The reciprocal relationship between physical activity and depression in older European adults: A prospective cross-lagged panel design using SHARE data.

Objective: The aim of this prospective study was to investigate the reciprocal nature of the physical activity-depressive symptoms relationship in 17,593 older adults from 11 European countries older adults (M age = 64.07, SD = 9.58) across two-year follow-up. Also, gender and age were examined as potential moderators of this relation. Method: A two-wave cross-lagged panel design and latent change score models with structural equation modeling was used to analyze data. Depressive symptoms were measured at baseline (T1) and follow-up (T2) using the EURO-D scale, capturing the two factors of affective suffering and motivation. Physical activity was measured at T1 and T2 as frequency of moderate physical activity and vigorous physical activity. Results: Cross-sectional latent variable analyses revealed that higher levels of physical activity at T1 and T2 were associated with lower levels of affective suffering and motivation at T1 and T2. Physical activity at T1 was significantly associated with affective suffering and motivation at T2. The relations of depressive symptoms at T1 with physical activity at T2 were not significant. However, a cross-lagged model showed best model fit, supporting a reciprocal prospective relationship between physical activity and depressive symptoms in older adults. Latent change in depressive symptoms factors was related to latent change in physical activity indicating complex and dynamic associations across time. Conclusions: Regular physical activity may be a valuable tool in the prevention of future depressive symptoms in older adults, and depressive symptoms may also prevent older adults from engaging in regular physical activity. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Effects of depressive symptoms on health behavior practices among older adults with vision loss.

Objective: The authors examined the interface between visual impairment and depressive symptoms on health behaviors, self-care, and social participation among adults ages 65 and older. Method: The authors analyzed data from the 1997–2004 National Health Interview Survey on visual impairment and depressive symptoms for 49,278 adults ages 65 and older, comparing visually impaired adults (n = 8,787) with and without depressive symptoms with a reference group of adults with neither condition (n = 3,136) for outcome measures: physical health, health behaviors, and difficulties with self-care and social participation. Results: Adults with visual impairment and severe depressive symptoms were more likely than adults with neither condition to smoke (14.9%, adjusted odds ratio [AOR] = 1.6), be obese (28.2%, AOR = 1.9), be physically inactive (80.5%, AOR = 3.0), have fair–poor health (76.0%, AOR = 26.5), and have difficulties with self-care (27.9%, AOR = 11.8) and social participation (52.1%, AOR = 10.9). Discussion and Conclusions: Older visually impaired adults with depressive symptoms are vulnerable to health decline and further disablement without timely interventions that target smoking cessation, healthy eating, and increased physical activity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Assessment of depression in aging contexts: General considerations when working with older adults.

Popular assertions portray depression as an inevitable outcome of aging, a widespread image embraced by many health professionals. Although epidemiological data contradict the prevalent image that depressive syndromes increase with age, the prognosis becomes more negative as one grows older. An early thorough assessment is vital to identify depressive symptoms in older adults, thus promoting the development of tailored interventions and improved recovery rates. The main problems associated with the assessment of depressive symptoms in older adults include a lack of knowledge about changes in the pattern of symptoms, the inadequacy of techniques developed for other age cohorts, the misuse of psychometric instruments, and deficits in additional areas of assessment. The underlying goal of this article is to analyze the obstacles to a successful assessment of depression symptoms in older adults, suggesting strategies to overcome them. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relationship between age and aspects of depression: Consistency and reliability across two longitudinal studies.

In this study, the authors examined cross-sectional and longitudinal age and gender differences in each of the Center for Epidemiological Studies Depression Scale's 4 subscales of depressive symptomatology. Two independent studies (Sample 1 = 2,076; Sample 2 = 943) were used for purposes of establishing stability of findings. Results indicate a reasonable degree of stability among adults under 70 years of age. However, there were significant age-related increases in somatic symptoms and lack of well-being after approximately 70 years of age, whereas symptoms related to depressed affect and interpersonal problems remained stable. Notably, depressive affect symptoms remained stable given significant age-related somatic changes. The addition of comorbid physical illness to the analysis did not reduce the association between age and depressive symptoms, indicating that part of the association was not substantially accounted for by physical health. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A longitudinal analysis of anxiety and depressive symptoms.

