@article {12544, title = {The Cost of Widowhood: A Matching Study of Process and Event}, journal = {SocArXiv Papers}, year = {Forthcoming}, abstract = {Widowhood is a common life transition entailing far-reaching consequences. We examine the consequences of widowhood in a novel way by assessing the consequences of bereavement for meaningful comparison groups allowing us to evaluate the impact of bereavement before and after the event. The analysis of the cost of widowhood for mental health and economic wellbeing focuses on two scenarios: unexpected and expected widowhood. The first scenario models a two-period process in which effects of widowhood occur only after the event. The second models a three-period process in which effects of widowhood also occur before spousal loss. US Health and Retirement Study data and a combination of random-coefficient modelling, propensity score matching, and regressions are used to estimate the consequences of widowhood from ten years before to six years after spousal loss. Results on mental health show a slow but full recovery for unexpected widowhood, but larger and lasting declines for expected widowhood. Findings on economic wellbeing show sizable losses for expected widowhood due to the economic cost of the pre-widowhood period. In sum, the impact of widowhood is smaller for unexpected compared to expected events. Our approach advances knowledge about spousal loss, but also research on life events more generally.}, keywords = {depression, economic wellbeing, life course, Widowhood}, doi = {10.31235/osf.io/t8jef}, author = {Van Winkle, Zachary and Thomas Leopold} } @article {11904, title = {Depressive symptoms in older adults with and without a history of incarceration: A matched pairs comparison.}, journal = {Aging \& Mental Health}, year = {Forthcoming}, abstract = {

OBJECTIVES: Previous research has found that many incarcerated individuals have mental health conditions and that incarcerated women may be at elevated risk. These individuals have been shown to experience mental health concerns shortly after their release, but little is known about their mental health later in life. This study compared depressive symptoms in older adults with and without a history of incarceration and examined the impact of gender on this relationship.

METHOD: Data from 160 pairs of adults aged 65 or older (82.5\% male, mean age = 73.4 years) who participated in the 2012 wave of the Health and Retirement Study (HRS) was utilized. Older adults with a history of incarceration were matched to those without based on age, gender, race, and education level. Depressive symptoms (CES-D) of older adults with and without a history of incarceration were compared using a repeated-measures ANOVA.

RESULTS: The main effect of incarceration history (=.001, =.07) and the interaction between incarceration history and gender (=.01, =.04) were significant. Follow-up analyses revealed that the difference between depressive symptoms for older women with and without a history of incarceration was significant (=.02, = 0.69), whereas the difference for older men was not significant (=.19, = 0.16).

CONCLUSIONS: Findings suggest older adults with a history of incarceration report more depressive symptoms than those without and that the effect is seen among older women. Negative effects of incarceration on mental health may therefore persist into later life, highlighting the importance of pre- and post-release mental health services.

}, keywords = {depression, former inmates, incarceration}, issn = {1364-6915}, doi = {10.1080/13607863.2021.1984392}, author = {Steigerwald, Victoria L and Rozek, David C and Daniel Paulson} } @article {12238, title = {The Effects of Religiosity on Depression Trajectories After Widowhood.}, journal = {Omega }, year = {Forthcoming}, abstract = {

This longitudinal study analyzed data from the 2006-2016 waves of the nationally representative Health and Retirement Study (HRS). Trajectories of depression among older adults >= 50~years ( = 1254) were examined over time to explore patterns of depression among those entering widowhood and the potential impact of religiosity on depressive symptoms during various stages of widowhood. Ordinary least squares (OLS) regression analysis was used to examine the association between widowhood and depression and the role of religiosity as a moderator of this association. Older adults experienced a statistically significant increase in depressive symptomology after the onset of widowhood, and depressive symptomology decreased post widowhood, but did not return to pre-widowhood levels. Additionally, high religious service attendance and higher intrinsic religiosity were both associated with lower depressive symptomology. High religious service attendance moderated the relationship between widowhood and depression among widowed older adults living alone.

}, keywords = {depression, Depressive symptoms, religiosity, Social Support, Widowhood}, issn = {1541-3764}, doi = {10.1177/00302228211051509}, author = {Hawes, Frances M and Jane Tavares and Corina R Ronneberg and Miller, Edward Alan} } @article {11997, title = {Exploring the bidirectional associations between handgrip strength and depression in middle and older Americans.}, journal = {Journal of Psychosomatic Research}, year = {Forthcoming}, abstract = {

OBJECTIVE: Current evidence on the relationship between decreased handgrip strength and depression risk is controversial, and there is limited study focus on the potential bidirectional associations between them. We aim to explore their bidirectional relationships.

METHODS: This study used panel data from the Health and Retirement Study involving 17,713 aging Americans (>=50~years old) who participated in at least 2 waves. Smedley spring-type hand-held dynamometer was used to assess the handgrip strength. Depression was evaluated by the 8-item Center for Epidemiologic Studies-Depression (CESD) scale. Time-lagged general estimating equations (GEE) were used to assess the bidirectional association between handgrip strength and the depression risk.

RESULTS: In the fully adjusted model, every 5~kg decreased handgrip strength was associated with a 6\% (95\%CI: 3\%-9\%) increased risk of depression. Compared with non-weakness participants, those with weakness had a higher depression risk (OR~=~1.22, 95\%CI: 1.09-1.36). Conversely, depression might associate with a 0.33~kg (95\% CI: 0.09-0.56) decrease in handgrip strength and increased the risk of weakness by 18\% (95\% CI: 6\%-33\%). In addition, the results remained stable in the stratified analyses by gender and sex. Interestingly, the above-mentioned associations were also observed in overweight and obese participants.

CONCLUSIONS: The present study found bidirectional associations between handgrip strength and depression risk. Our results indicated early interventions for depression and handgrip strength might achieve reciprocal benefits over time.

}, keywords = {Bidirectional associations, depression, Handgrip strength}, issn = {1879-1360}, doi = {10.1016/j.jpsychores.2021.110678}, author = {Luo, Jia and Yao, Wenqin and Zhang, Tianhao and Ge, Honghan and Zhang, Dongfeng} } @article {13040, title = {Hospitalization{\textquoteright}s association with depression in adults over 50 years old: does living arrangement matter? Findings from the Health and Retirement Study.}, journal = {Aging \& Mental Health}, year = {Forthcoming}, abstract = {

OBJECTIVES: To examine how living arrangements are associated with depressive symptoms in late middle-life and older adults following hospitalization within the last two years.

DESIGN: We used the 2016 wave of the Health and Retirement Study (HRS), a nationally representative survey of adults over 50 years old living in the United States.

METHODS: The dependent variable was whether HRS participants screened positive for having depressive symptoms. The primary independent variable was self-reported hospitalization in the prior two years. We stratified bivariate analyses and multivariate logistic regressions by living arrangement to examine hospitalizations{\textquoteright} association with depressive symptoms.

RESULTS: Depressive symptoms were less prevalent among participants who were married or partnered and living with a partner (14.0\%) compared to those who were not married or partnered and were living with others (31.7\%) and were not married or partnered and were living alone (27.8\%). In multivariate analyses stratified by living arrangement, however, hospitalization was associated with depressive symptoms for those married or partnered and living with a partner (OR = 1.39, 95\% CI: 1.14-1.69) but not for those who were not married and living with other(s) (OR = 0.88, 95\% CI: 0.65-1.18) and not married or partnered and living alone (OR = 1.06, 95\% CI: 0.82-1.36).

CONCLUSIONS: Late middle-life and older adults residing with spouses or cohabitating appear at risk for having depressive symptoms following a hospitalization. A better understanding of how relationships and living arrangements may affect depression risk in the context of an acute medical illness is needed to identify points of intervention.

}, keywords = {Caregiving, depression, Disability, Living arrangement, post-acute care}, issn = {1364-6915}, doi = {10.1080/13607863.2022.2163978}, author = {Missell-Gray, Rachel and Van Orden, Kimberly and Simning, Adam} } @article {13100, title = {Lifetime Adversity Prospectively Predicts Depression, Anxiety, and Cognitive Impairment in a Nationally Representative Sample of Older Adults in the United States}, year = {Forthcoming}, abstract = { Although life stress and adversity have emerged as risk factors for mental health problems and cognitive impairment among older adults, prior studies on this topic have been cross-sectional and based on relatively homogeneous samples. To address these issues, we examined prospective associations between lifetime adversity and symptoms of depression, anxiety, and cognitive impairment in a nationally representative, longitudinal sample of older adults in the U.S. Method: We analyzed data from the Health and Retirement Study (1992-2016). The sample included 3,496 individuals (59.9\% female), aged >=64 years old (M age=76.0 {\textpm}7.6 years). We used the individual-level panel data and ordinary least squares regressions to estimate associations between childhood and adulthood adversities and later-life depression, anxiety, and cognitive impairment. Results: Many participants experienced a significant early life (38\%) or adulthood (79\%) stressor. Second, experiencing a childhood adversity was associated with a 17.4\% increased risk of experiencing an adulthood adversity. Finally, childhood and adulthood adversities both prospectively predicted more symptoms of late-life depression, anxiety, and cognitive impairment. Discussion: These findings are among the first to demonstrate prospective associations between lifetime adversity and symptoms of depression, anxiety, and cognitive impairment in older adults. Screening for lifetime stressors may thus help health care professionals and policymakers identify individuals who could benefit from interventions designed to reduce stress and enhance resilience.}, keywords = {Anxiety, depression, LIFE STRESS}, doi = {10.22541/au.167407887.71569947/v1}, author = {SangNam Ahn and Seonghoon Kim and Hongmei Zhang and Aram Dobalian and George Slavich} } @article {13836, title = {Psychological Disorders Linked to Osteoporosis Diagnoses in a Population-Based Cohort Study of Middle and Older Age United States Adults.}, journal = {The Gerontologist}, year = {Forthcoming}, abstract = {

BACKGROUND AND OBJECTIVES: Although it is well-established that psychological disorders and osteoporosis risk are linked, how the relationship manifests is not. This study examines depressive symptoms and a history of psychological problems as potential risk factors for osteoporosis diagnosis, adjudicating between four theoretical models rarely tested together. We analyze these models across multiple domains (i.e., demographic, socioeconomic, and health-related), while accounting for bone mineral density (BMD) scans, which have been shown to improve health equity across sex and racial/ethnic identities.

RESEARCH DESIGN AND METHODS: Data from the 2012-2016, nationally representative, population-based, cohort Health and Retirement Study (N=18,224 to 18,359) were used to estimate four logistic regression models with the outcome of osteoporosis diagnosis. Approximately 50\% of the sample identified as female and 50\% as male, while about 81\% identified as White/European American, 11\% as Black/African American, and 8\% as another race/ethnicity. The key independent variables were depressive symptoms-measured using two common scales -and a history of psychological problems.

RESULTS: A history of psychological problems and one depressive symptoms measure were associated with the odds of osteoporosis diagnosis in the presence of other known risk factors for osteoporosis.

DISCUSSION AND IMPLICATIONS: Support for the theoretical models was limited. Evidence suggests possible directionality; a history of psychological distress may be a risk factor for osteoporosis, though we cannot rule out the other direction. Public health professionals and health care providers should consider a history of psychological problems as a risk factor for osteoporosis when deciding whether to recommend a BMD scan.

}, keywords = {bone mineral density, Center for Epidemiological Studies Depression Scale, Composite International Diagnostic Interview Short Form, depression, Health and Retirement Study}, issn = {1758-5341}, doi = {10.1093/geront/gnae027}, author = {Godde, K and Courtney, Margaret Gough and Roberts, Josephine} } @article {13714, title = {Religious Involvement and the Impact on Living Alone and Depression: An Examination of Gendered Pathways Post-Widowhood.}, journal = {Journal of Applied Gerontology}, year = {Forthcoming}, pages = {7334648231225355}, abstract = {

This study analyzed data from the nationally representative Health and Retirement Study (HRS) to examine the association between widowhood and depression. The results revealed that both men and women experienced increased depression after widowhood, with women exhibiting a better recovery pattern over time. Religiosity, especially attending religious services, was found to be a beneficial coping mechanism for both genders, although men were less religious than women. Living alone was a significant factor associated with depression in widowhood for both men and women. High religious service attendance moderated the association between living alone and depression for women, while both high and moderate religious service attendance moderated this association for men. These findings emphasize the importance of considering gender differences and the potential benefits of religious involvement in addressing depression during widowhood, highlighting the need for tailored interventions and support services for widows and widowers, particularly those living alone.

}, keywords = {depression, gender, Religion, Social Support, Widows}, issn = {1552-4523}, doi = {10.1177/07334648231225355}, author = {Hawes, Frances M and Tavares, Jane L} } @article {13711, title = {The Worst of Times: Depressive Symptoms Among Racialized Groups Living With Dementia and Cognitive Impairment During the COVID-19 Pandemic.}, journal = {Journal of Aging and Health}, year = {Forthcoming}, pages = {8982643231223555}, abstract = {

To explore differences in depressive symptoms for older adults (Black, Latinx, and White) by cognitive status during the 2020 COVID-19 pandemic. Data from the Health and Retirement Study identified older adults as cognitively normal, cognitively impaired without dementia (CIND), and persons living with dementia (PLWD). Multiple linear regression analyses examined associations between cognitive status and depressive symptoms among these racialized groups. Compared to the cognitively normal older adults racialized as Black, those with CIND reported higher depressive symptoms during the pandemic (overall and somatic) and PLWD had higher somatic symptoms ( < .01). Older adults racialized as White with CIND reported higher somatic ( < .01) symptoms compared to cognitively normal older adults racialized as White. The COVID-19 pandemic was a challenging event among older adults racialized as Black with CIND and PLWD. Future studies should examine if these depressive symptoms persist over time.

}, keywords = {Cognition, COVID, Dementia, depression, Older Adults}, issn = {1552-6887}, doi = {10.1177/08982643231223555}, author = {Brown, Monique J and Adkins-Jackson, Paris B and Sayed, Linda and Wang, Fei and Leggett, Amanda and Ryan, Lindsay H} } @article {13710, title = {Association of perceived discrimination with the risk of depression among US older adults: A prospective population-based cohort study.}, journal = {Heliyon}, volume = {10}, year = {2024}, pages = {e23843}, abstract = {

AIMS: Association between perceived discrimination and depression has been demonstrated in some sources of discrimination, such as age, sex, and race. However, the effects of perceived discrimination both in any domain and each domain on development of depression are still unclear. We aimed to estimate the association of any and each domain of perceived discrimination with the risk of depression among US older adults.

METHODS: We did a population-based cohort study using eight waves (from 2006 to 2020) of data from the Health and Retirement Study (HRS), a nationally representative study of US older adults aged 51 years and above. Perceived discrimination was measured by the shortened 5-item version of Williams{\textquoteright} discrimination scale, including five domains (less courtesy, service setting, not smart, threatened or harassed, and medical setting). Depressive symptoms were assessed with shortened 8-item version of the Center for Epidemiological Depression scale (8-item CES-D). Cox proportional hazards models were used to estimate the crude and adjusted hazards ratio (HRs) and their 95~\% confidence intervals (CIs) between perceived discrimination and risk of depression, after controlling for potential confounders.

RESULTS: A total of 18502 participants were included in our final analyses. 42.8~\% of them had any perceived discrimination at baseline, and the most prevalent perceived discrimination was feeling less courtesy, which was observed in 5893 people (31.6~\%). During a median of 9.8 years follow-up, 44.7~\% of participants developed depression. The risk of depression was 46~\% (adjusted HR: 1.46, 95~\% CI: 1.39-1.52) higher among people with perceived discrimination than those without. The associations between perceived discrimination in each domain and risk of depression were all prominent.

CONCLUSIONS: Both any and each domain of perceived discrimination were associated with an increased risk of depression. Considering the high prevalence of perceived discrimination and the following poor health outcomes, our findings suggested the integrated measures of providing public education and diversified communication to reduce discrimination, as well as accessible emotional supports to prevent depression are urgently needed.

}, keywords = {depression, Dose-response relationship, Older Adults, Perceived Discrimination}, issn = {2405-8440}, doi = {10.1016/j.heliyon.2023.e23843}, author = {Wang, Yaping and Liao, Jiaojiao and Chen, Hongguang and Tao, Liyuan and Liu, Jue} } @article {13813, title = {Grey divorce: Losing touch with adult children aggravates depression}, year = {2024}, publisher = {PsyPost}, keywords = {Adult children, depression, Divorce}, url = {https://www.psypost.org/grey-divorce-losing-touch-with-adult-children-aggravates-depression/}, author = {Hedrih, Vladimir} } @article {13677, title = {Physical Activity Participation Decreases the Risk of Depression in Older Adults: The ATHLOS Population-Based Cohort Study.}, journal = {Sports Medicine Open}, volume = {10}, year = {2024}, pages = {1}, abstract = {

BACKGROUND: To which extent physical activity is associated with depression independent of older adults{\textquoteright} physical and cognitive functioning is largely unknown. This cohort study using harmonised data by the EU Ageing Trajectories of Health: Longitudinal Opportunities and Synergies consortium, including over 20 countries, to evaluate the longitudinal association of physical activity (light-to-moderate or vigorous intensity) with depression in older adults (aged >= 50~years).

RESULTS: We evaluated 56,818 participants (light-to-moderate models; 52.7\% females, age 50-102~years) and 62,656 participants (vigorous models; 52.7\% females, age 50-105~years). Compared to never, light-to-moderate or vigorous physical activity was associated with a lower incidence rate ratio (IRR) of depression (light-to-moderate model: once/week: 0.632, 95\% CI 0.602-0.663; twice or more/week: 0.488, 95\% CI 0.468-0.510; vigorous model: once/week: 0.652, 95\% CI 0.623-0.683; twice or more/week: 0.591, 95\% CI 0.566-0.616). Physical activity remained associated with depression after adjustment for the healthy ageing scale, which is a scale that incorporated 41 items of physical and cognitive functioning (light-to-moderate model: once/week: 0.787, 95\% CI 0.752-0.824; twice or more/week: 0.711, 95\% CI 0.682-0.742; vigorous model: once/week: 0.828, 95\% CI 0.792-0.866; twice or more/week: 0.820, 95\% CI 0.786-0.856).

CONCLUSIONS: Physical activity, of any intensity and weekly frequency, was a strong protective factor against depression, independent of physical and mental functioning. Health policies could stimulate the incorporation of lower physical activity intensity to protect against depression, which might be more feasible at the population level.

}, keywords = {Data harmonization, depression, Health metric, KLoSA, lifestyle behaviors, Physical activity, SHARE}, issn = {2199-1170}, doi = {10.1186/s40798-023-00664-7}, author = {Lima, Rodrigo A and Condominas, Elena and Sanchez-Niubo, Albert and Olaya, Beatriz and Koyanagi, Ai and de Miquel, Carlota and Haro, Josep Maria} } @article {13729, title = {Residential greenspace and major depression among older adults living in urban and suburban areas with different climates across the United States.}, journal = {Environmental Research}, volume = {243}, year = {2024}, pages = {117844}, abstract = {

BACKGROUND AND AIM: Residential greenspace could alleviate depression - a leading cause of disability. Fewer studies of depression and greenspace have considered major depression, and, to our knowledge, none have considered how climate, which determines vegetation abundance and type, may change the impacts of greenspace. Our aim was to investigate whether residential greenspace is associated with major depression among older adults and explore effect modification by climate.

METHODS: We used biennial interviews between 2008 and 2016 from the Health and Retirement Study. We calculated greenness within walking distance of home addresses as the maximum NDVI for the year of each participant interview averaged within a 1~km buffer. Reflecting clinical criteria, a score of >=5 on the CIDI-SF indicated major depression in the preceding 12-months. We characterized climate using K{\"o}ppen-Geiger classifications. To estimate prevalence ratios, we used Poisson regression. Our models adjusted for sociodemographic characteristics, geography, annual sunshine, and bluespace.

RESULTS: The 21,611 eligible participants were 65~{\textpm}~10 years old on average, 55\% female, 81\% White, 12\% Black, 10\% Hispanic/Latino, and 31\% had at least a 4-year college degree. The 12-month prevalence of a major depression was 8\%. In adjusted models, more residential greenspace was associated with a lower prevalence of major depression (prevalence ratio per IQR, 0.91; 95\% CI, 0.84 to 0.98). There was evidence of effect modification by climate (P forinteraction, 0.062). We observed stronger associations in tropical (prevalence ratio per IQR 0.69; 95\% CI, 0.47 to 1.01) and cold (prevalence ratio per IQR, 0.83; 95\% CI, 0.74 to 0.93) climates compared to arid (prevalence ratio per IQR 0.99; 95\% CI, 0.90 to 1.09) and temperate (prevalence ratio per IQR 0.98; 95\% CI, 0.86 to 1.11) climates.

