Depression in older adults

Wilkinson, Philip; Ruane, Catherine; Tempest, Katie

doi:10.1136/bmj.k4922

Cited by 77 publications

(65 citation statements)

References 17 publications

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“…Depressive symptoms tend to increase when people transition from middle adulthood to older age, often together with worsening physical health. [1][2][3] Depressive symptoms among the elderly are frequently comorbid with chronic diseases, disability, and dementia, which may complicate differential diagnosis and treatment options. 3,4 Despite the adverse psychosocial effects of even mild depressive symptoms in older adults, 1,2 most people suffering from depressive symptoms do not receive adequate treatment.…”

Section: Introductionmentioning

confidence: 99%

“…[1][2][3] Depressive symptoms among the elderly are frequently comorbid with chronic diseases, disability, and dementia, which may complicate differential diagnosis and treatment options. 3,4 Despite the adverse psychosocial effects of even mild depressive symptoms in older adults, 1,2 most people suffering from depressive symptoms do not receive adequate treatment. 2,3,5 Several factors can contribute to why some individuals are more or less likely to be treated.…”

Section: Introductionmentioning

confidence: 99%

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Association of depressive symptoms with health care utilization in older adults: Longitudinal evidence from the Survey of Health, Aging, and Retirement in Europe

Komulainen

Gluschkoff

García-Velázquez

et al. 2020

Int J Geriat Psychiatry

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Objectives Many older adults with depression do not receive adequate treatment. Differences in treatment utilization may reflect the heterogeneous nature of depression, encompassing multiple distinct symptoms. We assessed whether depressive symptoms are differentially associated with subsequent health care utilization with respect to three outcomes as follows: (1) contact with a medical doctor (MD), (2) depression‐specific treatment, and (3) inpatient psychiatric admission. Methods/Design Longitudinal analyses were based on data from three follow‐up cycles conducted between 2004 and 2013 among 53,139 participants from the Survey of Health, Aging, and Retirement in Europe. Depressive symptoms were self‐reported at baseline of each follow‐up cycle using the 12‐item EURO‐D scale. Health care utilization was self‐reported at the end of each follow‐up cycle. Results After adjustment for sex, age, country of interview, follow‐up time, educational attainment, presence of a partner in household, body‐mass index, the number of chronic diseases, disability, average/prior frequency of contact with an MD, and all other depressive symptoms, people with more frequent contact with an MD had most often reported sleep problems (IRR = 1.10) and fatigue (IRR = 1.10), followed by sad/depressed mood, tearfulness, concentration problems, guilt, irritability, and changes in appetite. Those treated for depression had most often reported sad/depressed mood (OR = 2.18) and suicidal ideation (OR = 1.72), but also sleep problems, changes in appetite, fatigue, concentration problems, hopelessness, and irritability. Sad/depressed mood (OR = 2.87) was also associated with psychiatric inpatient admission. Similarly to other outcomes, appetite change, fatigue, and sleep problems were associated with inpatient admission. Conclusions Specific symptoms of depression may determine utilization of different types of health care among elderly.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Association of depressive symptoms with health care utilization in older adults: Longitudinal evidence from the Survey of Health, Aging, and Retirement in Europe

Komulainen

Gluschkoff

García-Velázquez

et al. 2020

Int J Geriat Psychiatry

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“…We conducted this case-control study in the rural setting of Bangladesh to assess the association between malnutrition and depression, and associated risk factors. A study reported that elderly depressed people have a greater risk of psychological disorders, which provoke suicide and suicidal behaviors [32]. The existing health care delivery system in Bangladesh provides limited health care for the elderly population in urban communities, but it is scarce in rural settings.…”

Section: Discussionmentioning

confidence: 99%

Malnutrition Concerning Geriatric Depression and Associated Risk Factors: A Community-based Case-control Study in Rural Elderly of Bangladesh

