Prospective associations between marital discord and depressive symptoms in middle-aged and older adults.

Data from both spouses in a population-based sample of middle-aged and older adults (N = 1,869 couples) were used to evaluate the 2-year prospective association between marital discord and depressive symptoms. Nested path analyses indicated that (a) baseline marital discord predicted one's own depressive symptoms at follow-up, (b) baseline depressive symptoms predicted one's own marital discord at follow-up, (c) baseline depressive symptoms predicted partners' marital discord at follow-up, and (d) there were no gender differences in the magnitudes of the pathways between one's own baseline depressive symptoms and one's own marital discord at follow-up or between one's own baseline marital discord and one's own depressive symptoms at follow-up. These results suggest a bidirectional longitudinal association between marital discord and depressive symptoms in middle-aged and older adults. (PsycINFO Database Record (c) 2010 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)     

Etiologic factors in the onset of depressive symptoms in older adults.

Examined the additive and interactive roles of 6 sociodemographic factors (education, age, sex, marital status, parental depression, and early parental death), 3 resources (health, social support, and locus of control), and 3 categories of life events (bereavement, health problem, and loss events) in the development of depressive symptoms. A probability sample of 1,233 persons (aged 55+ yrs) were interviewed twice in their homes, with a 6-mo interval between Times 1 and 2. All Ss were below a Center for Epidemiologic Studies Depression Scale (CES-D) cutoff point of 16 at Time 1. An onset group (n?=?66) was identified that had increases in depression to above a CES-D cut point of 20 at Time 2. A hierarchical discriminant analysis revealed significant effects for the following factors after initial symptom levels were statistically controlled: physical health, social support, social support and health interaction, loss events, and the interaction of social support and loss events. It is concluded that health and social support played both additive and interactive roles, life events had weak effects, and sociodemographic factors did not contribute to depressive onset in the Ss studied. (85 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Vascular health and longitudinal changes in brain and cognition in middle-aged and older adults.

The impact of vascular health on the relations between structural brain changes and cognition was assessed in a longitudinal study of 46 adults, 23 of whom remained healthy for 5 years and 23 of whom had hypertension at baseline or acquired vascular problems during follow-up. At both measurement occasions, the volume of white matter hyperintensities (WMH) and regional brain volumes correlated with age. In 5 years, WMH volume more than doubled in the vascular risk group but did not increase in healthy participants. The frontal lobes had the highest WMH load at baseline and follow-up; the parietal WMH showed the greatest rate of expansion. In the vascular risk group, systolic blood pressure at follow-up correlated with posterior WMH volume. The fastest cortical shrinkage was observed in the prefrontal cortex and the hippocampus. Fluid intelligence correlated with WMH burden and declined along with faster WMH progression. In the vascular risk group, WMH progression and shrinkage of the fusiform cortex correlated with decline in working memory. Thus, poor vascular health contributes to age-related declines in brain and cognition, and some of the age-related declines may be limited to persons with elevated vascular risk. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

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)     

Effects of attachment bereavement and pre-event conditions on subsequent depressive symptoms in older adults.

A sample of 1,411 older adults (age 55+) who had been interviewed both prior to and after bereavement was studied, allowing for pre-event controls. Those who had lost a parent, spouse, or child had the strongest depressive reactions, as predicted by an attachment-bonding hypothesis; however, material losses were also related to depression. Although bereavement/loss events were clearly related to subsequent depression even after pre-event depression, resources, and events were controlled, certain pre-event characteristics were predictive of the bereavement/loss events, including prior undesirable events, age, and urban/rural residency. A further analysis of 1,007 persons with two post-event interviews (at 6-month to 1-year follow-up) revealed an initial depressive reaction to a bereavement/loss event, which then dissipated completely within 1 year's time. Generally, bereavement appeared to have limited etiologic importance. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Chronic financial strain, social support, and depressive symptoms among older adults.

The purpose of this study is twofold: one, to determine whether chronic financial strain is related to depressive symptoms among a random community sample of older adults, and two, to assess whether social support counterbalances or buffers the deleterious effects of financial strain. The findings suggest that elderly people suffering from financial strain are more likely to be depressed than are older adults with fewer financial problems. In addition, the data support the stress-buffering hypothesis, that is, that older people who have more informational support and who provide support to others, more often report fewer symptoms of depression as a result of financial strain than do elderly respondents who have less informational support and who do not provide support to others. Tangible and emotional support are found to be less effective coping resources when financial strain is present. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Chronic stress and depressive disorders in older adults.

