Depression Among Older Adults: A 20-Year Update on Five Common Myths and Misconceptions

Haigh, Emily A. P.; Bogucki, Olivia E.; Sigmon, Sandra T.; Blazer, Dan G.

doi:10.1016/j.jagp.2017.06.011

Cited by 238 publications

(157 citation statements)

References 136 publications

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“…Older age predicted the poorest course in the Dutch study . Given the documented age differences in the etiology, diagnostics, and prognosis of depression, it is unclear whether the trajectories observed in younger adults would apply to older adults. The few studies that focused on older adults examined trajectories of depressive symptoms during follow‐ups among those with major depression at baseline and did not report on the diagnostic status of major depression during follow‐ups …”

Section: Introductionmentioning

confidence: 93%

Trajectories of major depression in middle‐aged and older adults: A population‐based study

Xiang

Cheng

2019

Int J Geriat Psychiatry

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Objectives This study aimed to examine depression trajectories and correlates in a nationally representative sample of middle‐aged and older adults in the United States. Methods The study sample consisted of 15 661 participants aged over 50 years from the US Health and Retirement Study. Major depression was assessed using the Composite International Diagnostic Interview (CIDI‐SF). Depression trajectories were identified using a group‐based trajectory modeling enhanced to account for nonrandom attrition. Multinomial logistic regression was conducted to investigate predictors of depression trajectories. Results Four depression trajectory groups were identified: “never” (85.8%), “increasing” (6.3%), “decreasing” (3.2%), and “persistently moderate/high” (4.7%). Baseline depressive symptom severity was a strong predictor of depression trajectories. Older age, male sex, and non‐Hispanic African American race were associated with a lower risk of the three trajectories with small to high depression burden, whereas chronic disease count was associated with a higher risk of these trajectories. The risk of being on the increasing trajectory increased with mobility difficulties. Difficulties in household activities predicted membership in the persistently moderate/high group. Conclusions A small but nonignorable proportion of middle‐aged and older adults have chronic major depression. Initial symptom severity and chronic disease burden are consistent risk factors for unfavorable depression trajectories and potential targets for screening and intervention.

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Section: Introductionmentioning

confidence: 93%

Trajectories of major depression in middle‐aged and older adults: A population‐based study

Xiang

Cheng

2019

Int J Geriat Psychiatry

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“…Some studies have highlighted that depression syndromes tend to become chronic and unremitting in a low but significant proportion (over 10%) of older adults . Chronic symptom conditions may show a poor prognosis, even though responsiveness to depression treatments is not undermined in old‐age . The cumulative effect of risk factors and the refusal to treatment may be involved in symptom persistence …”

Section: Discussionmentioning

confidence: 99%

Stability of clinically relevant depression symptoms in old‐age across 11 cohorts: a multi‐state study

Torre‐Luque

Sánchez-Niubò

et al. 2019

Acta Psychiatr Scand

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Stability of clinically relevant depression symptoms in old-age across 11 cohorts: a multi-state study de la Torre-Luque A, de la Fuente J, Sanchez-Niubo A, et al. Stability of clinically relevant depression symptoms in old-age across 11 cohorts: a multi-state study.Aims: To study the temporal dynamics of depression symptom episodes in old-age and the related influence of risk factors. Methods: Data from 41 362 old adults (54.61% women; mean age = 75.30, SD = 6.20) from the Ageing Trajectories of Health -Longitudinal Opportunities and Synergies (ATHLOS) project were used. Depressive symptoms were followed over an 18-year period. A multi-state model, comprising three statuses (no depression, new clinically relevant episode of symptoms and episode persistence), was fitted. Multinomial regression was used to study the role of risk factors in status transition. Results: Almost 85% of participants showed no depression, but prevalence became lower over time (B = À0.25, P < 0.001). New episode point prevalence was over 5.30% with a significant probability of moving to persistence status (transition probability = 0.27). Episode persistence became evident in 9.86% of episode status transitions, with increasing rate over time (B = 0.54, P < 0.01). Loneliness was proven to be the strongest predictor of episode emergence (OR = 17.76) and persistence (OR = 5.93). Conclusions: The course of depression tends to become chronic and unremitting in old-age. This study may help to plan interventions to tackle symptom escalation and risk factor influence. Significant outcomes• Most of older adults did not show any episode of clinically relevant symptoms of depression over time.• Almost one in four older individuals who showed a first episode of symptoms showed either episode persistence or episode recurrence later in life.• Loneliness was the most relevant factor in predicting symptom episode emergence and persistence. Limitations• This is an epidemiological study focused on providing a coarse-grained picture of late-life depression symptom dynamics.• Despite our large sample from multiple countries across the globe, cultural issues were not controlled in this study.

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“…Elise's disenfranchised grief likely contributed to her low mood that eventually became clinical depression and suicidal ideation. The prevalence of current depression among LGBT older adults ranges from 5% to 31%, two to three times higher than the estimated prevalence of depression among older adults in general . LGBT older adults are also likely to have at least equal, if not greater, risk for suicidal ideation and attempts compared with their non‐LGBT peers .…”

Section: Case Partmentioning

confidence: 95%

Meeting the Behavioral Health Needs of LGBT Older Adults

Goldhammer

Krinsky

Keuroghlian

2019

J American Geriatrics Society

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Lesbian, gay, bisexual, and transgender (LGBT) older adults face an increased risk of adverse behavioral health outcomes compared with the general population of older adults, yet little attention has been given to factors contributing to these disparities or to the ways in which clinicians can address these challenges. We present the case of a 75‐year‐old widowed lesbian woman with depression to illustrate how a lifetime of exposure to discrimination and stigma can produce high levels of stress and isolation while also fostering resilience. We then offer recommendations and resources for promoting psychological health among LGBT older adults by attending to the historical and cultural forces that affect LGBT health, and by implementing inclusive policies and programming. The article concludes with suggestions for advancing research and policy to help achieve greater health equity for LGBT older adults. J Am Geriatr Soc 67:1565–1570, 2019

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Depression Among Older Adults: A 20-Year Update on Five Common Myths and Misconceptions

Cited by 238 publications

References 136 publications

Trajectories of major depression in middle‐aged and older adults: A population‐based study

Trajectories of major depression in middle‐aged and older adults: A population‐based study

Stability of clinically relevant depression symptoms in old‐age across 11 cohorts: a multi‐state study

Meeting the Behavioral Health Needs of LGBT Older Adults

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