CONCLUSIONS: Residential greenspace may help reduce major depression. However, climate may influence how people benefit from greenspace.

}, keywords = {Aged, depression, Depressive Disorder, Major, Environmental Exposure, Female, Humans, Male, Mental Health, Middle Aged, Parks, Recreational, United States}, issn = {1096-0953}, doi = {10.1016/j.envres.2023.117844}, author = {Fossa, Alan J and D{\textquoteright}Souza, Jennifer and Bergmans, Rachel and Zivin, Kara and Adar, Sara D} } @article {12911, title = {Comparison of Cognitive and Physical Decline as Predictors of Depression Among Older Adults.}, journal = {Journal of Applied Gerontology}, volume = {42}, year = {2023}, pages = {387-398}, abstract = {

Activities of daily living (ADL) limitations and cognitive impairment have been identified as key risk factors for depression among older adults. However, little has been done to compare the strength of these relationships. The current study describes the prevalence and compares the independent and joint associations of ADL and cognitive limitations with depression among older adults in the US. Analyses are based on a sample of 30,923 observations on 13,545 unique respondents from three waves (2012, 2014, and 2016) of the Health and Retirement Study. Linear and logistic multivariate regression models with random and individual fixed effects were estimated. Findings indicate that both cognitive and ADL limitations are associated with depression; however, across all models, ADL limitations have a much stronger association. Further, in our most rigorous models, having both limitations is not significantly different from having just ADL, and not cognitive, limitations.

}, keywords = {Activities of Daily Living, Cognitive Dysfunction, depression, Retirement, Risk Factors}, issn = {1552-4523}, doi = {10.1177/07334648221139255}, author = {Scher, Clara and Nepomnyaschy, Lenna and Amano, Takashi} } @article {13231, title = {Depression trajectories, genetic risk, and cognitive performance in older adults: multilevel model with a 10-year longitudinal cohort.}, journal = {Gerontology}, year = {2023}, abstract = {

BACKGROUND: Cognitive performance in older ages is strongly affected by individuals{\textquoteright} genetic predispositions. We investigated whether depression trajectories were associated with subsequent cognitive performance independent of participants{\textquoteright} genetic predispositions.

METHODS: Participants from the Health and Retirement Study with European ancestry and aged over 50 were included in the analysis. Depressive symptoms were evaluated using the Center for Epidemiologic Studies Depression Scale, and the 6-year trajectories were fitted using latent class linear mixed models. Linear multilevel regression was applied to model the associations between depression trajectory and subsequent cognitive performance. Stratified analyses were performed to investigate these associations in participants with different genetic predispositions of cognitive performance and APOE ε4 allelic status.

RESULTS: A total of 5942 eligible participants were included in the study. Four depression trajectories were identified. Compared with the non-depression trajectory, all other depression trajectories were associated with worse cognitive performance (β [95\% CI]: mild-depression trajectory: -0.20 [-0.56, -0.06], p = 0.007; worsening-depression trajectory: -0.29 [-0.47, -0.12], p = 0.001; persistent-depression trajectory: -0.32 [-0.53, -0.13], p = 0.001). Although these associations were independent of participants{\textquoteright} inherent genetic risk, the participants with a low polygenetic score for cognitive performance were more likely to have an enhanced association between depression trajectories and cognitive decline. Similar relationships were also found in APOE ε4 noncarriers.

CONCLUSION: Among older participants with European ancestry, even a mild-depression trajectory was associated with worse cognitive performance. Early intervention in participants with any degree of depression might benefit regarding preventing cognitive performance decline.

}, keywords = {depression, genetic risk, Older Adults}, issn = {1423-0003}, doi = {10.1159/000530200}, author = {Liu, Zheran and Su, Yonglin and Huang, Rendong and Li, Ruidan and Wei, Zhigong and He, Ling and Pei, Yiyan and Min, Yu and Hu, Xiaolin and Peng, Xingchen} } @article {12418, title = {Depressive Symptoms Partially Mediate the Association of Frailty Phenotype Symptoms and Cognition for Females but Not Males.}, journal = {Journal of Aging and Health}, year = {2023}, abstract = {

OBJECTIVES: We aimed to evaluate whether depressive symptoms mediated the relationship between frailty phenotype and cognitive function by sex.

METHODS: Data came from the Health and Retirement Study from 2012-2016. The outcome was measured by Fried{\textquoteright}s frailty criteria, our outcome was continuous global cognition, and mediator was depressive symptoms. We used mediation analysis, stratified by sex, to estimate the direct and indirect effects of frailty symptoms on cognition mediated by depressive symptoms.

RESULTS: Males had a larger total effect (β= -0.43; 95\% CI: -0.66, -0.02) for lower cognitive score for each increase in frailty symptom compared to females (β= -0.28; 95\% CI: -0.47, -0.08). A significant indirect effect from frailty phenotype to cognition was found through depressive symptoms for females but not males.

CONCLUSION: These results highlight the importance of identifying individuals with frailty and depressive symptoms to monitor and provide interventions to preserve cognitive function.

}, keywords = {Cognitive decline, depression, Frailty}, issn = {1552-6887}, doi = {10.1177/08982643221100688}, author = {Resciniti, Nicholas V and Farina, Mateo P and Merchant, Anwar T and Lohman, Matthew C} } @mastersthesis {13230, title = {The Effects of the Social Security Amendments of 1983 on Employment Status, Alcohol Consumption, and Depression }, volume = {Master of Arts}, year = {2023}, pages = {29}, school = {City University of New York}, address = {New York}, keywords = {Alcohol Consumption, depression, employment status, Social Security}, url = {https://academicworks.cuny.edu/cgi/viewcontent.cgi?article=2067\&context=hc_sas_etds}, author = {Adam J. DelGenio} } @article {13680, title = {Family caregiving doesn{\textquoteright}t always mean poor mental health, study finds}, year = {2023}, publisher = {McKnights}, keywords = {Caregiving, depression, Mental Health}, url = {https://www.mcknights.com/news/clinical-news/family-caregiving-doesnt-always-mean-poor-mental-health-study-finds/}, author = {Fischer, Kristen} } @article {13249, title = {Gender differences in the association of polygenic risk and divergent depression trajectories from mid to late life: a national longitudinal study.}, journal = {Biodemography Soc Biol}, volume = {68}, year = {2023}, pages = {32-53}, abstract = {

Our research fills a critical gap in the depression literature by utilizing a life course perspective to examine gender-gene interactions in association with depression trajectories over time. Using data from the Health and Retirement Study, we estimated multi-level negative binomial and logistic mixed models to analyze gender-specific trajectories of depressive symptoms (CESD-8) and potential clinical depression risk from middle to late adulthood in relation to gender-by-polygenic-risk (PRS) interactions. We found increasingly greater female-male gaps in the CESD-8 scale and a higher probability of clinical depression risk with increasing polygenic risk scores. Furthermore, females{\textquoteright} higher genetic vulnerabilities to depressive conditions than males vary from ages 51 to 90 years, (e.g. 0.28 higher CESD-8 scale for females at ages 76-85 years than for similar-aged males; higher 3.44\% probability of depression risk for females at ages 81-85 compared to similar-aged males) (e.g. about 2.40\% higher probability of depression risk for females at ages 61-70 years than for similar-aged males) . This study contributes to new knowledge of how gender-by-polygenic-risk interactions are associated with depression trajectories across the life course.

}, keywords = {Adult, Aged, Aged, 80 and over, depression, Depressive Disorder, Major, Female, Humans, Longitudinal Studies, Male, Middle Aged, Risk Factors, Sex Factors}, issn = {1948-5573}, doi = {10.1080/19485565.2023.2196710}, author = {Chen, Ping and Li, Yi and Wu, Fang} } @article {13571, title = {Hobbies Are The Secret To Happiness? Pleasurable Activities Help Older Adults Avoid Depression}, year = {2023}, publisher = {StudyFinds}, keywords = {activities, depression, Happiness, hobbies}, url = {https://studyfinds.org/hobbies-happiness-depression/}, author = {Anderer, John} } @article {13156, title = {The impact of hearing loss on trajectories of depressive symptoms in married couples.}, journal = {Soc Sci Med}, volume = {321}, year = {2023}, month = {2023 Mar}, pages = {115780}, abstract = {

Hearing loss is a prevalent chronic stressor among older adults and is associated with numerous adverse health outcomes. The life course principle of linked lives highlights that an individual{\textquoteright}s stressors can impact the health and well-being of others; however, there are limited large-scale studies examining hearing loss within marital dyads. Using 11 waves (1998-2018) of the Health and Retirement Study (n~=~4881 couples), we estimate age-based mixed models to examine how 1) one{\textquoteright}s own hearing, 2) one{\textquoteright}s spouse{\textquoteright}s hearing, or 3) both spouses{\textquoteright} hearing influence changes in depressive symptoms. For men, their wives{\textquoteright} hearing loss, their own hearing loss, and both spouses having hearing loss are associated with increased depressive symptoms. For women, their own hearing loss and both spouses having hearing loss are associated with increased depressive symptoms, but their husbands{\textquoteright} hearing loss is not. The connections between hearing loss and depressive symptoms within couples are a dynamic process that unfolds differently by gender over time.

}, keywords = {Aged, depression, Female, Hearing loss, Humans, Male, Marriage, Retirement, Spouses}, issn = {1873-5347}, doi = {10.1016/j.socscimed.2023.115780}, author = {West, Jessica S and Smith, Sherri L and Dupre, Matthew E} } @article {13439, title = {In sickness and in health: Loneliness, depression, and the role of marital quality among spouses of persons with dementia.}, journal = {J Am Geriatr Soc}, year = {2023}, abstract = {

BACKGROUND: Older adults married to persons living with dementia (PLwD) may be at risk for loneliness and depression. We assessed the prevalence of loneliness and depressive symptoms among spouses of PLwD or cognitive impairment not dementia (CIND), and the role of marital quality in mediating these outcomes.

METHODS: We used a US population-based sample of 4071 couples enrolled in the Health and Retirement Study (2014 and 2016). We included older adults married to PLwD (N = 227), married to persons with CIND (N = 885), or married to persons with no cognitive impairment (NCI) (N = 2959). We determined the prevalence of loneliness (UCLA 3-item scale), depressive symptoms (CESD-8 scale), and both, using multivariable logistic regression adjusting for sociodemographic and health-related characteristics. We then tested for interaction terms between marital quality (4-item scale) and degree of spousal cognitive impairment for each outcome of loneliness and depressive symptoms.

RESULTS: The sample was 55\% women and on average 67-years-old (range: 50-97). After adjustment, spouses of persons with cognitive impairment were more likely to be lonely (NCI: 20\%, CIND: 23\%, PLwD: 29\%; p = 0.04), depressed (NCI: 8\%, CIND: 15\%, PLwD: 14\%; p < 0.01), and both (NCI: 4\%, CIND: 9\%, PLwD: 7\%; p < 0.01). The association between cognition and loneliness, but not depression, differed by marital quality (interaction p-value = 0.03). Among couples with high marital quality, spousal cognitive impairment was associated with higher likelihood of loneliness (p < 0.05). In contrast, no association existed between spousal cognition and loneliness among couples with lower marital quality (p = 0.37).

CONCLUSIONS: One in six spouses of persons with CIND or more advanced disease (PLwD) experienced depressive symptoms, and loneliness among spouses of PLwD was experienced at a twofold rate. By identifying and managing both, and facilitating interventions that promote high-quality social connection, clinical teams might improve the lives of older couples facing dementia.

}, keywords = {Dementia, depression, health, Loneliness, Marital quality, sickness, Spouses}, issn = {1532-5415}, doi = {10.1111/jgs.18520}, author = {Hsu, Kristie Y and Cenzer, Irena and Harrison, Krista L and Ritchie, Christine S and Waite, Linda and Kotwal, Ashwin} } @article {13117, title = {Longitudinal Associations Between Loneliness and Prescription Medication Use.}, journal = {J Gerontol B Psychol Sci Soc Sci}, volume = {78}, year = {2023}, month = {2023 Apr 01}, pages = {730-735}, abstract = {

OBJECTIVES: Both loneliness and the use of psychotropic drugs are common in later life. Although loneliness has been found to be associated with psychotropic drug use, most studies have been cross-sectional, and we know less about their longitudinal associations.

METHODS: Drawing on five waves of data from the Health and Retirement Study and two statistical approaches (fixed-effects and cross-lagged panel models), we examine longitudinal associations between loneliness and the use of prescription pain and depression/anxiety medications.

RESULTS: Across 57,654 observations among 20,589 respondents, 22.8\% reported regular use of pain prescription medications, 17.8\% regular use of depression/anxiety prescription medication, and 15.6\% feeling lonely in the past week. Loneliness and the use of depression/anxiety medications were associated according to both modeling approaches, net of covariates. In years when a respondent reported feeling lonely, the odds of regular use of depression/anxiety medications were 1.42 times higher (p < .001) than in years when they did not feel lonely. Regarding reciprocation, odds of regular depression/anxiety medication use in a given wave range from 1.3 to 1.5 times higher if loneliness was reported in the prior wave. Likewise, the odds of reporting loneliness in a given wave range from 1.5 to 1.8 times higher if regular depression/anxiety medication was reported in the prior wave.

DISCUSSION: Prior loneliness predicts contemporaneous regular use of depression/anxiety prescription medications. Although this confirms the directional association found in prior studies, we found prior use of depression/anxiety medications is also associated with increased odds of loneliness, suggesting further research is needed to understand mechanisms that explain their associations and potential interventions.

}, keywords = {Cross-Sectional Studies, depression, Humans, Loneliness, Longitudinal Studies, pain, Prescriptions}, issn = {1758-5368}, doi = {10.1093/geronb/gbad010}, author = {Lam, Jack and Vuolo, Michael} } @article {12493, title = {Long-term psychological consequences of parental bereavement prior to midlife: volunteering helps.}, journal = {Aging \& Mental Health}, year = {2023}, abstract = {

OBJECTIVES: Losing a child prior to midlife may be a uniquely traumatic event that continues to compromise parents{\textquoteright} well-being in later life. This study compared psychological well-being between bereaved and non-bereaved parents, and examined whether volunteering protects bereaved parents. Because most families have more than one child, we further explored whether the number of living children parents had differentiated bereaved parents in their well-being.

METHODS: We analyzed a pooled sample of parents aged 50+ ( = 12,023) from the (2010/2012-2012/2014), including parents who lost a child prior to 50 and those who never lost a child. Two-level linear regression models were estimated to test the associations between child loss, volunteering, and psychological well-being, and examine the moderating effect of number of living children.

RESULTS: Bereaved parents reported more depressive symptoms and lower life satisfaction than their non-bereaved counterparts, which was more evident among parents with fewer children alive. Among bereaved parents, volunteering, particularly volunteering 100+ hours/year, was associated with better psychological well-being at baseline; yet, volunteering 1-99 hours/year led to a larger increase in life satisfaction over time. The benefits of volunteering held true regardless of the number of living children.

CONCLUSION: This study adds to our understanding of the lasting effect of parental bereavement and suggests volunteering as a potential intervention aimed at helping bereaved older parents. Findings identify parents with fewer children as a particularly vulnerable population in the face of child loss and calls for more resources allocated to help them.

}, keywords = {bereaved parents, child loss, depression, volunteer}, issn = {1364-6915}, doi = {10.1080/13607863.2022.2087209}, author = {Huo, Meng and Kim, Kyungmin and Wang, Dahua} } @article {12861, title = {Mental and Physical Health Pathways Linking Insomnia Symptoms to Cognitive Performance 14 Years Later.}, journal = {Sleep}, volume = {46}, year = {2023}, pages = {zsac262}, abstract = {

STUDY OBJECTIVES: Insomnia may be a modifiable risk factor for later-life cognitive impairment. We investigated: (1) which insomnia symptoms are associated with subsequent cognitive functioning across domains; (2) whether insomnia-cognition associations are mediated by mental and physical health; and (3) whether these associations are modified by gender.

METHODS: Participants included 2,595 adults ages 51-88 at baseline (Mage=64.00{\textpm}6.66, 64.5\% women) in the Health and Retirement Study. The frequency of insomnia symptoms (difficulty initiating sleep, nighttime awakenings, early awakenings, and feeling unrested upon awakening) at baseline (2002) were quantified using a modified Jenkins Sleep Questionnaire. Cognition was assessed in 2016 via the Harmonized Cognitive Assessment Protocol and operationalized with factor scores corresponding to five domains. Depressive symptoms and vascular conditions in 2014 were assessed via self-report. Structural equation models estimated total, indirect, and direct effects of insomnia symptoms on subsequent cognition through depressive symptoms and vascular diseases, controlling for baseline sociodemographics and global cognition.

RESULTS: Frequent difficulty initiating sleep was associated with poorer episodic memory, executive function, language, visuoconstruction, and processing speed 14 years later (-0.06<=β<=-0.04; equivalent to 2.2-3.4 years of aging). Depressive symptoms explained 12.3\%-19.5\% of these associations and vascular disease explained 6.3\%-14.6\% of non-memory associations. No other insomnia symptoms were associated with cognition, and no associations were modified by gender.

CONCLUSIONS: Difficulty initiating sleep in later life may predict future cognitive impairment through multiple pathways. Future research with longitudinal assessments of insomnia, insomnia treatments, and cognition is needed to evaluate insomnia as a potential intervention target to optimize cognitive aging.

}, keywords = {cognitive aging, Dementia, depression, gender, insomnia, neuropsychology, vascular diseases}, issn = {1550-9109}, doi = {10.1093/sleep/zsac262}, author = {Zaheed, Afsara B and Chervin, Ronald D and Spira, Adam P and Zahodne, Laura B} } @article {13098, title = {Obesity Leaves Psychological Scars After the Weight Is Gone}, year = {2023}, publisher = {Bloomberg}, keywords = {depression, Mental Health, Obesity}, url = {https://www.bloomberg.com/news/newsletters/2023-05-18/obesity-leaves-psychological-scars-after-the-weight-is-gone}, author = {Kresge, Naomi} } @article {13558, title = {Older adults with digestive diseases have higher depression, loneliness}, year = {2023}, publisher = {McKnights}, keywords = {depression, digestive disease, Loneliness}, url = {https://www.mcknights.com/news/clinical-news/older-adults-with-digestive-diseases-have-higher-depression-loneliness/}, author = {Fischer, Kristen} } @article {13097, title = {Past obesity can have lasting effects on mental health, study finds}, year = {2023}, publisher = {The Guardian}, keywords = {Anxiety, depression, Mental Health, Obesity}, url = {https://www.theguardian.com/society/2023/may/17/past-obesity-can-have-lasting-effects-on-mental-health-study-finds}, author = {Thomas, Tobi} } @article {12890, title = {Polygenic Risk and Social Support in Predicting Depression Under Stress.}, journal = {The American Journal of Psychiatry}, volume = {180}, year = {2023}, pages = {139-145}, abstract = {

OBJECTIVE: Despite substantial progress in identifying genomic variation associated with major depression, the mechanisms by which genomic and environmental factors jointly influence depression risk remain unclear. Genomically conferred sensitivity to the social environment may be one mechanism linking genomic variation and depressive symptoms. The authors assessed whether social support affects the likelihood of depression development differently across the spectrum of genomic risk in two samples that experienced substantial life stress: 1,011 first-year training physicians (interns) in the Intern Health Study (IHS) and 435 recently widowed Health and Retirement Study (HRS) participants.

METHODS: Participants{\textquoteright} depressive symptoms and social support were assessed with questionnaires that were administered before and after the life stressor. Polygenic risk scores (PRSs) for major depressive disorder were calculated for both samples.

RESULTS: Depressive symptom scores increased by 126\% after the start of internship in the IHS sample and by 34\% after widowing in the HRS sample. There was an interaction between depression PRS and change in social support in the prediction of depressive symptoms in both the IHS sample (incidence rate ratio [IRR]=0.96, 95\% CI=0.93, 0.98) and the HRS sample (IRR=0.78, 95\% CI=0.66, 0.92), with higher depression PRS associated with greater sensitivity to changes in social support. Johnson-Neyman intervals indicated a crossover effect, with losses and gains in social support moderating the effect of PRS on depressive symptoms. (Johnson-Neyman interval in the IHS sample, -0.02, 0.71; in the HRS sample, -0.49, 1.92).

CONCLUSIONS: The study findings suggest that individuals with high genomic risk for developing increased depressive symptoms under adverse social conditions also benefit more from nurturing social environments.

