Objetivos : Constatando que a depressão é comum em idosos institucionalizados, associando-se à solidão, à ansiedade e à afetividade, pretendemos descrever a evolução da depressão durante dois anos e verificar que fatores se associam a essa evolução. Métodos : Em um estudo de coorte prospectivo em dois momentos (2011 e 2013), avaliamos 83 idosos institucionalizados, com idade no primeiro momento entre os 60 e os 100 anos, sendo 79,5% mulheres, 86,7% sem companheiro(a), e 72,3% com algum grau de escolaridade. Usamos a Escala Geriátrica da Depressão (GDS), a Escala de Solidão (UCLA-L), o Inventário Geriátrico de Ansiedade (GAI) e a Lista de Afetos Positivos e Negativos (PANAS). Resultados: Verificamos que 59,0% mantiveram a depressão e 10,8% desenvolveram depressão. Os idosos com depressão tiveram significativamente piores resultados na UCLA, GAI e PANAS, e os não depressivos tiveram afetos positivos mais altos. Quanto à evolução da depressão, os idosos que mantiveram depressão tiveram inicialmente pontuações elevadas no GDS, GAI, UCLA e na subescala PANAS negativo e pontuações baixas na subescala PANAS positivo. Esses idosos apresentaram associadamente um agravamento dos sentimentos de solidão, dos sintomas ansiosos e do afeto negativo ao longo dos dois anos. Os que desenvolveram depressão tiveram, no primeiro momento, pontuações elevadas na UCLA. Conclusões: Os sintomas de depressão com ou sem solidão no momento inicial, o agravamento da solidão, a ansiedade, o afeto negativo e o baixo afeto positivo poderão ser fatores de risco para a manutenção da depressão. A solidão poderá ainda ser um fator de risco para o desenvolvimento de depressão.
IntroductionCognitive rehabilitation techniques, reminiscence therapy, and reality orientation therapy, have shown an impact on cognition, life satisfaction, mood, and on the progression of cognitive decline in elderly.ObjectivesTo test the effectiveness of a NRGP on the cognitive and emotional functioning of institutionalized elderly.Methods.Designsingle blind randomized controlled study with paired groups.ParticipantsCoimbra institutionalized elderly, aged between 64-92 (N = 88) with cognitive impairment no dementia, mostly women (75.0%).Interventionrandomization of participants to the rehabilitation group/RG (n = 41) and to the comparison/waiting-list group/CG (n = 23). NRGP involved groups of five elders, and took 90 min. per day, once a week, for 10 weeks.MeasurementsMini-Mental State Examination/MMSE, Frontal Evaluation Battery/FAB, Geriatric Depression Scale/GDS.AnalysisWe used general linear model with repeated measures analysis of variance.ResultsRG improved significantly on cognitive, and executive function (p < 0.001), and CG worsened on cognitive, executive function, and mood (p < 0.01). There was a significant effect on the MMSE, FAB, and GDS scores, after excluding pre-rehabilitation scores as covariates [F (1, 81) = 43.98, p < 0.001; η2 = 0.35; F(1, 80) = 28.37, p < 0.001; η2 = 0.26; F(1, 79) = 19.66, p < 0.001; η2 = 0.20].ConclusionsA NRGP including cognitive rehabilitation, reminiscence therapy, and reality orientation proved to be effective on cognitive and executive functioning, and on depressive symptoms of institutionalized elders with cognitive impairment no dementia.
Introduction/objectivesDepression is very common among institutionalized elders. Because of the increased risk of cognitive impairment/dementia, and mortality we want to describe the evolution of depression and analyze predictive factors.MethodsIn the Aging Trajectories Study (Instituto Superior Miguel Torga - Coimbra), we followed up a sample of 83 nondemented persons (M ± SD baseline age = 79.51 ± 6.58; men: 17; women: 66). In a 2-year prospective cohort analysis (2010-2011, and 2013), we assessed depression using the Geriatric Depressive Scale/GDS as screening tool and the Mini International Neuropsychiatric Interview to diagnose depression. We also used the UCLA Loneliness Scale, the Geriatric Anxiety Inventory/GAI, the Positive and Negative Affect Scale/PANAS. Sociodemographics, and health were control variables. We performed a multinomial logistic regression to identify predicitive factors.ResultsFifty participants had depression at baseline, nine developed, 49 maintained, nine remitted, and 16 maintained without depression.Having depression was associated with worse scores in UCLA, GAI, and PANAS. Not having depression was correlated with higher positive affect.Baseline higher GAI and UCLA, and lower positive affect and satisfaction predicted recurrent depression.Improvement in GDS, GAI, and positive affect predicted depression remission.ConclusionResults show that depression is a concern issue for professionals working with institutionalized elderly. Anxiety, loneliness, low positive affect and satisfaction constitute a risk factor for maintaing depression in institutionalized elderly and low anxiety and depressive symptoms are a protective factors for depression. These results could be used in depression prevention programs.
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