scholarly journals Effects of Mobile App–Based Intervention for Depression in Middle-Aged and Older Adults: Mixed Methods Feasibility Study (Preprint)

2020 ◽  
Author(s):  
Christine E Gould ◽  
Chalise Carlson ◽  
Flora Ma ◽  
Valerie Forman-Hoffman ◽  
Kristian Ranta ◽  
...  
Keyword(s):  
Older Adults ◽  
Depressive Symptoms ◽  
Pilot Study ◽  
Health Program ◽  
Mobile App ◽  
Anxiety Symptoms ◽  
Community Dwelling ◽  
Health Interventions ◽  
Middle Aged ◽  
Patient Reported

BACKGROUND Digital mental health interventions may help middle-aged and older adults with depression overcome barriers to accessing traditional care, but few studies have investigated their use in this population. OBJECTIVE This pilot study examines the feasibility, acceptability, and potential efficacy of the Meru Health Program, an 8-week mobile app–delivered intervention. METHODS A total of 20 community-dwelling middle-aged and older adults (age: mean 61.7 years, SD 11.3) with elevated depressive symptoms participated in a single-arm pilot study investigating the Meru Health Program, an app-delivered intervention supported by remote therapists. The program primarily uses mindfulness and cognitive behavioral skills to target depressive symptoms. A semistructured interview was completed at the baseline to establish current psychiatric diagnoses. Depressive symptoms were measured using the Patient Health Questionnaire and Patient-Reported Outcomes Measurement Information System (PROMIS) depression measures. Anxiety symptoms were measured using the Generalized Anxiety Disorder Scale and the PROMIS Anxiety measure. User experience and acceptability were examined through surveys and qualitative interviews. RESULTS In total, 90% (18/20) of the participants completed the program, with 75% (15/20) completing at least 7 of the 8 introductory weekly lessons. On average, participants completed 60 minutes of practice and exchanged 5 messages with their therapists every week. The app was rated as helpful by 89% (17/19) participants. Significant decreases in depressive (P=.03) and anxiety symptom measures (P=.01) were found; 45% (9/20) of participants showed clinically significant improvement in either depressive symptoms or anxiety symptoms. CONCLUSIONS The findings suggest that the commercially available Meru Health Program may be feasible, acceptable, and potentially beneficial to middle-aged and older adults. Although larger controlled trials are needed to demonstrate efficacy, these findings suggest that digital health interventions may benefit adults of all ages.

scholarly journals Effects of Mobile App–Based Intervention for Depression in Middle-Aged and Older Adults: Mixed Methods Feasibility Study

10.2196/25808 ◽  
2021 ◽  
Vol 5 (6) ◽  
pp. e25808
Author(s):  
Christine E Gould ◽  
Chalise Carlson ◽  
Flora Ma ◽  
Valerie Forman-Hoffman ◽  
Kristian Ranta ◽  
...  
Keyword(s):  
Older Adults ◽  
Depressive Symptoms ◽  
Pilot Study ◽  
Health Program ◽  
Mobile App ◽  
Anxiety Symptoms ◽  
Community Dwelling ◽  
Health Interventions ◽  
Middle Aged ◽  
Patient Reported

Background Digital mental health interventions may help middle-aged and older adults with depression overcome barriers to accessing traditional care, but few studies have investigated their use in this population. Objective This pilot study examines the feasibility, acceptability, and potential efficacy of the Meru Health Program, an 8-week mobile app–delivered intervention. Methods A total of 20 community-dwelling middle-aged and older adults (age: mean 61.7 years, SD 11.3) with elevated depressive symptoms participated in a single-arm pilot study investigating the Meru Health Program, an app-delivered intervention supported by remote therapists. The program primarily uses mindfulness and cognitive behavioral skills to target depressive symptoms. A semistructured interview was completed at the baseline to establish current psychiatric diagnoses. Depressive symptoms were measured using the Patient Health Questionnaire and Patient-Reported Outcomes Measurement Information System (PROMIS) depression measures. Anxiety symptoms were measured using the Generalized Anxiety Disorder Scale and the PROMIS Anxiety measure. User experience and acceptability were examined through surveys and qualitative interviews. Results In total, 90% (18/20) of the participants completed the program, with 75% (15/20) completing at least 7 of the 8 introductory weekly lessons. On average, participants completed 60 minutes of practice and exchanged 5 messages with their therapists every week. The app was rated as helpful by 89% (17/19) participants. Significant decreases in depressive (P=.03) and anxiety symptom measures (P=.01) were found; 45% (9/20) of participants showed clinically significant improvement in either depressive symptoms or anxiety symptoms. Conclusions The findings suggest that the commercially available Meru Health Program may be feasible, acceptable, and potentially beneficial to middle-aged and older adults. Although larger controlled trials are needed to demonstrate efficacy, these findings suggest that digital health interventions may benefit adults of all ages.