}, keywords = {depression, Risk Factors, Social Environment, Social Support, Stress}, issn = {1535-7228}, doi = {10.1176/appi.ajp.21111100}, author = {Cleary, Jennifer L and Fang, Yu and Zahodne, Laura B and Bohnert, Amy S B and Burmeister, Margit and Sen, Srijan} } @article {13099, title = {Predictors of cognitive functioning trajectories among older Americans: A new investigation covering 20 years of age- and non-age-related cognitive change.}, journal = {PLoS One}, volume = {18}, year = {2023}, pages = {e0281139}, abstract = {

Despite the extensive study of predictors of cognitive decline in older age, a key uncertainty is how much these predictors explain both the intercept and age- and non-age-related change in cognitive functioning (CF). We examined the contribution of a broad range of life course determinants to CF trajectories. Data came from 7,068 participants in the 1996-2016 Health and Retirement Study. CF was measured as a summary score on a 27-point cognitive battery of items. We estimated multilevel growth curve models to examine the CF trajectories in individuals ages 54-85. We found that the variation in CF level at age 54 was three times as much as the variation in age slope. All the observed individual predictors explained 38\% of the variation in CF at age 54. Personal education was the most important predictor (25\%), followed by race, household wealth and income, parental education, occupation, and depression. The contributions of activity limitations, chronic diseases, health behaviors (obesity, smoking, vigorous activity), childhood conditions (childhood health, nutrition, financial situation), gender, marital status, and religion were rather small (<5\%). Even though the age slope varied with many adulthood factors, they only explained 5.6\% of the between-person variation in age slope. Moreover, age explained 23\% of within-person variation in CF from age 54 to 85. The rest non-age-related within-person variation could not be explained by the observed time-varying factors. These findings suggest that future research is urgently needed to discover the main determinants of the slope of cognitive decline to slow down the progression of cognitive impairment and dementia.

}, keywords = {Cognitive decline, depression, Education, Occupation, race, Wealth}, issn = {1932-6203}, doi = {10.1371/journal.pone.0281139}, author = {Zheng, Hui and Cagney, Kathleen and Choi, Yoonyoung} } @article {13218, title = {Prevalence of unpaid caregiving, pain, and depression in older seriously ill patients undergoing elective surgery.}, journal = {J Am Geriatr Soc}, year = {2023}, month = {2023 Mar 13}, abstract = {

INTRODUCTION: Serious illness is a life-limiting condition negatively impacting daily function, quality of life, or excessively straining caregivers. Over 1 million older seriously ill adults undergo major surgery annually, and national guidelines recommend that palliative care be available to all seriously ill patients. However, the palliative care needs of elective surgical patients are incompletely described. Understanding baseline caregiving needs and symptom burden among seriously ill older surgical patients could inform interventions to improve outcomes.

METHODS: Using Health and Retirement Study data (2008-2018) linked to Medicare claims, we identified patients >=66 years who met an established serious illness definition from administrative data and underwent major elective surgery using Agency for Healthcare Research and Quality (AHRQ) criteria. Descriptive analyses were performed for preoperative patient characteristics, including: unpaid caregiving (no or yes); pain (none/mild or moderate/severe); and depression (no, CES-D < 3, or yes, CES-D >= 3). Multivariable regression was performed to examine the association between unpaid caregiving, pain, depression, and in-hospital outcomes, including hospital days (days admitted between discharge date and one-year post-discharge), in-hospital complications (no or yes), and discharge destination (home or non-home).

RESULTS: Of the 1343 patients, 55.0\% were female and 81.6\% were non-Hispanic White. Mean age was 78.0 (SD 6.8); 86.9\% had >=2 comorbidities. Before admission, 27.3\% of patients received unpaid caregiving. Pre-admission pain and depression were 42.6\% and 32.8\%, respectively. Baseline depression was significantly associated with non-home discharge (OR 1.6, 95\% CI 1.2-2.1, p~=~0.003), while baseline pain and unpaid caregiving needs were not associated with in-hospital or post-acute outcomes in multivariable analysis.

CONCLUSIONS: Prior to elective surgery, older adults with serious illnesses have high unpaid caregiving needs and a prevalence of pain and depression. Baseline depression alone was associated with discharge destinations. These findings highlight opportunities for targeted palliative care interventions throughout the surgical encounter.

}, keywords = {depression, Surgery, unpaid caregiving}, issn = {1532-5415}, doi = {10.1111/jgs.18316}, author = {Hu, Frances Y and Wang, Yihan and Abbas, Muhammad and Bollens-Lund, Evan and Reich, Amanda J and Lipsitz, Stuart R and Gray, Tamryn F and Kim, Dae and Ritchie, Christine and Kelley, Amy S and Cooper, Zara} } @article {resor_cooke_katz_2021, title = {The role of social communication technologies in cognition and affect in older adults}, journal = {Ageing \& Society}, volume = {43}, year = {2023}, pages = {24 - 52}, abstract = {Affect and cognition have both been associated with communication across one{\textquoteright}s social network during ageing. Thus, it is important to consider how communication varies by different aspects of one{\textquoteright}s social network, and by communication mode, including phone, email and social media. This study aimed to investigate the relationship between technology-mediated communication, depression and an executive function-related fluid-reasoning measure among older adults. Data were drawn from the Health and Retirement dataset{\textquoteright}s 2016 wave. Hierarchical regression analyses were conducted to examine the link between communication modes (phone, email and social media) with children, family and friends with a fluid-reasoning cognition measure and Center for Epidemiologic Studies Depression Scale, controlling for demographic covariates, among 3,798 older American adults. Phone and email communication, but not social media, were significantly related to depression and cognition. The model fit was considerably stronger for the analyses with cognition than depression. Curvilinear associations were found for communication via phone and email with cognition, suggesting moderate amounts of communication by phone and email across social groups were most closely linked with higher scores on fluid reasoning. For depression, curvilinear relationships were found for talking on the phone with family and friends, and emailing for children and family, indicating that moderate communication levels revealed the lowest depression levels. Implications for how older adults{\textquoteright} social support may contribute to depression and cognition status are discussed.}, keywords = {Cognition, Communication, depression, technologies}, doi = {10.1017/S0144686X21000386}, author = {Resor, Jessica and Cooke, Steph and Katz, Benjamin} } @article {12840, title = {Screen for depression to help prevent functional decline in seniors, clinicians urged}, year = {2023}, publisher = {McKnights}, keywords = {depression, functional decline}, url = {https://www.mcknights.com/news/clinical-news/screen-for-depression-to-help-prevent-functional-decline-in-seniors-clinicians-urged/}, author = {Lasek, Alicia} } @article {13021, title = {Sex differences in changes of depressive symptoms among older adults before and during the COVID-19 pandemic: evidence from two longitudinal cohorts.}, journal = {BMC Geriatrics}, volume = {23}, year = {2023}, pages = {64}, abstract = {

BACKGROUND: Major concerns about the adverse mental health impact of the rapidly spread COVID-19 pandemic have been raised. Previous studies on changes of depressive symptoms during the COVID-19 pandemic have yielded inconsistent results regarding the sex differences. Since women have higher depressive symptoms even without the pandemic, it is essential to consider the pre-existing change of depressive symptoms of a similar period to discern the effect of the pandemic on depression. This study aimed to evaluate sex differences in depressive symptoms before and during the pandemic.

METHODS: Data from the Health and Retirement Study (HRS; waves 13 to 15) and the English Longitudinal Study of Ageing (ELSA; wave 8 to COVID-19 wave 2) were analyzed. Depressive symptoms were assessed by the 8-item Center for Epidemiological Studies Depression (CES-D) scale. According to the time of COVID-19 outbreak in the US and the UK, the intervals from waves 13 to 14 surveys of the HRS and from waves 8 to 9 surveys of the ELSA were employed as pre-pandemic periods to control for the pre-existing depressive symptoms, respectively. Changes of CES-D scores during the pre-pandemic and pandemic periods were assessed by linear mixed models.

RESULTS: Nine thousand, seven hundred thirty-seven participants (mean age: 66.7 {\textpm} 10.7~years) from the HRS and 5,098 participants (mean age: 68.7 {\textpm} 10.0~years) from the ELSA were included. CES-D scores among women were significantly higher than those among men at all waves in both cohorts. During the pre-pandemic period, no significant sex difference on changes of CES-D scores was detected in either the HRS or the ELSA. During the pandemic period, CES-D scores were increased in both men and women and the sex differences in CES-D increments of the two cohorts were both significant. Enlarged sex differences were demonstrated in increments of CES-D scores during the pandemic period.

CONCLUSIONS: Our results suggest women suffered from worse depressive symptoms in response to the pandemic, although the changes of depression were similar between men and women before the pandemic. These findings underscore the necessity to support the vulnerable populations, especially women, to manage the distress brought by the pandemic and maintain optimal mental health status.

}, keywords = {COVID-19, depression, ELSA, Pandemics, Sex Characteristics}, issn = {1471-2318}, doi = {10.1186/s12877-023-03744-1}, author = {Zheng, Fanfan and Li, Chenglong and Hua, Rong and Liang, Jie and Gao, Darui and Xie, Wuxiang} } @article {13108, title = {Social Determinants of Health Contribute to Racial and Ethnic Disparities in Depression, Cognition}, year = {2023}, publisher = {Psychiatry Advisor}, keywords = {Cognition, depression, Disparities, health, Race/ethnicity, social determinants}, url = {https://www.psychiatryadvisor.com/home/topics/general-psychiatry/sdoh-contribute-racial-ethnic-disparities-depression-cognition/}, author = {Nye, Jessica} } @article {HSU2023e304, title = {Spousal Loneliness, Depression, and Closeness Among Older Adults Married to Persons with Dementia: A Nationally Representative Study (SA314B)}, journal = {Journal of Pain and Symptom Management}, volume = {65}, year = {2023}, pages = {e304-e305}, abstract = {Outcomes 1. Analyze the role of marriage in serious illness and dementia 2. Discuss interactive biopsychosocial model underlying marriage and health among older adults with serious illness, and key social measures 3. Describe the prevalence of loneliness, depression, or both among spouses married to persons with dementia 4. Discuss how one{\textquoteright}s partner{\textquoteright}s cognitive decline is associated with higher levels of loneliness and depression Background Older adults married to persons with dementia (PWD) may be at risk for loneliness and depression. However, it is unclear how often each occur and the extent to which they are distinct. Research objectives To determine the prevalence of loneliness and depression among older adults married to PWD or mild cognitive impairment (MCI) and the role of marital closeness in mediating these outcomes Methods We used a nationally representative sample of 3,666 married couples enrolled in the Health and Retirement Study (2014 and 2016). We included older adults married to PWD (N=201), married to persons with MCI (N=778), or married to persons with normal cognition (N=2,687). We determined the prevalence of loneliness using multivariable logistic regression adjusting for socio-demographic characteristics, then tested for interaction between marital closeness and degree of spousal cognitive impairment. We assessed the prevalence of depression, and both loneliness and depression, using the same method. Results The sample was 54\% women and on average 67 years old (Range: 50{\textendash}97). After adjustment, older adults married to PWD were more likely to be lonely (Normal: 20\%, MCI: 21\%, PWD: 30\%; p=0.02), depressed (Normal: 7\%, MCI: 14\%, PWD: 16\%; p< 0.01), and both (Normal: 4\%, MCI: 8\%, PWD: 9\%; p< 0.01). The association between spousal cognition and loneliness differed by marital closeness (interaction p-value=0.01); among {\textquotedblleft}close{\textquotedblright} couples, spousal cognitive impairment was associated with higher likelihood of loneliness (p=0.01). In contrast, no association existed between spousal cognitive impairment and loneliness among {\textquotedblleft}not close{\textquotedblright} couples (p=0.24). Conclusion Nearly 1 in 3 spouses of PWD experienced loneliness and 1 in 6 experienced depression. The association between spousal cognition and loneliness was stronger among those with close marital bonds. Implications Findings highlight substantial opportunity to identify and address loneliness and depression among spouses of PWD with close relational bonds to improve quality of life.}, keywords = {closeness, depression, Loneliness, Older Adults}, issn = {0885-3924}, doi = {https://doi.org/10.1016/j.jpainsymman.2022.12.132}, author = {Kristie Hsu and Irena Cenzer and Krista Harrison and Christine Ritchie and Linda Waite and Linda Waite} } @article {12889, title = {Support from others in stressful times can ease impact of genetic depression risk}, year = {2023}, publisher = {Michigan Medicine, University of Michigan}, address = {Ann Arbor, MI}, abstract = {Study in first-year doctors and recently widowed older adults shows greatest impact of social support in those with highest polygenic risk scores for depression}, keywords = {depression, Polygenic risk score, Social Support, Widowhood}, url = {https://www.michiganmedicine.org/health-lab/support-others-stressful-times-can-ease-impact-genetic-depression-risk}, author = {Gavin, Kara} } @mastersthesis {13523, title = {Three Essays on Intergenerational Transfers}, volume = {Ph.D.}, year = {2023}, pages = {163}, school = {Syracuse University}, type = {phd}, address = {New York}, abstract = {Intergenerational transfers of money, time, and other resources are major drivers of wealth inequality in the United States (U.S.). Wealth confers a wide array of advantages, from financial security to social prestige, power, and health. Wealth also can be used to accumulate more wealth. Given that intergenerational transfers generate economic inequality, this three-essay dissertation will seek to examine the causes and consequences of intergenerational transfers in the U.S. The first two essays are devoted to the understanding of the precedents of intergenerational transfers, while the last essay assess the consequence of intergenerational transfers on mental health.Essay 1: Cumulative inequality theory (CIT) posits that disadvantage experienced in early life may not only adversely affect one{\textquoteright}s life course, it may also shape one{\textquoteright}s ability to provide assistance to the next generation. Since intergenerational exchanges can either promote or set back the next generation{\textquoteright}s success, this study therefore aims to determine how childhood disadvantages of parents are associated with the inter vivos downward transfers. Data from the Panel Study of Income Dynamics Childhood Retrospective Circumstances Survey and Rosters and Transfers Module were used to estimate linear regression models. Childhood experiences were measured in the following ways: an aggregate index, categorical variables, or as separate domains. Following CIT, domains included were economic, psychosocial (family, peer), environmental, and health. Downward transfers considered in this study were measured in terms of time transfers and money transfers in the past year, for aid in schooling, for home purchase, and for other purposes. Controlling for adult children{\textquoteright}s characteristics that reflect needs for parental assistance, and upward time and money transfers to account for reciprocity, the results indicate that parent{\textquoteright}s assistance to their adult children vary by their early-life experiences, and some childhood domains matter more (i.e., economic, family, environmental) than others (i.e., peer, health). Those with less affluent upbringing gave significantly more time transfers but less money to their adult children. Money earmarked for schooling purposes were at most $9,000 less for those with the worst level of childhood misfortunes. The forces that shape parental assistance to adult children, therefore, date as far back as the grandparent generation.Essay 2: Whether private intergenerational transfers crowd out or crowd in public welfare, have been subject to debate for almost half a century. Crowding out considers public and private transfers as substitutes, whereas when crowding in occurs the public sector frees up family{\textquoteright}s resources via social welfare provisions, allowing families to transfer resources amongst their members. Often, studies on this topic either use cross-country variation from different welfare regimes or average social welfare expenditure per capita, without consideration of the varied social welfare experiences among givers and receivers. This is the first study to document how parental financial transfers and time transfers in the form of grandchild care are associated with the relative welfare experiences of the parent (giver) and the adult child (beneficiary) by exploiting the heterogeneity of public welfare across U.S. states. Parent-child dyadic data come from the Health and Retirement Study (HRS), a longitudinal and nationally representative study of older adults in the U.S. I linked data from the HRS respondent file and the child-level file constructed by the RAND Corporation with state-specific public welfare expenditures per capita from the Government Finance Database. Controlling for parent, adult child, and reciprocity related determinants of downward transfers, mixed effects logistic regressions clustered by households showed that compared to dyads who both live in a state with low levels of welfare generosity: (1) dyads whose parents live in a less generous state compared to their children have lower odds of downward money and time transfers and (2) dyads whose parents live in a more generous state while the child lives in a relatively less generous states have lower odds of providing both money and time transfers. The results from this study provide partial support for both crowding out and crowding in while implying support for both altruistic and selfish transfer motives. These mixed results call for scholars to reevaluate the consensus of the crowding in hypothesis as the main explanation of downward transfers of money and time from aging parents to adult children, and suggest that better data on both givers{\textquoteright} and receivers{\textquoteright} public welfare experiences are needed to fully contextualize family transfers.Essay 3: Intergenerational transfers are potential social determinants of health, as multiple generations coexisting has become a commonplace in aging societies and austere social protections push families to support their members. This study therefore aims to assess the association between intergenerational transfers between parents, adult children, and other kin, and depressive symptoms among U.S. older adults aged 51+ using data from the Health and Retirement Study waves 2010-2018. Two subsamples were constructed to account for the effect of kin: (1) respondents with at least one adult child and deceased parents/ parents-in-law, and (2) respondents with at least one adult child and one living parent/ parent-in-law throughout the study period. Transfers were categorized as either giving or receiving money and time. Net of relevant sociodemographic factors, random effects logistic regression models revealed that for both subsamples, the odds of having high depressive symptoms were greater for those who have given money transfers. Receiving money transfers and time transfers were also found to be detrimental for mental health. The findings are consistent with the stress process model and also provide partial support for economic exchange theory and contingency exchange. Understanding the factors that are related to older adult well-being is vital as this age group is at risk of mental health decline due to the life course challenges that typically occur in advanced ages like social isolation, bereavement, as well as illnesses and functional limitations.}, keywords = {0347:Mental health, 0351:Gerontology, 0626:Sociology, 0938:Demography, childhood circumstances, Demography, depression, Gerontology, Intergenerational transfers, life course, Mental Health, Older Adults, Sociology, Transfer motives}, isbn = {9798380339124}, url = {https://proxy.lib.umich.edu/login?url=https://www.proquest.com/dissertations-theses/three-essays-on-intergenerational-transfers/docview/2864812703/se-2}, author = {Cheng,Kent J. G.} } @article {13352, title = {The value of Medicare coverage on depressive symptoms among older immigrants.}, journal = {Gerontologist}, year = {2023}, abstract = {

BACKGROUND AND OBJECTIVES: The immigrant population, the primary driver of U.S. population growth, is aging and many immigrants remain uninsured. Lack of health insurance limits access to care, aggravating the already high level of depression for older immigrants. However, there is scarce evidence on how health insurance, particularly Medicare, affects their mental health. Using the Health and Retirement Study, this study examines the effect of Medicare coverage on depressive symptoms of older immigrants in the U.S.

RESEARCH DESIGN AND METHODS: Exploiting the fact that many immigrants are not covered by Medicare after passing age 65, we use a difference-in-difference model with propensity score weighting to compare differences in depressive symptoms pre- and post-age-65. We further stratify the sample by socioeconomic status and by race/ethnicity.

RESULTS: Medicare coverage was significantly associated with a reduction in the probability of reporting depressive symptoms for immigrants with low socioeconomic status, especially for those below median wealth levels. The beneficial effect of Medicare coverage was also statistically significant for non-White immigrants - Black, Hispanic, and Asian/Pacific Islander - even when holding socioeconomic status constant.

DISCUSSION AND IMPLICATIONS: Our findings imply that immigration policies that expand healthcare protection to older immigrants can lead to further health benefits and reduce existing disparities for the aging population. Policy reforms such as providing limited Medicare access to immigrants who paid sufficient taxes but are still awaiting permanent residency status could increase coverage for the uninsured and improve participation of immigrants in the payroll system.

}, keywords = {depression, Disparities, Health Insurance}, issn = {1758-5341}, doi = {10.1093/geront/gnad070}, author = {Jun, Hankyung and Mattke, Soeren and Chen, Alice and Aguila, Emma} } @article {12311, title = {Accelerated epigenetic aging mediates link between adverse childhood experiences and depressive symptoms in older adults: Results from the Health and Retirement Study.}, journal = {SSM Population Health}, volume = {17}, year = {2022}, pages = {101071}, abstract = {

Adverse childhood experiences (ACEs) increase risk for depression at subsequent ages and have been linked to accelerated biological aging. We hypothesize that accelerated epigenetic aging may partially mediate the link between ACEs and depression. This study examines 3~three second-generation epigenetic aging measures (viz., GrimAge, PhenoAge, and DunedinPoAm38) as mediators of the link between ACEs and depressive symptoms in older adulthood. We utilize structural equation modeling to assess mediation in the Health and Retirement Study (N~=~2672). Experiencing ACEs is significantly associated with an older GrimAge and a faster pace of aging via the DunedinPoAm38. Having an older GrimAge and faster DunedinPoAm38 pace of aging were also significantly associated with more depressive symptoms. PhenoAge was not significantly associated with depressive symptoms and was only associated with experiencing three ACEs. These associations were reduced by socioeconomic and lifestyle factors, including obesity and substance use. GrimAge explained between 9 and 14\% of the association between ACEs and adult depressive symptoms, and DunedinPoAm38 explained between 2 and 7\% of the association between ACEs and adult depressive symptoms. Findings indicate accelerated aging, as measured by GrimAge and DunedinPoAm38, is associated with ACEs and with depressive symptoms in older Americans. Findings also show these epigenetic aging measures mediate a portion of the association between ACEs and adult depressive symptoms. Epigenetic aging may represent a physiological mechanism underlying the link between early life adversity and adult depression. Weight maintenance and substance use are potentially important areas for intervention.

