Burden of frailty and its correlates among the elderly: a cross-sectional study in a rural community of West Bengal.

Context: With the ageing of Indian society, providing a healthy life among older people is a public health precedence. Therefore, beforehand discovery and possible forestalment of frailty may help promote healthy ageing and dwindle the social, mental and financial burden of their families and caregivers. Aims: The study aimed to assess the proportion of frailty and its associated factors among the elderly aged 65 years and above in a rural community of West Bengal. Settings and Design: A community-based cross-sectional study was conducted among 270 elderlies selected from 15 villages out of a total 64 villages of Singur under the Hooghly District of West Bengal from January 2019 to February 2020. Materials and Methods: Cluster sampling technique was used. Data was collected using a pre-designed, pre-tested structured schedule including Fried frailty phenotype (FFP), geriatric depression scale short form (GDS 15) and mini nutritional assessment (MNA) tool. Statistical Analysis Used: Associated factors of frailty were assessed by univariate and multivariable logistic regression using SPSS version 16 software and MS Excel 2019. Results: The proportion of frailty was observed to be 23.7% and that of prefrailty 40.7%. Frailty was significantly associated with increasing age [AOR(CI) 1.2(1.1-1.3)], decreasing years of schooling [AOR(CI) 1.3(1.1-1.5)], loss of spouse [AOR(CI) 4.2(1.2-15.2)], financial dependency [AOR(CI) 19.3(2.7-139.0)], staying at home [AOR(CI) 16.3(2.7-98.2)], presence of anaemia [AOR(CI) 3.6(1.3-9.5)], at risk of malnutrition [AOR(CI) 6.5(1.9-22.3)], increasing number of falls in the last 1 year [AOR(CI) 4.3(1.2-15.6)], presence of 3 or more chronic diseases [AOR(CI) 154.7(12.1-1981.9)] and depression [AOR(CI) 8.3(2.5-27.0)]. Conclusion: The burden of frailty among the study population is relatively high. It's an intimidating situation that needs bettered screening provisions for early discovery with special stress on nutritive upliftment. Screening for depression should also be done regularly.

An Artificial Neural Network Predicts Gender Differences of Motor and Non-Motor Symptoms of Patients with Advanced Parkinson's Disease under Levodopa-Carbidopa Intestinal Gel.

Background and Objectives: Currently, no tool exists to predict clinical outcomes in patients with advanced Parkinson's disease (PD) under levodopa-carbidopa intestinal gel (LCIG) treatment. The aim of this study was to develop a novel deep neural network model to predict the clinical outcomes of patients with advanced PD after two years of LCIG therapy. Materials and Methods: This was a longitudinal, 24-month observational study of 59 patients with advanced PD in a multicenter registry under LCIG treatment from September 2019 to September 2021, including 43 movement disorder centers. The data set includes 649 measurements of patients, which make an irregular time series, and they are turned into regular time series during the preprocessing phase. Motor status was assessed with the Unified Parkinson's Disease Rating Scale (UPDRS) Parts III (off) and IV. The NMS was assessed by the NMS Questionnaire (NMSQ) and the Geriatric Depression Scale (GDS), the quality of life by PDQ-39, and severity by Hoehn and Yahr (HY). Multivariate linear regression, ARIMA, SARIMA, and Long Short-Term Memory-Recurrent NeuralNetwork (LSTM-RNN) models were used. Results: LCIG significantly improved dyskinesia duration and quality of life, with men experiencing a 19% and women a 10% greater improvement, respectively. Multivariate linear regression models showed that UPDRS-III decreased by 1.5 and 4.39 units per one-unit increase in the PDQ-39 and UPDRS-IV indexes, respectively. Although the ARIMA-(2,0,2) model is the best one with AIC criterion 101.8 and validation criteria MAE = 0.25, RMSE = 0.59, and RS = 0.49, it failed to predict PD patients' features over a long period of time. Among all the time series models, the LSTM-RNN model predicts these clinical characteristics with the highest accuracy (MAE = 0.057, RMSE = 0.079, RS = 0.0053, mean square error = 0.0069). Conclusions: The LSTM-RNN model predicts, with the highest accuracy, gender-dependent clinical outcomes in patients with advanced PD after two years of LCIG therapy.

Knowledge and attitudes of primary care nurses towards geriatric depression in Jazan Region, Saudi Arabia.

