Depression as prognostic factor: 6 months follow-up in a geriatric institution

Depression in the elderly and especially in the demented elderly is common, but it is unclear to what extent depression affects the prognosis of dementia. We performed a 6 months follow-up on the elderly to evaluate the effect of depression on the prognosis of dementia. Among the residents in a Korean geriatric institution, a total of 141 elderly residents were included in this study. Those residents who had geriatric depression scale (GDS) scores over 20 were considered as having depression. The subjects were assessed at baseline and at 6 months later with the Korean Mini-Mental State Examination (K-MMSE), Clinical Dementia Rating (CDR) and Barthel index (BI). For all the 141 subjects, the changes of the K-MMSE, CDR and BI scores were first compared between the depressed and non-depressed groups. Then, for the 58 depressed subjects subdivided into three groups (36 subjects in the non-demented group, 14 subjects in the Alzheimer disease (AD) group and 8 subjects in the vascular dementia (VaD) group), the changes of the scores among the three groups were compared. For all subjects, the changes of the K-MMSE and CDR scores were more severe in the depressed group than in the non-depressed group. For the 58 depressed subjects, the changes were significantly different among the three groups (p=0.02 for the K-MMSE, p<0.001 for the CDR), and the changes were the most severe in the VaD group. For the elderly, depression has a significant influence on the cognitive deterioration. Moreover, the effect of depression on the cognitive dysfunction and on the prognosis of dementia is more severe in the demented elderly, and especially for the VaD patients.     

Predicting Depression in Mothers With and Without HIV: The Role of Social Support and Family Dynamics

Many women with HIV are primary caregivers for their children. Social factors, including family dynamics, play a major role in women’s depression. We hypothesized an impact of HIV seropositivity on greater depression mediated through poorer family functioning and social support. Participants include 332 Mothers Living with HIV (MLH) and 200 Neighborhood Control Mothers (NCM) recruited in Los Angeles County. The NCM were matched by neighborhood. All had children ages 6 through 20. Analyses using structural equation modeling (SEM) indicated HIV seropositivity was positively correlated with depression and negatively correlated with positive social support and effective family functioning. In a predictive path model, the relationship between having HIV and depressed mood was mediated by social support and family functioning. Findings offer explanation for increased depression resulting from HIV and social and family dynamics, and suggest innovative interventions to abate psychosocial health problems and lower risk for depression among women with HIV.     

Geriatric depression in advanced cancer patients: The effect of cognitive and physical functioning

Aim: The aims of the current study were to evaluate geriatric depression and its risk factors in advanced cancer patients. Methods: A cross‐sectional study was carried out in a palliative care unit in Greece. Patients completed the Geriatric Depression Scale, the M. D. Anderson Symptoms Instrument (MDASI), the Activities of Daily Living and the Mini‐Mental State Examination. Patients were included if they were aged >65 years, if they had cancer, were able to communicate and had agreed to sign informed consent. The final sample consisted of 92 elderly advanced cancer patients. Results: The prevalence of depression was found to be 67.4%. The univariate comparison between the depressed elderly and non‐depressed group showed that patients with metastases were found to be 2.2‐fold more likely to suffer from geriatric depression compared with those without metastases (P = 0.074). Patients with moderate or severe cognitive impairment were found to be 3.61‐fold more likely to suffer from geriatric depression in comparison with those with normal cognitive function (P = 0.019). In the multiple logistic regression analysis, elderly with cognitive impairment were 3.3‐fold more likely to have geriatric depression than those without (adjusted odds ratio = 3.3 [95% CI 0.99–10.74], P = 0.052) and MDASI factor 1 was consistently a significant risk factor for depression in the elderly; when MDASI factor 1 increased by 1 unit, the odds of being classified as depressed increased by 7.6%. Conclusions: The present study found that cognitive impairment and symptoms such as enjoyment of life, walking, relationship with people, general activity, sadness and pain (MDASI F1) are strong independent predictors of depression in the elderly. Geriatr Gerontol Int 2013; 13: 281–288. .     