}, keywords = {ACEs, Adverse childhood events, Ageing, depression, Epigenetic aging}, issn = {2352-8273}, doi = {10.1016/j.ssmph.2022.101071}, author = {Klopack, Eric T and Eileen M. Crimmins and Cole, Steve W and Seeman, Teresa E and Carroll, Judith E} } @article {11243, title = {Age at Immigration and Depression: The Mediating Role of Contemporary Relationships with Adult Children among Older Immigrants.}, journal = {The Journals of Gerontology: Series B}, volume = {77}, year = {2022}, pages = {413-423}, abstract = {

OBJECTIVES: For the growing population of older immigrants in the United States, both age at immigration and familial relationships are important factors affecting psychological well-being. This study explores how age at immigration and contemporary relationships with adult children combine to explain older immigrants{\textquoteright} depressive symptoms.

METHOD: This study uses 2014 Health and Retirement Study data from a sample of 759 immigrants age 65 and older who have at least one adult child age 21 or older. A series of ordinary least squares regressions and mediational analyses were conducted.

RESULTS: Findings indicate that structural solidarity significantly mediates the association between age at immigration and depressive symptoms. Specifically, immigrating in later life was associated with a lower level of depressive symptoms through its relationship with structural solidarity. In addition, giving monetary support to children and providing care for grandchildren may alleviate depressive symptoms for older immigrants.

DISCUSSION: This study suggests that relationships with adult children may differ with age at immigration. The types of support that older immigrants provide to their adult children may be crucial because such support may instill a sense of obligation and reciprocity that may be beneficial to the psychological well-being of older immigrants.

}, keywords = {depression, Intergenerational Relations, Later-life immigration, Migration}, issn = {1758-5368}, doi = {10.1093/geronb/gbaa209}, author = {Heejung Jang and Pilkauskas, Natasha V and Tang, Fenyan} } @article {12633, title = {The Contribution of Health Behaviors to Depression Risk across Birth Cohorts.}, journal = {Epidemiology}, volume = {33}, year = {2022}, pages = {880-889}, abstract = {

BACKGROUND: More recent birth cohorts are at a higher depression risk than cohorts born in the early 20th century. We aimed to investigate to what extent changes in alcohol consumption, smoking, physical activity, and obesity contribute to these birth cohort variations.

METHODS: We analyzed panel data from US adults born 1916-1966 enrolled in the Health and Retirement Study (N=163,760 person-years). We performed a counterfactual decomposition analysis by combining age-period-cohort models with g-computation. We thereby compared the predicted probability of elevated depressive symptoms (CES-D 8 score >=3) in the natural course to a counterfactual scenario where all birth cohorts had the health behaviors of the 1945 birth cohort. We stratified analyses by sex and race-ethnicity.

RESULTS: We estimated that depression risk of the 1916-1949 and 1950-1966 birth cohort would be on average 2.0\% (-2.3 to -1.7) and 0.5\% (-0.9 to -0.1) higher with the alcohol consumption levels of the 1945 cohort. In the counterfactual with the 1945 BMI distribution, depression risk is on average 2.1\% (1.8 to 2.4) higher for the 1916-1940 cohorts and 1.8\% (-2.2 to -1.5) lower for the 1950-1966 cohorts. We find no cohort variations in depression risk for smoking and physical activity. The contribution of alcohol is more pronounced for Whites than for other race-ethnicity groups, and the contribution of BMI more pronounced for women than for men.

CONCLUSIONS: Increased obesity levels were associated with exacerbated depression risk in recent birth cohorts in the US, while drinking patterns only played a minor role.

}, keywords = {Age{\textendash}period{\textendash}cohort Analysis, Body Mass Index, Causal inference, Decomposition, depression, Health Behavior, Parametric g-formula}, issn = {1531-5487}, doi = {10.1097/EDE.0000000000001524}, author = {Gueltzow, Maria and Bijlsma, Maarten J and van Lenthe, Frank J and Myrskyl{\"a}, Mikko} } @article {12667, title = {Depression among those caring for partners with dementia can start a decade before dementia diagnosis}, year = {2022}, publisher = {Michigan News, University of Michigan}, address = {Ann Arbor, MI}, keywords = {Cognition, Dementia, depression, partner}, url = {https://news.umich.edu/depression-among-those-caring-for-partners-with-dementia-can-start-a-decade-before-dementia-diagnosis/}, author = {Bailey, Laura} } @article {12677, title = {Depression and Loneliness Among the Elderly Poor}, number = {30330}, year = {2022}, institution = {NBER}, address = {Cambridge, MA}, abstract = {The mental health of the elderly in low- and middle-income countries (LMICs) is a largely neglected subject, both by policy and research. We combine data from the health and retirement family of surveys in seven LMICs (plus the US) to document that depressive symptoms among those aged 55 and above are more prevalent in those countries and increase sharply with age. Depressive symptoms in one survey wave are associated with a greater decline in functional abilities and higher probability of death in the next wave. Using data from a panel survey we conducted in Tamil Nadu with a focus on elderly living alone, we document that social isolation, poverty, and health challenges are three of the leading correlates of depression. We discuss potential policy interventions in these three domains, including some results from our randomized control trials in the Tamil Nadu sample.}, keywords = {depression, Loneliness, Low income}, doi = {10.3386/w30330}, author = {Banerjee, Abhitjit and Duflo, Esther and Grela, Erin and McKelway, Madeline and Schilbach, Frank and Sharma, Garima and Vaidyanathan, Girija} } @article {12582, title = {Does Genetic Predisposition to Alzheimer Disease Contribute to Midlife Depression?}, year = {2022}, publisher = {NeurologyAdvisor}, keywords = {Alzheimer disease, depression, genetic data}, url = {https://www.neurologyadvisor.com/topics/alzheimers-disease-and-dementia/genetic-predisposition-alzheimer-disease-midlife-depression/}, author = {Jacobs, Sheila} } @article {10.1525/collabra.37611, title = {Dyadic Associations Between Conscientiousness Facets, Health, and Health Behavior Over Time}, journal = {Collabra: Psychology}, volume = {8}, year = {2022}, pages = {37611}, abstract = {Previous studies show consistent associations between conscientiousness and health outcomes. However, less is known about how various facets of conscientiousness, of both individuals and their partners, are associated with changes in health in older adults over time. Applying the actor{\textendash}partner interdependence model, we examined dyadic associations of broader conscientiousness and its six facets and changes in health, health behavior, and well-being in middle-aged and older couples. With a sample of 3,271 couples (N=6,542) from the Health and Retirement Study, we found that actor conscientiousness, orderliness, and industriousness were most reliably associated with better health outcomes over time. Partner orderliness was associated with better health and more positive health behavior. The remaining associations were near-zero in their effect sizes. Many of these associations persisted over the 10-year period of the study, and there was little evidence for gender differences or multiplicative interactions.}, keywords = {actor-partner interdependence model, Conscientiousness, depression, health, personality facets}, issn = {2474-7394}, doi = {10.1525/collabra.37611}, author = {Chopik, William and Lee, Ji Hyun} } @article {12576, title = {Eight-Year Depressive Symptom Trajectories and Incident Stroke: A 10-Year Follow-Up of the HRS (Health and Retirement Study).}, journal = {Stroke}, volume = {53}, year = {2022}, pages = {2569-2576}, abstract = {

BACKGROUND: Evidence suggests a link between depressive symptoms and risk of subsequent stroke. However, most studies assess depressive symptoms at only one timepoint, with few examining this relationship using repeatedly measured depressive symptoms. This study aimed to examine the relationship between depressive symptom trajectories and risk of incident stroke.

METHODS: This prospective cohort included 12 520 US individuals aged >=50 years enrolled in the Health and Retirement Study, free of stroke at study baseline (1998). We used the 8-item Center for Epidemiologic Studies Depression scale to assess depressive symptoms (high defined as >=3 symptoms; low <3 symptoms) at 4 consecutive, biennial timepoints from 1998 to 2004. We assigned individuals to 5 predefined trajectories based on their scores at each timepoint (consistently low, decreasing, fluctuating, increasing, and consistently high). Using self-reported doctors{\textquoteright} diagnoses, we assessed incident stroke over a subsequent 10-year period from 2006 to 2016. Cox regression models estimated the association of depressive symptom trajectories with risk of incident stroke, adjusting for demographics, health behaviors, and health conditions.

RESULTS: During follow-up, 1434 incident strokes occurred. Compared with individuals with consistently low symptoms, individuals with consistently high depressive symptoms (adjusted hazard ratio, 1.18 [95\% CI, 1.02-1.36]), increasing symptoms (adjusted hazard ratio, 1.31 [95\% CI, 1.10-1.57]), and fluctuating symptoms (adjusted hazard ratio, 1.21 [95\% CI, 1.01-1.46]) all had higher hazards of stroke onset. Individuals in the decreasing symptom trajectory group did not show increased stroke risk.

CONCLUSIONS: Depressive symptom trajectories characterized by high symptoms at multiple timepoints were associated with increased stroke risk. However, a trajectory with depressive symptoms that started high but decreased over time was not associated with higher stroke risk. Given the remitting-relapsing nature of depressive symptoms, it is important to understand the relationship between depressive symptoms and stroke risk over time through repeated assessments.

}, keywords = {depression, Follow-Up Studies, Prospective Studies, Retirement, Risk Factors, Stroke}, issn = {1524-4628}, doi = {10.1161/STROKEAHA.121.037768}, author = {Soh, Yenee and Tiemeier, Henning and Kawachi, Ichiro and Berkman, Lisa F and Kubzansky, Laura D} } @article {11945, title = {Elevated C-Reactive Protein in Alzheimer{\textquoteright}s Disease without Depression in Older Adults: Findings from the Health and Retirement Study.}, journal = {The Journals of Gerontology, Series A }, volume = {77}, year = {2022}, pages = {673-682}, abstract = {

We examined the association between differential diagnoses of major stroke and probable Alzheimer{\textquoteright}s disease (AD) and Mixed AD on c-reactive protein (CRP) in older adults with and without depression. Secondary data analyses examined associations between blood-based measures of probable peripheral inflammation using CRP collected from dried blood spots in the Health and Retirement Study (HRS), a nationally representative sample of individuals aged 50 and older. A validated pattern recognition algorithm was utilized to identify cognitive decline indicative of probable AD, Mixed AD, and major stroke. Negative binomial regressions were utilized to model concentrations of serologic CRP. On average, participants (N=4,601) were 70 years old, female, and non-Hispanic white. Mixed AD participants had 0.26~mg/dL increase in CRP compared to unimpaired participants, controlling for demographics, health behaviors and comorbidities. Those with Mixed AD had 2.14 times increased odds of having high CRP (OR=2.14; [1.19-3.85]). In analyses stratified by depression, adults with Mixed AD and without depression had an additional 0.37~mg/dL increase in CRP (SE=0.06; p<0.001) compared to unimpaired adults. Those with AD without depression had an 0.20~mg/dL increase in CRP (SE=0.07; p<0.01). Age was not associated with increased CRP in non-depressed older adults. Depressed adults with major stroke had a -0.26~mg/dL decrease in CRP (SE=0.11; p=0.02), controlling for hypertension, alcoholic drinks/beverages per week and smoking status. Concentration modeling revealed that participants with major stroke, probable AD and probable mixed AD without depression had significantly higher CRP concentrations when compared to unimpaired older adults.

}, keywords = {Alzheimer disease, C-reactive protein, Dementia, depression, Inflammation, major stroke}, issn = {1758-535X}, doi = {10.1093/gerona/glab282}, author = {Natale, Ginny and Sean A. P. Clouston and Smith, Dylan} } @article {PPR:PPR314453, title = {Engagement in leisure activities and depression in older adults in the United States: Longitudinal evidence from the Health and Retirement Study}, journal = {Social Science \& Medicine}, volume = {294}, year = {2022}, pages = {114703}, abstract = {Objectives: Receptive cultural engagement, such as going to the theater and museums, has been shown to reduce depression in older adults. However, whether more active engagement in artistic and creative activities is associated with lower rates of depression remains unknown. We aimed to test whether active arts engagement was associated with concurrent and subsequent depression. Methods: Using longitudinal data from 19,134 participants aged over 50 in the Health and Retirement Study, arts engagement was measured every four years, and depression every two years, between 2008 and 2016. A score of three or more on the Center for Epidemiologic Studies Depression Scale indicated depression. We fitted population-averaged panel data models using generalized estimating equations with a logit link. Results: Engaging in artistic and creative activities, such as clubs, hobbies, and baking/cooking was associated with reduced depression, independent of confounders. Concurrently, spending time on hobbies (monthly OR=0.80, 95\% CI=0.72-0.88; weekly OR=0.81, 95\% CI=0.73-0.89) and clubs (monthly OR=0.85, 95\% CI=0.77-0.94; weekly OR=0.78, 95\% CI=0.69-0.88) was associated with lower odds of depression versus not engaging. Longitudinally, the odds of depression two years later were reduced amongst people engaging in weekly baking/cooking (OR=0.85, 95\% CI=0.75-0.95), hobbies (OR=0.81, 95\% CI=0.71-0.92), and clubs (OR=0.82, 95\% CI=0.71-0.94). Writing, reading, sewing, and attending non-religious organizations were not consistently associated with depression. Discussion: Active engagement in artistic and creative activities is associated with reduced odds of depression. We should consider how older adults can be supported to actively engage in the arts as a health-promoting behavior.}, keywords = {activities, Arts, depression, Leisure}, doi = {10.1101/2021.04.15.21255495}, author = {Bone, Jessica and Feifei Bu and Meg Fluharty and Paul, Elise and Jill Sonke and Fancourt, Daisy} } @article {12105, title = {Engagement in leisure activities and depression in older adults in the United States: Longitudinal evidence from the Health and Retirement Study.}, journal = {Social Science \& Medicine}, volume = {294}, year = {2022}, pages = {114703}, abstract = {

BACKGROUND: Receptive cultural engagement (e.g. attending theaters and museums) can reduce depression in older adults. However, whether specific participatory leisure activities are associated with lower rates of depression remains unknown. We aimed to test whether engagement in a diverse range of leisure activities, all of which could involve artistic or creative elements, was associated with concurrent and subsequent depression.

METHODS: Using longitudinal data from 19,134 participants aged over 50 in the Health and Retirement Study, engagement in leisure activities was measured every four years, and depression every two years, between 2008 and 2016. Leisure activities included: reading books, magazines, or newspapers; writing; baking/cooking something special; making clothes, knitting, or embroidery (sewing); working on hobbies/projects; going to sport, social, or other clubs; and attending non-religious organization meetings. A score of three or more on the Center for Epidemiologic Studies Depression Scale indicated depression. We fitted population-averaged panel data models using generalized estimating equations with a logit link.

RESULTS: Engaging in some leisure activities, such as clubs, hobbies/projects, and baking/cooking was associated with reduced depression, independent of confounders. Concurrently, spending time on hobbies/projects (monthly OR~=~0.80, 95\% CI~=~0.72-0.88; weekly OR~=~0.81, 95\% CI~=~0.73-0.89) and clubs (monthly OR~=~0.85, 95\% CI~=~0.77-0.94; weekly OR~=~0.78, 95\% CI~=~0.69-0.88) was associated with lower odds of depression versus not engaging. Longitudinally, the odds of depression two years later were reduced amongst people engaging in weekly baking/cooking (OR~=~0.85, 95\% CI~=~0.75-0.95), hobbies (OR~=~0.81, 95\% CI~=~0.71-0.92), and clubs (OR~=~0.82, 95\% CI~=~0.71-0.94). Writing, reading, sewing, and attending non-religious organizations were not consistently associated with depression.

CONCLUSIONS: Engagement in some leisure activities is associated with reduced odds of depression. We should consider how older adults can be supported to actively participate in leisure activities as health-promoting behaviors.

}, keywords = {Aging, Creative activities, depression, Leisure}, issn = {1873-5347}, doi = {10.1016/j.socscimed.2022.114703}, author = {Jessica K Bone and Feifei Bu and Meg Fluharty and Paul, Elise and Jill Sonke and Fancourt, Daisy} } @article {12531, title = {Genetic Associations Identified Between Midlife Depression and Alzheimer Disease}, year = {2022}, publisher = {NeurologyLive}, keywords = {Alzheimer disease, depression, polygenetic risk score}, url = {https://www.neurologylive.com/view/genetic-associations-identified-between-midlife-depression-alzheimers}, author = {Meglio, Marco} } @article {12028, title = {Inner child of the past: long-term protective role of childhood relationships with mothers and fathers and maternal support for mental health in middle and late adulthood.}, journal = {Social Psychiatry and Psychiatric Epidemiology}, volume = {57}, year = {2022}, pages = {1399-1416}, abstract = {

PURPOSE: National longitudinal studies that investigate the long-term association between early family life and mental health in middle and older adulthood are limited. This study aims to fill the gap by examining the protective effect of positive childhood relationships with mothers and fathers and parental support against depression among women and men in middle and late adulthood.

METHODS: The sample of 12,606 adults (7319 females; 5287 males) from the US Health and Retirement Study was nationally representative with the inclusion of 7 depression measures from 2008 to 2018. Two depression measures, CESD-8 scale and binary indicators of severe depressive symptoms, were used. Generalized estimation equations (GEE)-negative binomial models were estimated for CESD-8 and GEE-logit models were estimated for the binary indicator of severe depression. This study aimed to assess how positive parent-child relationships and maternal support protect the mental health of women and men in adulthood. Other risk and psychosocial factors, such as childhood depression, traumatic life events, stressful life events, marital status, and social support in adulthood were adjusted for.

RESULTS: Positive childhood relationships with mothers, fathers, or both parents and increased maternal support were associated with a lower risk of depression among both females and males from middle to old age, even if they experienced trauma, stressful life events, divorce, singlehood, widowhood, or little social support. Females benefited more psychologically than males from positive mother-daughter relationships and high-quality relationships with both parents. However, compared to mother-child relationships, positive father-child relationships protected men better psychosocially than females.

CONCLUSION: Findings underscore the importance of fathers{\textquoteright} roles in promoting their children{\textquoteright}s, especially sons{\textquoteright}, emotional well-being. Interventions in early mother-child and father-child relationships and parental support are crucial for healthy aging in mental development.

}, keywords = {depression, Mental Health, Paternal support}, issn = {1433-9285}, doi = {10.1007/s00127-021-02200-y}, author = {Chen, Ping} } @article {12320, title = {Later-life transitions and changes in prescription medication use for pain and depression.}, journal = {BMC Geriatrics}, volume = {22}, year = {2022}, pages = {222}, abstract = {

BACKGROUND: Over the past two decades, prescription medication use for pain and depression increased dramatically. Most studies consider the early life course, despite a similar increase among those in later life. In this paper, we examine whether and how later life transitions may relate to changes in medication use.

METHODS: We draw on data from the Health and Retirement Study and fixed-effects models to examine whether work, family, and civic transitions in later life are related to changes in the usage of prescription pain and depression medication.

RESULTS: Results show that individuals had higher odds of regularly using prescription pain and depression medications in periods when out of the labor market. Higher odds of depression medication use were also associated with periods of widowhood, and lower odds of use when frequently volunteering. Such relations persist adjusting for reported levels of pain and depression.

CONCLUSION: Our findings call attention to the importance of social ties and the presence of actors that may regulate health behaviors, as well as a change in social context, that may shape medication use in later life.

