Coping and Depression in Old Age: A Literature Review

Abstract

Background/Aims: The interest in the relation between coping and depression in older persons is growing, but research on the concepts and instruments of coping in relation to depression among older persons is scarce and systematic reviews are lacking. With this background, we wanted to gain a systematic overview of this field by performing a systematic literature search. Methods: A computer-aided search in MEDLINE, CINAHL, PsycINFO, Embase, PubMed and www.salutogenesis.fi was conducted. We systematically searched for studies including coping and depression among persons 60 years of age and above. The included studies were evaluated according to predefined quality criteria. Results: Seventy-five studies, 38 clinical and 37 community settings, were included. Of these, 44 were evaluated to be of higher quality. Studies recruiting samples of older persons with a major depressive disorder, moderate or severe cognitive impairment or those who were dependent on care were scarce, thus the research is not representative of such samples. We found a huge variety of instruments assessing resources and strategies of coping (55 inventories). Although we found the relation between resources and strategies of coping and depression to be strong in the majority of studies, i.e. a higher sense of control and internal locus of control, more active strategies and positive religious coping were significantly associated with fewer symptoms of depression both in longitudinal and cross-sectional studies in clinical and community settings. Conclusion: Resources and strategies of coping are significantly associated with depressive symptoms in late life, but more research to systematize the field of coping and to validate the instruments of resources and strategies of coping in older populations is required, especially among older persons suffering from major depression and cognitive decline.

Depression and Quality of Life in Older Persons: A Review

“…We do not have a firm explanation for this, but it may be that persons with severe depression do not have the internal resources or capacity to adapt or adjust over time in the same way. It is evident that poor resources and coping strategies are associated with depressive disorder or severity of depressive symptoms in older persons [16]. …”

“…In addition to depression, the studies also looked at and controlled for a wide range of risk factors for poor QOL. In the studies that had long-term follow-up, factors other than the risk factors considered by the studies might also influence QOL, such as a functional decline, stressful life events [36], locus of control [16], or a response shift in the participants' view of standards and expectations for life [49]. Despite this, the findings in the longitudinal community studies we reviewed are unambiguous: depression affects QOL negatively over time.…”

“…Choosing a summary cutoff score for ‘high quality' remains arbitrary [55] but is usually within a threshold between 50 and 70% of the maximum obtainable points [16,53,56], and an a priori cutoff value for ‘high quality' above 60% was established. A study was considered to be ‘high quality' when it scored ≥7 points, and ‘low quality' when it scored ≤6 points of the maximum obtainable 11 points.…”

“…Depression in older persons (≥60 years) is prevalent in community living settings [2,3,4,5,6,7,8] and even more prevalent among older individuals who have been hospitalized due to serious physical diseases or institutionalized due to reduced physical and/or cognitive functioning [9,10,11,12]. Known risk factors for depression are female gender [1,13], older age [14,15], poorer coping abilities [16], physical morbidity [2,4,9,17,18,19,20,21,22], impaired level of functioning [2,5,6,9,13,18,23,24,25,26,27,28,29], reduced cognition [2,3,8,20,30,31,32,33,34,35], and bereavement [13,36]. Depression has been associated with an increased risk of mortality [2,37], and poorer outcome of treatment of physical disorders [4,10].…”

Mild Cognitive Impairment and Driving Cessation: A 3-Year Longitudinal Study

“…For some, this may necessitate that they stop driving, either immediately or in the longer term. This is associated with its own morbidity, including greater depression [8,9,10,11,12], poorer health [9,13], and lower community engagement [14,15]. For others, however, their driving skills may be relatively unaffected and they may be able to continue driving indefinitely.…”