The authors modeled depressive and anxiety symptom data from 1,391 participants in a longitudinal study of middle-aged and older Swedish twins (M age?=?60.9 years, SD?=?13.3). Although anxiety and depression were highly correlated, a model with distinct Anxiety and Depression factors fit the data better than models with Positive and Negative Affect factors or a single Mental Health factor. Lack of well-being was associated with anxiety rather than depression. Over two 3-year intervals, anxiety symptoms led to depressive symptoms, but the relationship was not reciprocal. Anxiety symptoms were more stable than depression. These findings provide additional support for the idea that anxiety symptoms may reflect a personality trait such as neuroticism more than do depressive symptoms and suggest that low positive affect may not be as specific to depression among older adults as in younger people. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Activity limitation and depression: Perspectives of older African American women and their close companions.

Objective: To compare self-report of activity limitations and depressive symptoms of older African American women following physical rehabilitation with the views of a self-nominated close companion. Participants: Thirty-seven African American women (mean age = 72.57 years) and their designated companions (mean age = 54.81 years). Study Design: Telephone interview with the older female respondents and a parallel interview with their companions. Results: The women and their companions provided comparable information regarding activity limitations and depressive symptoms. An association between activity limitation and depression was detected from the perspectives of both the women and their companions. Conclusions: Findings indicate the utility of proxy reports about the functioning of older adults but also indicate the need to carefully consider criteria used in selection of proxy reporters. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Moderators and mediators of exercise-induced objective sleep improvements in midlife and older adults with sleep complaints.

Objective: Exercise can improve sleep quality, but for whom and by what means remains unclear. We examined moderators and mediators of objective sleep improvements in a 12-month randomized controlled trial among underactive midlife and older adults reporting mild/moderate sleep complaints. Methods: Participants (N = 66, 67% women, 55–79 years) were randomized to moderate-intensity exercise or health education control. Putative moderators were gender, age, physical function, self-reported global sleep quality, and physical activity levels. Putative mediators were changes in BMI, depressive symptoms, and physical function at 6 months. Objective sleep outcomes measured by in-home polysomnography were percent time in Stage I sleep, percent time in Stage II sleep, and number of awakenings during the first third of sleep at 12 months. Results: Baseline physical function and sleep quality moderated changes in Stage I sleep; individuals with higher initial physical function (p = .01) and poorer sleep quality (p = .03) had greater improvements. Baseline physical activity level moderated changes in Stage II sleep (p = .04) and number of awakenings (p = .01); more sedentary individuals had greater improvements. Decreased depressive symptoms (CI:-1.57 to ?0.02) mediated change in Stage I sleep. Decreased depressive symptoms (CI:-0.75 to ?0.01), decreased BMI (CI:-1.08 to ?0.06), and increased physical function (CI: 0.01 to 0.72) mediated change in number of awakenings. Conclusions: Initially less active individuals with higher initial physical function and poorer sleep quality improved the most. Affective, functional, and metabolic mediators specific to sleep architecture parameters were suggested. These results indicate strategies to more efficiently treat poor sleep through exercise in older adults. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Loneliness predicts reduced physical activity: Cross-sectional & longitudinal analyses.

Objective: To determine cross-sectional and prospective associations between loneliness and physical activity, and to evaluate the roles of social control and emotion regulation as mediators of these associations. Design: A population-based sample of 229 White, Black, and Hispanic men and women, age 50 to 68 years at study onset, were tested annually for each of 3 years. Main Outcome Measures: Physical activity probability, and changes in physical activity probability over a 3-year period. Results: Replicating and extending prior cross-sectional research, loneliness was associated with a significantly reduced odds of physical activity (OR = 0.65 per SD of loneliness) net of sociodemographic variables (age, gender, ethnicity, education, income), psychosocial variables (depressive symptoms, perceived stress, hostility, social support), and self-rated health. This association was mediated by hedonic emotion regulation, but not by social control as indexed by measures of social network size, marital status, contact with close ties, group membership, or religious group affiliation. Longitudinal analyses revealed that loneliness predicted diminished odds of physical activity in the next two years (OR = 0.61), and greater likelihood of transitioning from physical activity to inactivity (OR = 1.58). Conclusion: Loneliness among middle and older age adults is an independent risk factor for physical inactivity and increases the likelihood that physical activity will be discontinued over time. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Physical status as a moderator of depressive symptoms among older adults with dual sensory loss.

Objective: This study evaluated the ability of three measures of physical status—physical activity, physical condition, and body mass index (BMI)—to moderate the relationship between dual sensory loss (DSL) and depressive symptoms in older adults. Method: Nationally representative longitudinal data were used to develop multilevel models predicting depressive symptoms among two groups of older adults, 1380 who developed DSL during the study and 1308 without sensory loss. Results: All three measures were associated with depressive symptoms for persons who had or would develop a DSL: participation in physical activity and being in better physical condition were associated with lower levels of depressive symptoms, while lower BMI levels were associated with higher levels of depressive symptoms. All moderator variables had a larger effect for persons with DSL as compared to persons without sensory loss. Implications: The implication of these findings is that participation in a regular program of physical activity may provide multiple benefits to older persons with DSL. Families and health care providers can offer support for being physically active by ensuring the person has the best possible correction for the sensory losses, providing encouragement, and/or providing physical assistance with exercise. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Effects of Pain on Functioning and Well-Being in Older Adults With Osteoarthritis of the Knee.