}, keywords = {depression, pain, prescription drugs, Prescriptions, Retirement}, issn = {1471-2318}, doi = {10.1186/s12877-022-02921-y}, author = {Lam, Jack and Vuolo, Mike} } @article {12086, title = {Loneliness, age at immigration, family relationships, and depression among older immigrants: A moderated relationship}, journal = {Journal of Social and Personal Relationships}, volume = {39}, year = {2022}, pages = {1602-1622}, abstract = {Guided by a convoy model of social relations, this study explores the complex relationships between loneliness, age at immigration, familial relationships, and depressive symptoms among older immigrants. This study used 2010 Health and Retirement Study data from a sample of 575 immigrants (52\% female, age range 65-99 years). Ordinary least squares regression models were estimated. The findings indicate that for older immigrants who came to the United States at age 45 or older, loneliness was significantly positively associated with depressive symptoms. Further, perceived negative strain and hours spent helping family moderated this relationship such that the effect of loneliness on depressive symptoms was stronger among respondents who perceived more negative family strain and spent fewer hours helping family. Familial relationships are crucial for the psychological well-being of older immigrants because they can be a source of either stress or support. The results have implications for how research and practices can support the immigrant families.}, keywords = {age at immigration, depression, family relationships, Loneliness, Migration}, isbn = {0265-4075}, doi = {https://doi.org/10.1177/02654075211061279}, author = {Heejung Jang and Tang, Fengyan} } @article {11561, title = {A longitudinal study shows stress proliferation effects from early childhood adversity and recent stress on risk for depressive symptoms among older adults.}, journal = {Aging \& Mental Health}, volume = {26}, year = {2022}, pages = {870-880}, abstract = {

We evaluated whether the effects of recent stressful life events (SLEs) and early childhood adversities (ECAs) on depressive symptoms are consistent between men and women and across older age, and whether there was evidence for the following: stress sensitization, whereby the psychological impact of SLEs is greater for individuals with ECAs compared with those without; or stress proliferation effect, whereby those with ECAs are more likely to report more SLEs than those without ECAs to effect depressive symptoms. ECAs, SLEs in the past two years, and current depressive symptoms through a modified CES-D were obtained from 11,873 individuals participating in a population representative study of older adults, yielding 82,764 observations. Mixed-effects regression models on depressive symptoms were constructed to control for multiple observations per participant and evaluate within-person effects over time, thereby reducing bias from reverse causation. Results suggest a stress proliferation effect and do not support stress sensitization. ECAs contribute to vulnerability for depressive symptoms, with a dosage effect for each additional ECA. Recent SLEs result in greater depressive symptom risk, with stable effects over age and dosage effects for each additional SLE that were smaller than the effects of ECAs among men, but not women. Belonging to an ethnic minority group, having less education, and less household income at baseline were associated with greater depressive symptom risk. Findings suggest the importance of addressing early childhood adversity and sociodemographic factors, among at-risk older adults to mitigate life-course stress proliferative processes and thereby reduce disparate risk for depression in older age.

}, keywords = {adverse child events, depression, Mental Health, stress generation, Trauma}, issn = {1364-6915}, doi = {10.1080/13607863.2021.1904379}, author = {Thalida E. Arpawong and Mekli, Krisztina and Lee, Jinkook and Drystan F. Phillips and Margaret Gatz and Carol A Prescott} } @article {12036, title = {Marital Transitions, Change in Depressive Symptomology, and Quality of Social Relationships in Midlife and Older U.S. Adults: An Analysis of the Health and Retirement Study.}, journal = {The International Journal of Aging and Human Development}, volume = {95}, year = {2022}, pages = {349-371}, abstract = {

Preventing negative health outcomes following marital transitions can promote personal recovery and well-being. We used the Health and Retirement Study (HRS) (2012, 2014) to test whether social relationship quality moderated the association between marital transition and change in depressive symptomology among U.S. adults aged 50 and older (n = 3,705). Marital status transitions between 2012 and 2014 included remained married/partnered, divorced/separated, and widowed. Depressive symptomology was measured using the Center for Epidemiological Studies Depression Scale 8 Short Form (CES-D 8). Social support, social contact, and social strain were indicators of social relationship quality. Change in depressive symptomology was modeled using autoregressive multiple regression. Social relationship quality appeared to influence depressive symptomatology for those experiencing divorce/separation. Compared to individuals who remained married/partnered, depressive symptomatology in those experiencing separation/divorce decreased among those reporting low social support, increased among those reporting high social support, and increased among those who reported low social strain. Limitations and clinical implications are discussed.

}, keywords = {depression, Divorce, marital transitions, Mental Health, Social Support, Widowhood}, issn = {1541-3535}, doi = {10.1177/00914150211066551}, author = {Julia E Tucker and Nicholas J Bishop and Wang, Kaipeng and Phillips, Farya} } @article {12926, title = {Multidimensional trajectories of multimorbidity, functional status, cognitive performance, and depressive symptoms among diverse groups of older adults.}, journal = {Journal of Multimorbidity and Comorbidity}, volume = {12}, year = {2022}, pages = {26335565221143012}, abstract = {

BACKGROUND: Inter-relationships between multimorbidity and geriatric syndromes are poorly understood. This study assesses heterogeneity in joint trajectories of somatic disease, functional status, cognitive performance, and depressive symptomatology.

METHODS: We analyzed 16~years of longitudinal data from the Health and Retirement Study (HRS, 1998-2016) for n = 11,565 older adults (>=65~years) in the United States. Group-based mixture modeling identified latent clusters of older adults following similar joint trajectories across domains.

RESULTS: We identified four distinct multidimensional trajectory groups: (1) (32.7\% of the sample; mean = 0.60 conditions at age 65, 2.1 conditions at age 90) had limited deterioration; (2) (32.9\%; mean = 2.3 conditions at age 65, 4.0 at age 90) had minimal deterioration; (3) (19.9\%; mean = 1.3 conditions at age 65, 2.7 at age 90) had moderate depressive symptomatology and functional impariments with worsening cognitive performance; (4) (14.1\%; mean = 3.3 conditions at age 65; 4.7 at age 90) had substantial functional limitation and high depressive symptomatology with worsening cognitive performance. Black and Hispanic race/ethnicity, lower wealth, lower education, male sex, and smoking history were significantly associated with membership in the two classes.

CONCLUSIONS: There is substantial heterogeneity in combined trajectories of interrelated health domains in late life. Membership in the two most impaired classes was more likely for minoritized older adults.

}, keywords = {Cognition, depression, joint trajectories, multimorbidity}, issn = {2633-5565}, doi = {10.1177/26335565221143012}, author = {Qui{\~n}ones, Ana R and Nagel, Corey L and Botoseneanu, Anda and Newsom, Jason T and Dorr, David A and Kaye, Jeffrey and Thielke, Stephen M and Allore, Heather G} } @article {11568, title = {Parental dementia and subjective memory impairment in the Health and Retirement Study.}, journal = {Aging \& Mental Health}, volume = {26}, year = {2022}, pages = {992-1000}, abstract = {

OBJECTIVES: To examine relationships between subjective memory impairment (SMI) and parental dementia among in older adults while considering the interactive influence of depressive symptoms, ethnicity, and race.

METHOD: The sample was drawn from the Health and Retirement Study, a nationally representative longitudinal study of aging ( = 3,809; = 66.09; = 1.88; 84.20\% White; 12.23\% Black; 7.88\% Hispanic). Biennial assessments included two measures of SMI (current memory problems and perceived memory decline), depressive symptoms, and parental dementia, over periods of up to sixteen years. Multilevel modeling analyses examined longitudinal relationships between parental dementia and SMI and whether depressive symptoms, ethnicity, and race interactively influenced this association.

RESULTS: Results showed that when older adults reported parental dementia, they were more likely to report a decline in memory in the past two years. They also reported poorer current memory problems, especially when they experienced increased depressive symptoms. Associations of parental dementia were consistent across ethnicity and race.

CONCLUSIONS: Results demonstrate the importance of considering parental dementia as a factor that may contribute to SMI in older adults.

}, keywords = {Dementia, depression, race, subjective memory impairment}, issn = {1364-6915}, doi = {10.1080/13607863.2021.1910790}, author = {Tyler Reed Bell and Nikki L Hill and Bhargava, Sakshi and Mogle, Jacqueline} } @article {DIXON2022101113, title = {Perceived healthcare discrimination and well-being among older adults in the United States and Brazil}, journal = {SSM - Population Health}, volume = {18}, year = {2022}, pages = {101113}, abstract = {Despite well-documented evidence illustrating the relationship between discrimination and health, less is known about the influence of unfair treatment when receiving medical care. Moreover, our current knowledge of cross-national and racial variations in healthcare discrimination is limited in aging populations. This article addresses these gaps using two harmonized data sets of aging populations to clarify the relationship between healthcare discrimination and health in the United States and Brazil. We use nationally representative, harmonized data from the Health and Retirement Study in the United States and the Brazilian Longitudinal Study of Aging to examine and compare perceived discrimination in the healthcare setting and its relationship to self-rated health, depression diagnosis, and depressive symptoms across national contexts. Using Poisson regression models and population attributable risk percent estimates, we found that aging adults reporting healthcare discrimination were at higher risk of poor self-rated health, diagnosed depression, and depressive symptoms. Our results also suggest that reducing perceived healthcare discrimination may contribute to improved self-rated health and mental well-being in later life across racialized societies. In two comparative settings, we highlight the differential impact of healthcare discrimination on self-rated health and depression. We describe the implications of our study{\textquoteright}s findings for national public health strategies focused on eliminating discrimination in the healthcare setting, particularly among aging countries.}, keywords = {Comparative analysis, depression, Discrimination, ELSI, Health Disparities, Race/ethnicity, Social determinants of health}, issn = {2352-8273}, doi = {https://doi.org/10.1016/j.ssmph.2022.101113}, author = {Angela R. Dixon and Leslie B. Adams and Tszshan Ma} } @article {11932, title = {Reciprocal effects between depressive symptoms and pain in veterans over 50 years of age or older}, journal = {Pain Medicine}, volume = {23}, year = {2022}, pages = {295-304}, abstract = {

OBJECTIVE: Depression and chronic pain are major problems in American veterans, yet there is limited long-term research examining how they relate to one another in this population. This study examined the relationship between depressive symptoms and pain in U.S. veterans aged 50+.

METHODS: This study used data on veterans from the 2002-2016 waves of the Health and Retirement Study (n = 4,302), a large-scale observational study of Americans aged 50+. Measures included a short form of the Center for Epidemiologic Studies Depression scale and two items assessing the presence and degree of pain. Analyses included random intercept cross-lagged panel models (RI-CLPM).

RESULTS: In the RI-CLPM, there were roughly equivalent cross-lagged effects between depressive symptoms and pain. There was also evidence that depressive symptoms and pain have a trait-like component and that these trait-like characteristics are associated.

CONCLUSIONS: These findings indicate that depressive symptoms and pain in veterans are stable characteristics in American veterans over 50. There appear to be reciprocal effects between the two, whereby deviations in one{\textquoteright}s typical depressive symptoms predict subsequent deviations in one{\textquoteright}s pain level and vice-versa; however, the size of these effects is very small. These findings suggest that clinicians should treat both depressive symptoms and pain, rather than assume that treatment benefits in one domain will lead to major benefits in another.

}, keywords = {depression, pain, Veterans}, issn = {1526-4637}, doi = {10.1093/pm/pnab294}, author = {Sarah C. Griffin and Young, Jonathan R and Naylor, Jennifer C and Allen, Kelli D and Beckham, Jean C and Patrick S Calhoun} } @article {11833, title = {The Relationship between Pain and Psychological Distress during the COVID-19 Pandemic: Is Social Technology Use Protective?}, journal = {Pain Medicine}, volume = {23}, year = {2022}, pages = {280-287}, abstract = {

OBJECTIVES: The COVID-19 pandemic and resulting shelter-in-place orders have profoundly changed the everyday social environment. This study examines the relationship between pain and psychological distress (depression, anxiety, and loneliness) among US adults ages 54+ during the pandemic. We also test whether use of technology for social purposes moderates the association between pain severity and psychological distress.

METHODS: Using cross-sectional data on 1,014 adults ages 54 + (pain-free, n = 637; mild pain, n = 106; moderate pain, n = 227; and severe pain, n = 64) from the 2020 Health and Retirement Study COVID-19 Project (Early, Version 1.0), we conducted regression analyses to test the association between pain severity and psychological outcomes, and to assess social technology use frequency as a moderator.

RESULTS: Compared to their pain-free peers, participants with mild-to-moderate pain reported more depressive symptoms and greater loneliness; those with severe pain reported higher levels of depression, anxiety, and loneliness. Social technology use was associated with lower levels of depression and loneliness. However, interaction analyses show that social technology use predicted an increase in depression for individuals with pain, but a decrease in depression among pain-free individuals. For anxiety and loneliness, no significant effects of social technology use were observed.

CONCLUSION: Older adults with pain are at high risk of depression, anxiety, and loneliness during the pandemic. Although social technologies have become a common alternative to face-to-face interactions during the COVID-19 crisis, and overall they can provide mental health benefits, our results suggest that social technologies can be detrimental to psychological well-being among people with pain. These findings can inform technology-based interventions aiming to promote well-being among older adults with pain.

}, keywords = {Anxiety, COVID-19, depression, Loneliness, technology use for social purpose}, issn = {1526-4637}, doi = {10.1093/pm/pnab262}, author = {Yang, Yulin and Grol-Prokopczyk, Hanna and Reid, M Carrington and Pillemer, Karl} } @article {12400, title = {Retirement Depression: Coping with the Emotional Pain}, year = {2022}, publisher = {PyschCentral}, abstract = {The loss of a routine and sense of purpose could lead you to experience symptoms of depression after retirement. Help is available and relief is possible.}, keywords = {depression, Mental Health, Retirement}, url = {https://psychcentral.com/depression/retirement-depression}, author = {Chamlou, Nina} } @mastersthesis {12521, title = {The Role of Physical Activity and Gender as Moderators for the Relationship between Insomnia and Depression}, volume = {Ph.D.}, year = {2022}, school = {University of Massachusetts, Boston}, address = {Boston, MA}, abstract = {Objective: The aim of this study was to examine the association between insomnia and depressive symptoms among middle-aged and older adults and to investigate whether gender or physical activity moderates this relationship. Method: This study used nationally representative data from the 2016 and 2018 waves of the Health and Retirement Study (HRS) and binomial logistic regression was used to estimate models. Regression models for risk of depressive symptoms (2018) were based on a longitudinal model with time-lagged indicators of insomnia, levels of physical activity, and covariates (2016). Results: Analyses showed that participants who reported having insomnia in 2016 were more likely to report depressive symptoms in 2018. This study did not find a statistically significant interaction between insomnia and physical activity or insomnia and gender. Discussion: This study showed how insomnia is associated with an increased risk of depression over a two-year period among middle-aged and older adults. Further research is needed to explore differences in gender and physical activity in greater detail. Findings from this study have the potential to inform health professionals and policymakers about the importance of insomnia and depression and develop health promotion programs to reduce the negative and costly health consequences of depression. Moreover, results from the current study can be useful in providing a baseline for pre-and post-pandemic levels of insomnia and depression.}, keywords = {depression, Depressive symptoms, gender, insomnia, Physical activity, Sleep disturbances}, url = {www.proquest.com/dissertations-theses/role-physical-activity-gender-as-moderators/docview/2681823300/se-2}, author = {Wickersham, Claire E.} } @article {12403, title = {The severity of depressive symptoms over time may help predict stroke risk}, year = {2022}, publisher = {American Heart Association News}, abstract = {People who consistently have higher depressive symptoms may be at higher risk for a stroke, according to new research. But stroke risk did not increase in those with decreasing severity of symptoms over time, even if they had high depressive symptoms early on.}, keywords = {depression, stroke risk}, url = {https://www.heart.org/en/news/2022/05/23/the-severity-of-depressive-symptoms-over-time-may-help-predict-stroke-risk$\#$:~:text=The\%20severity\%20of\%20depressive\%20symptoms\%20over\%20time\%20may\%20help\%20predict\%20stroke\%20risk,-By\%20Thor\%20Christensen\&text=Peop}, author = {Christensen, Thor} } @article {12468, title = {Study: Boomers have more medical woes than their parents did at same age}, year = {2022}, publisher = {The Atlanta Journal-Constitution}, keywords = {boomers, Chronic condition, depression}, url = {https://www.ajc.com/pulse/study-boomers-have-more-medical-woes-than-their-parents-did-at-same-age/IKVEPLNZU5DFPFQHJ3RFWSSBG4/}, author = {Clanton, Nancy} } @article {11998, title = {Trajectories of Depressive Symptoms and Incident Diabetes: A Prospective Study.}, journal = {Annals of Behavioral Medicine}, volume = {56}, year = {2022}, pages = {311-316}, abstract = {

BACKGROUND: Elevated depressive symptoms are associated with an increased risk for diabetes. Depression is a heterogeneous and chronic condition in which symptoms may remit, emerge, lessen, or intensify over time.

PURPOSE: The purpose of this study was to determine if trajectories of depressive symptoms measured at five time points over 8 years predicted incident diabetes over an 8-year follow-up in middle-aged and older adults. A secondary aim was to determine if trajectories of depressive symptoms predict incident diabetes, above and beyond depressive symptoms measured at a single time point.

METHODS: Data came from the Health and Retirement Study (n = 9,233). Depressive symptoms were measured biennially from 1998 to 2006. Self-reported incident diabetes was measured during an 8-year follow-up.

RESULTS: Five trajectories of depressive symptoms were identified (no depressive symptoms, low depressive symptoms, low-moderate depressive symptoms, moderate depressive symptoms, elevated and increasing depressive symptoms). Compared to the no depressive symptoms trajectory group (referent), all other trajectory groups were at higher risk of developing diabetes after adjusting for covariates. In most cases, trajectory group membership was associated with incident diabetes after controlling for depressive symptoms at a single time point.

CONCLUSIONS: Patterns of depressive symptoms over time were associated with incident diabetes. Patterns of depressive symptoms may be more predictive of diabetes incidence than depressive symptoms measured at a single time point.

}, keywords = {depression, Depressive symptoms, Diabetes, Trajectories}, issn = {1532-4796}, doi = {10.1093/abm/kaab094}, author = {Burns, Rachel J and Briner, Esther and Schmitz, Norbert} } @article {11722, title = {Unmet Expectations About Work at Age 62 and Depressive Symptoms.}, journal = {The Journals of Gerontology, Series B }, volume = {77}, year = {2022}, pages = {615-625}, abstract = {

OBJECTIVES: Exiting the labor force earlier or later than planned is common, with predictable economic consequences. However, the mental health ramifications of such off-time events are not known but are important to promoting well-being in retirement.

METHODS: Using the Health and Retirement Study (1992-2016), we created six groups based on the alignment of expectations about full-time work at age 62 (reported at ages 51-61) with realized labor force status after reaching age 62 (N=10,421). Negative binomial models estimated the adjusted association between unmet expectations about work and depressive symptoms.

RESULTS: Unexpectedly not working was associated with higher depressive symptoms than working as expected after adjusting for sociodemographic, economic, and health factors at the time of expectations (IRR=1.35, 95\% CI:1.17, 1.56). Additionally adjusting for health declines and marriage dissolution between expectations and age 62 partially attenuated the association, but unexpectedly not working remained significantly associated with a 1.16 increase in the incidence rate of depressive symptoms. Unexpectedly working at 62 was not associated with depressive symptoms. Race/ethnicity interacted with expectation alignment (F(15,42)=2.44, p=0.0118) in that Hispanic respondents experienced an increase in depressive symptoms when working after unmet and unsure expectations compared to met expectations, whereas white respondents did not.

DISCUSSION: Unlike working longer than expected, unexpectedly not working at 62 was associated with depressive symptoms, even after accounting for health declines. Public and employer policies should assist workers in remaining in the labor force as long as planned and offer mental health supports for unexpected work exits.

}, keywords = {depression, Expectations, Mental Health, Retirement}, issn = {1758-5368}, doi = {10.1093/geronb/gbab113}, author = {Leah R. Abrams and Philippa J Clarke and Neil K Mehta} } @article {MILLER202215, title = {The welfare cost of late-life depression}, journal = {Journal of Economic Behavior \& Organization}, volume = {204}, year = {2022}, pages = {15-36}, abstract = {We quantify the welfare cost of depression among older Americans by estimating a panel VAR model of mental and physical health, labor supply, and consumption using data from the Health and Retirement Study. We use the estimated model and age sixty joint distribution of outcomes to simulate life-cycle paths with and without prevalence of depressive symptoms after age sixty. We estimate that the prevalence of late-life depressive symptoms costs an average of between 0.85 and 2.1 years in quality-adjusted life expectancy per person. Moreover, depression may result in an average loss of labor supply of up to 1.1 months and lifetime consumption of up to $16,000. Combining into a single compensating variation welfare metric, we estimate a bound on the average welfare cost of depression of 8{\textendash}15\% of annual consumption after age sixty. On aggregate, this amounts to roughly $180{\textendash}360 billion annually. We also project that while the average welfare cost of late-life depression is declining slightly over birth cohorts, the welfare burden is becoming significantly more unequal.}, keywords = {consumption, Cost-utility analysis, depression, Mental Health, Retirement}, issn = {0167-2681}, doi = {10.1016/j.jebo.2022.10.001}, author = {Ray Miller and Sayorn Chin and Ashish Kumar Sedai} } @article {12466, title = {Why Do Mental Illnesses{\textemdash}From Depression to Schizophrenia{\textemdash}Raise the Risk of Dementia?}, year = {2022}, publisher = {Scientific America}, keywords = {Dementia, depression, Mental Illness, Schizophrenia}, url = {https://www.scientificamerican.com/article/why-do-mental-illnesses-from-depression-to-schizophrenia-raise-the-risk-of-dementia/}, author = {Wallis, Claudia} } @article {12591, title = {Work expectations, depressive symptoms, and passive suicidal ideation among older adults: Evidence from the Health and Retirement Study.}, journal = {The Gerontologist}, volume = {62}, year = {2022}, pages = {1477-1485}, abstract = {

BACKGROUND AND OBJECTIVES: Employment and work transitions (e.g., retirement) influence mental health. However, how psychosocial contexts such as anticipation and uncertainty about work transitions, irrespective of the transitions themselves, relate to mental health is unclear. This study examined the relationships of work expectations with depressive symptoms, major depression episodes (MDE), and passive suicidal ideation over a 10-year period among the "Baby Boom" cohort of the Health and Retirement Study.