Depression is a global health concern, particularly in the geriatric population. The increasing number of hospital admissions among older individuals highlights the need for healthcare professionals, particularly nurses, to understand and treat geriatric depression. Nurses play a crucial role in caring for older adults with depressive symptoms or depression. This study aimed to assess knowledge and attitudes regarding geriatric depression among primary care nurses in Jazan Region, Saudi Arabia. A cross-sectional study was conducted among 210 primary healthcare nurses in Jazan City using a validated self-administered questionnaire. Knowledge scores were measured and compared among selected demographic variables as well as attitudes toward geriatric depression. Data obtained were analyzed using the Statistical Package for the Social Sciences, version. 20.0. Chi-square test, fisher's exact test were used for comparison of variables with categorical data. Most primary care nurses were interested in caring for older patients with depression; however, they never attended training courses focused on geriatric depression. Where the study indicated that 38.1% of participants have poor knowledge about geriatric depression while 25.2% have good knowledge. Where the majority had a high understanding of the potential side effects of antidepressant medications, while they had limited knowledge about symptoms, diagnosis, and medications, the majority of participants demonstrated a positive attitude regarding feeling comfortable dealing with depressed patients' needs (56.7%) and considered their profession as a well-placed to assist patients (83.3%) However, 15.2% had a negative attitude citing a lack of self-discipline and willpower.

La dépression est un problème de santé mondial, en particulier dans la population gériatrique. Le nombre croissant d'hospitalisations chez les personnes âgées met en évidence la nécessité pour les professionnels de santé, en particulier les infirmières, de comprendre et de traiter la dépression gériatrique. Les infirmières jouent un rôle crucial dans la prise en charge des personnes âgées présentant des symptômes dépressifs ou une dépression. Cette étude visait à évaluer les connaissances et les attitudes concernant la dépression gériatrique parmi les infirmières de soins primaires de la région de Jazan, en Arabie Saoudite. Une étude transversale a été menée auprès de 210 infirmières de soins primaires de la ville de Jazan à l'aide d'un questionnaire auto-administré validé. Les scores de connaissances ont été mesurés et comparés parmi certaines variables démographiques ainsi que les attitudes à l'égard de la dépression gériatrique. Les données obtenues ont été analysées à l'aide du progiciel statistique pour les sciences sociales, version. 20,0. Le test du Chi carré et le test exact de Fisher ont été utilisés pour comparer les variables avec les données catégorielles. La plupart des infirmières de soins primaires souhaitaient soigner des patients âgés souffrant de dépression ; cependant, ils n'ont jamais suivi de formation axée sur la dépression gériatrique. L'étude indique que 38,1 % des participants ont de mauvaises connaissances sur la dépression gériatrique tandis que 25,2 % ont de bonnes connaissances. Alors que la majorité des participants avaient une bonne compréhension des effets secondaires potentiels des médicaments antidépresseurs, alors qu'ils avaient une connaissance limitée des symptômes, du diagnostic et des médicaments, la majorité des participants ont démontré une attitude positive et se sentaient à l'aise pour répondre aux besoins des patients déprimés (56,7 %). et considéraient leur profession comme bien placée pour assister les patients (83,3 %). Toutefois, 15,2 % avaient une attitude négative citant un manque d'autodiscipline et de volonté.

Usability of the Japanese Late-Stage Elderly Questionnaire for screening major depression.

BACKGROUND: Older adults with major depression are at risk of frailty and long-term care needs. Consequently, screening for major depression is imperative to prevent such risks. In Japan, the Late-Stage Elderly Questionnaire was developed to evaluate older adults' holistic health, including mental well-being. It comprises one specific question to gauge life satisfaction, but the effectiveness of this question to screen for major depression remains unclear. Therefore, we aimed to assess the usability of this question to screen for major depression. METHODS: This retrospective cohort study used a large, commercially available claims database in Japan. Participants were older adults aged ≥75 years who completed the Late-Stage Elderly Questionnaire and were classified with and without new major depression within 1 year. We evaluated the questionnaire's ability to screen for major depression using C-statistics, developing three models to assess the cut-off value based on responses to the life satisfaction question ('Satisfied', 'Somewhat satisfied', 'Somewhat unsatisfied', or 'Unsatisfied'), estimating the sensitivity and specificity of each model. RESULTS: Among 11 117 older adults, 77 newly experienced major depression within 1 year. The C-statistic for screening major depression was 0.587. The model setting the cut-off between 'Somewhat unsatisfied' and 'Unsatisfied' the demonstrated lowest sensitivity and highest specificity, while the model setting the cut-off between 'Satisfied' and 'Somewhat satisfied' demonstrated highest sensitivity and lowest specificity. CONCLUSIONS: Our results suggest that due to its poor screening ability and high rate of false negatives, the question assessing life satisfaction in the Late-Stage Elderly Questionnaire may not be useful for screening major depression in older adults and may require modification.