The effects of pain on functioning and well-being were examined in 367 older adults with osteoarthritis (OA) of the knee. The relationship of OA-related pain to depressive symptoms and perceived health was hypothesized to be direct as well as mediated by physical and social functioning. Results showed that OA-related pain was related to poorer physical and social functioning, had a direct effect on depressive symptoms, and direct and indirect effects on perceived health. Lower social functioning was related to more depressive symptoms, and both lower social and physical functioning predicted worse perceived health. Thus, distinguishing between physical and social functioning when examining the costs of OA-related pain is useful. Moreover, existing pain-psychological well-being models can be generalized to perceived health. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A longitudinal study of gender differences in depressive symptoms from age 50 to 80.

The Obvious Depression Scale was administered to 739 community residents at ages 50, 60, and 80 years, with 151 present at all waves. Although selective attrition influenced the level of depressive symptoms in cross-sectional vs. longitudinal samples, both sets of analyses revealed higher scores in women than in men at ages 50 and 60, but not at age 80. Men showed increases in depressive symptoms from age 60 to 80, but women did not (interaction p ?     

Neuroticism and depressive symptoms among spouse caregivers: Do health behaviors mediate this relationship?

This study examined the mediating role of health behaviors in the relationship between neuroticism and depressive symptoms among spouse caregivers. Path analysis was used to test a model of the caregiver stress process among 233 caregivers of people with dementia. Results indicate that neuroticism has a significant direct effect on depressive symptoms and also indirectly influences depressive symptoms through health behaviors and perceived stress. When individual health behaviors were examined in the path model, only physical activity served a significant mediating role. These findings suggest that neuroticism may lead to depressive symptoms among caregivers partly through declines in physical activity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Loneliness as a specific risk factor for depressive symptoms: Cross-sectional and longitudinal analyses.

The extent to which loneliness is a unique risk factor for depressive symptoms was determined in 2 population-based studies of middle-aged to older adults, and the possible causal influences between loneliness and depressive symptoms were examined longitudinally in the 2nd study. In Study 1, a nationally representative sample of persons aged 54 and older completed a telephone interview as part of a study of health and aging. Higher levels of loneliness were associated with more depressive symptoms, net of the effects of age, gender, ethnicity, education, income, marital status, social support, and perceived stress. In Study 2, detailed measures of loneliness, social support, perceived stress, hostility, and demographic characteristics were collected over a 3-year period from a population-based sample of adults ages 50-67 years from Cook County, Illinois. Loneliness was again associated with more depressive symptoms, net of demographic covariates, marital status, social support, hostility, and perceived stress. Latent variable growth models revealed reciprocal influences over time between loneliness and depressive symptomatology. These data suggest that loneliness and depressive symptomatology can act in a synergistic effect to diminish well-being in middle-aged and older adults. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Body mass index and environmental supports for physical activity among active and inactive residents of a U. S. Southeastern county.

Objective: This study examined the associations between body mass index (BMI) and environmental supports for physical activity in active and inactive adults based on national recommendations for physical activity and walking. Residents of a southeastern community (N = 1,111; ages 18-75 years) were contacted using a random-digit-dial method and were asked about neighborhood and community social and environmental supports for physical activity. Main Outcome Measure: Physical activity was measured using the 2001 Behavioral Risk Factor Surveillance System (BRFSS) physical activity module. Results: There was a positive association between higher physical activity and walking levels and lower BMI levels. Trusting neighborhoods having recreational facilities present, and using trails were each associated with twice the odds of being overweight versus obese among those not meeting the national physical activity recommendations. Using trails was also associated with 2.7 times the odds of being overweight as opposed to obese among participants who were not regular walkers. Conclusion: Improving environmental supports for access and use of trails and recreational facilities may be important for future environmental interventions aimed at reducing obesity among inactive individuals. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Depressive symptoms and lymphocyte proliferation in older adults.

