Depressive Disorder in the Elderly

A special issue of Geriatrics (ISSN 2308-3417).

Deadline for manuscript submissions: closed (31 March 2017) | Viewed by 70695

Special Issue Editor


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Guest Editor
Department of Psychiatry and Division of Geriatrics and Palliative Medicine, Weill Cornell Medical College, P.O. Box 140, New York Presbyterian Hospital, 525 East 68th Street, New York, NY 10065, USA
Interests: geriatric depression; psychosocial interventions; innovative interventions; costs; symptoms; suicide; aging; pain and depression; personality

Special Issue Information

Dear Colleagues,

Depression in the elderly is a protean condition with a multiplicity of presentations and consequences. It is associated with numerous adverse outcomes for individual patients, including symptomatic chronicity, suicide, cognitive decline, excess disability, medical morbidity, poor quality of life, and institutionalization. Additionally, there are extensive social and financial costs. However, we know that contemporary pharmacological interventions do not bring a majority of patients into full remission.

This Special Issue therefore focuses broadly on a wide range of issues relevant to geriatric depression: clinical presentation and course, pharmacological and innovative psychosocial interventions, costs and social implications. Submitted manuscripts describing current research, review articles and communications in any of these areas are sought.

Prof. Dr. Robert C. Abrams
Guest Editor

Manuscript Submission Information

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Keywords

  • geriatric depression
  • psychosocial interventions
  • innovative interventions
  • costs
  • symptoms
  • suicide
  • aging

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Published Papers (7 papers)