Depression,Social Support,and Functional Abilities

Abstract

This longitudinal cohort study compared older adults, a group of whom were depressed at baseline and at a 3-month follow-up, and a group of whom were depressed at baseline, but not at 3 months. Patients participated as part of a larger study, which included 146 consecutive geriatric rehabilitation patients from the Detroit metropolitan area. Depressed patients, which included 47 elders (n = 30 females, n = 17 males) were selected from the larger sample and were rated on depression, instrumental activities of daily living (IADLs), and perceived social support at baseline and at a 3-month follow-up. At baseline, Caucasian elders were significantly more depressed than Black elders, x² 0-,N=193) = 7.21. Additionally, at baseline, elders who were depressed reported significantly more decline in functional ability, t(190) = 3.04, p <0.01, and significantly lower levels of perceived social support, t(180) = 2.72, p <0.01, than their nondepressed counterparts. Those patients who remained depressed at 3 months had significantly more functional impairment, t(28) = 2.66, p <0.05, and reported lower levels of perceived social support, t(28) = 2.55, p <0.05, as well.     

Determinants of life satisfaction and self-perception of ageing among elderly people in China: An exploratory study in comparison between physical and social functioning

ObjectiveThis study attempted to figure out the difference between physical and social functioning in determining life satisfaction and self-perception of ageing among community-dwelling elderly people in China.MethodsA representative random sample of 2161 participants aged 60 years or older was surveyed by face-to-face interview. Sociodemographic factors were measured by age, educational level, and marital status. Physical functioning was identified in terms of self-perceived health, basic and instrumental activities of daily living, and number of chronic illnesses. Social functioning was characterized in terms of number of people living together, social support network, and sense of loneliness. Hierarchical multiple linear regressions were performed to identify significant determinants of life satisfaction and self-perception of ageing.ResultsOlder age and lower educational level were related to higher degree of life satisfaction; whereas younger age and higher educational level were related to higher level of self-perception of ageing. Social functioning took precedence over physical functioning in contributing to life satisfaction. In contrast, physical functioning outweighed social functioning in promoting a positive self-perception of ageing.ConclusionA sense of companionship and a supportive social network are vital in enhancing life satisfaction, whereas perceived physical health and functional independence are essential in facilitating a positive self-perception of ageing. Understanding the underlying determinants can provide a novel insight into the mechanism involved in achieving successful ageing.     

Diabetes mellitus and geriatric syndromes

Diabetes mellitus is associated with an increased prevalence and incidence of geriatric syndrome: functional disabilities, depression, fall, urinary incontinence, malnutrition and cognitive impairment. Geriatric syndrome not only leads to frailty, loss of independence and low quality of life, but also becomes a major obstacle in the treatment and care of diabetic people. The risk factors or contributing factors of geriatric symptoms are micro- and macrovascular complications, age-rated comorbid disease and aging per se. Comprehensive geriatric assessment of geriatric syndrome, including basic activities of daily living, instrumental activities of daily living, gait and balance, visual acuity, the Mini-Mental State Examination, depression scores, history and risk of fall, urination and nutrition, should be performed as part of the care of elderly diabetic patients, in particular old-old patients. Because geriatric syndromes are multifactorial and share risk factors, diabetic people with any geriatric symptoms should be treated with a common concentric strategy, such as supervised exercise therapy including muscle-strengthening training, psychological support, social support for adherence, and good glycemic control with avoidance of hypoglycemia.     

Efficacy of group psychotherapy for geriatric depression: A systematic review

BackgroundGeriatric depression is a common and debilitating psychopathology, but evidence supports the efficacy of psychotherapy in its treatment. Group therapy provides advantages over individual interventions. However, only three systematic reviews have focused specifically on the efficacy of group therapy for geriatric depression.ObjectiveTo ascertain the effects of group psychotherapy on geriatric depression in people aged 60 years and older, compared with alternative treatments or no treatment.Data sourcesA systematic review of English, Portuguese, and Spanish studies using the EBSCOhost Research and Science Direct databases (2011–2017). Additional studies were identified through reference lists. Search terms included group therapy, group psychotherapy, older adults, elderly, depressive disorder, geriatric depression, and depression in the elderly.Review methodsThe researcher screened any study designs concerning the effects of any paradigm of group therapy on geriatric depression versus alternative interventions or no treatment. Relevant data, including indicators of risk of bias, were extracted.Data synthesisNine studies were reviewed. Reminiscence therapy and cognitive-behavioral therapy are viable group interventions for geriatric depression, and were significantly superior to most controls. Conclusions about the long-term effects were unclear. Significant improvements were obtained for different intervention durations and facilitators, and with participants of different nationalities and age. Most studies recruited participants from the community, which limited generalizability. Group therapy also resulted in improvements in other psychological variables.ConclusionsGroup therapy can significantly improve geriatric depression. Improvements were found across a variety of settings, protocols, participant characteristics, and for several psychological domains.     