Islam¹,

Disu²,

Farjana³

et al. 2020

Preprint

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Background: Malnutrition and depression are highly prevalent in the elderly and can lead to disparaging outcomes. Analytical studies on malnutrition concerning geriatric depression (GD) are very scarce in Bangladesh, although the size of the elderly population is increasing fast in the country. The current study aimed to assess the association between malnutrition and depression and associated risk factors in the rural elderly.Methods: A case-control study was conducted in 600 elderly residents (aged ≥60 years) of three rural communities of Bangladesh from January to October 2019. Three hundred depressed elderly people were enrolled as cases and 300 non-depressed elderly individuals were included as community controls by matching the age and living area of the cases. We used a semi-structured questionnaire based on the Geriatric Depression Scale-15 and the Bangla version of Mini-Nutritional Assessment-Short Form to collect data through face-to-face interviews. Measures included baseline and personal characteristics, malnutrition, GD, and associated risk factors. A binary logistic regression model was fitted to identify variables associated with the risk of GD.Results: The study found no significant difference in gender (male Vs. female) between cases (44.0% Vs. 56.0%) and controls (46.0% Vs. 54.0%). The study revealed that malnutrition was significantly (p<0.01) higher in cases (56.0%) than in controls (18.0%). The malnourished elderly had around three times AOR=3.155; 95% CI: 1.53-6.49, p=0.002) more (risk of having depression than the controls. The unemployed elderly (AOR=4.964; 95% CI: 2.361-10.440; p=0.0001) and the elderly of the lower and middle class (AOR=3.654; 95% CI: 2.266-7.767; p=0.001) were more likely to experience depression. The elderly having a poor diet were more likely to experience depression (AOR=3.384; 95% CI: 1.764-6.703; p=0.0001). The single elderly (AOR=2.368; 95% CI: 1.762-6.524; p=0.001) and the elderly tobacco users (AOR=2.332; 95% CI: 1.663-5.623; p=0.003) were more likely to experience depression.Conclusions: A significant association between malnutrition and depression is evident in the rural elderly individuals of Bangladesh. It will be a prolific initiative if policymakers merge malnutrition and the risk factors associated with geriatric depression in the provision of universal health care for better health and well-being of the rural elderly populations.

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“…The World Health Organisation (WHO) estimates that more than twenty percent of adults aged sixty and over face mental health problems [1]. While depression is the most common across all age groups, depression in late life poses speci c challenges to the individual as well as to the healthcare system [2]. Symptoms of depression in old age may be different compared to younger cohorts, showing more vegetative and somatic, rather than affective symptoms; moreover, comorbidities and associated loss of physical functioning, cognitive impairment and chronic pain may overlap with depressive symptoms [3,4].…”

Section: Introductionmentioning

confidence: 99%

Perceived Need for Treatment and Non-utilization of Outpatient Psychotherapy in Old Age: Two Cohorts of a Nationwide Survey

Gellert

Lech

Kessler

et al. 2021

Preprint

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Objectives: Older adults with mental health problems may benefit from psychotherapy; however, their perceived need for treatment in relation with rates of non-utilization of outpatient psychotherapy as well as predisposing, enabling, and need factors proposed by Andersen’s Model of Health Care Utilization that account for these differences warrants further investigation.Method: We used two separate cohorts (2014 and 2019) of a German weighted nationwide telephone survey of German-speaking adults with N=12,197 participants. Across the two cohorts, 12.9% (weighted) reported perceived need for treatment for mental health problems and were selected for further analyses. Logistic Generalized Estimation Equations (GEE) was applied to model the associations between disposing (age, gender, single habiting, rural residency), enabling (education, general practitioner visit, general health status) non-utilization of psychotherapy (outcome) across cohorts in those with need for treatment (need factor).Results: In 2014/2019, out of 6,087/6,110 participants, 11.8%/14.0% reported perceived need for treatment due to mental health problems, which reflects a significant increase in prevalence from 2014 to 2019. Of those who reported perceived need for treatment, 36.4%/36.9% did not see a psychotherapist – where rates of non-utilization of psychotherapy were vastly higher in the oldest age (59.3/52.5%; 75+) category, than in the youngest (29.1/10.7%; 18-25 years). Concerning factors associated with non-utilization, multivariate findings indicated participation in the cohort of 2014 (OR 0.94), older age (Age 55-64 OR 1.02, Age 65-74 OR 1.47, Age 75+ OR 4.76), male gender (OR 0.83), lower educational status (OR 0.84), rural residency (OR 1.38), single habiting (OR 1.37), and seeing a GP (OR 1.39) to be related with non-utilization of psychotherapy; general health status was not significantly associated with non-utilization when GP contact was included in the model.Conclusion: There is a strong age effect in terms of non-utilization of outpatient psychotherapy. Individual characteristics of both healthcare professionals and patients and structural barriers may add to this picture. Effective strategies to increase psychotherapy rates in those older adults with unmet needs for treatment are required.

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Depression in older adults

Abstract: A neglected chronic disease as important as dementia

Cited by 77 publications

References 17 publications

Association of depressive symptoms with health care utilization in older adults: Longitudinal evidence from the Survey of Health, Aging, and Retirement in Europe

Association of depressive symptoms with health care utilization in older adults: Longitudinal evidence from the Survey of Health, Aging, and Retirement in Europe

Malnutrition Concerning Geriatric Depression and Associated Risk Factors: A Community-based Case-control Study in Rural Elderly of Bangladesh

Perceived Need for Treatment and Non-utilization of Outpatient Psychotherapy in Old Age: Two Cohorts of a Nationwide Survey

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