Attributional styles are associated with care burden in geriatric depression: older adults and their caregivers in Taiwan.

BACKGROUND: Given the rising prevalence of depression among older adults and the associated increase in caregiving responsibilities, understanding factors influencing caregiver burden is crucial. Previous research has not extensively explored the impact of caregivers' attributional styles, that is, how individuals interpret the causes of life events, on their care burden. AIM: This study examined the relationship between caregivers' attributional styles and their care burden for older patients with depression. METHODS: This cross-sectional study enrolled older adults aged ≥ 65 years diagnosed with depression and their caregivers. Depression was diagnosed according to the DSM-V criteria for Major Depressive Disorder or Persistent Depressive Disorder. Caregivers completed the Chinese Depression Caregiver Burden Scale (CDCBS) to assess care burden, the Hamilton Depression Rating Scale (HAM-D) to evaluate patient symptom severity, the Center for Epidemiological Studies Depression Scale (CES-D) for measuring caregivers' depression, and the Chinese Depression Patient Caregiver Attribution Style Scale (CDPCAS) to assess attributional styles. Hierarchical regression analysis was used to identify the factors independently associated with the caregiver's subjectively assessed care burden. RESULTS: The sample included 146 caregivers of geriatric patients with depression. Most depression patients were women (74.7%) with a mean age of 74.3 years, whereas the mean age of caregivers was 57.7 years. Hierarchical regression analysis identified that caregivers' gender (ß = - 0.14, p = .044), educational level (ß = 0.19, p = .008), caregivers' own depression assessed by the Center for Epidemiological Studies Depression Scale (ß = 0.41, p < .001), and attributional styles, particularly manipulation (ß = 0.29, p < .001) and illness/stress attributional style (ß = 0.23, p = .002) as independent factors associated with care burden. Patient symptom severity assessed using the Hamilton Depression Scale was not significantly correlated with care burden after controlling for attributional styles. CONCLUSIONS: Certain attributional styles, particularly the manipulation and illness/stress attributional styles, significantly increased self-reported care burden. These findings highlight the need for educational resources to change the attribution style, along with support systems and accessible mental health services for caregivers to potentially ease the care burden.

Frailty in the Elderly is Associated with an Increased Risk of Depression: A Systematic Review and Meta-Analysis.

Objective: The aim was to systematically review the association between depression and frailty in the elderly. Methods: Databases such as PubMed, Web of Science, Embase, and Scopus were searched for articles on the link between the risk of depression and frailty since the creation of the databases to September 1, 2023. A pair of investigators collaboratively conducted the screening, collected data, and evaluated the potential for bias in the included studies. R software was utilized for meta-synthesis. Results: Eight cohort studies comprising 13 043 participants and 14 854 senior individuals with depression were included. The meta-analysis showed that there was a significant connection regarding frailty and the incidence of depression among the elderly (Risk Ratio [RR] = 3.26, 95% Confidence Interval [CI]: 1.68-6.32). Subgroup evaluations showed that there was no association between frailty and depression in the community-dwelling elderly (RR = 2.28, 95% CI: 0.644-8.102) and in the elderly patients with depression assessed by Center for Epidemiological Studies Depression Scale (CES-D) (RR = 5.82, 95% CI: 0.481-70.526). Conclusion: Frailty is correlated with the risk of depression in the elderly. Frailty is a contributing factor to depression in the elderly.

Prediction of depressive symptoms at high age (80+) by psychological, biological and functional factors.