Reliability,validity, and clinical utility of the social functioning exam in the assessment of stroke patients

Social functioning is an important variable in the rehabilitation of stroke patients. We have designed a 28 item semi-structured interview to measure social functioning and have used this instrument in 103 stroke patients in whom we were investigating the occurrence of mood disorders. The social functioning exam was demonstrated to have high interrater and test-retest reliability as well as good agreement with social functioning as measured by other instruments or clinical assessment. The utility of the measurement of social functioning in the assessment of post-stroke mood disorders was demonstrated by the significant correlation between severity of depression and the degree of dysfunction in social functioning six months after the acute stroke, as well as the significant difference in mean social functioning scores between non-depressed and depressed groups.     

The concept of anorexia of aging in late life depression: A cross-sectional analysis of a cohort study.

IntroductionAnorexia of aging (AA) is classically associated with depression. However, robust evidence is lacking regarding general clinic populations. Our aim was to evaluate the association between AA and major depressive disorder (MDD) in geriatric outpatients from a middle-income country.MethodsWe conducted a cross-sectional analysis of a cohort study. MDD diagnosis was assessed with a psychiatric interview (SCID-5-CV) according to DSM-5 criteria. Depressive symptomatology was assessed by a 15-items Geriatric Depression Scale (GDS) and the PHQ-9 questionnaire. Appetite was measured with the Simple Nutrition Appetite Questionnaire (SNAQ), whereas AA was defined as a SNAQ score ≤13 points). Linear and logistic regression analysis adjusted for potential confounders were applied to assess the association between depressive symptomatology, MDD and AA.ResultsOf the total 339 participants, MDD was present in 65. AA was more frequent in patients with MDD compared to non-depressed patients (30.7 versus 7.7%; p<0.001). The SNAQ score was lower in depressed patients (14.5 vs. 16.6, p<0.001). Adjusted for confounding, linear and logistic regression showed a significant association between the GDS score, PHQ-9 score and MDD with the SNAQ score (p<0.001) and cut-off representing AA (p<0.001), respectively. Moreover, MDD and AA interacted significantly with their association with weight loss (p<0.001).ConclusionsDepression scales (even without somatic complaints) and MDD were associated with AA in geriatric outpatients. AA is associated with weight loss in MDD. Prospective studies should expand these findings.     

A psychosocial model of functional disability

With advancing age, many older adults are vulnerable to a decline in physical functioning. Functional disability has been shown to affect the subjective well-being of the individual, and has been associated with increased morbidity and mortality. Social support is commonly assumed to protect people from the experience of psychological distress and enhance well-being. Other studies have demonstrated that satisfaction with social support, rather than the frequency with which support was received, is a powerful predictor of self-reported health status. The present study tests a psychosocial model of functional disability in two elderly populations (61 years of age and older): 178 seniors living in the community (136 females and 42 males) and 168 in-patients in a rehabilitation hospital following total hip and knee arthroplasty (118 females and 50 males). Predictors of functional disability were age, gender, and satisfaction with support. In this model, functional disability, with its related loss of independent functioning, was expected to lead to depression. Results indicated that the two samples differed slightly. Specifically, the elderly in the community sample were significantly older than the rehabilitation patients, whereas the hospital sample reported greater functional disability and were more satisfied with their social relations than the community-residing elderly. Results of path analysis in both samples showed that women reported more functional disability than men and satisfaction with support was associated with lower functional disability. Furthermore, functional disability led directly to depression in both samples. Practical implications for the maintenance and enhancement of daily functioning, as well as well-being in later life are discussed. Her research interests include social functioning among the elderly, organizational issues, stress, and coping. Ms. Fiksenbaum has published papers in these areas and presented research papers at international psychology conferences. Her research interests include gender, job stress, burnout and coping, psychosocial factors and aging, and psychological effects of SARS on nurses. Professor Greenglass serves on numerous academic journal editorial boards and does extensive reviewing for journals, academic conferences, and granting agencies. Sandra R. Marques is currently completing her second year of a Master’s program in Social and Personality Psychology at Queen’s University in Kingston, Ontario, Canada. Her present interests include self-conscious emotions—particularly guilt and shame—and their influence on intentions and condom use. Judy Eaton recently received her Ph.D. from York University, and is currently assistant professor at Wilfrid Laurier University Brantford Campus in Brantford, Ontario, Canada. Her research interests include apology, forgiveness, and interpersonal transgressions.     