In an 18-month prospective study, community-dwelling older adults, including both spousal caregivers of dementia patients and noncaregiving controls, were examined. Participants were selected on the basis of the presence or absence of chronic depressive symptoms that exceeded a cutoff score for clinically relevant depressive symptoms on a self-report symptom measure. Compared with nondepressed older adults, those with chronic, mild depressive symptoms had poorer T cell responses to 2 mitogens from baseline to follow-up. Additionally, among individuals with depressive symptoms, older age was associated with the poorest blastogenic response to the mitogens at follow-up. These findings extend the association between depression and immune function to community-dwelling older adults with chronic, mild depressive symptoms. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Aging and symptoms of anxiety and depression: Structural invariance of the tripartite model.

Negative affect measures were evaluated in a cross-sectional community sample of adults aged 18-93 (N = 335) to examine the structure of neuroticism, anxiety, and depressive symptoms in young, middle, and older adult cohorts. Structural equation modeling was used to contrast 3 nested models: a 1-factor general distress model; a 2-factor high negative-low positive affect model; and a 3-factor "tripartite model" reflecting a higher order Negative Affect factor that is common to depression and anxiety problems and 2 lower order factors, Low Positive Affect (mostly specific to depression) and Arousal (specific to anxiety/panic). As expected, the tripartite model fit best for all age groups. Further, multigroup analyses indicated age invariance for the tripartite model, suggesting the model can be effectively applied with older populations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of positive and negative social exchanges with various sources on depressive symptoms in younger and older adults

Addressing a previous gap in the gerontological literature, the present study examined the effects of both positive and negative social exchanges within key relationships (spouse, children, and other relatives/friends) on the depressive symptoms of younger (28 to 59 years old) and older (60 to 92 years old) men and women. Separate analyses were carried out on younger adults (N = 452) and older adults (N = 849) who were respondents in the Americans' Changing Lives study. In both age groups, positive and negative social exchanges with the same source were significantly (p < .001), inversely related (rs range from -.23 to -.43); and positive social exchanges exerted stronger net effects on depressive symptoms than negative social exchanges. For older adults, some buffering effects were found when negative and positive social exchanges were associated with different sources; for younger adults, buffering effects were found when negative and positive social exchanges were associated with the same source. These buffering effects were not conditioned by gender. The findings of the present study highlight the importance of taking into account the age of the recipient and the provider-recipient relationship when studying the joint influence of negative and positive social exchanges on adults' depressive symptoms.     

The association of anxiety and depressive symptoms with cognitive performance in community-dwelling older adults.

The authors examined the association of anxiety, depressive symptoms, and their co-occurrence on cognitive processes in 102 community-dwelling older adults. Participants completed anxiety and depression questionnaires as well as measures of episodic and semantic memory, word fluency, processing speed/shifting attention, and inhibition. Participants with only increased anxiety had poorer processing speed/shifting attention and inhibition, but depressive symptoms alone were not associated with any cognitive deficits. Although coexisting anxiety and depressive symptoms were associated with deficits in 3 cognitive domains, reductions in inhibition were solely attributed to anxiety. Findings suggest an excess cognitive load on inhibitory ability in normal older adults reporting mild anxiety. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Prospective reciprocal relations between physical activity and depression in female adolescents.

Objective: Although an inverse correlation between physical activity and depression among adolescents has been found in research, this relation has seldom been examined prospectively. Thus, we tested whether physical activity reduces risk for future escalations in depression and whether depression decreases likelihood of future change in physical activity. Method: Data from a longitudinal study involving annual assessments of 496 adolescent girls (mean age = 13 years, SD = 0.73) followed over a 6-year period were analyzed to address these questions. Results: Using analyses that controlled for several covariates, we found that physical activity significantly reduced risk for future increases in depressive symptoms and risk for onset of major–minor depression. Further, depressive symptoms and major–minor depression significantly reduced future physical activity. However, predictive effects were modest for both. Conclusions: Results support a bidirectional relation between exercise and depression and imply that interventions that increase physical activity may reduce risk for depression among this high-risk population. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Life Review Therapy Using Autobiographical Retrieval Practice for Older Adults With Depressive Symptomatology.

The aim of this study was to examine the efficacy of life review based on autobiographical retrieval practice for treating depressed older adults. Forty-three adults aged 65-93 with clinically significant depressive symptomatology and no dementia were randomly assigned to treatment or to no treatment. The results indicated significant differences between experimental and control groups after 4 weeks of autobiographical retrieval practice. At posttest, those in the treatment condition showed fewer depressive symptoms, less hopelessness, improved life satisfaction, and retrieval of more specific events. The findings suggest that practice in autobiographical memory for specific events may be among the components of life review that account for its effectiveness and could be a useful tool in psychotherapy with older adults. (PsycINFO Database Record (c) 2010 APA, all rights reserved)