Major depression in community-dwelling middle-aged and older adults: prevalence and 2- and 4-year follow-up symptoms

2004 ◽  
Vol 34 (4) ◽  
pp. 623-634 ◽  
Author(s):  
RAMIN MOJTABAI ◽  
MARK OLFSON
Keyword(s):  
Older Adults ◽  
Depressive Symptoms ◽  
Major Depression ◽  
Short Form ◽  
Large Population ◽  
Population Sample ◽  
Depression Scale ◽  
Community Dwelling ◽  
Middle Aged

Background. Although major depression is a common condition across the age range, there is some evidence from clinical studies that it may be more persistent and disabling in older adults. This study examined the demographic, socio-economic and clinical factors associated with major depression and with persistence of depressive symptoms at 2- and 4-year follow-ups in a large population sample of middle-aged and older adults.Method. In a sample of 9747 participants aged over 50 in the 1996 wave of the US Health and Retirement Study, the authors assessed the 12-month prevalence of major depression using the Composite International Diagnostic Interview – Short Form (CIDI-SF). Significant depressive symptoms at the time of 1996, 1998 and 2000 interviews were assessed using a short form of the Center for Epidemiological Studies Depression Scale (CES-D).Results. The 12-month prevalence of CIDI-SF major depression was 6·6%. With age, prevalence declined, but the likelihood of significant depressive symptoms at follow-ups increased. Both prevalence and persistence of significant depressive symptoms at follow-ups were associated with socio-economic disadvantage and physical illness. Persistence of depressive symptoms at follow-ups was also associated with symptoms of anhedonia, feelings of worthlessness, and thoughts of death at baseline.Conclusions. Sociodemographic, physical health and a specific profile of depressive symptoms are associated with a poorer course of major depression in the middle-aged and older adults. These indicators may identify a subgroup of patients in need of more careful follow-up and intensive treatment.

scholarly journals Mobile Intervention Outcomes Compared Pre and Post-Shelter-in-Place for Middle Aged and Older Adults

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 861-861
Author(s):  
Chalise Carlson ◽  
Ana Alfaro ◽  
Christina Chick ◽  
Martha Bruce ◽  
Valerie Forman Hoffman ◽  
...  
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Depressive Symptoms ◽  
Mobile App ◽  
Depression Symptoms ◽  
Older Individuals ◽  
Middle Aged ◽  
Behavioral Skills ◽  
Patient Health ◽  
Health Quality

Abstract The Meru Health Program (MHP), a mobile app-based intervention targeting depressive symptoms, teaches mindfulness and cognitive behavioral skills through video lessons and practices. MHP includes integrated asynchronous therapist and peer support. Our aim was to examine whether using the MHP reduced loneliness and improved mental health quality of life (QoL) in middle-aged and older adults with depressive symptoms (Patient Health Questionairre-9 [PHQ-9] ≥ 7). The timing of this study partially overlapped with the emergence of the SARS-CoV-2 (COVID-19) pandemic resulting in California’s shelter-in-place (SIP) orders. Fifty participants (42 enrolled prior to SIP) completed baseline assessments with a mean age of 57.06 (SD = 11.26; Range: 40-81 years) exhibiting mild to moderate depression symptoms (PHQ-9: M = 12.28, SD = 5.47). Participants enrolled pre-SIP exhibited significant improvements in QoL, F(1,38) = 12.61, p = .001, η2 = .25, and significant declines in loneliness, F(1,38) = 5.42, p = .03, η2 = .13. Improvements in QoL were found for post-SIP participants as well, F(1,44) = 6.02, p = .02, η2 = .12. In contrast, loneliness did not improve for the post-SIP cohort, perhaps alluding to the increased impact of social isolation during SIP. Our findings indicate MHP can improve QoL symptoms before and during SIP. It is possible that middle-aged and older individuals may require more individualized support during SIP to help alleviate loneliness when social connection is severely restricted. MHP remains a promising and scalable solution for those middle-aged and older adults struggling with mental health symptoms.