RESEARCH DESIGN AND METHODS: Analysis was limited to 13,247 respondents aged 53 - 70 observed from 2008 to 2018. Past-year depressive symptoms, MDE, and passive suicidal ideation were indexed using the Composite International Diagnostic Interview-Short Form. Expectations regarding working full-time after age 62 were assessed using a probability scale (zero to 100\%). Mixed effect logistic regressions with time-varying covariates were used to assess the relationship of work expectations with mental health, accounting for demographics, health status, and functioning, and stratified by baseline employment status.

RESULTS: At baseline, higher work expectations were inversely associated with depressive symptoms. Longitudinally, higher expectations were associated with lower odds of depressive symptoms (Odds Ratio (OR) = 0.93, 95\% CI: 0.91, 0.94). This association was more pronounced among respondents not working at baseline (ORNot working=0.93 vs. ORWorking=0.96). Greater uncertainty (i.e., expectations near 50\%) was also inversely associated with depressive symptoms. Results were similar for past-year MDE and passive suicidal ideation.

DISCUSSION AND IMPLICATIONS: Expectations (overall likelihood and uncertainty), as indicators of psychosocial context, provide insight into the processes that link work transitions with depression risk.

}, keywords = {depression, Employment}, issn = {1758-5341}, doi = {10.1093/geront/gnac110}, author = {Mezuk, Briana and Dang, Linh and Jurgens, David and Jacqui Smith} } @article { ISI:000548876000001, title = {A 2-Year Longitudinal Relationship Between Work-Family Conflict and Health Among Older Workers: Can Gardening Help?}, journal = {Journal of Applied Gerontology}, volume = {40}, year = {2021}, pages = {1330-1341}, abstract = {With the graying workforce worldwide, identifying factors that facilitate older workers{\textquoteright} health is critically important. We examined whether gardening mitigates the relationship of work-family conflict with disability, chronic conditions, depressive symptoms, and self-rated health among older workers. We drew a subsample of older workers aged 55 years and above from the Health and Retirement Study (N= 1,598). Our results indicate that the relationships of work-to-family conflict at baseline with disability and with poorer self-rated health at a 2-year follow-up were stronger for those who gardened less than those who gardened more. No significant interaction was found between family-to-work conflict and gardening in predicting the health outcomes. This study is the first to show that gardening may have a protective effect against the adverse impact of work-to-family conflict on older workers{\textquoteright} health.}, keywords = {Chronic conditions, depression, Disability, Leisure activities, Self-rated health, Senior workers, work-family interference}, issn = {0733-4648}, doi = {10.1177/0733464820934678}, author = {Eunae Cho and Tuo-Yu Chen and Megan C Janke} } @article {11895, title = {The Association between Multiple Chronic Conditions and Depressive Symptoms: Intersectional Distinctions by Race, Nativity, and Gender.}, journal = {Journal of Health and Social Behavior}, volume = {62}, year = {2021}, pages = {599-617}, abstract = {

Using random coefficient growth curve analysis, this study utilizes 12 waves of data from the Health and Retirement Study (1994-2016; person-waves = 145,177) to examine the association between multiple chronic conditions (MCC) and depressive symptoms among older adults. Applying cumulative disadvantage and intersectionality theories, we also test whether the association between MCC and depressive symptoms differs by race, nativity, and gender. Findings reveal that MCC prevalence is highest among U.S.-born black women, whereas depressive symptoms are highest among foreign-born Hispanic women. Compared to men, MCC has a stronger effect on women{\textquoteright}s depressive symptoms. Furthermore, the MCC-depressive symptoms association is strongest for foreign-born Hispanic women. Despite an increase in MCC in the transition from midlife to late life, all race-nativity-gender groups experience a decline in depressive symptoms as they age. The decline in depressive symptoms is steepest for U.S.-born black and foreign-born Hispanic women. Study implications are discussed.

}, keywords = {cumulative disadvantage, depression, Intersectionality, Multiple Chronic Conditions}, issn = {2150-6000}, doi = {10.1177/00221465211040174}, author = {Christy L Erving and Frazier, Cleothia} } @article {11889, title = {The Association of Delayed Care With Depression Among US Middle-Aged and Older Adults During the COVID-19 Pandemic: Cross-sectional Analysis.}, journal = {JMIR Aging}, volume = {4}, year = {2021}, pages = {e29953}, abstract = {

BACKGROUND: During the Coronavirus Disease 2019 (COVID-19) pandemic, the depression level among US adults has significantly increased. Age disparity in depression during the pandemic was also reported in recent studies. Delay or avoidance of medical care is one of the collateral damages caused by the COVID-19 pandemic and it can lead to increased morbidity and mortality.

OBJECTIVE: The present study aims to assess the prevalence of depression and delayed care among US middle-aged adults and older adults during the pandemic, as well as investigate the association of delayed care with depression among those two age groups.

METHODS: This cross-sectional study used the 2020 Health and Retirement Study (HRS) COVID-19 Project (Early, Version 1.0) data. Univariate analyses, bivariate analyses, and binary logistic regression were applied. US adults older than 46 years old were included. Depression was measured by Composite International Diagnostic Interview Short Form (CIDI-SF). Delayed care was measured by four items: delayed surgery, delayed seeing a doctor, delayed dental care, and other delayed care.

RESULTS: More than half of participants were older than 65 years old (58.23\%) and 274 participants (8.75\%) had depression during the pandemic. Delayed dental care was positively associated with depression among both middle-aged adults (OR=2.05, 95\%CI=1.04-4.03, P<0.05) and older adults (OR=3.08, 95\%CI=1.07-8.87, P<0.05). Delayed surgery was positively associated with depression among older adults (OR=3.69, 95\%CI=1.06-12.90, P<0.05). Self-reported pain was positively related to depression among both age groups. Middle-aged adults who reported higher education level (some college of above) or worse self-reported health had higher likelihood to have depression. While perceived more loneliness was positively associated with depression among older adults, financial difficulty was positively associated with depression among middle-aged adults.

CONCLUSIONS: This study found that depression among middle-aged and older adults during the pandemic was also prevalent. The study highlighted the collateral damage of the COVID-19 pandemic by identifying the association of delayed surgery and dental care with depression during the pandemic. Although surgery and dental care cannot be delivered by telehealth, telehealth services can still be provided to address patients{\textquoteright} concern on delayed surgery and dental care. Moreover, the implementation of tele-mental health services is also needed to address mental health symptoms among US middle-aged and older adults during the pandemic. Future research that uses more comprehensive measurements for delayed care is needed to decipher the path through which delayed care is associated with depression.

CLINICALTRIAL:

}, keywords = {COVID-19, delayed care, depression}, issn = {2561-7605}, doi = {10.2196/29953}, author = {Luo, Yan} } @article {11704, title = {Association of late-life depression with cognitive impairment: evidence from a cross-sectional study among older adults in India.}, journal = {BMC Geriatrics}, volume = {21}, year = {2021}, pages = {364}, abstract = {

BACKGROUND: Late-life depression (LLD) is considered as a prodrome to dementia and plays a major role in the development of long-term cognitive disabilities. We aimed to estimate the prevalence and correlates of LLD and cognitive impairment and to explore their associations among older adults in India.

METHODS: Data for this study was derived from the Longitudinal Ageing Study in India (LASI) Wave 1 (2017-18). The total sample included 31,464 (15,098 male and 16,366 female) older individuals aged 60 years and above. Cognitive impairment measured from various domains derived from~the cognitive module of the Health and Retirement Study~(HRS),~and major depression measured by the CIDI-SF (Composite International Diagnostic Interview- Short Form) were the outcome variables. Descriptive, bivariate, and multivariable analyses were performed to fulfill the objectives of the study.

RESULTS: The overall prevalence of LLD and cognitive impairment for the current sample was 8.7\% and 13.7 \% respectively. Among older individuals who have rated their health status as poor were 2.59 times more likely to suffer from LLD [OR: 2.59, CI: 2.24-2.99] as compared to their counterparts. The older adults who had difficulty in activities of daily living (ADL) and instrumental activities of daily living (IADL) were 74\% and 69 \% more likely to suffer from LLD. Similarly, older adults who were depressed had higher odds of cognitive impairment [OR: 1.22, CI: 1.01-1.48] compared to their counterparts. Also, older adults who were depressed and belonged to rural areas were 2.58 times [AOR: 2.58, CI: 1.95-3.41] more likely to be cognitively impaired than those who were not depressed and resided in urban areas.

CONCLUSIONS: Depression is linked to an increased risk of cognitive decline and dementia; therefore, failing to diagnose and treat LLD in later life may have significant health implications.~Moreover, treatment under the care of a cognitive neurologist or geriatric psychiatrist is recommended for people with LLD and cognitive disability due to both~the disorders{\textquoteright} complex existence.

}, keywords = {Activities of Daily Living, Cognitive Dysfunction, Cross-Sectional Studies, depression, LASI}, issn = {1471-2318}, doi = {10.1186/s12877-021-02314-7}, author = {Muhammad, T and Meher, Trupti} } @article {11024, title = {Associations Between Alzheimer{\textquoteright}s Disease and Related Dementias and Depressive Symptoms of Partner Caregivers}, journal = {Journal of Applied Gerontology}, volume = {40}, year = {2021}, pages = {772-780}, abstract = {Family members - mainly spouses and partners - are the primary caregivers for individuals with Alzheimer{\textquoteright}s disease and related dementias (ADRDs), chronic progressive illnesses requiring increasing levels of care. We performed a retrospective observational analysis comparing depressive symptoms of 16,650 older individuals with partners without ADRDs, and those recently (within 2 years) or less recently diagnosed (>=2 years prior), controlling for lagged sociodemographic and health characteristics. The mean number of reported depressive symptoms was 1.2 (SD = 1.8). Compared with respondents with partners with no ADRD, having a partner with any ADRD was associated with a 0.35 increase (95\% confidence interval [CI] = [0.30, 0.41]), or 30\% increase, in depressive symptoms. A less recent partner diagnosis was associated with a 33\% increase, while a recent diagnosis was associated with a 27\% increase. Clinically meaningful and longitudinally worsening depressive symptoms amplify the need to prioritize partner health and family-centered care following an ADRD diagnosis.}, keywords = {Alzheimer{\textquoteright}s disease, Caregiving, Dementia, depression, quantitative methods}, isbn = {0733-4648}, doi = {10.1177/0733464820952252}, author = {Harris, Melissa L. and Marita G. Titler and Geoffrey J Hoffman} } @article {WEZIAKBIALOWOLSKA2021114494, title = {Being good, doing good: The role of honesty and integrity for health}, journal = {Social Science \& Medicine}, volume = {291}, year = {2021}, pages = {114494}, abstract = {Psychological traits, such as character strengths, have been already established in experimental studies as factors playing a favorable role for well-being and potentially reducing the risk of depression. Positive associations have been also reported between character strengths and physical fitness, self-reported physical and mental health. Yet, evidence with large scale, epidemiological data on the role of character strength of honesty and integrity (CSHI) in shaping subsequent health outcomes and daily functioning remains unexplored. We examined whether the character strength of honesty and integrity was prospectively associated with six physical health outcomes, two depression outcomes, and two daily functioning outcomes. We used data from the Health and Retirement Study obtained from a sample of 9813 older adults. We found that after a 4-year follow-up period, compared with individuals who scored the lowest in CSHI, participants who scored in the third tertile had a 18\% lower risk of lung disease (RR = 0.824; 95\% CI = 0.732; 0.927), and a 11\% lower risk of depression (RR = 0.891; 95\% CI = 0.806; 0.986). They also reported lower limitations in mobility (β = -0.048; 95\% CI (-0.089; -0.008)] and less difficulty in instrumental activities of daily living [β = -0.088; 95\% CI (-0.128; -0.047)]. These associations were independent of demographics, prior socioeconomic status, psychological factors, health conditions, and health behaviors. Policy makers and practitioners may consider the character strength of honesty and integrity as a factor for promoting healthy longevity, limiting risks of becoming physically inactive and reducing risk of physical and mental disease.}, keywords = {Character strength, depression, Honesty, integrity, Lung disease, Physical Health}, issn = {0277-9536}, doi = {https://doi.org/10.1016/j.socscimed.2021.114494}, author = {Dorota Weziak-Bialowolska and Piotr Bialowolski and Ryan M. Niemiec} } @article {11658, title = {Changes in depressive symptoms from pre- to postretirement over a 20-year span: The role of self-perceptions of aging}, journal = {Journal of Affective Disorders}, volume = {292}, year = {2021}, pages = {1-8}, abstract = {Background Retirement-related changes in depressive symptoms are not clear. This research examined short- and long-term changes in older adults{\textquoteright} depressive symptoms before, upon, and after retirement. It also tested if and how changes in depressive symptoms varied by different levels of negative self-perceptions of aging (nSPA) in men and women. Methods We analyzed longitudinal data from individuals who retired between 1994 and 2016 in the Health and Retirement Study (N = 9027). Using fixed-effect regression models, we examined changes in depressive symptoms from the 10-year preretirement phase through the 10-year postretirement phase. We also examined how changes in depressive symptoms during the retirement transition varied across four groups: low nSPA men, low nSPA women, high nSPA men, and high nSPA women. Results Both male and female retirees experienced increased short- and long-term depressive symptoms after retirement. However, the pattern of change varied by nSPA and gender. For both low nSPA men and women, there were no significant changes in depressive symptoms across different retirement phases. Adults with high nSPA showed important changes in depressive symptoms, but there were gender differences{\textemdash}High nSPA men experienced increases in depressive symptoms mainly in preretirement years and during the year of retirement; high nSPA women experienced symptoms increase during the year of retirement and the years after retirement. Limitations The use of self-report measures may lead to recall bias. Studies are needed to understand mechanisms behind the protective role of low nSPA.ConclusionsThe findings attest to the health benefits of low nSPA during later-life stages.}, keywords = {Age stereotypes, Ageism, attitude toward aging, depression, psychological well-being}, isbn = {0165-0327}, doi = {10.1016/j.jad.2021.05.059}, author = {Luo, Meng Sha and Li, Lydia} } @article {11951, title = {Childhood Residue in the Aging Body}, journal = {Observer}, year = {2021}, publisher = {Association for Psychological Science}, keywords = {Childhood, Chronic illness, depression, NICOLA, SHARE, TILDA}, url = {https://www.psychologicalscience.org/observer/childhood-residue}, author = {Sleek, Scott} } @article {11629, title = {Depression as a Mediator of the Association Between Wealth Status and Risk of Cognitive Impairment and Dementia: A Longitudinal Population-Based Cohort Study.}, journal = {Journal of Alzheimer{\textquoteright}s Disease}, volume = {80}, year = {2021}, pages = {1591-1601}, abstract = {

BACKGROUND: Wealth and income are potential modifiable risk factors for dementia, but whether wealth status, which is composed of a combination of debt and poverty, and assessed by wealth and income, is associated with cognitive impairment among elderly adults remains unknown.

OBJECTIVE: To examine the associations of different combinations of debt and poverty with the incidence of dementia and cognitive impairment without dementia (CIND) and to evaluate the mediating role of depression in these relationships.

METHODS: We included 15,565 participants aged 51 years or older from the Health and Retirement Study (1992-2012) who were free of CIND and dementia at baseline. Dementia and CIND were assessed using either the modified Telephone Interview for Cognitive Status (mTICS) or a proxy assessment. Cox models with time-dependent covariates and mediation analysis were used.

RESULTS: During a median of 14.4 years of follow-up, 4,484 participants experienced CIND and 1,774 were diagnosed with dementia. Both debt and poverty were independently associated with increased dementia and CIND risks, and the risks were augmented when both debt and poverty were present together (the hazard ratios [95\% confidence intervals] were 1.35 [1.08-1.70] and 1.96 [1.48-2.60] for CIND and dementia, respectively). The associations between different wealth statuses and cognition were partially (mediation ratio range: 11.8-29.7\%) mediated by depression.

CONCLUSION: Debt and poverty were associated with an increased risk of dementia and CIND, and these associations were partially mediated by depression. Alleviating poverty and debt may be effective for improving mental health and therefore curbing the risk of cognitive impairment and dementia.

}, keywords = {cognitive impairment, Dementia, depression, mediation analysis, wealth status}, issn = {1875-8908}, doi = {10.3233/JAD-201239}, author = {Zhou, Rui and Liu, Hua-Min and Li, Fu-Rong and Yang, Hai-Lian and Zheng, Jia-Zhen and Zou, Meng-Chen and Zou, Lian-Wu and Wu, Xiao-Xiang and Wu, Xian-Bo} } @article {11539, title = {Discriminating Heterogeneous Trajectories of Resilience and Depression After Major Life Stressors Using Polygenic Scores.}, journal = {JAMA Psychiatry}, volume = {78}, year = {2021}, pages = {744-752}, abstract = {

Importance: Major life stressors, such as loss and trauma, increase the risk of depression. It is known that individuals show heterogeneous trajectories of depressive symptoms following major life stressors, including chronic depression, recovery, and resilience. Although common genetic variation has been associated with depression risk, genomic factors that could help discriminate trajectories of risk vs resilience following adversity have not been identified.

Objective: To assess the discriminatory accuracy of a deep neural net combining joint information from 21 psychiatric and health-related multiple polygenic scores (PGSs) for discriminating resilience vs other longitudinal symptom trajectories with use of longitudinal, genetically informed data on adults exposed to major life stressors.

Design, Setting, and Participants: The Health and Retirement Study is a longitudinal panel cohort study in US citizens older than 50 years, with data being collected once every 2 years between 1992 and 2010. A total of 2071 participants who were of European ancestry with available depressive symptom trajectory information after experiencing an index depressogenic major life stressor were included. Latent growth mixture modeling identified heterogeneous trajectories of depressive symptoms before and after major life stressors, including stable low symptoms (ie, resilience), as well as improving, emergent, and preexisting/chronic symptom patterns. Twenty-one PGSs were examined as factors distinctively associated with these heterogeneous trajectories. Local interpretable model-agnostic explanations were applied to examine PGSs associated with each trajectory. Data were analyzed using the DNN model from June to July 2020.

Exposures: Development of depression and resilience were examined in older adults after a major life stressor, such as bereavement, divorce, and job loss, or major health events, such as myocardial infarction and cancer.

Main Outcomes and Measures: Discriminatory accuracy of a deep neural net model trained for the multinomial classification of 4 distinct trajectories of depressive symptoms (Center for Epidemiologic Studies-Depression scale) based on 21 PGSs using supervised machine learning.

Results: Of the 2071 participants, 1329 were women (64.2\%); mean (SD) age was 55.96 (8.52) years. Of these, 1638 (79.1\%) were classified as resilient, 160 (7.75) in recovery (improving), 159 (7.7\%) with emerging depression, and 114 (5.5\%) with preexisting/chronic depression symptoms. Deep neural nets distinguished these 4 trajectories with high discriminatory accuracy (multiclass micro-average area under the curve, 0.88; 95\% CI, 0.87-0.89; multiclass macro-average area under the curve, 0.86; 95\% CI, 0.85-0.87). Discriminatory accuracy was highest for preexisting/chronic depression (AUC 0.93), followed by emerging depression (AUC 0.88), recovery (AUC 0.87), resilience (AUC 0.75).

Conclusions and Relevance: The results of the longitudinal cohort study suggest that multivariate PGS profiles provide information to accurately distinguish between heterogeneous stress-related risk and resilience phenotypes.

}, keywords = {depression, polygenic score, Resilience}, issn = {2168-6238}, doi = {10.1001/jamapsychiatry.2021.0228}, author = {Schultebraucks, Katharina and Choi, Karmel W and Isaac R Galatzer-Levy and George A. Bonanno} } @article {11769, title = {Do depressive symptoms link chronic diseases to cognition among older adults? Evidence from the Health and Retirement Study in the United States.}, journal = {Journal of Affective Disorders}, volume = {294}, year = {2021}, pages = {357-365}, abstract = {

BACKGROUND: Few studies have assessed psychological pathways that connect the association between non-psychotropic chronic disease and cognition. We assessed the extent to which the association between the two was mediated by depressive symptoms in older adults.