Comprehensive geriatric assessment for community-dwelling elderly in Asia compared with those in Japan: I. Singapore

Background: The objective of the present study is to compare the findings of comprehensive geriatric assessments of community‐dwelling elderly people in Singapore with those in Japan.. Methods: A cross‐sectional, interview‐ and examination‐based study was conducted of community‐dwelling elderly people living in an urban district, Choa Chu Kang, in Singapore and in a rural town, Urausu, in Hokkaido in Japan. Volunteers were recruited by advertising. One hundred and seventeen and 163 community‐dwelling elderly aged 70 years and over in Singapore and Japan, respectively, were examined using a common comprehensive geriatric assessment tool. Interviews pertaining to activities of daily living (ADL), medical and social history, quality of life (QOL) and the 15‐item Geriatric Depression Scale as well as anthropometric, neurobehavioral and blood chemical examinations were included in the assessment. Using unpaired t‐tests and χ² tests, findings from the two groups were compared. Results: Intellectual ADL scores were higher in Japan than in Singapore, while there was no significant difference in basic ADL, instrumental ADL or social ADL between the two groups. The prevalence of depression was lower and QOLs were higher in Singaporean elderly subjects than in Japanese. Scores on cognitive functions were higher in Japanese subjects than in Singaporean ones. Mean blood pressure measurements and the prevalence of both hypertension and impaired glucose tolerance were higher in Singapore than in Japan. Conclusion: Comparative findings between comprehensive geriatric assessment of community‐dwelling elderly in Singapore and in Japan were reported. Between these highly economically developed countries, there was no significant difference in such ADLs as basic, information‐related, instrumental and social, but there were differences in the intellectual ADL scores. Japanese elderly people were more highly educated than their Singaporean counterparts, however, higher QOLs and a lower prevalence of depression in the community‐dwelling elderly population were revealed in Singapore than in Japan. Understanding of the need to control chronic risk factors such as hypertension or diabetes mellitus was less popularly spread among community‐dwelling elderly in Singapore than in Japan.     

Comprehensive geriatric assessment for community-dwelling elderly in Asia compared with those in Japan: II. Hongchon in Korea

Background: The objective of the present study is to compare the findings of comprehensive geriatric assessment between community‐dwelling elderly people in Korea and in Japan. Methods: A cross‐sectional, interview‐ and examination‐based study was undertaken of community‐dwelling elderly people living in a rural district, Hongchon, in Korea and in a rural town, Sonobe, in Kyoto in Japan. Two hundred and thirty‐eight community‐dwelling elderly people aged 60 years and over in Korea and 411 aged 65 years and over in Kyoto, Japan were examined using a common comprehensive geriatric assessment tool. Interviews concerning activities of daily living (ADL), medical and social history, quality of life (QOL) and the 15‐item Geriatric Depression Scale were conducted as well as anthropometric and blood chemical examinations. Findings from the two groups were compared using unpaired T‐test and χ² test. Results: All examined ADLs except for the social ADL were significantly lower in Korean elderly subjects than in Japanese. Only the mean social ADL score of each group showed no difference. The prevalence of depression assessed by the 15‐item Geriatric Depression Scale was higher in Korean elderly subjects than in Japanese. Scores for QOL indices were lower in the Korean subjects than in the Japanese. Korean subjects showed higher mean body mass indices, blood sugar concentrations and prevalences of impaired glucose tolerance than Japanese. Mean age, sex ratio and living situation (living alone or not, etc.) were not significantly different between the two groups. Conclusion: Comparative features of comprehensive geriatric assessment of community‐dwelling elderly between Korea and Japan were reported. Although both are highly economically developed countries in Asia, it was revealed that elderly Korean subjects were in poorer condition with regard to such ADLs as those relating to basic activities, information, instrumental and intellectual ones, in comparison with Japanese subjects. The one exception was the social ADL. At the same time, Korean subjects showed a higher prevalence of depression and lower scores for QOL. A high prevalence of impaired glucose tolerance in Korea was noteworthy. We assumed psychosocial rather than biological factors had produced such diversities.     