Current and lifetime rates of Diagnostic and Statistical Manual of Mental Disorders-III—Revised (DSM-III—R) disorders were compared in 86 older adults caring for a spouse with a progressive dementia and 86 sociodemographically matched control subjects. Dementia caregivers were significantly more dysphoric than noncare givers. The frequencies of depressive disorders did not differ between groups in the years before care giving, and there were no group differences in first-degree relatives' incidence of psychiatric disorder. During the years they had been providing care, 30% of care givers experienced a depressive disorder (major depression, dysthymia, or depression not otherwise specified) versus 1% of their matched controls in the same time period. Only two care givers who met criteria during care giving had met criteria for a depressive disorder before care giving, and family history was not even weakly related to the identification of at-risk care givers. In contrast to these group differences in depressive disorders, there were no significant differences in other Axis I disorders either before or during care giving. Thus, the chronic strains of care giving appear to be linked to the onset of depressive disorders in older adults with no prior evidence of vulnerability. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Modeling the cross-sectional relationships between religion, physical health, social support, and depressive symptoms

The authors examined models of the relationships between religious activities, physical health, social support, and depressive symptoms in a sample of 4,000 persons age 65 and over. Religious activity was examined first as a single composite construct and then split into three component variables that were examined individually. Religious activity as a single construct was correlated with both social support and good physical health but was unrelated to depression. Split into the three components, model fit was significantly increased. Frequency of church attendance was positively related to physical health and negatively related to depression, but was surprisingly unrelated to social support. Frequent churchgoers were about half as likely to be depressed. Private prayer/Bible reading was negatively correlated with physical health and positively correlated with social support, but unrelated to depression. Religious TV/radio listening was unrelated to social support, negatively related to good physical health, and, unexpectedly, positively associated with depression.     

Age differences in hostility among middle-aged and older adults.

Multiple measures of hostility were administered to middle-aged and older volunteers. There was a positive association between age and self-report measures reflecting hostile beliefs about others, including cynicism and suspiciousness. There was a weak inverse relationship between age and self-report measures of the overt expression of anger and aggression, but no association between age and measures of covert hostility was found. There was a positive relationship between age and an assessment of hostile behavior that was based on the respondent's interaction style during an interview. The magnitude of these age trends did not differ between men (n?=?50) and women (n?=?75). Findings illustrate the multidimensional nature of hostility. They also have practical implications for older people because hostility is associated with psychological well-being and has been shown to have consequences for health and longevity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Perceived discrimination, sense of control, and depressive symptoms among Korean American older adults.

This study explored a potential pathway by which perceived discrimination may affect levels of depressive symptoms in a sample of 472 Korean American older adults (Mage = 69.9, SD = 7.04). Building upon previous studies demonstrating that perceived discrimination has negative impacts on mental health, we hypothesized that sense of control would mediate the associations between perceived discrimination and depressive symptoms. Our analyses showed that the effects of perceived discrimination on depressive symptoms were not only direct but also mediated through a lowered sense of control. Finding that sense of control serves as an intervening step between perceived discrimination and mental health may help explicate the psychological mechanisms involved in responses to discriminatory experience and has implications for intervention strategies. (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)     

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)     

Association between depressive symptoms and mortality in older women. Study of Osteoporotic Fractures Research Group

BACKGROUND: Major depression is associated with increased mortality, but it is not known whether patients who report depressive symptoms have greater mortality. SUBJECTS AND METHODS: We performed a prospective cohort study of 7518 white women 67 years of age or older who were recruited from population-based listings in Baltimore, Md, Minneapolis, Minn, Portland, Ore, and the Monongahela Valley, Pa. Participants completed the Geriatric Depression Scale (short form) and were considered depressed if they reported 6 or more of 15 possible symptoms of depression. Women were followed up for an average of 6 years. If a participant died, we obtained a copy of the official death certificate and hospital records, if available, and used International Classification of Diseases, Ninth Revision, codes to classify death attributable to cardiovascular, cancer, or noncancer, noncardiovascular cause. RESULTS: Mortality during 7-year follow-up varied from 7% in women with no depressive symptoms to 17% in those with 3 to 5 symptoms to 24% in those with 6 or more symptoms of depression (P<.001). Of 473 women (6.3%) with 6 or more depressive symptoms at baseline, 24% died (111 deaths in 2610 woman-years of follow-up) compared with 11% of women who reported 5 or fewer symptoms of depression (760 deaths in 41 460 woman-years of follow-up) (P<.001). Women with 6 or more depressive symptoms had a 2-fold increased risk of death (age-adjusted hazard ratio [HR], 2.14; 95% confidence interval [CI], 1.75-2.61; P<.001) compared with those who had 5 or fewer depressive symptoms. This association remained strong after adjusting for potential confounding variables, including history of myocardial infarction, stroke, diabetes mellitus, hypertension, chronic obstructive pulmonary disease, smoking, perceived health, and cognitive function (HR, 1.47; 95% CI, 1.14-1.88; P=.003). Depressive symptoms were associated with an increased adjusted risk of death from cardiovascular diseases (HR, 1.8; 95% CI, 1.2-2.5; P= .003), and non-cancer, noncardiovascular diseases (HR, 1.8; 95% CI, 1.2-2.7; P = .01), but were not associated with deaths from cancer (HR, 1.0; 95% CI, 0.6-1.7; P=.93). CONCLUSIONS: Depressive symptoms are a significant risk factor for cardiovascular and noncancer, noncardiovascular mortality but not cancer mortality in older women. Whether depressive symptoms are a marker for, or a cause of, life-threatening conditions remains to be determined.     