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Research

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648 KiB  
Article
Memory and Learning Complaints in Relation to Depression among Elderly People with Multimorbidity
by Bishwajit Ghose and Mahaman Yacoubou Abdoul Razak
Geriatrics 2017, 2(2), 15; https://doi.org/10.3390/geriatrics2020015 - 9 May 2017
Cited by 11 | Viewed by 6580
Abstract
Although current models of care are generally well-suited to providing treatment for individual medical conditions, the emergence of multimorbidity is becoming a serious concern for practitioners and policy researchers, particularly in developing countries. The challenges of tackling multimorbidity are further compounded when the [...] Read more.
Although current models of care are generally well-suited to providing treatment for individual medical conditions, the emergence of multimorbidity is becoming a serious concern for practitioners and policy researchers, particularly in developing countries. The challenges of tackling multimorbidity are further compounded when the multimorbidity co-occurs with psychiatric conditions such as cognitive and depressive disorders. Understanding the relationships between multimorbidity and psychiatric illnesses is therefore of considerable clinical importance. In the present study, we cross-sectionally examined whether multimorbidity has an association with perceived cognition—including memory, learning complaints, and depression—among elderly population in South Africa. Study subjects were 422 men and women aged 50 years and older. The prevalence of arthritis, asthma, cancer, diabetes, heart disease, chronic lung disease, hypertension, and stroke was respectively 31.5, 7.3, 1.7, 10.2, 1.2, 1.7, 52.1, and 31.5%, and that of multimorbidity was 30.8%. In the multivariate analysis, women with multimorbidity were 4.33 times (OR = 4.33, 95%CI = 2.96–14.633) more likely to report memory complaints. The odds of diagnosed depression were 1.4 times (OR = 1.4, 95%CI = 1.045–5.676), and the odds of self-reported depression were 1.7 times (OR = 1.7, 95%CI = 1.41–2.192) higher among women who had multimorbidity compared with those who had no morbid conditions. However, the association was not significant among men. Overall, the findings suggest that the occurrence of multimorbidity warrants special attention, especially regarding its compounding effects on psychological health. The findings need to be replicated through longitudinal studies that consider a broader range of chronic conditions. Full article
(This article belongs to the Special Issue Depressive Disorder in the Elderly)
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522 KiB  
Article
Problem Adaptation Therapy for Pain (PATH-Pain): A Psychosocial Intervention for Older Adults with Chronic Pain and Negative Emotions in Primary Care
by Dimitris N. Kiosses, Lisa D. Ravdin, Amy Stern, Ruth Bolier, Cara Kenien and M. Carrington Reid
Geriatrics 2017, 2(1), 5; https://doi.org/10.3390/geriatrics2010005 - 16 Jan 2017
Cited by 7 | Viewed by 8532
Abstract
Chronic pain is highly prevalent in older adults, contributes to activity restriction and social isolation, disrupts family and interpersonal relationships, and poses a significant economic burden to society. Negative emotions such as sadness, anxiety, helplessness, and hopelessness are associated with chronic pain and [...] Read more.
Chronic pain is highly prevalent in older adults, contributes to activity restriction and social isolation, disrupts family and interpersonal relationships, and poses a significant economic burden to society. Negative emotions such as sadness, anxiety, helplessness, and hopelessness are associated with chronic pain and contribute to poor quality of life, impaired interpersonal and social functioning, and increased disability. Psychosocial interventions for older adults with chronic pain have been historically developed for, and are almost exclusively delivered to, cognitively intact patients. Therefore, many older adults with chronic pain and comorbid cognitive deficits have limited treatment options. Our multidisciplinary team developed Problem Adaptation Therapy for Pain in Primary Care (PATH-Pain), a psychosocial intervention for older adults with chronic pain, negative emotions, and a wide range of cognitive functioning, including mild-to-moderate cognitive impairment. In the current article, we describe the principles underlying PATH-Pain, review the steps taken to adapt the original PATH protocol, outline the treatment process, and present a case illustrating its potential value. Full article
(This article belongs to the Special Issue Depressive Disorder in the Elderly)
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187 KiB  
Communication
Call to Caution with the Use of Atypical Antipsychotics for Treatment of Depression in Older Adults
by Katherine Amodeo, Ruth B. Schneider and Irene Hegeman Richard
Geriatrics 2016, 1(4), 33; https://doi.org/10.3390/geriatrics1040033 - 16 Dec 2016
Cited by 3 | Viewed by 6476
Abstract
Atypical antipsychotics are increasingly being used to manage depression in older adults where these symptoms can often be refractory to first-line treatment with selective serotonin reuptake inhibitors (SSRIs) or serotonin norepinephrine reuptake inhibitors (SNRIs). Unfortunately, atypical antipsychotics can be associated with the development [...] Read more.
Atypical antipsychotics are increasingly being used to manage depression in older adults where these symptoms can often be refractory to first-line treatment with selective serotonin reuptake inhibitors (SSRIs) or serotonin norepinephrine reuptake inhibitors (SNRIs). Unfortunately, atypical antipsychotics can be associated with the development of extrapyramidal symptoms (EPS), with drug-induced parkinsonism (DIP) being the most common movement disorder induced by this class of medication. The management of treatment-resistant depression in older adults is of particular concern as depression is a common feature of idiopathic Parkinson’s disease (IPD) and can manifest prior to the development of motor symptoms. Herein, we discuss the use of atypical antipsychotics for the management of depression in older adults including the risk of DIP and propose that antipsychotics may potentially unmask IPD. Full article
(This article belongs to the Special Issue Depressive Disorder in the Elderly)
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331 KiB  
Article
Medically Serious and Non-Serious Suicide Attempts in Persons Aged 70 and Above
by Stefan Wiktorsson, Petter Olsson and Margda Waern
Geriatrics 2016, 1(3), 23; https://doi.org/10.3390/geriatrics1030023 - 15 Sep 2016
Cited by 9 | Viewed by 7059
Abstract
High rates of suicide are observed among older adults in many countries worldwide. In clinical settings, those who make a medically serious suicide attempt are generally considered to be at higher risk of subsequent suicide than those who make less serious attempts. Medically [...] Read more.
High rates of suicide are observed among older adults in many countries worldwide. In clinical settings, those who make a medically serious suicide attempt are generally considered to be at higher risk of subsequent suicide than those who make less serious attempts. Medically serious attempts in older clinical cohorts are, however, relatively understudied. The aim was to compare older adult suicide attempters (70+) who did or did not make medically serious attempts. We hypothesized, in line with the Interpersonal Model of suicide, that social problems and feelings of being a burden would be associated with medical seriousness. Participants (n = 101) were recruited in hospitals in the aftermath of a suicide attempt; they took part in an interview with a research psychologist. Attempters with (n = 28) and without (n = 73) medically serious attempts were compared. Major depression was common in both groups, and scores on the Geriatric Depression Scale did not differ. However, older adults who made medically serious attempts scored higher on the Brief Scale of Anxiety and lower on the Mini Mental State Examination than their peers who made less serious attempts. Medically serious attempters more often attributed the attempt to social problems as well as problems with functioning and autonomy, but perceived burdensomeness was not associated with seriousness. Findings may help to inform clinicians who meet and treat older suicidal persons. Full article
(This article belongs to the Special Issue Depressive Disorder in the Elderly)
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Review