Age and recognition for one’s creative hobby are associated with fewer depressive symptoms in middle-aged and older adults.

2020 ◽  
Author(s):  
Sarah M. Israel ◽  
Carolyn E. Adams-Price ◽  
Courtney J. Bolstad ◽  
Danielle K. Nadorff
Keyword(s):  
Older Adults ◽  
Depressive Symptoms ◽  
Middle Aged

scholarly journals COVID-19 lockdown has altered the dynamics between affective symptoms and social isolation among older adults: results from a longitudinal network analysis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Junhong Yu ◽  
Rathi Mahendran
Keyword(s):  
Older Adults ◽  
Social Isolation ◽  
Anxiety Symptoms ◽  
Community Dwelling ◽  
Depression Symptoms ◽  
Network Analyses ◽  
Correlation Networks ◽  
Affective Symptoms ◽  
Tightly Coupled ◽  
Community Dwelling Older Adults

AbstractThe COVID-19 lockdown has drastically limited social interactions and brought about a climate of fear and uncertainty. These circumstances not only increased affective symptoms and social isolation among community dwelling older adults but also alter the dynamics between them. Using network analyses, we study the changes in these dynamics before and during the lockdown. Community-dwelling older adults (N = 419) completed questionnaires assessing depression, anxiety, and social isolation, before the COVID-19 pandemic, as part of a cohort study, and during the lockdown period. The total scores of these questionnaires were compared across time. For the network analyses, partial correlation networks were constructed using items in the questionnaires as nodes, separately at both timepoints. Changes in edges, as well as nodal and bridge centrality were examined across time. Depression and anxiety symptoms, and social isolation had significantly increased during the lockdown. Significant changes were observed across time on several edges. Greater connectivity between the affective and social isolation nodes at lockdown was observed. Depression symptoms have become more tightly coupled across individuals, and so were the anxiety symptoms. Depression symptoms have also become slightly decoupled from those of anxiety. These changing network dynamics reflect the greater influence of social isolation on affective symptoms across individuals and an increased vulnerability to affective disorders. These findings provide novel perspectives and translational implications on the changing mental health context amidst a COVID-19 pandemic situation.

scholarly journals The Impact of Work Hours on Depressive Symptoms among Koreans Aged 45 and Over

2021 ◽  
Vol 18 (3) ◽  
pp. 853
Author(s):  
Juyeong Kim ◽  
Eun-Cheol Park
Keyword(s):  
Older Adults ◽  
Depressive Symptoms ◽  
Social Services ◽  
Depression Scale ◽  
Epidemiological Studies ◽  
Work Hours ◽  
Middle Aged ◽  
Health Studies ◽  
Males And Females ◽  
The Impact

Background: Given the documented importance of employment for middle-aged and older adults’ mental health, studies of the association between their number of work hours and depressive symptoms are needed. Objectives: To examine the association between the number of work hours and depressive symptoms in Korean aged 45 and over. Methods: We used data from the first wave to fourth wave of the Korea Longitudinal Study of Aging. Using the first wave at baseline, data included 9845 individuals. Depressive symptoms were measured using the 10-item Center for Epidemiological Studies Depression scale. We performed a longitudinal analysis to estimate the prevalence of depressive symptoms by work hours. Results: Both unemployed males and females aged 45–65 years were associated with higher depressive symptoms (β = 0.59, p < 0.001; β = 0.32, p < 0.001). Females working ≥ 69 h were associated with higher depressive symptoms compared to those working 41–68 h (β = 0.25, p = 0.013). Among those both middle-aged and older adults, both males and females unemployed were associated with higher depressive symptoms. Those middle-aged female working ≥69 h were associated with higher depressive symptoms. Conclusions: An increase in depressive symptoms was associated with unemployed males and females working ≥69 h compared to those working 41–68 h. Although this association was found among middle-aged individuals, a decrease in depressive symptoms in both sexes was associated with working 1–40 h. Depressive symptoms should decrease by implementing employment policies and social services to encourage employers to support middle-aged and older adults in the workforce considering their sex and age differences.

scholarly journals Health and social care service utilisation and associated expenditure among community-dwelling older adults with depressive symptoms

