF (Composite International Diagnostic Interview- Short Form) were the outcome variables. Descriptive, bivariate, and multivariable analyses were performed to fulfill the objectives of the study. Results The overall prevalence of LLD and cognitive impairment for the current sample was 8.7% and 13.7 % respectively. Among older individuals who have rated their health status as poor were 2.59 times more likely to suffer from LLD [OR: 2.59, CI: 2.24–2.99] as compared to their counterparts. The older adults who had difficulty in activities of daily living (ADL) and instrumental activities of daily living (IADL) were 74% and 69 % more likely to suffer from LLD. Similarly, older adults who were depressed had higher odds of cognitive impairment [OR: 1.22, CI: 1.01–1.48] compared to their counterparts. Also, older adults who were depressed and belonged to rural areas were 2.58 times [AOR: 2.58, CI: 1.95–3.41] more likely to be cognitively impaired than those who were not depressed and resided in urban areas. Conclusions Depression is linked to an increased risk of cognitive decline and dementia; therefore, failing to diagnose and treat LLD in later life may have significant health implications. Moreover, treatment under the care of a cognitive neurologist or geriatric psychiatrist is recommended for people with LLD and cognitive disability due to both the disorders' complex existence.


Author(s):  
Hyung-Seop Sim ◽  
Sang-Gyu Lee ◽  
Tae-Hyun Kim

Previous studies have shown that the physical functioning of older adults directly affects their depressive symptoms, and suicide is also closely associated with depression. This study determined the effects of physical functioning on depressive symptoms and suicidal ideation among older Korean adults. This study used data from the 2017 National Survey of Older Persons. Among the 10,299 participants in the entire data set, 10,083 participants were analyzed, excluding 216 participants who did not respond to the dependent variables. Data analyses included frequency, chi-squared tests, and binary logistic regression. The results indicated that physical functioning among older adults was associated with reduced depressive symptoms and suicidal ideation. Compared to the group that had non-limited activities of daily living (ADL) function, the group with limitations was 1.66 times more likely to show depressive symptoms (OR: 1.66, 95% CI: 1.36–2.02). Similar trends were observed in instrumental activities of daily living (IADL) (OR: 1.85, 95% CI: 1.58–2.16). When suicidal ideation was set as a dependent variable, IADL had a statistically significant impact (OR: 1.41, 95% CI: 1.14–1.74); however, ADL did not seem to have an impact. Moreover, both ADL (OR: 1.62, 95% CI: 1.35–1.94) and IADL (OR: 1.72, 95% CI: 1.49–1.97) had statistically significant effects when combined with depressive symptoms and suicidal ideation. Better physical functioning was associated with a reduction in depressive symptoms and suicidal ideation. This study emphasizes the importance of physical functioning when examining older adults’ mental health.


2019 ◽  
Author(s):  
Ching Fu Weng ◽  
Kun-Pei Lin ◽  
Feng-Ping Lu ◽  
Jen-Hau Chen ◽  
Chiung-Jung Wen ◽  
...  

Abstract Background The three geriatric conditions, depression, dementia and delirium (3D’s), are common among hospitalized older patients and often lead to impairments of activities of daily living. The aim of this study is to explore the impact of depression, dementia and delirium on activities of daily living (ADLs) during and after hospitalization. Methods A prospective cohort study was conducted between 2012 and 2013 in a tertiary medical center in Taiwan. Patients aged 65 years and older admitted to the geriatric ward were invited to this study. Geriatric Depression Scale Short Form, Mini-Mental State and Confusion Assessment Method were used to identify patients with depression, dementia and delirium on admission, respectively. Barthel Index (BI) was used to evaluate patients’ functional status on admission, at discharge, 30-day, 90-day and 180-day after discharge. Generalized Estimating Equation was used to calculate the associations between 3 D’s and BI. Results One-hundred-and-forty-nine patients were included in this study. Twenty-seven patients (18.1%) had depression, 37 (24.8%) had dementia, and 85 (57.0%) had delirium. There were significant lower BI scores in patients with dementia and delirium compared with those without up to 180 days after discharge, but no difference was seen in the depression group. In general, patients had delirium or dementia had worsening functional status, even though significant magnitude of improvements on BI scores after discharge. Conclusions Depression does not affect patients’ ADLs. On the other hand, dementia and delirium can persistently limit patients’ physical function. Future care should focus more on dementia and delirium to restore function.


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