Religious denomination and depression in older Dutch citizens: patterns and models.

This study describes the distribution of depressive symptoms in older Dutch citizens (N = 3,020) across religious denominations. Reformed Calvinists had the lowest depressive scores (CES-D); Protestants from liberal denominations the highest; Roman Catholics, Dutch Reformed, and nonchurch members were in between. Two types of explanatory mechanisms are examined: (a) social integration and (b) positive self-perceptions, which both help to prevent depression. Alternatively, strict Calvinist doctrines are hypothesized to enforce negative self-perceptions, facilitating depression. For 2,509 respondents, complete data were available on social integration and self-perceptions, as well as on the parental religious denomination. Explanatory effects were tested using hierarchic regression models. The negative association between Calvinist background and depressive symptoms was partly explained by size of social network, and between Roman Catholic background and depressive symptoms by self-esteem. Leaving church had a positive association with depressive symptoms. This depressogenic effect remained after controlling for explanatory variables.     

National context of healthcare, economy and religion, and the association between disability and depressive symptoms in older Europeans: results from the EURODEP concerted action

Associations between disability and depression have been shown to be consistent across cultures among middle-aged adults. In later life the association between disability and depression is much more substantial and may be amenable to influences by health care facilities as well as economic and sociocultural factors. Fourteen community-based studies on depression in later life in 11 western European countries contribute to a total study sample of 22,570 respondents aged 65 years or older. Measures are harmonised for depressive symptoms (EURO-D scale) and disability. Using multilevel modelling to control for the stratified data structure we examined whether the association between disability and depressive symptoms is modified by national health care and mental health care availability, national economic circumstances, demographic characteristics and religious tradition. The association between depressive symptoms and disability is attenuated by health care expenditure and availability of mental health care and also by gross domestic product; it was more pronounced in countries with high levels of orthodox religious beliefs. Higher levels of depressive symptoms are found in countries with a larger gross domestic product (per capita) and higher health care expenses but are interpreted with care because of measurement differences between the centres. The findings from this contextual perspective indicate that general and mental health care should be geared to one another wherever possible.     

The validity of nutritional status as a marker for future disability and depressive symptoms among high-risk older adults.

OBJECTIVE: To measure the validity of the DETERMINE Checklist as a marker for future functional disability, depressive symptoms, and mortality among high-risk older adults. DESIGN: A Cohort study. SETTING: An Urban-suburban Midwestern community. PARTICIPANTS: Community-dwelling Medicare beneficiaries at high risk for hospital admission who received geriatric evaluation and management (GEM) (n = 251). MEASUREMENTS: Demographic, health-related, functional, psychosocial, survival, and nutritional data were collected through telephone and in-home interviews. RESULTS: GEM recipients with baseline Checklist scores of four or higher were found to be significantly more likely than those with lower scores to have functional disability or high levels of depressive symptoms a year later. Checklist scores did not predict mortality. CONCLUSIONS: The 10-item Checklist could be used as a secondary screen to identify older persons who, without treatment, are at especially high-risk to have disability or depression a year later.     

Impairments in health functioning and sleep quality in older adults with a history of depression

OBJECTIVES: To determine whether older adults with a history of depression show impairments in health functioning and sleep quality at a gradient between older adults with no history of depression and those with current major depression and to examine whether poor sleep quality contributes to declines in health functioning in addition to the contribution of depressive symptoms. DESIGN: Cross-sectional. SETTING: Three urban communities: Denver, Colorado, and Los Angeles and San Diego, California. PARTICIPANTS: Two hundred community-dwelling adults aged 60 and older who were never mentally ill, 143 with a history of major or minor depressive disorder in remission, and 67 with a current depressive disorder. MEASUREMENTS: Diagnosis, Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition; health functioning (Medical Outcomes Study 36-item Short-Form Health Survey); depressive symptom severity (Beck Depression Inventory); and sleep quality (Pittsburgh Sleep Quality Index). RESULTS: Older adults with a history of depression showed impairments in sleep quality and had lower levels of health functioning than controls; these impairments were at a gradient with declines in those with current depression. Poor sleep quality was independently associated with declines in health perception in older adults with and without depression. CONCLUSION: These findings have important health implications for older people who have a lifetime history of depression, given evidence that poor health functioning is a risk factor for depression recurrence as well as mortality. Moreover, in view of the association between sleep quality and health status, testing of interventions that target sleep quality might identify strategies to improve health functioning in older adults.     