BACKGROUND: Late-life depression (LLD) is highly prevalent, especially in people aged 80 years and older. We aimed to investigate predictors and their influence on depressive symptoms in LLD. METHODS: We analysed data from the NRW80+ study, a population-based cross-sectional study of individuals aged 80 years and older. Data from n = 926 cognitively unimpaired participants were included. We reduced 95 variables to 21 predictors of depressive symptoms by using a two-step cluster analysis (TSCA), which were assigned to one of four factors (function, values and lifestyle, autonomy and contentment, biological-somatic) according to a principal component analysis. A second TSCA with complete data sets (n = 879) was used to define clusters of participants. Using weighted mean composite scores (CS) for each factor group, binary logistic regression analyses were performed to predict depressive symptoms for each cluster and the total population. RESULTS: The second TSCA yielded two clusters (cluster 1 (n = 688), cluster 2 (n = 191)). The proportion of participants with depressive symptoms was significantly higher in cluster 2 compared to cluster 1 (39 % vs. 15 %; OR = 3.6; 95 % CI 2.5-5.1; p < .001). Participants in cluster 2 were significantly older (mean age 88 vs. 85 years; p < .001), with a higher proportion of women (56 % vs. 46 %; OR = 1.5; 95 % CI 1.1-2.0; p = .016), had a higher BMI (p = .017), lower financial resources (OR = 2.3; 95 % CI 1.6-3.5; p < .001), lower educational level (OR = 1.8; 95 % CI 1.2-2.5; p = .002), higher proportion of single, separated or widowed participants (OR = 1.9; 95 % CI 1.3-2.6; p < .001) and a smaller mean social network (p = .044) compared to cluster 1. Binary logistic regression analyses showed that the weighted mean CS including the autonomy and contentment predictors explained the largest proportion of variance (22.8 %) for depressive symptoms in the total population (Nagelkerke's R2 = 0.228, p < .001) and in both clusters (cluster 1: Nagelkerke's R2 = 0.171, p < .001; cluster 2: Nagelkerke's R2 = 0.213, p < .001), respectively. LIMITATIONS: The main limitations are the restriction to cognitively unimpaired individuals and the use of a self-rated questionnaire to assess depressive symptoms. CONCLUSIONS: Psychological factors such as autonomy and contentment are critical for the occurrence of depressive symptoms at higher age, independent of the functional and somatic status and may serve as specific targets for psychotherapy.

Treatment resistant late-life depression: A narrative review of psychosocial risk factors, non-pharmacological interventions, and the role of clinical phenotyping.

BACKGROUND: Treatment resistant depression (TRD) is a subset of major depressive disorder (MDD) in which symptoms do not respond to front line therapies. In older adults, the assessment and treatment of TRD is complicated by psychosocial risk factors unique to this population, as well as a relative paucity of research. METHODS: Narrative review aimed at (1) defining TRLLD for clinical practice and research; (2) describing psychosocial risk factors; (3) reviewing psychological and non-pharmacological treatments; (4) discussing the role of clinical phenotyping for personalized treatment; and (5) outlining research priorities. RESULTS: Our definition of TRLLD centers on response to medication and neuromodulation in primary depressive disorders. Psychosocial risk factors include trauma and early life adversity, chronic physical illness, social isolation, personality, and barriers to care. Promising non-pharmacological treatments include cognitive training, psychotherapy, and lifestyle interventions. The utility of clinical phenotyping is highlighted by studies examining the impact of comorbidities, symptom dimensions (e.g., apathy), and structural/functional brain changes. LIMITATIONS: There is a relative paucity of TRLLD research. This limits the scope of empirical data from which to derive reliable patterns and complicates efforts to evaluate the literature quantitatively. CONCLUSIONS: TRLLD is a complex disorder that demands further investigation given our aging population. While this review highlights the promising breadth of TRLLD research to date, more research is needed to help elucidate, for example, the optimal timing for implementing risk mitigation strategies, the value of collaborative care approaches, specific treatment components associated with more robust response, and phenotyping to help inform treatment decisions.

Association of Geriatric Depressive Symptoms and Government-Initiated Senior Employment Program: A Population-Based Study.

OBJECTIVE: The impact of the government-initiated senior employment program (GSEP) on geriatric depressive symptoms is underexplored. Unearthing this connection could facilitate the planning of future senior employment programs and geriatric depression interventions. In the present study, we aimed to elucidate the possible association between geriatric depressive symptoms and GSEP in older adults. METHODS: This study employed data from 9,287 participants aged 65 or older, obtained from the 2020 Living Profiles of Older People Survey. We measured depressive symptoms using the Korean version of the 15-item Geriatric Depression Scale. The principal exposure of interest was employment status and GSEP involvement. Data analysis involved multiple linear regression. RESULTS: Employment, independent of income level, showed association with decreased depressive symptoms compared to unemployment (p<0.001). After adjustments for confounding variables, participation in GSEP jobs showed more significant reduction in depressive symptoms than non-GSEP jobs (ß=-0.968, 95% confidence interval [CI]=-1.197 to -0.739, p<0.001 for GSEP jobs, ß=-0.541, 95% CI=-0.681 to -0.401, p<0.001 for non-GSEP jobs). Notably, the lower income tertile in GSEP jobs showed a substantial reduction in depressive symptoms compared to all income tertiles in non-GSEP jobs. CONCLUSION: The lower-income GSEP group experienced lower depressive symptoms and life dissatisfaction compared to non-GSEP groups regardless of income. These findings may provide essential insights for the implementation of government policies and community-based interventions.