Depressive symptoms across older spouses: Longitudinal influences.

Cross-sectional findings that depressive symptoms in one older spouse influence those of the other and that marital closeness increases the influences (R.B. Tower & S.V. Kasl, 1995) were tested longitudinally. Independent interviews in 1982, 1985, and 1988 with spouse-pairs who participated in the Established Populations for the Epidemiologic Study of the Elderly showed that changes in depressive symptoms in one older spouse contributed to changes in depressive symptoms in the other. For wives in 1985 and for husbands in 1988, a spouse's baseline depressive symptoms also contributed independent variance to an increase in respondent's score on the Center for Epidemiologic Studies Depression Scale. These findings were stronger when a couple was close. These results held when known intrapersonal risk factors and the health status of the spouse were controlled. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Longitudinal effects of conflict behaviors on depressive symptoms in young couples.

This study investigated relationship dynamics contributing to gender differences in depression by testing longitudinal associations between observed conflict behaviors and depressive symptoms in young couples. Direct effects of psychological aggression, positive engagement, and withdrawal, as well as indirect effects via relationship satisfaction were considered. Participants were 68 heterosexual couples involving men from the Oregon Youth Study who remained in a stable relationship across at least 2 and up to 10 years from their early 20s to early 30s. Hierarchical linear modeling was used to test both between-couples differences in symptom trajectories predicted by partner behaviors and within-couple covariation between behaviors and depressive symptoms across 5 time points. Higher levels of women’s positive engagement predicted lower symptom levels for both partners, and higher women’s withdrawal predicted higher own symptom levels. Relative increases in couples’ psychological aggression and decreases in positive engagement were additionally associated with increases in women’s symptoms over time. Whereas between-couples behavior effects on women’s symptoms were mediated by relationship satisfaction, within-couple effects proved independent of satisfaction. Implications for mechanisms of depression risk and maintenance in couples are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Interrelations and moderators of longitudinal links between marital satisfaction and depressive symptoms among couples in established relationships.

Extending research based on newlywed couples, this study investigated longitudinal associations between marital satisfaction and depressive symptoms in a community sample of 296 couples in established relationships (M = 13.25 years, SD = 5.98) with children (M age = 11.05 years, SD = 2.31). Support was found for reciprocal relations between marital satisfaction and depressive symptoms in couples with established relationships. Further extending previous work, the study showed that relationship length and hostile marital conflict were significant moderators of these linkages. Husbands in longer term relationships were more vulnerable to depressive symptoms in the context of marital problems compared with husbands in shorter term relationships. At higher levels of marital conflict, the negative relationship between marital satisfaction and depressive symptoms was strengthened. Reflecting an unexpected finding, increased conflict buffered spouses from marital dissatisfaction in the context of depressive symptoms. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological health and problem-solving self-appraisal in older adults.

This study investigated relations between psychological health and problem-solving self-appraisal in 97 adults aged 65–96 years. Participants completed the Problem-Solving Inventory (P. P. Heppner, 1988) and two measures of psychological health encompassing both well-being and distress dimensions. Results of a canonical correlation analysis indicated that relations between problem-solving self-appraisal and psychological health were complex and sometimes contradictory. On the one hand, as problem-solving self-appraisal became more favorable (more confidence, more control, and increased approaching of problems), well-being increased and distress decreased. Conversely, perceptions of avoidant problem solving and decreased control were also associated with some increases in psychological health. Research and counseling implications are discussed. (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.     

Efficacy of leader-led and self-directed career workshops for middle-aged and older adults.

The differential effectiveness of leader-led and self-directed career and life planning workshops for 98 middle-aged and older adult participants was examined. First, a test of the magnitude of change on multiple attitudinal and behavioral variables revealed that participants improved regardless of treatment condition. Those participants in the leader-led condition, however, had greater posttest employment research interview behaviors than did participants in the self-directed condition. Second, 2 theoretically derived attributes, goal directedness and sociability–structure, were chosen to test the interaction effects between potentially salient participant attributes and workshop format. By means of a multivariate multiple regression strategy, no Attribute?×?Treatment interactions were identified. Results of this study suggest that the career and life planning workshops were positively received regardless of format and participant attribute. (PsycINFO Database Record (c) 2010 APA, all rights reserved)