Cognitive deficits and the course of major depression in a cohort of middle-aged and older community-dwelling adults

OBJECTIVES: To examine associations between cognitive deficits and persistent significant depressive symptoms at baseline and 2- and 4-year follow-ups in a sample of community-dwelling middle-aged and older adults. DESIGN: Prospective cohort study. SETTING: A U.S. national prospective cohort study of middle-aged and older adults, the Health and Retirement Study. PARTICIPANTS: A sample of 661 participants of the 1996 wave of the Health and Retirement Study who met criteria for 12-month Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised major depression (MD). MEASUREMENTS: MD was assessed using the World Health Organization Composite International Diagnostic Interview-Short Form. Persistent significant depressive symptoms were assessed using an eight-item version of the Center for Epidemiological Studies Depression scale. RESULTS: Cognitive deficits were associated with persistent significant depressive symptoms at follow-up. In a latent state-trait analysis, two stable and strongly correlated traits best explained variations in cognitive functioning and depressive symptoms across assessment points. CONCLUSION: Trait-like cognitive deficits commonly complicate the course of MD in community-dwelling middle-aged and older adults and may help to explain the persistent course of depressive symptoms in a large subgroup of adults with MD in this age range.     

The significance of nonmarital cohabitation: marital status and mental health benefits among middle-aged and older adults

OBJECTIVES: According to the 2000 Census, about 1.2 million persons over age 50 are currently cohabiting. Do these unmarried cohabiting partnerships provide adults with mental health benefits that are similar to those enjoyed by marrieds? We extended prior work on marital status and depression by including cohabitation in our conceptualization of marital status. METHODS: We used data from the 1998 Health and Retirement Study (N = 18,598) to examine the relationship between marital status and depressive symptoms among adults over age 50. We also examined gender differences in this association. RESULTS: We found that cohabitors report more depressive symptoms, on average, than do marrieds, net of economic resources, social support, and physical health. Additional analyses revealed that only among men do cohabitors report significantly higher depression scores. Cohabiting and married women as well as cohabiting men experience similar levels of depression, and all of these groups report levels that are significantly higher than married men's. DISCUSSION: Our findings demonstrate the importance of accounting for nontraditional living arrangements among persons aged 50 and older. Cohabitation appears to be more consequential for men's than women's depressive symptoms.     

Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and Depressive Complaints in Older Adults

The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) is a commonly administered test used to identify cognitive impairment in geriatric patients. To date, no published studies have examined the relationship between depressive symptoms and performance on the RBANS in older adults. Using a clinical sample of 45 older adults, we found a significant negative correlation between depression scores (measured by Geriatric Depression Scale-15) and RBANS Immediate Memory Index. Further examination showed that the List Learning subtest was associated with depression, but Story Memory was not. All other RBANS indices and related subtests were not associated with depression scores. Clinical implications are discussed.     

The relationship between age and depressive symptoms: a test of competing explanatory and suppression influences

OBJECTIVE. The objective is to examine competing explanatory and suppression influences on a negative, linear association between age and depressive symptoms. METHODS. Two samples were used: a community sample of physically disabled individuals and a comparison sample matched on age, sex, and area of residence. RESULTS. Fewer economic hardships and fewer experiences of negative interpersonal exchanges among older disabled and nondisabled respondents account for the negative relationship between age and depressive symptoms. Higher scores on a composite measure of religiosity among older disabled adults also account for part of the negative age effect. Conversely, a lower sense of mastery among older respondents in both samples suppresses the size of the negative age slope. DISCUSSION. Findings are discussed in terms of stress process and socioemotional selectivity theories, which predict that personal and social arrangements influence the experience of emotions differentially across the life course.     