METHODS: Data came from waves 10-13 (2010-2016) of the Health and Retirement Study in the United States (7,651 men and 10,248 women). Multilevel path analysis, allowing for random intercepts and slopes, was employed to estimate the extent to which depressive symptoms mediated the total effect of a chronic disease on cognition.

RESULTS: We found that the presence of stroke, high blood pressure, diabetes, heart problems, and comorbidity, in both men and women, and lung disease in women, was associated with lower levels of cognition. The total effects of chronic diseases on cognition were partially mediated through depressive symptoms. Depressive symptoms mediated approximately 19\%-39\% and 23\%-54\% of the total effects of chronic diseases on cognition in men and women, respectively.

LIMITATIONS: We relied on self-reported diagnoses of diseases and depressive symptoms. Our use of a multilevel path analysis with random slopes precluded the inclusion of binary/categorical dependent variables, and the estimation of standardized beta values.

CONCLUSIONS: To understand the cognitive challenges that chronically ill older adults face, practitioners and policymakers should consider not just the direct symptoms related to chronic diseases, but also the often overlooked psychological conditions faced by older adults.

}, keywords = {Chronic condition, cognitive aging, depression, Psychological condition}, issn = {1573-2517}, doi = {10.1016/j.jad.2021.07.012}, author = {Lu, Wentian and Pai, Manacy and Shaun Scholes and Xue, Baowen} } @article {11399, title = {Early-life stress, depressive symptoms, and inflammation: the role of social factors.}, journal = {Aging \& Mental Health}, year = {2021}, abstract = {

OBJECTIVE: To identify modifiable, social factors that moderate the relationship between early-life stress (ELS) and health outcomes as measured by depressive symptoms and inflammation.

METHODS: Data were from 3,416 adults (58.28\% female), ages 36 - 97 (M= 68.41; SD= 10.24) who participated in the 2006 wave of the Health and Retirement Study, a nationally representative sample of older adults in the United States. This study used hierarchical regression analyses to first test the main effects of ELS on depressive symptoms and inflammation (high-sensitivity C-reactive protein). Four social factors (perceived support, frequency of social contact, network size, and volunteer activity) were assessed as moderators of the ELS-depression and ELS-inflammation relationships.

RESULTS: There was a small, positive association between ELS and depressive symptoms ( = 0.17, = 0.05, = .002), which was moderated by social contact and perceived support. Specifically, ELS was only associated with elevated depressive symptoms for participants with limited social contact ( = 0.24, = 0.07, < .001) and low perceived support ( = 0.24, = 0.07, < .001). These associations remained after accounting for potential confounds (age, body-mass index, adulthood stress, and marital status).

CONCLUSIONS: Increased social contact and perceived support may be protective for individuals at a higher risk of developing depressive symptoms as a result of ELS. Future interventions may benefit from leveraging these social factors to improve quality of life in adults with ELS.

}, keywords = {Aging, depression, Inflammation, Social Factors, Stress}, issn = {1364-6915}, doi = {10.1080/13607863.2021.1876636}, author = {Julia S Nakamura and Eric S Kim and Kelly E Rentscher and Bower, Julienne E and Kate Kuhlman} } @article {11948, title = {Epidemiology of undiagnosed depression in people with diabetes mellitus: a comparative analysis of Ireland, England and the USA.}, journal = {BMJ Open}, volume = {11}, year = {2021}, pages = {e049155}, abstract = {

OBJECTIVES: Improving detection of depression in people with diabetes is recommended. However, little is known about how different health systems compare in depression detection. We estimated and compared the (1) prevalence of depression detection in people with and without diabetes, and (2) association between diabetes and undiagnosed depression across three health systems.

DESIGN: Cross-sectional analysis of three nationally representative studies: The Irish Longitudinal Study on Ageing, the English Longitudinal Study on Ageing and the Health and Retirement Study.

SETTING: Community-dwelling adults in Ireland, England and the USA.

PARTICIPANTS: Adults aged >=50 years.

PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome was depression diagnosis. The secondary outcome was any depression. Any depression was defined by the presence of self-reported doctor-diagnosed depression or current depression symptoms on the Centre for Epidemiological Studies-Depression scale. Depression diagnosis was categorised as: undiagnosed, symptomatic and diagnosed, and asymptomatic and diagnosed. We estimated age-standardised prevalence of depression diagnosis by country and diabetes status. Anyone who self-reported having ever received a doctor diagnosis of diabetes was classified as having diabetes. Among respondents with depression, we estimated the association between diabetes and undiagnosed depression by country using multivariable logistic regression.

RESULTS: The prevalence of depression (diagnosed and undiagnosed) was higher in people with diabetes in each country with absolute rates varying by country; undiagnosed prevalence (Ireland: diabetes 10.1\% (95\% CI 7.5\% to 12.8\%) vs no diabetes 7.5\% (95\% CI 6.8\% to 8.2\%), England: diabetes 19.3\% (95\% CI 16.5\% to 22.2\%) vs no diabetes 11.8\% (95\% CI 11.0\% to 12.6\%), USA: diabetes 7.4\% (95\% CI 6.4\% to 8.4\%) vs no diabetes 6.1\% (95\% CI 5.7\% to 6.6\%)). In the fully adjusted model, there was no clear pattern of association between diabetes status and undiagnosed depression; Ireland: OR=0.82 (95\% CI 0.5 to 1.3), England: OR=1.47 (95\% CI 1.0 to 2.1), USA: OR=0.80 (95\% CI 0.7 to 1.0).

CONCLUSIONS: Although undiagnosed depression was more prevalent among people with diabetes, the relationship between diabetes and undiagnosed depression differed by country. Targeted efforts are needed to improve depression detection among community-dwelling older adults, particularly those with diabetes.

}, keywords = {depression, Diabetes, Epidemiology}, issn = {2044-6055}, doi = {10.1136/bmjopen-2021-049155}, author = {McGrath, Niamh and O Neill, Kate and McHugh, Sheena M and Toomey, Elaine and Kearney, Patricia M} } @article {11824, title = {Estimating the effects of Mexico to U.S. migration on elevated depressive symptoms: evidence from pooled cross-national cohorts.}, journal = {Annals of Epidemiology}, volume = {64}, year = {2021}, pages = {53-66}, abstract = {

BACKGROUND: Migrating from Mexico to the U.S. is a major, stressful life event with potentially profound influences on mental health. However, estimating the health effects of migration is challenging because of differential selection into migration and time-varying confounder mediators of migration effects on health.

METHODS: We pooled data from the Mexican Health and Aging Study (N=17,771) and Mexican-born U.S. Health and Retirement Study (N=898) participants to evaluate the effects of migration to the U.S. (at any age and in models for migration in childhood or adulthood) on depressive symptom-count, measured with a modified Centers for Epidemiologic Studies-Depression scale. We modeled probability of migrating in each year of life from birth to either age at initial migration to the U.S. or enrollment and used these models to calculate inverse probability of migration weights. We applied the weights to covariate-adjusted negative binomial GEE models, estimating the ratio of average symptom-count associated with migration.

RESULTS: Mexico to U.S. migration was unrelated to depressive symptoms among men (ratio of average symptom-count= 0.98 [95\% CI: 0.89, 1.08]) and women (ratio of average symptom-count=1.00 [95\% CI: 0.92, 1.09]). Results were similar for migration in childhood, early adulthood, or later adulthood.

CONCLUSIONS: In this sample of older Mexican-born adults, migration to the U.S. was unrelated to depressive symptoms.

}, keywords = {depression, Immigration, Mental Health, MHAS, Selection}, issn = {1873-2585}, doi = {10.1016/j.annepidem.2021.08.014}, author = {Audrey R Murchland and Adina Zeki Al Hazzouri and Zhang, Lanyu and Elfassy, Tali and Grasset, Leslie and Riley, Alicia and Wong, Rebecca and Mary Haan and Richard N Jones and Jacqueline M Torres and M. Maria Glymour} } @article {11920, title = {Financial hardship and depression experienced by pre-retirees during the COVID-19 pandemic: the mitigating role of stimulus payments}, journal = {Applied Economics Letters}, year = {2021}, abstract = {This study examines the association between financial hardship and depression among pre-retirees (ages 50 to 65) using the Health and Retirement Study (HRS) and its 2020 COVID-19 supplement. We find a negative association between the amount of stimulus received and financial hardship experienced by respondents during the pandemic. Additionally, the results indicate that African American households were less likely to increase spending, Hispanic households were more likely to increase savings, and households with lower educational attainment were more likely to pay down debt using their stimulus money. Financial wealth was negatively associated with the perception of feeling depressed. Overall, the findings from this study underscore the important role that the stimulus checks and other financial resources played in buffering the economic shock experienced by American households during the COVID-19 pandemic.}, keywords = {COVID-19, depression, Financial hardship, pre-retirees, stimulus checks}, isbn = {1350-4851}, doi = {https://doi.org/10.1080/13504851.2021.1989364}, author = {Liu, Yingyi and Zhang, Yu and Chatterjee, Swarn} } @article { ISI:000550762400001, title = {How Do Older Adults Recruited Using MTurk Differ From Those in a National Probability Sample?}, journal = {International Journal of Aging \& Human Development}, volume = {93}, year = {2021}, pages = {700-721}, abstract = {A growing number of studies within the field of gerontology have included samples recruited from Amazon{\textquoteright}s Mechanical Turk (MTurk), an online crowdsourcing portal. While some research has examined how younger adult participants recruited through other means may differ from those recruited using MTurk, little work has addressed this question with older adults specifically. In the present study, we examined how older adults recruited via MTurk might differ from those recruited via a national probability sample, the Health and Retirement Study (HRS), on a battery of outcomes related to health and cognition. Using a Latin-square design, we examined the relationship between recruitment time, remuneration amount, and measures of cognitive functioning. We found substantial differences between our MTurk sample and the participants within the HRS, most notably within measures of verbal fluency and analogical reasoning. Additionally, remuneration amount was related to differences in time to complete recruitment, particularly at the lowest remuneration level, where recruitment completion required between 138 and 485 additional hours. While the general consensus has been that MTurk samples are a reasonable proxy for the larger population, this work suggests that researchers should be wary of overgeneralizing research conducted with older adults recruited through this portal.}, keywords = {Cognition, depression, feasibility, MTurk, online participants}, issn = {0091-4150}, doi = {10.1177/0091415020940197}, author = {Ogletree, Aaron M. and Katz, Benjamin} } @article {10863, title = {Longitudinal dyadic effects of aging self-perceptions on health}, journal = {The Journal of Gerontology: Series B }, volume = {76}, year = {2021}, pages = {900-909}, abstract = {Adults{\textquoteright} perceptions of aging are known to affect their mental and physical health. However, not much is known about how perceptions of aging within the couple-unit affect each member of the unit. Therefore, the current study explores the effects of husbands{\textquoteright} and wives{\textquoteright} self-perceptions of aging (SPA) on each other{\textquoteright}s physical and mental health, both directly and indirectly, through impacting each other{\textquoteright}s SPA.The study used data from the Health and Retirement Study, focusing on couples aged 50 and above. Self-rated health and CES-D depression scale were used as indicators of physical and mental health. SPA was measured using the "Attitudes toward aging" subscale of the "Philadelphia Geriatric Center Morale Scale". An actor{\textendash}partner interdependence mediation model was used to examine the effects of the 2008 SPA of couples on each other{\textquoteright}s 2012 SPA and 2016 health.The SPA of both husbands and wives was associated with their own future mental and physical health in 2016, but not with that of their partner. However, their SPA was associated with their partner{\textquoteright}s health indirectly, by influencing the SPA of the partner. That is, the SPA of both husbands and wives in 2008 impacted their partner{\textquoteright}s SPA in 2012, which was subsequently related to that partner{\textquoteright}s mental and physical health in 2016.Older couples can influence each other{\textquoteright}s health indirectly, by affecting each other{\textquoteright}s SPA. This indicates that adults{\textquoteright} SPA are interconnected and thus, the entire couple-unit should be targeted to enhance positive SPA.}, keywords = {depression, longitudinal change, Marriage, Self-rated health}, isbn = {1079-5014}, doi = {10.1093/geronb/gbaa082}, author = {Cohn-Schwartz, Ella and Dikla Segel-Karpas and Liat Ayalon} } @article {11358, title = {Longitudinal effects of nocturnal insomnia symptom subtypes and nonrestorative sleep on the incidence of depression among community-dwelling older adults: Results from the Health and Retirement Study}, journal = {Sleep Medicine}, volume = {79}, year = {2021}, pages = {155-163}, abstract = {Objective The relationships between different insomnia symptom subtypes and the onset of depression among older adults are inconsistent. It may be that each subtype has a distinct temporal effect on depression not easily captured by the different follow-up intervals used in past studies. We systemically investigated the temporal effects by examining the links between subtypes and the onset of depression at different follow-up intervals among community-dwelling older adults. Methods We used the 2006 wave of the Health and Retirement Study as baseline (n=9,151). The outcome was the onset of depression at 2-year (2008 wave), 4-year (2010 wave), and 6-year (2012 wave) follow-ups. The independent variables were difficulty with falling asleep (initial insomnia), waking up during the night (middle insomnia), waking up too early and being unable to fall asleep again (late insomnia), and nonrestorative sleep at baseline. Factors known to be related to depression among older adults were included as covariates. Results Our findings showed that each insomnia symptom subtype had distinct temporal effects on the onset of depression. It appeared that the effects of initial insomnia may take longer to emerge than indicated in previous studies. Middle insomnia and late insomnia had weak relationships with depression. Nonrestorative sleep predicted the onset of depression at every follow-up period. Conclusions We found that documenting the temporal effects of insomnia symptom subtypes helps both to classify individuals{\textquoteright} insomnia symptoms and predict the onset of depression. We recommend taking temporal effects of insomnia symptom subtypes into account in future investigations and clinical practice.}, keywords = {depression, insomnia subtypes, Older Adults, temporal effects}, isbn = {1389-9457}, doi = {https://doi.org/10.1016/j.sleep.2021.01.003}, author = {Chen, Tuo-Yu and Saito, Yasuhiko} } @mastersthesis {11826, title = {A Longitudinal Examination of Depression Among Older Adults: The Role of Working Memory and Sleep}, volume = {Ph.D. }, year = {2021}, school = {University of Central Florida}, address = {Orlando, FL}, abstract = {Introduction: The development and regulation of depressive symptoms and the ability to regulate their development is a complex process. Both working memory and sleep disturbance relates to depressive symptom endorsement, though the mechanisms relating these variables have not been examined longitudinally. The current manuscript contains a series of three interrelated studies that aim to elucidate the relationship between potential emotion regulation resources longitudinally within the context of the Selection, Optimization, and Compensation of Emotion Regulation (SOC-ER) model. Study one examined the temporal relationship between working memory and depression, study two examined working memory and depression following loss of spouse, and finally, study three examined the relationship between sleep quality, working memory, and depressive symptoms. Method: Participants were drawn from the Health and Retirement Study, which is a longitudinal dataset sponsored by the National Institute on Aging and collected through the University of Michigan. Data have been collected every two years since 1992 and consists of randomly selected participants ages 65 years and older (Hauser \& Willis, 2004). Working memory was measured by Serial 7{\textquoteright}s, and the 8-question CES-D was used to measure depressive symptoms. Results: Study one utilized a latent growth model to evaluate the relationship between working memory and depressive symptoms over time. A significant bidirectional rather than a temporal relationship between the two was observed. Furthermore, both depressive symptoms and working memory ability was found to become worse over time. Study two utilized a latent growth model of the trajectory of depressive symptom development following the loss of a spouse. Results indicated that the starting point of initial depressive symptom endorsement was significantly related to working memory ability. Working memory also moderated the relationship between depressive symptom endorsement and time, where individuals with better working memory tended to report lower depressive symptoms and demonstrated a lesser increase in depressive symptoms. Study three utilized a multilevel model that demonstrated depression increases over time and with age. Regardless of time, better sleep quality and better working memory both result in lower depressive symptom endorsement, and there were associations between lower depressive symptom endorsement and both better sleep quality and better working memory. Conclusions: Findings strongly support working memory, sleep quality, and spousal support as emotion regulation resources within the context of the SOC-ER model. Future research should continue to examine these and similar interrelated factors such as inhibitory control, processing speed, and vascular burden longitudinally to provide further understanding of changes in emotion regulation processing among older adults.}, keywords = {depression, Sleep, Working memory}, url = {https://stars.library.ucf.edu/cgi/viewcontent.cgi?article=1653\&context=etd2020}, author = {Brush, David} } @mastersthesis {11688, title = {Measurement Invariance in the CESD-8 and Assessment of Mood Correlates Between American and Mexican Community Studies on the Multisystemic Geriatric Depression Cycle}, volume = {Ph.D.}, year = {2021}, school = {University of Central Florida}, address = {Orlando, FL}, abstract = {The Health and Retirement Study is a longitudinal study that is conducted every other year in the United States and has served as a precursor to similar studies across the world, such as the Mexican Health and Aging Study. The purpose of the current project was evaluating the relationship between depressive symptoms, inflammation and physical activity levels using data from the HRS and MHAS studies. The current project was divided in two main studies. The first study aimed at establishing measurement invariance in a brief questionnaire about depressive symptoms, the CES-D 8. The second study looked at various theories of depression including the inflammation theory and the economic theory of depression and other constructs in a larger, novel model called the Multisystemic Geriatric Depression Cycle. For the first study, MPlus was used to conduct measurement invariance analyses in 15,319 participants ages sixty- five and older from both datasets. For the second study, various regression, mediation and moderation analyses were conducted using variables like C-reactive protein, physical activity, loneliness, frequency of social contact and perceived social support. Because measurement invariance was not supported by results in Study 1, analyses and results in Study 2 were only interpreted for the HRS sample. Results from second study showed support for the inflammation theory of depression, partial support for the economic theory of depression with cross-sectional data, and the cross-sectional and longitudinal mediating effect of perceived negative social support in the relationship between loneliness and depression. This project highlights further need for improvement of measures administered cross-culturally to guarantee meaningful comparison of construct of depression among culturally diverse groups. This study adds to the growing body of literature guiding harmonization efforts from the Program on Global Aging, Health and Policy.}, keywords = {CESD-8, depression, Inflammation, Loneliness, Measurement Invariance, MHAS, perceived social support, Physical activity}, url = {https://stars.library.ucf.edu/cgi/viewcontent.cgi?article=1510\&context=etd2020}, author = {Manuel Herrera Legon} } @mastersthesis {11621, title = {Perceived Neighborhood Char ed Neighborhood Characteristics and Cognitiv acteristics and Cognitive Function unction among Older Adults: Examining the Role of Depression }, volume = {MPH}, year = {2021}, school = {Xavier University of Louisiana}, address = {New Orleans, LA}, abstract = {Purpose: African American older adults have a greater risk of cognitive impairment compared to White older adults. While some research has established that neighborhoods are an important determinant of health, relatively little research has examined the relationship between perceived neighborhood characteristics and cognitive functioning among older adults. Moreover, little is known about how depression is implicated in the relationship between perceived neighborhood characteristics and cognitive functioning, and if racial differences exist. Thus, this thesis aims to determine the mediating and moderating role of depression in the association between perceived neighborhood characteristics and cognitive functioning in older African American and White adults. Methods: I used data from the Health and Retirement Study and limited the sample to older Black and White adults age >=65 years (n=7,620). Cognitive functioning was measured using the Telephone Interview for Cognitive Status (range: 0-35), with higher scores indicating better cognitive functioning. Depression was measured as a dichotomous variable using the Center for Epidemiologic Studies Depression Scale (CES-D). Depression scores ranged from 0 to 8 and the >=3 cutoff was used to categorize adults with depression. Neighborhood perceptions of safety, cleanliness, and social cohesion were measured on a scale ranging from 0 to 7 with higher scores indicating worse perceptions. Linear regression models stratified by race were used to determine if depression played a mediating role in the relationship between perceived neighborhood characteristics (safety, social cohesion, and cleanliness) and cognitive functioning. The moderating role of depression was also examined using interaction terms with each neighborhood characteristic and depression. Results: The results indicated that there is a negative relationship between perceived neighborhood characteristics and cognitive functioning among White older adults. Depression moderates the relationship between neighborhood characteristics (cleanliness, discohension) and cognitive functioning among White older adults. However, there was no moderating effect of depression among African American older adults. However, after controlling for neighborhood characteristics and other covariates, depression was associated with worse cognitive functioning. Discussion/Conclusion: Depression is associated with worse cognitive functioning for both African American and White adults. Among White older adults with depression, there was a more pronounced negative association between neighborhood perceptions and cognitive functioning compared to those without depression. However, depression in African Americans was associated with worse cognitive functioning after controlling for neighborhood characteristics and other covariates. Therefore, depression is directly related to worse cognitive functioning in older adults.}, keywords = {cognitive function, depression, Neighborhood characteristics, race}, url = {https://digitalcommons.xula.edu/cgi/viewcontent.cgi?article=1052\&context=etd}, author = {Allison R Sullivan} } @article {11799, title = {Predictors of Post-stroke Cognition Among Geriatric Patients: The Role of Demographics, Pre-stroke Cognition, and Trajectories of Depression.}, journal = {Frontiers in Psychology}, volume = {12}, year = {2021}, pages = {717817}, abstract = {

Stroke is a prevalent disease among geriatric population, which tends to deteriorate cognitive ability and mental health. In such context, cognitive impairment and geriatric depression generate mutually deteriorating impacts on each other. Using the Health and Retirement Study, this study examined depression and cognition before, immediately after, and 2 years after the onset of stroke. Through latent growth mixture modeling, four different trajectories of depression were identified: resilience, recovery, emergent depression, and chronicity. We used demographics including gender, age, race, and ethnicity, activity of daily life, baseline cognition, and trajectories of depression to predict cognitive ability 2 years after the stroke. Both aforementioned demographic factors and pre-stroke cognition were predictive of post-stroke cognition, but the inclusion of depression trajectories further improved the predictive ability. Emergent depression and chronicity were two significant predictors of worse post-stroke cognition. This study showed the importance of considering a more specific trajectotrial interrelationship between depression and cognition in geriatric stroke patients.