2021 ◽  
Vol 30 ◽  
Author(s):  
Shiyu Lu ◽  
Tianyin Liu ◽  
Gloria H. Y. Wong ◽  
Dara K. Y. Leung ◽  
Lesley C. Y. Sze ◽  
...  
Keyword(s):  
Older Adults ◽  
Depressive Symptoms ◽  
Symptom Severity ◽  
Social Care ◽  
Late Life ◽  
Community Dwelling ◽  
Service Utilisation ◽  
Late Life Depression ◽  
Social Care Service ◽  
Health And Social Care

Abstract Aims Late-life depression has substantial impacts on individuals, families and society. Knowledge gaps remain in estimating the economic impacts associated with late-life depression by symptom severity, which has implications for resource prioritisation and research design (such as in modelling). This study examined the incremental health and social care expenditure of depressive symptoms by severity. Methods We analysed data collected from 2707 older adults aged 60 years and over in Hong Kong. The Patient Health Questionnaire-9 (PHQ-9) and the Client Service Receipt Inventory were used, respectively, to measure depressive symptoms and service utilisation as a basis for calculating care expenditure. Two-part models were used to estimate the incremental expenditure associated with symptom severity over 1 year. Results The average PHQ-9 score was 6.3 (standard deviation, s.d. = 4.0). The percentages of respondents with mild, moderate and moderately severe symptoms and non-depressed were 51.8%, 13.5%, 3.7% and 31.0%, respectively. Overall, the moderately severe group generated the largest average incremental expenditure (US$5886; 95% CI 1126–10 647 or a 272% increase), followed by the mild group (US$3849; 95% CI 2520–5177 or a 176% increase) and the moderate group (US$1843; 95% CI 854–2831, or 85% increase). Non-psychiatric healthcare was the main cost component in a mild symptom group, after controlling for other chronic conditions and covariates. The average incremental association between PHQ-9 score and overall care expenditure peaked at PHQ-9 score of 4 (US$691; 95% CI 444–939), then gradually fell to negative between scores of 12 (US$ - 35; 95% CI - 530 to 460) and 19 (US$ -171; 95% CI - 417 to 76) and soared to positive and rebounded at the score of 23 (US$601; 95% CI -1652 to 2854). Conclusions The association between depressive symptoms and care expenditure is stronger among older adults with mild and moderately severe symptoms. Older adults with the same symptom severity have different care utilisation and expenditure patterns. Non-psychiatric healthcare is the major cost element. These findings inform ways to optimise policy efforts to improve the financial sustainability of health and long-term care systems, including the involvement of primary care physicians and other geriatric healthcare providers in preventing and treating depression among older adults and related budgeting and accounting issues across services.

scholarly journals Predictors of frailty among Chinese community-dwelling older adults with type 2 diabetes: a cross-sectional survey

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e041578
Author(s):  
Linglin Kong ◽  
Huimin Zhao ◽  
Junyao Fan ◽  
Quan Wang ◽  
Jie Li ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Older Adults ◽  
Depressive Symptoms ◽  
Community Health ◽  
Community Dwelling ◽  
Central China ◽  
Chinese Community ◽  
Cross Sectional ◽  
Community Dwelling Older Adults

ObjectivesTo assess the prevalence of frailty and identify predictors of frailty among Chinese community-dwelling older adults with type 2 diabetes.DesignA cross-sectional design.SettingTwo community health centres in central China.Participants291 community-dwelling older adults aged ≥65 years with type 2 diabetes.Main outcome measuresData were collected via face-to-face interviews, anthropometric measurements, laboratory tests and community health files. The main outcome measure was frailty, as assessed by the frailty phenotype criteria. The multivariate logistic regression model was used to identify the predictors of frailty.ResultsThe prevalence of prefrailty and frailty were 51.5% and 19.2%, respectively. The significant predictors of frailty included alcohol drinking (ex-drinker) (OR 4.461, 95% CI 1.079 to 18.438), glycated haemoglobin (OR 1.434, 95% CI 1.045 to 1.968), nutritional status (malnutrition risk/malnutrition) (OR 8.062, 95% CI 2.470 to 26.317), depressive symptoms (OR 1.438, 95% CI 1.166 to 1.773) and exercise behaviour (OR 0.796, 95% CI 0.716 to 0.884).ConclusionsA high prevalence of frailty was found among older adults with type 2 diabetes in the Chinese community. Frailty identification and multifaceted interventions should be developed for this population, taking into consideration proper glycaemic control, nutritional instruction, depressive symptoms improvement and enhancement of self-care behaviours.

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