Religious involvement,social support,and health among African-American women on the east side of detroit

BACKGROUND: A significant body of research suggests that religious involvement is related to better mental and physical health. Religion or spirituality was identified as an important health protective factor by women participating in the East Side Village Health Worker Partnership (ESVHWP), a community-based participatory research initiative on Detroit's east side. However, relatively little research to date has examined the mechanisms through which religion may exert a positive effect on health. OBJECTIVE: The research presented here examines the direct effects of different forms of religious involvement on health, and the mediating effects of social support received in the church as a potential mechanism that may account for observed relationships between church attendance and health. DESIGN: This study involved a random sample household survey of 679 African-American women living on the east side of Detroit, conducted as part of the ESVHWP. MAIN RESULTS: Results of multivariate analyses show that respondents who pray less often report a greater number of depressive symptoms, and that faith, as an important source of strength in one's daily life, is positively associated with chronic conditions such as asthma or arthritis. Tests of the mediating effect of social support in the church indicated that social support received from church members mediates the positive relationship between church attendance and specific indicators of health. CONCLUSIONS: These findings are consistent with the hypothesis that one of the major ways religious involvement benefits health is through expanding an individual's social connections. The implications of these findings for research and practice are discussed.     

Older patients’ depressive symptoms 6 months after prolonged hospitalization: Course and interrelationships with major associated factors

The aim of this study was to examine the course of depressive symptoms in older patients 6 months following a prolonged, acute hospitalization, especially the interrelationships among depressive symptoms and its major associated factors. For this study, we conducted a secondary analysis of data from a prospective cohort study of 351 patients aged 65 years and older. Participants were recruited from five surgical and medical wards at a tertiary medical center in northern Taiwan and assessed at three time points: within 48 h of admission, before discharge, and 6 months post-discharge. The course of depressive symptoms was dynamic with symptoms increased spontaneously and substantially during hospitalization and subsided at 6 months after discharge, but still remained higher than at admission. Overall, 26.7% of older patients at hospital discharge met established criteria for minor depression (15-item Geriatric Depressive Scale (GDS-15) scores 5–9) and 21.2% for major depression (GDS-15 scores >10). As the strongest associated factors, functional dependence and nutritional status influenced depressive symptoms following hospitalization. Depressive symptoms at discharge showed significant cross-lagged effects on functional dependence and nutritional status at 6 months after discharge, suggesting a reciprocal, triadic relationship. Thus, treating one condition might improve the other. Targeting the triad of depressive symptoms, functional dependence, and nutritional status, therefore, is essential for treating depressive symptoms and improving the overall health of older adults hospitalized for acute illness.     

Religious attendance and mortality: an 8-year follow-up of older Mexican Americans

OBJECTIVE: Studies in the area of religion and mortality are based primarily on data derived from samples of predominantly non-Hispanic Whites. Given the importance of religion in the lives of Hispanics living in the United States, particularly older Hispanics, we examine the effects of religious attendance on mortality risk among Mexican Americans aged 65 and older. METHODS: We employ data from the Hispanic Established Populations for Epidemiologic Studies of the Elderly to predict the risk of all-cause mortality over an 8-year follow-up period. RESULT: Overall, the results show that those who attend church once per week exhibit a 32% reduction in the risk of mortality as compared with those who never attend religious services. Moreover, the benefits of weekly attendance persist with controls for sociodemographic characteristics, cardiovascular health, activities of daily living, cognitive functioning, physical mobility and functioning, social support, health behaviors, mental health, and subjective health. DISCUSSION: Our findings suggest that weekly church attendance may reduce the risk of mortality among older Mexican Americans. Future research should focus on identifying other potential mediators of the relationship between religious involvement and mortality risk in the Mexican-origin population.     

Religiousness and Psychological Distress in Jewish and Christian Older Adults

ABSTRACT

Objectives: In this study, the authors explore how the association between religiousness and psychological distress varies by religious affiliation. Prior work has shown that the association between religious belief and psychological distress is stronger for Christians than Jews, while religious activity is associated with lower psychological distress for both groups.

Methods: Interviews were conducted using a community sample of 143 Christian and Jewish older adults, ages 65 and over. Quantitative measures were used to assess levels of organizational and intrinsic religiosity, as well as symptoms of depression and anxiety.

Results: Christians who are highly involved in the organizational aspects of their religion report fewer depressive symptoms than Jews who have high levels of organizational religiosity, and the opposite is the case at lower levels of organizational religiosity. No significant group differences were found in the relationship between religiousness and anxiety.

