Background: Mental health of the elderly is one of the health problems in most societies. This study aimed to investigate the relationship between spiritual well-being (SWB), resilience, and depression among the elderly. Methods: This descriptive-correlational study was conducted on 384 elderly selected by convenience-sampling method. Abbreviated Mental Test (AMT), SWB, Connor-Davidson Resilience Scale (CD-RISC), and Geriatric Depression Scale (GDS) were used to collect the data. Pearson correlation coefficient, analysis of variance and independent t-test were used to analyze the data. A path analysis was also run to test the direct and indirect effects of SWB and resilience on the depression variable. Results: The results showed a statistically significant positive correlation between SWB and resilience (r = 0.458, P < 0.001), a statistically significant negative correlation between SWB and depression (r = À0.471, P < 0.001) and between resilience and depression (r = À0.371, P < 0.001). Path analysis showed that SWB and resilience directly affected depression while SWB indirectly affected depression. Conclusions: The results indicated there was an inverse relationship between SWB and resilience with depression. Religious programs and appropriate educational programs can help improve SWB and promote resilience in the elderly, which will reduce their depression symptoms.

Background: The population of old people in Iran is increasing, as well as the prevalence of dementia. For early detection and intervention, proper dementia screening tools are needed. The clock drawing test (CDT) is a quick, inexpensive and well accepted test for the screening of cognitive problems. Objectives: The aim of this study was to evaluate psychometric properties of CDT among aged people in Iran. Methods: The clock drawing test, using Shulman's modified scoring method, was performed on 74 aged members of Iran's Alzheimer Association services in Tehran from May to September 2012 convenient sampling method was used. The participants with the following characteristics were selected: age 60 years or more, able to communicate and with 4 years of formal education. Using the diagnostic criteria for dementia of the diagnostic and statistical manual of mental disorder, 4th edition, (DSM-IV) as a gold standard, the difference between CDT mean scores of dementia and non-dementia patients were evaluated. The receiver operating characteristics (ROC) curve was used to determine the optimal cut off points for CDT using the 20th version of SPSS. Results: The mean age of participants was 72 ± 7.95 years. There was a significant difference between the scores of participants with and without dementia (P < 0.001). The best cut off point was 3/4 with 90% sensitivity and 73% specificity. The area under the ROC curve was 0.896 (P < 0.001), which indicates proper accuracy of the test. Conclusions: The clock drawing test has acceptable psychometric properties among the aged people of Iran. The Persian version of CDT can be applied for the screening and monitoring cognitive problems in this population. Further studies are required to assess the impact of literacy level and different scoring systems on the accuracy of the results obtained by the CDT.

Context: Depression is a major health problem in geriatric population and has many adverse consequences. The aim of this study was to review the existing literature on psychosocial factors that protect against depression in later life.Evidence Acquisition: A MEDLINE systematic search was done via Pubmed and Sciencedirect web pages to gather the published articles on psychosocial factors of late life depression First, the titles and abstracts reviewed and relevant articles were selected according to the inclusion criteria. Then full texts of the selected articles obtained, read, and data were extracted and categorized.Results: There were 204 articles on psychosocial factors of late life depression in community dwelling older adults and among them 29 articles included protective factors. Reading them carefully, protective factors were extracted and organized into 5 main categories: Demographic factors, psychological factors, social factors, health related factors and also spiritual factors. Conclusion:Psychosocial factors protecting older adults against depression are diverse. Identification of the modifiable ones and provision of appropriate interventions to enhance them, can be helpful in preventing geriatric depression.

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Background: Depression is a major health problem in old age that is closely related to cultural and social contexts. Studies have shown a higher prevalence of geriatric depression in Iran. Objectives: This qualitative content analysis study aimed to explore the psychosocial factors related to the experience of late life depression in older people in Iran. Methods: This qualitative study with a directed content analysis approach was conducted in Tehran in 2015. First, a systematic search in major English and Persian data banks was carried out to develop an analysis matrix. The participants with maximum variations in demographic characteristics were recruited from psychiatric clinics, if they met inclusion criteria, which included: 1) age of 60 years and, and 2) diagnosis above of depression by a psychiatrist in the last six months. Semi-structured interviews were conducted up to reaching data saturation. The interviews were recorded, transcribed verbatim and transformed into meaning units and codes. The codes were then analyzing matrix and reviewed again to form new subcategories and categories. Results: Twelve old people participated in this study. Analyzing the data, 534 codes in 42 subcategories and 17categories led to six main themes which included: 1) transition of value system, 2) role changes, 3) life concerns, 4) inadequacy of social relations, 5) regrets, and 6) impaired health and function. Discussion: From the perspective of the depressed old people, recent changes in values and impaired social relations, made them feel lonely confronting life struggles and inevitable changes of roles, health status and function. Some context-based interventions such as community alertness and providing more formal support may be helpful in preventing late life depression.