Gender Disparities in the Treatment of Late-Life Depression: Qualitative and Quantitative Findings From the IMPACT Trial

Hinton, Ladson; Zweifach, Mark; Tang, Lingqi; Unützer, Jürgen; Oishi, Sabine

doi:10.1097/01.jgp.0000219282.32915.a4

Cited by 99 publications

(98 citation statements)

References 28 publications

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“…This is in agreement with a finding on subthreshold depression in older community residents (Hybels et al 2002). Men are usually more reluctant to admit or assimilate the diagnosis, leading to worse resources for resilience or coping (Hinton et al 2006;Murray et al 2006). In fact, the general pattern (of lower mortality in individuals with detected depression) was not confirmed in men, among whom depression detection did not seem to make a notable difference (Fig.…”

Section: Discussionsupporting

confidence: 76%

Association of detected depression and undetected depressive symptoms with long-term mortality in a cohort of institutionalised older people

Damián

Pastor-Barriuso

Valderrama-Gama

et al. 2016

Epidemiol Psychiatr Sci

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Background. Studies on depression and mortality in nursing homes have shown inconclusive findings, and none has studied the role of detection. We sought to measure the association of depression with long-term all-cause mortality in institutionalised older people and evaluate a potential modification in the association by its detection status.Methods. We selected a stratified cluster sample of 591 residents aged 75 years or older (mean age 84.5 years) living in residential and nursing homes of Madrid, Spain, who were free of severe cognitive impairment at the 1998-1999 baseline interview. Mortality was ascertained until age 105 years or September 2013 (median/maximum follow-up 4.8/15.2 years) through linkage to the Spanish National Death Index. Detected depression was defined at baseline as a physician's diagnosis or antidepressant use, undetected depression as significant depressive symptoms (score of 4 or higher on the ten-item version of the Geriatric Depression Scale) without documented diagnosis or treatment, and no depression as the absence of diagnosis, treatment, and symptoms. Constant and age-dependent hazard ratios for mortality comparing detected and undetected depression with no depression were estimated using Cox models, and absolute years of life gained and lost using Weibull models.Results. The baseline prevalences of detected and undetected depression were 25.9 and 18.8%, respectively. A total of 499 participants died during 3575 person-years of follow-up. In models adjusted for age, sex, type of facility, number of chronic conditions, and functional dependency, overall depression was not associated with long-term all-cause mortality (hazard ratio 0.87, 95% confidence interval (CI): 0.70-1.08). However, compared with no depression, detected depression showed lower mortality (hazard ratio 0.63, 95% CI: 0.46-0.86), while undetected depression registered higher, not statistically significant, mortality (hazard ratio 1.35, 95% CI: 0.98-1.86). The median life expectancy increased by 1.8 years (95% CI: −3.1 to 6.7 years) in residents with detected depression and decreased by 6.3 years (95% CI: 2.6-10.1 years) in those undetected. Results were more marked in women than men and they were robust to the exclusion of antidepressants from the definition of depression and also to the use of a stricter cut-off for the presence of depressive symptoms.Conclusions. The long-term mortality risk associated with depression in nursing homes depends on its detection status, with better prognosis in residents with detected depression and worse in those undetected. The absolute impact of undetected depressive symptoms in terms of life expectancy can be prominent.

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Section: Discussionsupporting

confidence: 76%

Association of detected depression and undetected depressive symptoms with long-term mortality in a cohort of institutionalised older people

Damián

Pastor-Barriuso

Valderrama-Gama

et al. 2016

Epidemiol Psychiatr Sci

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“…Data from the Health and Retirement Study 2002 indicates that more than 11% of men aged 55 years and older experience clinically relevant depressive symptoms (He, Sengupta, Velkoff, & DeBarros, 2005;The Health & Retirement Study, n.d.). This percentage, likely an underestimate of the actual incidence of depression among middle-aged and older men (Hinton, Zweifach, Oishi, Tang, & Unützer, 2006), points to the prevalence of the illness in this population. In fact, depression is the most common mental illness and the greatest risk factor among men who commit suicide (Schmutte, O'Connell, Weiland, Lawless, & Davidson, 2009), is associated with sleep disturbances in older men (Paudel et al, 2008), and incorrect diagnosis and treatment of the disorder has been linked with higher public health care costs (Carta, Hardoy, Kovess, Dell'Osso, & Carpiniello, 2003).…”

mentioning

confidence: 99%

Grandfather Involvement and Aging Men’s Mental Health

Bates

Taylor

2012

Am J Mens Health

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The mental health of aging men is an understudied social issue. Although it is widely accepted that meaningful family relationships are associated with fewer depressive symptoms and greater positive affect, scholars have largely overlooked relationships between grandfathers and grandchildren as being beneficial to men's mental health. This study investigates the differences in the depressive symptoms and positive affect of 351 grandfathers. Using a cluster analytic technique, participants were categorized as involved, passive, and disengaged based on their frequency of contact, level of commitment, and participation in activities with grandchildren. Comparative analyses indicate that involved grandfathers had fewer depressive symptoms than disengaged grandfathers. Involved grandfathers had significantly higher scores on positive affect than disengaged grandfathers, and passive grandfathers had significantly higher scores on positive affect than disengaged grandfathers. This study provides evidence that grandfather-grandchild relationships influence aging men's mental health. Implications for practitioners working with aging men are discussed.

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“…This result is somewhat surprising given the prevalence of depression diagnosis and use of primary care appear to be higher in women. [16][17][18] The reasons for the lack of sex differences require more research. The most frequently prescribed type of antidepressant, SSRIs, is comparable to past American Veteran Affairs studies involving patients with Parkinson disease and depression.…”

Section: Discussionmentioning

confidence: 99%

Using Canadian Primary Care Sentinel Surveillance Network data to examine depression in patients with a diagnosis of Parkinson disease: a retrospective cohort study

et al. 2016

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Gender Disparities in the Treatment of Late-Life Depression: Qualitative and Quantitative Findings From the IMPACT Trial

Cited by 99 publications

References 28 publications

Association of detected depression and undetected depressive symptoms with long-term mortality in a cohort of institutionalised older people

Association of detected depression and undetected depressive symptoms with long-term mortality in a cohort of institutionalised older people

Grandfather Involvement and Aging Men’s Mental Health

Using Canadian Primary Care Sentinel Surveillance Network data to examine depression in patients with a diagnosis of Parkinson disease: a retrospective cohort study

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