Conclusions: The results of this study indicate a difference between Jews and Christians in the reasons that they turn to their respective religious services, particularly in late life.     

Behavioral Activation as a Treatment for Geriatric Depression

By encouraging older adults to become more active, behavioral activation (BA) may help reduce depressive symptoms brought on by activity restriction. The purpose of this study was to determine, through a multiple-baseline design, whether BA could be successfully applied to older adults with depression. Nine depressed older adults (M = 75 years of age) underwent a course of in-home BA therapy (mean number of sessions = 14.7). Overall, participants' Geriatric Depression Scale and Hamilton Rating Scale for Depression scores decreased from pre- to post-treatment, and 71% of participants no longer met criteria for a depressive disorder. Behavioral activation shows promise as a treatment for geriatric depression.     

Prevalence and related influencing factors of depression symptoms among empty-nest older adults in China

BackgroundThe phenomenon of empty-nest older adults has raised growing concerns in contemporary Chinese society. In this study, we examined the prevalence and related influencing factors of depression symptoms among empty-nest older adults in China at a national level.MethodsThe database of the 2015 China Health and Retirement Longitudinal Study (N = 8549, aged ≥ 60) was used. The 10-item version of the Centre for Epidemiologic Studies Depression Scale was employed to measure depression symptoms.ResultsThe prevalence of depression symptoms was 34.7 % for empty-nest respondents, 32.2 % for respondents living with a spouse only and 43.4 % for those living alone. Multivariable logistic regression indicated that, compared with the non-empty-nest respondents, older adults living alone were more susceptible to depression symptoms (OR 1.194, 95 %CI 1.016–1.405) whereas older adults living with a spouse only were not exposed to an elevated probability of being depressed (OR 0.945, 95 %CI 0.847–1.055). Multivariable logistic regression also suggested that empty nesters who were female, lived in rural areas, had a lower frequency of children’s visits, had lower socioeconomic status and had worse physical health conditions were more vulnerable to depression symptoms.ConclusionsThe association between empty-nest status and later-life depression is mixed. More concerns should be raised about the mental health of empty nesters living alone. Increased attention should also be paid to empty nesters who are female, rural residents and have low contact frequency with their children, disadvantaged socioeconomic status and poor physical health conditions.     

Religious attendance and cognitive functioning among older Mexican Americans

Research shows that social engagement reduces the probability of cognitive decline in late life. The purpose of this study was to test whether religious attendance, a major source of social engagement for many older individuals, is associated with slower rates of cognitive decline among older Mexican Americans. Using four waves of data collected from a sample of 3,050 older Mexican-origin individuals, we estimated a series of linear growth curve models to assess the effects of religious attendance on cognitive functioning trajectories. We used the Mini-Mental State Examination to measure cognitive functioning. Our central finding is that religious attendance is associated with slower rates of cognitive decline among older Mexican Americans. Specifically, respondents who attend church monthly, weekly, and more than weekly tend to exhibit slower rates of cognitive decline than those who do not attend church.     

Depressive symptoms in older African-American and white adults with functional difficulties: the role of control strategies

OBJECTIVES: To examine whether control-oriented strategies buffer effects of functional difficulties on depressive symptoms over time in older African-American and white adults with disability. DESIGN: Community-based, prospective study. SETTING: Baseline and 12-month data from a randomized trial. PARTICIPANTS: One hundred twenty-nine African-American and 151 white older adults with 12-month data from 319 participants in the trial. MEASUREMENTS: Data were obtained for functional difficulties, the extent that respondents reported using control (cognitive and behavioral) strategies to enhance and maintain independence, and baseline and 12-month depressive symptoms (Center for Epidemiologic Studies Depression Scale; CES-D). RESULTS: African Americans reported greater baseline functional difficulty (P=.009), fewer depressive symptoms (P=.002) and higher control strategy use (P=.001) than whites. Functional difficulty was associated with depressive symptoms for both groups at baseline and 12 months. Living alone for whites and low spirituality for African Americans predicted higher 12-month depressive symptom scores. African Americans with baseline functional difficulty and high strategy use had lower 12-month depression than those with similar difficulty levels but low strategy use (P=.04 for interaction), representing a 28.5-point CES-D score differential. Control strategies did not buffer the function-depression relationship over time for whites. CONCLUSION: Control-oriented strategies moderated the experience of depressive symptomatology over time for African Americans with disability but not for whites. This may explain the paradox of greater functional disparities but less reported emotional distress in African Americans than whites. Results suggest that the use and benefits of adaptive resources to attain functional goals and determinants of depression differ by race. Depression prevention programs should be modified to be suitable for different cultural groups.     