Higher odds and rising trends in arrhythmia among young cannabis users with comorbid depression

BackgroundCannabis (marijuana) use and depression are known to be strongly interconnected. However, amid alarming rates of mental health problems in the United States young population, the risk of arrhythmia among young cannabis users with comorbid depression has never been studied.MethodsIn-hospital encounters of arrhythmia were identified among young cannabis users (18–39 years) with or without depression using the National Inpatient Sample (2007–2014) databases and apposite ICD-9 codes. Baseline characteristics and trends in prevalence of arrhythmia were evaluated among inpatient young cannabis users with or without depression. A multivariable regression was performed after adjusting for baseline demographics, comorbidities and parallel history of substance abuse.ResultsOf 2,011,598 young cannabis users (59.6% male) admitted from 2007–2014, 190,146 (9.5%) of patients had comorbid depression, of which 6.9% of patients experienced arrhythmias with atrial fibrillation being most common. Cannabis users with depression were more likely older, white, females and frequently hospitalized in Midwest and rural hospitals. We observed a steadily rising trend in prevalence of arrhythmia in both groups, but a more rapid rise in cannabis users with depression (4.9% in 2007 to 8.5% in 2014 vs. 3.7% in 2007 to 5.7% in 2014). Correspondingly, young depressed cannabis users had higher odds of arrhythmia compared to non-depressed even after controlling for demographics and comorbidities (OR: 1.41, 95% CI: 1.38–1.44, p<0.001).ConclusionRampant recreational use of marijuana may increase the risk of arrhythmia by 40% in young cannabis users with depression as compared to non-depressed.     

NK cell immunesenescence is increased by psychological but not physical stress in older adults associated with raised cortisol and reduced perforin expression

NK cell cytotoxicity (NKCC) reduces with age and this has been associated previously with increased mortality. The immune response is also modulated by stress, and here, we assessed the effect of the physical stress of hip fracture and the psychological stress of depression on NKCC in an aged immune system. NKCC was assessed in 101 hip fracture patients (81 female) 6 weeks and 6 months after injury and in 50 healthy age-matched controls (28 female). Thirty-eight patients were depressed at 6 weeks post-injury, and NKCC was reduced in patients who developed depression compared with non-depressed hip fracture patients (p = 0.004) or controls (p < 0.02). NKCC remained lower in the depressed patients compared to those without depression 6 months post-fracture (p = 0.017). We found reduced expression of perforin in NK cells of depressed hip fracture patients compared with controls at 6 weeks (p = 0.001) post-fracture. Serum cortisol levels were also elevated in patients with depression compared to non-depressed patients at 6 weeks (p = 0.01) and 6 months (p = 0.05). NK cells treated with dexamethasone showed a concentration-dependent reduction in NKCC and perforin expression. We propose that depression is the major factor affecting NK cell immunity after hip fracture.     

Risk factors for depression in the elderly inflammatory bowel disease population

Background and aimsLittle is known about depression in elderly individuals with inflammatory bowel diseases (IBD). We assessed the point prevalence of depression and determined associations with disease activity, quality of life, and medication adherence in elderly patients with IBD.MethodsWe identified elderly (≥ 65 years) individuals within Crohn's and Colitis Foundation of America Partners, an online IBD cohort. Individuals completed the short geriatric depression scale (GDS). We used bivariate statistics to determine whether demographic or disease-related factors, disease activity, quality of life or medication adherence was associated with depression. We used logistic regression to estimate independent effects of depression on medication adherence.ResultsA total of 359 elderly individuals with IBD completed the GDS. The mean age was 70.2 years (SD 4.7); mean disease duration was 25.6 years (SD 17.6), and 62.6% had Crohn's disease (CD). The point prevalence of depression was 22.6%. Lower education levels (p = 0.001), higher corticosteroid use (< 0.01) and lower exercise levels (< 0.001) were associated with depression. For both CD and ulcerative colitis (UC), those with depression had increased disease activity (short Crohn's disease activity index 52.5 versus 29, p = 0.005, and simple clinical colitis activity index 5 versus 2, p = 0.003). Depressed patients had lower quality of life (short IBD questionnaire 4.6 versus 5.7, p < 0.001). Depressed individuals had reduced medication adherence (adjusted OR 2.18; 95% CI 1.04–4.57).ConclusionsDepression is common in this geriatric IBD cohort. Depression is independently associated with reduced medication adherence. Recognition and treatment of depression in elderly patients with IBD could improve outcomes.     