Elucidating the influence of familial interactions on geriatric depression: A comprehensive nationwide multi-center investigation leveraging machine learning.

OBJECTIVE: A plethora of studies have unequivocally established the profound significance of harmonious familial relationships on the psychological well-being of the elderly. In this study, we elucidate the intergenerational relationships, probing the association between frequent interactions or encounters with their children and the incidence of depression in old age. METHODOLOGY: We employed a retrospective cross-sectional study design, sourcing our data from the 2018 wave of the China Health and Retirement Longitudinal Study (CHARLS). To identify cases of depression, we utilized the 10-item Center for Epidemiologic Studies Depression Scale (CESD). Employing a five-fold cross-validation methodology, we endeavored to fashion five distinct machine learning models. Subsequently, we crafted learning curves to facilitate the refinement of hyperparameters, assessing model classification performance through metrics such as accuracy and the Area Under the Receiver Operating Characteristic (AUROC) curve. To further elucidate the relationship between variables and geriatric depression, logistic regression was subsequently applied. RESULTS: Our findings accentuated that sleep patterns emerged as the paramount determinants influencing the onset of depression in the elderly. Relationships with offspring ranked as the second most significant determinant, only surpassed by sleep habits. A negative correlation was observed between sleep patterns (Odds Ratio [OR]: 0.78, 95 % Confidence Interval [CI]: 0.75-0.81, P < 0.01), communication with offspring (OR: 0.86, 95 % CI: 0.82-0.90, P < 0.01), and the prevalence of depressive symptoms. Among the evaluated models, the k-Near Neighbor algorithm demonstrated commendable discriminative power. However, it was the Random Forest algorithm that manifested unparalleled discriminative prowess and precision, establishing itself as the most efficacious classifier. CONCLUSION: Prolonging the duration of nocturnal sleep, and elevating the frequency of communication with offspring have been identified as measures conducive to mitigating the onset of geriatric depression.

Geriatric Depression Scale - 30 assessments: face-to-face or telephone interviews for older people - a randomized crossover study.

INTRODUCTION AND OBJECTIVE: The Geriatric Depression Scale - 30 (GDS-30) for detecting depressive disorders provides an objective and reliable outcome measure validated by many studies and scientific articles. The aim of the study was to compare the concordance of measurements using the GDS-30 conducted in face-to-face and telephone interviews. MATERIAL AND METHODS: The study design was approved by the Bioethical Committee of the University of Rzeszów (Resolution No. 2022/075). Study participants were community-dwelling older people in south-eastern Poland, aged 60 years and over, with a normal cognitive status. They were divided into 2 groups, each examined with the Geriatric Depression Scale - 30 questionnaire. The first group (G1) was examined first by means of direct contact (A), and the second group (G2) by telephone (B). After an average period of 2 weeks, the study was repeated, this time swapping the method of contact: in G1 telephone contact (B) was used, in G2 face-to-face contact (A). RESULTS: The study involved a group of 225 people (128 women and 97 men), mean aged 68.2 years, randomly divided into the 2 groups (G1 and G2). Cohen's kappa coefficient analysis showed good (14 questions) to very good (16 questions) concordance for individual responses to questions. Analysis of Krippendorf's alpha coefficient values showed very good concordance for results on the whole questionnaire. Good concordance of the means of measurement was also confirmed by the Bland and Altman method, where more than 95% of the sample was within the 95% concordance limits. DISCUSSION AND CONCLUSIONS: Findings of the study showed that the GDS-30 questionnaire had a high compliance in both face-to-face and telephone surveys.

A scoping review of functional near-infrared spectroscopy biomarkers in late-life depression: Depressive symptoms, cognitive functioning, and social functioning.

Late-life depression is one of the most damaging mental illnesses, disrupting the normal lives of older people by causing chronic illness and cognitive impairment. Patients with late-life depression, accompanied by changes in appetite, insomnia, fatigue and guilt, are more likely to experience irritability, anxiety and somatic symptoms. It increases the risk of suicide and dementia and is a major challenge for the public health systems. The current clinical assessment, identification and effectiveness assessment of late-life depression are primarily based on history taking, mental status examination and scale scoring, which lack subjectivity and precision. Functional near-infrared spectroscopy is a rapidly developing optical imaging technology that objectively reflects the oxygenation of hemoglobin in different cerebral regions during different tasks and assesses the functional status of the cerebral cortex. This article presents a comprehensive review of the assessment of functional near-infrared spectroscopy technology in assessing depressive symptoms, social functioning, and cognitive functioning in patients with late-life depression. The use of functional near-infrared spectroscopy provides greater insight into the neurobiological mechanisms underlying depression and helps to assess these three aspects of functionality in depressed patients. In addition, the study discusses the limitations of previous research and explores potential advances in the field.