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264 KiB  
Review
The Gender Difference in Depression: Are Elderly Women at Greater Risk for Depression Than Elderly Men?
by Joan S. Girgus, Kaite Yang and Christine V. Ferri
Geriatrics 2017, 2(4), 35; https://doi.org/10.3390/geriatrics2040035 - 15 Nov 2017
Cited by 187 | Viewed by 20976
Abstract
Numerous epidemiological reports have found that adolescent, young adult, and middle-aged adult girls and women are more likely to be diagnosed with unipolar depression and report greater symptoms of depression when compared to boys and men of similar ages. What is less well-known [...] Read more.
Numerous epidemiological reports have found that adolescent, young adult, and middle-aged adult girls and women are more likely to be diagnosed with unipolar depression and report greater symptoms of depression when compared to boys and men of similar ages. What is less well-known is whether this gender difference persists into late life. This literature review examines whether the well-known gender difference in unipolar depression continues into old age, and, if it does, whether the variables that are known to contribute to the gender difference in unipolar depression from adolescence through adulthood continue to contribute to the gender difference in the elderly, and/or whether there are new variables that arise in old age and contribute to the gender difference in the elderly. In this review of 85 empirical studies from every continent except for Antarctica, we find substantial support for the gender difference in depression in individuals who are 60 and older. More research is necessary to determine which factors are the strongest predictors of the gender difference in depression in late life, and particularly whether the factors that seem to be responsible for the gender difference in depression in earlier life stages continue to predict the gender difference in the elderly, and/or whether new factors come into play in late life. Longitudinal research, meta-analyses, and model-based investigations of predictors of the gender difference in depression are needed to provide insights into how and why the gender difference in depression persists in older age. Full article
(This article belongs to the Special Issue Depressive Disorder in the Elderly)
183 KiB  
Review
The Indirect Costs of Late-Life Depression in the United States: A Literature Review and Perspective
by Caitlin E. Snow and Robert C. Abrams
Geriatrics 2016, 1(4), 30; https://doi.org/10.3390/geriatrics1040030 - 14 Nov 2016
Cited by 12 | Viewed by 7721
Abstract
Late-life depression is a leading cause of disability in older adults and is associated with significant economic burden. This article draws from the existing literature and publicly available databases to describe the relative importance of the indirect costs associated with late-life depression. The [...] Read more.
Late-life depression is a leading cause of disability in older adults and is associated with significant economic burden. This article draws from the existing literature and publicly available databases to describe the relative importance of the indirect costs associated with late-life depression. The authors found that unpaid caregiver costs represent the largest component of the indirect costs of late-life depression, with the highest level of economic burden attributed to the majority of care recipients who have fewer depressive symptoms. Other indirect costs, such as productivity losses related to early retirement, reduced ability to fulfill work and family functions and diminished financial success were mostly under-appreciated in the literature. Also, mortality cost estimates provided little clarity, employing variable methodologies and revealing mixed results. With respect to late-life suicide studies, studies approximated both economic costs and savings. More rigorous efforts to evaluate the indirect costs of late-life depression would afford a better understanding of the social and economic toll of this disorder and could influence the allocation of resources for research and treatment. Full article
(This article belongs to the Special Issue Depressive Disorder in the Elderly)
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177 KiB  
Review
Is Pet Ownership Helpful in Reducing the Risk and Severity of Geriatric Depression?
by Nancy J. Needell and Nisha Mehta-Naik
Geriatrics 2016, 1(4), 24; https://doi.org/10.3390/geriatrics1040024 - 4 Oct 2016
Cited by 17 | Viewed by 12352
Abstract
Many community-dwelling older adults are searching for ways to remain mentally and physically healthy as they age. One frequently offered suggestion is for older people to adopt a pet to avoid loneliness, to stay socially engaged, and to stave off depression. Despite the [...] Read more.
Many community-dwelling older adults are searching for ways to remain mentally and physically healthy as they age. One frequently offered suggestion is for older people to adopt a pet to avoid loneliness, to stay socially engaged, and to stave off depression. Despite the ubiquity of this advice in popular culture, research findings are equivocal on whether pet ownership is beneficial to the physical and psychological health of older adults. This article evaluates published data relating to pet ownership and its possible impact on depression and related symptoms in the elderly. Full article
(This article belongs to the Special Issue Depressive Disorder in the Elderly)
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