Prevalence of and factors contributing to anxiety,depression and cognitive disorders among urban elderly in Odisha – A study through the health systems’ Lens

IntroductionGrowing geriatric mental health needs of urban population in India pose several programmatic challenges. This study aimed to assess anxiety, depression and cognitive disorders among urban elderly, and explore availability of social support mechanisms and of a responsive health system to implement the national mental health programme.Methods244 respondents were randomly selected from Berhampur city. We administered a semi-structured interview schedule to assess substance abuse, chronic morbidity, anxiety, depression and cognitive abilities. Further, in-depth interviews were conducted with 25 key informants including district officials, psychiatrists, and programme managers. We used R software and ‘thematic framework’ approach, respectively, for quantitative and qualitative data analysis. Ethical standards were complied with.ResultsAbout half of the respondents were economically dependent; 57.3% had moderate to severe anxiety; 46.7% had moderate to severe depression; while about 25% had severe cognitive impairments. We found association of chewing tobacco (1.34(0.28–2.40)) and depression (0.52(0.37–0.68)) with anxiety; negative perception about elderly-friendly society (1.64(0.75–2.53)) and physical inactivity (2.88(1.60–4.16)) with depression; and age (-0.11(-0.20 – -0.02)) and physical inactivity (-3.44(-5.13 – -1.74)) with cognitive disorders. Qualitative analysis revealed lack of awareness, social stigma, poor availability of trained human resources, and poor political commitment as important systemic barriers to early detection and treatment of mental ailments among the elderly.ConclusionEstablishing tobacco cessation centres, sensitizing community about mental health needs of elderly, incentivizing physical activity of elderly, integrating mental health with primary care, multi-skilling providers and developing a cadre of community counsellors need urgent attention of policy makers and programme implementers.     

Depressive Symptoms Among Older Adults in Mexico City

BACKGROUND  Ageing and depression are associated with disability and have significant consequences for health systems in many other developing countries. Depression prevalence figures among the elderly are scarce in developing countries. OBJECTIVE  To estimate the prevalence of depressive symptoms and their cross-sectional association with selected covariates in a community sample of Mexico City older adults affiliated to the main healthcare provider. DESIGN  Cross-sectional, multistage community survey. PARTICIPANTS  A total of 7,449 persons aged 60 years and older. MEASUREMENTS  Depression was assessed using the 30-item Geriatric Depression Scale (GDS); cognitive impairment, using the Mini-Mental State Examination; and health-related quality of life with the SF-36 questionnaire. MAIN RESULTS  The prevalence of significant depressive symptoms was estimated to be 21.7%, and 25.3% in those aged 80 and older. After correcting for GDS sensitivity and specificity, major depression prevalence was estimated at 13.2%. Comparisons that follow are adjusted for age, sex, education and stressful life events. The prevalence of cognitive impairment was estimated to be 18.9% in depressed elderly and 13.7% in non-depressed. SF-36 overall scores were 48.0 in depressed participants and 68.2 in non-depressed (adjusted mean difference = −20.2, 95% CI = −21.3, −19.1). Compared to non-depressed elderly, the odds of healthcare utilization were higher among those depressed, both for any health problem (aOR 1.4, 95% CI = 1.1, 1.7) and for emotional problems (aOR 2.7, 95% CI = 2.2, 3.2). CONCLUSIONS  According to GDS estimates, one of every eight Mexican older adults had major depressive symptoms. Detection and management of older patients with depression should be a high priority in developing countries.     

The burden of chronic obstructive pulmonary disease in the elderly population

BackgroundChronic obstructive pulmonary disease (COPD) is a common disease and an important health care problem in older adults. The impact of age and specific geriatric issues on COPD in elderly patients has not been well established.MethodsA cross-sectional study of elderly COPD patients was conducted in Japan by using a regional COPD registry database. We compared indices of disease severity (pulmonary function, exercise tolerance, quality of life, and frequency of exacerbations), presence of comorbidities, geriatric conditions (cognitive function, mental status, and activities of daily living [ADL]), and adherence to prescribed drug regimens between elderly and younger patients with COPD.ResultsIn total, 279 patients with stable COPD (median age, 74 years) were identified; 86% of these patients were elderly (65 years of age or older). Elderly COPD patients, especially those who were 75 years of age or older, had significantly more cases of dyspnea, lower exercise tolerance, and poorer ADL and a higher incidence of severe exacerbations than younger patients (all P<0.05). In addition, the prevalence of comorbidities, including cardiovascular disease and cancer, was significantly higher in elderly COPD patients. Elderly COPD patients had specific geriatric conditions, including cognitive impairment. Adherence to inhaled drug regimens in elderly patients was as favorable as that in younger patients.ConclusionsAge and specific geriatric conditions have a great negative impact on COPD in elderly patients. Geriatric conditions should be addressed in the management of elderly COPD patients.