Understanding the impact of socioeconomic and health factors on geriatric depression: A comparative study in rural and urban Bangladesh.

Background and Aims: The prevalence of depression among the elderly is a growing concern, and this study examines the differences between urban and rural areas in terms of geriatric depression. Methods: Using a two-stage random sampling approach in urban areas and a multistage random sampling approach in rural areas, the study surveyed 944 elderly individuals of both sexes. Results: The results indicate that the prevalence of depression was high, with 52.5% of the elderly population experiencing mild to severe depression. The study found that increasing age, female gender, nuclear family structure, and involvement of housewives or others were significant factors affecting depression in urban areas, while increasing age and elderly people without spouses were significant factors in rural areas. Additionally, the study identified hearing impairment, asthma, and arthritis as risk factors for depression in rural areas, and bronchitis, heart disease, and thyroid illness as significant factors in urban areas. Conclusion: These findings highlight the need for policymakers to focus on addressing the mental health needs of older people, particularly women and those without spouses.

Association between Internet use and depressive symptoms among older adults in two regions of Myanmar: a cross-sectional study.

BACKGROUND: Internet use has both positive and negative effects on mental health. However, few studies have examined the association between internet use and mental health among older adults in developing countries. This study aimed to investigate the association between Internet use and depressive symptoms among older adults in two regions of Myanmar. METHODS: Data based on a visit to 1,200 older adults in urban and rural Myanmar were obtained through stratified random sampling using the cross-sectional baseline survey of the longitudinal study titled "Healthy and Active Aging in Myanmar." Our analysis included 1,186 participants. The dependent variable was depressive symptoms, and the 15-item version of the Geriatric Depression Scale (GDS) was used as a continuous variable; the higher the score, the more likely a person was to be depressed. Internet use (one of the questions about household property ownership) was used as an independent variable. After confirming the absence of multicollinearity, we adjusted for age, gender, educational background, activities of daily living, residential area, and frequency of meeting friends, and stratified by subjective economic status (above or below average). We also examined the interaction between internet use and subjective economic status. A linear regression analysis was performed. RESULTS: Among the 1,186 participants included in the analysis (women: 59.5%; median age: 68 years old), 202 (17.0%) were Internet users (95% Confidential Interval [CI]: 0.15, 0.19), and they had significantly lower GDS scores than the participants who did not use the Internet (B: -1.59, 95% CI: -2.04, -1.13).GDS showed a negative association with Internet use even in the multivariate analysis (B: -0.95, 95% CI: -1.41, -0.50). However, the interaction term for GDS between Internet use and subjective economic status was not significantly associated (B: 0.43, 95% CI: -1.11, 1.98). CONCLUSIONS: Internet use and depressive symptoms were associated especially among the older adults. However, there were no significant interaction between Internet use and subjective economic status for GDS.

Compassion Meditation for Distressed Older Veterans: A Feasibility Study.

OBJECTIVES: Older Veterans are at elevated risk for psychological distress and may encounter barriers to accessing mental health services. Compassion Meditation (CM) promotes positive emotions and outcomes among distressed individuals; thus, we conducted a preliminary feasibility study of CM among distressed older Veterans. METHODS: Participants included 25 Veterans aged 55+ (M = 69.0, SD = 10.6) with anxiety and/or depressive symptoms, recruited from primary care, mostly male (76.0%), and White (60.0%). CM consisted of 10 groups, which were transitioned from in-person to telehealth due to COVID-19. Feasibility indices included rates of intervention initiation and completion, and attendance. Participants completed measures of symptom severity and well-being pre- and post-intervention. RESULTS: Of 25 enrolled participants, 88.0% (n = 22) attended at least one session, and 52% (n = 13) completed the intervention (attended six or more sessions). Among intervention completers, the average number of sessions attended was 9.46. Seven Veterans withdrew from intervention due to difficulties engaging via telehealth. CONCLUSIONS: These findings support the feasibility of CM training in older Veterans with psychological distress, though dropouts highlighted potential need for additional strategies to facilitate telehealth participation. CLINICAL IMPLICATIONS: Older Veterans appear amenable to meditation-based practices, provided they are easy to access.