Non-pharmacological prevention of major depression among community-dwelling older adults: A systematic review of the efficacy of psychotherapy interventions

Depression is a major public health burden among the aging population. While older adults prefer non-pharmacological treatment, few options for psychotherapy are available in primary care settings, which is where older adults tend to receive mental health services. Indicated prevention is a cost-effective, public health approach to prevent major depressive disorder among people with depressive symptoms who do not yet meet standard criteria for major depression. We critically reviewed randomized controlled trials (RCTs) that assessed the efficacy of psychotherapy among community-dwelling older adults with subthreshold depression (depressive symptoms that do not meet standard criteria for major depression). We examined the intervention types, results, internal validity, and external validity of five studies. We used the United States Preventive Services Task Force (USPSTF) guidelines to rate the quality of the studies and to provide recommendations. Results suggest that psychotherapy is a safe and cost-effective method to reduce the public health burden of depression among older adults with subthreshold depression.     

Changes in driving patterns and worsening depressive symptoms among older adults.

OBJECTIVES: This study examined whether changes in driving patterns-driving cessation and reduction-have negative consequences for the depressive symptoms of older Americans and whether these consequences are mitigated for people with a spouse who drives. METHODS: The project used data from 3 waves of the Asset and Health Dynamics Among the Oldest Old (AHEAD) study. Depressive symptoms were assessed with an abbreviated Center for Epidemiologic Studies-Depression scale. Using 2 models, the project examined how driving cessation and reduction that occurred between Waves 1 and 2 contributed to increases in depressive symptoms between Waves 2 and 3. The first model included the entire sample (N = 5,239), and the second model focused on drivers only (n = 3,543). A third model added interaction terms to the analysis to consider whether respondents who stopped driving but had a spouse who drove were less at risk of worsening depressive symptoms. RESULTS: Respondents who stopped driving had greater risk of worsening depressive symptoms. Drivers who restricted their driving distances before the study began also had greater risk of worsening depressive symptoms, but seemingly less so than the respondents who stopped driving altogether. For respondents who stopped driving, having a spouse available to drive them did not mitigate the risk of worsening symptoms. DISCUSSION: Changes in driving patterns can be deleterious for older people's depressive symptoms. Initiatives for assisting older people should focus on strategies that help them retain driving skills, that prepare them for the possible transition from driver to ex-driver, and that ensure that they have access to mental health therapies if driving changes are imminent.     

Mental Health,resilience, and religiosity in the elderly under COVID-19 quarantine in Qatar

Introduction: Corona Virus Disease 2019 (COVID-19) quarantine has been associated with depression, anxiety, and stress symptoms. We hypothesize these symptoms might even be more pronounced in the elderly, who may be particularly sensitive to social isolation. However, certain individuals might be more resilient than others due to their coping mechanisms, including religious coping.Objectives: We aimed to examine the levels of perceived stress, depressive, and anxiety symptoms in older adults under COVID-19 quarantine in Qatar; and to identify the sociodemographic, psychological, and clinical factors associated with mental health outcomes, with a focus on the role of resilience, and religiosity.Methods: A cross-sectional study assessing depressive, anxiety, and stress symptoms as well as resilience, and religiosity through a phone survey in adults aged 60 years or more under COVID-19 quarantine in the State of Qatar, in comparison to age and gender-matched controls.Results: The prevalence of depressive, anxiety, and stress symptoms in elderly subjects under COVID-19 quarantine in Qatar was not significantly different from the prevalence in gender and age-matched controls. In the quarantined group, higher depressive, anxiety, and stress scores were associated with the female gender and with lower resilience scores but were not linked to age, psychiatric history, medical history, duration of quarantine, or religiosity.Conclusion: The elderly population does not seem to develop significant COVID-19 quarantine-related psychological distress, possibly thanks to high resilience and effective coping strategies developed through the years.