Associations Between Vitamin D Deficiency/Insufficiency and Depression Expose Health Disparities in Older Rural West Texans: A Project FRONTIER Study.

OBJECTIVE: To determine associations between Vitamin D (VD) levels and clinical depression through the Geriatric Depression Scale (GDS) and its questions and subdomains, stratified by demographics and Hispanic/Latino ethnicity (HLE). DESIGN, SETTING, AND PARTICIPANTS: A cohort of 299 Project FRONTIER participants aged 62.6 ± 11.7 years old, 70.9% female, and 40.5% HLE were used. Standard correlation and regression analyses were employed. MEASUREMENTS: The main outcome measures were VD (serum 25(OH)-VD) level, GDS-30 (30-item questionnaire), GDS-30 subfactors and questions, and HLE status. VD categories were defined as VD deficiency (VDD; ≤20 ng/mL), VD insufficiency (VDI; 21-29 ng/mL), VD sufficiency (30-38 ng/mL) and high VD sufficiency (>38 ng/mL). RESULTS: The majority (61.5%) of samples fell into VDD/VDI categories. A significant negative association was found between VD level and GDS-30 total score. VD level was negatively correlated with Dysphoria and Meaninglessness GDS-30 subfactors. Although GDS subfactors were similar between HLE and non-HLE groups, VD levels were significantly lower in HLE samples. Finally, HLE/non-HLE groups were differentially stratified across VD categories. Only 4% of HLEs fell into the high VD sufficient category, suggesting low VD supplementation. CONCLUSION: A significant negative association between VD level and depressive symptoms was revealed in our aging Project FRONTIER participants. HLE individuals were overrepresented in VDD/VDI samples, and VDD/VDI was associated primarily with the Dysphoria GDS subdomain. Regression analysis predicted high VD sufficiency (95.5 ng/mL) to be associated with no depressive symptoms (GDS=0). Our results underscore troubling disparities in VD-related depressive symptoms between HLE and non-HLE populations.

Association between Depressive Mood, Antidepressant Therapy and Neuropsychological Performances: Results from a Cross-Sectional Study on Elderly Patients.

BACKGROUND: Currently, the global demographic landscape is undergoing a transformative shift towards an increasingly aging population. This leads to an increase in chronic pathologies, including depression and cognitive impairment. This study aimed to evaluate the association between depressive mood, whether in treatment or not, and cognitive capacities, assessed using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). METHODS: This study included 259 subjects, aged 65 years or older, evaluated at the Geriatric Outpatient Service of the University Hospital of Monserrato, Cagliari, between July 2018 and May 2022, who experienced subjective depressive mood and/or cognitive deficits. RESULTS: Only 25.1% of the sample showed no cognitive impairment on the RBANS. Education was a significant regressor of the RBANS Total Scale scores (p < 0.0001) and was negatively associated with mood deflection (r = -0.15, p = 0.0161). Subjects with depressive mood had more impaired attention and visuospatial/constructional abilities compared to untreated euthymic patients. Post-hoc analysis, conducted with the Conover test, showed that untreated euthymic patients (GDS-15 ≤ 5, group 2) had a higher score on the RBANS total scale than patients with mood deflection (GDS-15 > 5, group 1), and treated euthymic patients (GDS-15 ≤ 5, group 3). Finally, different logistic regression analyses revealed a significant negative coefficient for GDS as a regressor of the RBANS total scale (coefficient: -0.04, p = 0.0089), visuospatial/constructional abilities (coefficient: -0.03, p = 0.0009), language (coefficient: -0.05, p = 0.0140), and attention (coefficient: -0.05, p < 0.0001). CONCLUSIONS: Our analysis demonstrated that "naturally" euthymic people show better cognitive performances than people with depressive mood and subjects with acceptable mood due to antidepressants. Furthermore, the gender-based difference observed in the language domain suggests the potential utility of incorporating an alternative category for male patients in the Semantic Fluency test.

Depressive symptoms in the entire spectrum of cognitive ageing in Greece: evidence from the Hellenic Longitudinal Investigation of Aging and Diet (HELIAD).

OBJECTIVES: To study (i) the prevalence of mild and moderate-to-severe depressive symptoms in the entire spectrum of cognitive ageing in Greece and (ii) the relationship between these symptoms and demographic and clinical data. METHODS: The study was based on the randomly selected cohort of the Hellenic Longitudinal Investigation of Aging and Diet (HELIAD). Depressive symptoms were assessed with the 15-item version of the Geriatric Depression Scale. Participants also received a comprehensive neuropsychological assessment, while the clinical diagnoses of dementia and mild cognitive impairment were established according to international diagnostic criteria. Statistical analyses relied on comparison tests and a logistic (proportional odds) ordinal regression model. RESULTS: Depressive symptoms were detected in 19.5% of the 1936 study participants, while 11.3% of both people with MCI and dementia had moderate-to-severe depressive symptoms. The regression model revealed that older adults with more severe depressive symptoms were more likely female, cognitively impaired, less educated, were treated with psychotropic medication and lived in Attica versus Thessaly. CONCLUSIONS: Since depressive symptoms were detected in almost one in five older adults, healthcare professionals in Greece should safeguard the timely detection and effective treatment of such symptoms and the post-diagnostic care of older adults with depression.

Depressive symptoms are present in approximately 20% of older adults.More than 10% of older individuals with dementia or mild cognitive impairment report moderate-to-severe depressive symptoms.Female sex, lower education, lower cognitive performance, living in urban areas and treatment with psychotropic medication pertain to more severe depressive symptoms in ageing.Timely detection and effective treatment of depressive symptoms are crucial in the clinical practice of the care of older adults.Further research is needed in order to elucidate the complex relationship between depressive symptoms and cognitive impairment in ageing.

Doing housework and having regular daily routine standing out as factors associate with physical function in the older people.

Background and objectives: Nationwide data were used to explore factors associated with physical function in order to identify interventions that could improve and maintain physical function in the older people. Methods: The physical function was assessed by gait speed (GS). We selected 2,677 male and 2,668 female older adults (aged ≥60) who could perform the GS test as study subjects. GS was measured by having subjects walk across and back a 10-m course. A gait speed less than 20% that of a reference population (<0.7 m/s) was used as the definition of slow gait speed (SGS). Co-morbidity, polypharmacy, medical expenses, need for care, and hospitalization were used to evaluate health status. A stepwise logistic regression model was used to determine factors associated with SGS. Results: SGS was associated with poorer health status, higher medical cost, lower ranking on the Geriatric Depression Scale (GDS) and decreased Mini-mental State Examination (MMSE). Co-morbidity (OR = 1.81, 1.58-2.07), polypharmacy (OR = 1.47, 1.25-1.74), MMSE <24 (OR = 1.85, 1.54-2.22), and GDS ≥ 11 (OR = 1.40, 1.18-1.65) were associated with SGS. In contrast, doing housework (DHW, OR = 0.43, 0.38-0.49), having a regular daily routine (RDR, OR = 0.64, 0.45-0.91), and current alcohol consumption (OR = 0.74, 0.62-0.90) were inversely associated with SGS. DHW plus having RDR could greatly reduce the risk of SGS (OR = 0.29, 0.19-0.43). Conclusion: Poor physical function is associated with poorer health status in Chinese older people. Maintaining a regular daily routine and doing some housework may be important factors that can help older people preserve their physical function.

Grey matter volume predicts improvement in geriatric depression in response to Tai Chi compared to Health Education.

OBJECTIVES: Geriatric depression (GD) is associated with cognitive impairment and brain atrophy. Tai-Chi-Chih (TCC) is a promising adjunct treatment to antidepressants. We previously found beneficial effects of TCC on resting state connectivity in GD. We now tested the effect of TCC on gray matter volume (GMV) change and the association between baseline GMV and clinical outcome. PARTICIPANTS: Forty-nine participants with GD (>=60 y) underwent antidepressant treatment (38 women). INTERVENTION: Participants completed 3 months of TCC (N = 26) or health and wellness education control (HEW; N = 23). MEASUREMENTS: Depression and anxiety symptoms and MRI scans were acquired at baseline and 3-month follow-up. General linear models (GLMs) tested group-by-time interactions on clinical scores. Freesurfer 6.0 was used to process T1-weighted images and to perform voxel-wise whole-brain GLMs of group on symmetrized percent GMV change, and on the baseline GMV and symptom change association, controlling for baseline symptom severity. Age and sex served as covariates in all models. RESULTS: There were no group differences in baseline demographics or clinical scores, symptom change from baseline to follow-up, or treatment-related GMV change. However, whole-brain analysis revealed that lower baseline GMV in several clusters in the TCC, but not the HEW group, was associated with larger improvements in anxiety. This was similar for right precuneus GMV and depressive symptoms. CONCLUSIONS: While we observed no effect on GMV due to the interventions, baseline regional GMV predicted symptom improvements with TCC but not HEW. Longer trials are needed to investigate the long-term effects of TCC on clinical symptoms and neuroplasticity.