}, keywords = {cognitive impairment, depression, geriatric population, post stroke depression, Stroke}, issn = {1664-1078}, doi = {10.3389/fpsyg.2021.717817}, author = {Kang, Christiana} } @article {11318, title = {Prevalence and predictors of depressive symptoms in older adults with cancer.}, journal = {Journal of Geriatric Oncology}, volume = {12}, year = {2021}, pages = {618-622}, abstract = {

INTRODUCTION: Older adults with cancer are at risk of developing depressive symptoms. However, little is known about the prevalence and predictors of depressive symptoms in older adults with cancer.

MATERIALS AND METHODS: This study examined the prevalence and predictors of depressive symptoms among older adults with cancer in the United States using the data from the 2012 and 2014 wave of the Health and Retirement Study. This analysis included 1799 older adults aged 65 and over with a self-reported diagnosis of cancer. Multivariate regression analysis was used to examine the predictors of depressive symptoms. The main predictors included age, gender, race, education, marital status, chronic conditions, and functional limitations.

RESULTS: Results revealed that the prevalence of depressive symptoms in older adults with cancer was 14.9\%. Results of Poisson regression revealed that greater age, belonging to a race other than White or African American, not being married, presence of more chronic conditions, and higher levels of functional limitations were associated with higher levels of depressive symptoms.

DISCUSSION: The prevalence of depressive symptoms is high in older adults with cancer and several factors predict depressive symptoms in this population. Individuals who are at high risk of developing depressive symptoms should be identified and appropriate timely interventions should be initiated to reduce the rates of depressive symptoms in older adults with cancer.

}, keywords = {Cancer, Chronic conditions, depression, Depressive symptoms, Functional limitations, Older Adults}, issn = {1879-4076}, doi = {10.1016/j.jgo.2020.12.009}, author = {Parajuli, Jyotsana and Berish, Diane and Valenti, Korijna G and Jao, Ying-Ling} } @article {11162, title = {The relationship between perceived support and depression in spousal care partners: a dyadic approach.}, journal = {Aging \& Mental Health}, volume = {25}, year = {2021}, pages = {1830-1838}, abstract = {

OBJECTIVES: Caregiving within a spousal partnership marks a novel relationship stage for couples. Caregiving introduces new stressors and affects couples{\textquoteright} ability to cope, and potentially alters perceptions of emotional support. Prior research on older married couples illustrates how perceived support not only affects an individual{\textquoteright}s mental health, but also that of their partner. To date, the dyadic relationship between emotional support and mental health is largely unexamined among caregiving partners, where support expectations may differ.

METHOD: Actor partner interdependence models using linear mixed modeling were applied to data from spouses where one partner received caregiving within the 2014 and 2016 waves of the Health and Retirement Study. We examined the cross-sectional and lagged associations between perceived emotional support and strain from a spouse on actor and partner depression scores, as well as whether one was the caregiver or the care recipient moderated associations.

RESULTS: More positive perceptions of support were associated with lower depression scores for oneself (= -0.55, < 0.001) and one{\textquoteright}s partner (= -0.24, < 0.001). Actor effects-how one{\textquoteright}s own perceptions of support associate with one{\textquoteright}s own depressive symptomology-were stronger for care recipients than for caregivers (= -0.83, < 0.001 v. = -0.26, < 0.05). Higher perceptions of strain were also associated with higher depression scores for oneself ( = 0.57, < 0.001) and one{\textquoteright}s partner ( = 0.39, < 0.001), associations that remained even in lagged models.

CONCLUSIONS: The observation of both actor and partner effects in this study suggests opportunities to improve care recipient outcomes through intervention with caregivers or both members of the care dyad.

}, keywords = {Caregiving, depression, Social Support}, issn = {1364-6915}, doi = {10.1080/13607863.2020.1836474}, author = {Meyer, Kylie and Patel, Neela and White, Carole} } @article {11603, title = {Skilled Nursing Facilities Modify the Relationship Between Depressive Symptoms and Hospital Readmissions but Not Health Outcomes Among Older Adults.}, journal = {Journal of Aging and Health}, volume = {33}, year = {2021}, pages = {817-827}, abstract = {

Despite detrimental effects of depressive symptoms on self-care and health, hospital discharge practices and the benefits of different discharge settings are poorly understood in the context of depression. This retrospective cohort study comprised 23,485 hospitalizations from Medicare claims linked to the Health and Retirement Study (2000-2014). Respondents with depressive symptoms were no more likely to be referred to home health, whereas the probability of discharge to skilled nursing facilities (SNFs) went up a half percentage point with each increasing symptom, even after adjusting for family support and health. Rehabilitation in SNFs, compared to routine discharges home, reduced the positive association between depressive symptoms and 30-day hospital readmissions (OR = 0.95, = 0.029) but did not prevent 30-day falls, 1-year falls, or 1-year mortality associated with depressive symptoms. Depressive symptoms were associated with discharges to SNFs, but SNFs do not appear to address depressive symptoms to enhance functioning and survival.

}, keywords = {depression, Medicare, post-acute care, Readmissions, Rehabilitation}, issn = {1552-6887}, doi = {10.1177/08982643211013127}, author = {Leah R. Abrams and Geoffrey J Hoffman} } @article {11401, title = {Social Support and Depressive Symptoms among Trauma-Impacted Older Adults.}, journal = {Journal of Evidence-Based Social Work (2019)}, volume = {18}, year = {2021}, pages = {371-378}, abstract = {

: The present study investigates the association between social support and depressive symptomatology among older adults who have been impacted by trauma. Previous studies have not sufficiently explored this topic to date. : The current study analyzed public-use data from the 2012 Health and Retirement Study ( = 4,195), focusing specifically on community-dwelling older adults (> 50). They had at least one traumatic event in their lifetime. : This study found that higher levels of social support were significantly associated with lower levels of depressive symptoms after controlling for life satisfaction, age, gender, race, ethnicity, and education.. : The recent emergence of trauma-informed research has consistently emphasized the importance of social interaction for mental health. The current study shows that social support can reduce depressive symptoms of those who have experienced trauma.

}, keywords = {depression, Social Support, trauma-impacted older adults, trauma-informed research}, issn = {2640-8074}, doi = {10.1080/26408066.2020.1866729}, author = {Cho, Seungjong and Bulger, Morgan} } @article {11655, title = {Take a Sad Song and Make it Better: Spousal Activity Limitations, Caregiving, and Depressive Symptoms Among Couples}, journal = {Social Science \& Medicine}, volume = {281}, year = {2021}, pages = {114081}, abstract = {ObjectivesFramed around key concepts of the life course perspective, we examined the linkages between spousal activity limitations, caregiving transitions, and depression among married couples. The key study objectives were 1) to demonstrate how the caregiving-depression link widely reported in earlier research may have been over-stated, and 2) to investigate whether caregiving yields mental health benefits by weakening the link between spousal activity limitations and depressive symptoms.MethodsWe used longitudinal data from the Health and Retirement Study (2004{\textendash}2016) to examine a national sample of coupled individuals (6,475 couples; 57,844 person-wave observations). A series of longitudinal actor-partner interdependence models were used to estimate within-person associations between spousal activity limitations, caregiving transitions, and depressive symptoms among coupled individuals.ResultsFindings demonstrated that spousal activity limitations function as a confounder for the association between caregiving transitions and depressive symptoms. Results further provided evidence that transitioning into a caregiving role in the context of spousal activity limitations alleviated symptoms of depression for the caregiver.ConclusionOur findings provide an explanation for the extended longevity benefit reaped by caregivers increasingly reported in recent population studies. Implications for policy, practice, and future research are discussed.}, keywords = {agency, Caregivers, caregiving system model, depression, Disability, linked lives, Transitions}, isbn = {0277-9536}, doi = {10.1016/j.socscimed.2021.114081}, author = {Sae Hwang Han and Kim, Kyungmin and Jeffrey A Burr} } @article {11486, title = {Unwelcome Companions: Loneliness Associates with the Cluster of Pain, Fatigue, and Depression in Older Adults}, journal = {Gerontology and Geriatric Medicine}, volume = {7}, year = {2021}, pages = {2333721421997620}, abstract = {Objective: Pain, fatigue, and depression commonly co-occur as a symptom cluster in pathological inflammatory states. Psychosocial stressors such as loneliness may lead to similar states through shared mechanisms. We investigated the association of loneliness with pain, fatigue, and depression in older adults. Methods: Using Health and Retirement Study data (N?=?11,766), we measured cross-sectional prevalence of frequent, moderate to severe pain; severe fatigue; depressive symptoms; and co-occurrence of symptoms surpassing threshold levels (i.e., symptom cluster). Logistic regression models evaluated associations with loneliness. Results: Pain, fatigue, and depression were reported in 19.2\%, 20.0\%, and 15.3\% of the total sample, respectively. The symptom cluster was seen in 4.9\% overall; prevalence in lonely individuals was significantly increased (11.6\% vs. 2.3\%, p?BACKGROUND AND OBJECTIVES: Scholars argue that volunteering enhances social, physical, and cognitive activities that are increasingly valued as people age, which in turn improves older adults{\textquoteright} well-being via a host of psychosocial and neurobiological mechanisms. This study explicitly tested older adults{\textquoteright} self-perceptions of aging as a mechanism underlying the mental health benefits of volunteering.

RESEARCH DESIGN AND METHODS: Using 2-wave data from the Health and Retirement Study (2008/2010 for Wave 1 and 2012/2014 for Wave 2), we analyzed reports from a pooled sample of older adults aged 65+ (N = 9,017). Participants reported on demographic characteristics, volunteer work (did not volunteer, 1-99 hours per year, 100+ hours per year), self-perceptions of aging, and depressive symptoms. We estimated an autoregressive cross-lagged panel model.

RESULTS: Volunteering for 100 hours or more per year was associated with older adults{\textquoteright} more positive and less negative self-perceptions of aging in the subsequent wave (i.e., 4 years later), which in turn predicted fewer depressive symptoms.

DISCUSSION AND IMPLICATIONS: This study suggests the promising role of volunteering in shaping older adults{\textquoteright} self-perceptions of aging on a sustained basis and refines our understanding of the benefits volunteering brings. Findings shed light on future interventions aimed at improving older adults{\textquoteright} adjustment to age-related changes and lessening ageism in society.

}, keywords = {age stereotype, depression, Subjective aging, volunteer}, issn = {1758-5341}, doi = {10.1093/geront/gnaa164}, author = {Huo, Meng and Miller, Lisa M Soederberg and Kim, Kyungmin and Liu, Siwei} } @article {article, title = {Binge Drinking, Depressive Symptoms, and Sleep Health in Middle-Aged and Older Adults}, journal = {Innovation in Aging}, volume = {4}, year = {2020}, month = {12}, pages = {425-425}, abstract = {Unhealthy alcohol consumption such as binge drinking and depression are common problems among adults. The combined effect of binge drinking and depression might contribute to negative health outcomes, such as accidents, addiction, or sleep problems. Previous evidence has indicated that alcohol consumption differs by age. However, little is known about the association between binge drinking, depression, and sleep health, and how age might play a role in this association. This study aimed to examine the association between binge drinking, depressive symptoms, and sleep health in middle-aged and older adults and characterize any age differences. A total of 5191 middle-aged and older adults from the 2014 Core Survey of the Health and Retirement Survey (HRS) data aged 50 to 80 were included for this study. Binge drinking was defined as the consumption of 5 or more drinks (men) and 4 or more drinks (women) per drinking day. Depressive symptoms were measured using a validated 8-item Center for Epidemiologic Studies Depression Scale. Sleep health was assessed using a composite measure. Age was grouped into middle-aged (50-64.9 years) and older (65-79.9 years) adults. Multiple linear regression analysis was used to examine the associations between variables of interest. Our findings indicated that binge drinking and depressive symptoms negatively influenced sleep health among middle-aged adults, however this relationship was not found in older adults. Clinicians should simultaneously assess problematic alcohol consumption, depressive symptoms, and sleep health. Future research can develop and test age-specific interventions to reduce unhealthy drinking behaviors in middle-aged adults.}, keywords = {depression, Depressive symptoms, Drinking, Drinking problems, Sleep, Sleep disturbance}, doi = {10.1093/geroni/igaa057.1373}, author = {Lorenz, Rebecca and Auerbach, Samantha and Chang, Yu-Ping} } @article {11222, title = {Changes in physical and mental health of Black, Hispanic, and White caregivers and non-caregivers associated with onset of spousal dementia.}, journal = {Alzheimer{\textquoteright}s \& Dementia}, volume = {6}, year = {2020}, pages = {e12082}, abstract = {

Introduction: We aim to determine whether racial/ethnic health disparities are a consequence of caregiving for persons with dementia and/or health status before becoming a caregiver.

Methods: Longitudinal data from the Health and Retirement Study (1998-2012) on 7859 Black, Hispanic, and White couples were analyzed for changes in physical and mental health with incident dementia of a spouse.

Results: Blacks and Hispanics, but not Whites, had poorer health before becoming caregivers for a spouse with dementia, than those who did not become caregivers. Spouse{\textquoteright}s dementia onset was associated with caregiver{\textquoteright}s higher odds of depressive disorder, with no racial/ethnic variation. Racial disparities in caregiver{\textquoteright}s health were attributed to health differences before caregiving, not differential health changes due to caregiving.

Discussion: Older Blacks and Hispanics with poor health are at increased risk of caregiving for a spouse with dementia. Protecting the health of persons supporting spouses with dementia requires understanding socioeconomic and cultural factors driving care provision.

}, keywords = {Caregiving, Dementia, depression, Racial Disparities}, issn = {2352-8737}, doi = {10.1002/trc2.12082}, author = {Chen, Cynthia and Thunell, Johanna and Julie M Zissimopoulos} } @mastersthesis {11167, title = {Comparing Diabetic and Non-Diabetic Latinxs: Racial Discrimination Perception, Depressive Symptoms, and Blood Pressure}, volume = {Master of Science}, year = {2020}, school = {University of North Texas}, address = {Denton, TX}, abstract = {Associations between greater perceived racial discrimination and both higher levels of depressive symptomology and higher blood pressure have been established in the literature. Research has found that depression is often comorbid with diabetes and individuals with type 2 diabetes are at an increased risk for depression as the prevalence of depression is 2 to 3 times higher in people with diabetes when compared to the general population. Additionally, individuals with type 2 diabetes are also at an increased risk for high blood pressure. Although these associations are present in the literature, no studies have been found that examine all of these variables in conjunction. The current study used data from the 2014 Health and Retirement Study to examine the associations among perceived racial/ethnic discrimination, depression symptoms, and blood pressure for older Latinx adults (ages 50+) with type 2 diabetes (n = 303) and without type 2 diabetes (n = 521), while controlling for sex, age, partner status, and education. Findings indicated diabetes status was positively associated with both depression symptoms (t(790) = 5.32, p < .001) and systolic blood pressure (t(703) = 2.74, p = .006). Racial/ethnic discrimination was positively associated with depression (r(206) = .14, p = .045); however, it was not associated with blood pressure. No statistically significant interactions were found. Discussion focuses on possible explanations for the research findings, future directions, and clinical implications. }, keywords = {Blood pressure, depression, Diabetes, ethnic discrimination, Hispanics, Racial Discrimination}, url = {https://digital.library.unt.edu/ark:/67531/metadc1707276/}, author = {Escobar, Irene} } @article {AIRAKSINEN2020230, title = {Connectivity of depression symptoms before and after diagnosis of a chronic disease: A network analysis in the U.S. Health and Retirement Study}, journal = {Journal of Affective Disorders}, volume = {266}, year = {2020}, pages = {230 - 234}, abstract = {Background Many chronic diseases increase the risk of depressive symptoms, but few studies have examined whether these diseases also affect the composition of symptoms a person is likely to experience. As the risk and progression of depression may vary between chronic diseases, we used network analysis to examine how depression symptoms are connected before and after the diagnosis of diabetes, heart disease, stroke, and cancer. Methods Participants (N = 7779) were from the longitudinal survey of the Health and Retirement Study. Participants were eligible if they had information on depression symptoms two and/or four years before and after the diagnosis of either diabetes, heart disease, cancer or stroke. We formed a control group with no chronic disease that was matched on age, sex and ethnic background to those with a disease. We constructed depression symptom networks and compared the overall connectivity of those networks, and depression symptom sum scores, for before and after the diagnosis of each disease. Results Depression symptom sum scores increased with the diagnosis of each disease. The connectivity of depression symptoms remained unchanged for all the diseases, except for stroke, for which the connectivity decreased with the diagnosis. Limitations Comorbidity with other chronic diseases was not controlled for as we focused on the onset of specific diseases. Conclusions Our results suggest that although the mean level of depression symptoms increases after the diagnosis of chronic disease, with most chronic diseases, these changes are not reflected in the network structure of depression symptoms.}, keywords = {Chronic disease, depression, Network analysis}, issn = {0165-0327}, doi = {https://doi.org/10.1016/j.jad.2020.01.170}, url = {http://www.sciencedirect.com/science/article/pii/S0165032719313539}, author = {Jaakko Airaksinen and Kia Gluschkoff and Mika Kivim{\"a}ki and Markus Jokela} } @article {jindra_li_tsang_bauermeister_gallacher_2020, title = {Depression and memory function {\textendash} evidence from cross-lagged panel models with unit fixed effects in ELSA and HRS}, journal = {Psychological Medicine}, year = {2020}, abstract = {Background Individuals with depression are often found to perform worse on cognitive tests and to have an increased risk of dementia. The causes and the direction of these associations are however not well understood. We looked at two specific hypotheses, the aetiological risk factor hypothesis and the reverse causality hypothesis. Method We analysed observational data from two cohorts, English Longitudinal Study of Ageing (ELSA) and Health and Retirement Study (HRS), using cross-lagged panel models with unit fixed effects. Each model was run once with depression and repeated with cognition as the dependent variable and the other variable as the main explanatory variable. All models were estimated separately for contemporaneous effects and lagged effects up to 8 years in the past. We contrasted the results with models making the random effects assumption. Results Evidence from the fixed effects models is mixed. We find no evidence for the reverse causality hypothesis in ELSA and HRS. While there is no evidence for the aetiological risk factors hypothesis in ELSA, results from HRS indicate some effects. Conclusion Our findings suggest that current levels of cognitive function do not influence future levels of depression. Results in HRS provide some evidence that current levels of depressive symptoms influence future cognition.}, keywords = {Cognition, cross-lagged panel models, depression, ELSA, fixed effects}, doi = {10.1017/S0033291720003037}, author = {Jindra, Christoph and Li, Chenlu and Tsang, Ruby S. M. and Bauermeister, Sarah and Gallacher, John} } @mastersthesis {11388, title = {Depression trajectories of older adults in the transition to widowhood }, volume = {Doctor of Philosophy}, year = {2020}, school = {Iowa State University}, address = {Ames, IA}, abstract = {As a significant life event and a turning point in the life course, losing a spouse to death is one of the most stressful experiences that requires the most intense readjustment in life. The immediate psychological effects of spousal death are usually severe, and there might be a significant increase in depression level right after the death of the spouse. For most people, psychological distress usually resolves over time. For a small number of widowed adults, however, the impact of widowhood on emotional health and depression levels might last for years. Unlike most studies that use cross-sectional data to investigate the level of depression at a specific time point after the loss of a spouse, this study uses longitudinal data from the Health and Retirement Study to investigate the heterogeneity in the changes in depression level of widowed older adults (n = 446) over eight years before and after the death of a spouse. Continuously married adults (n = 1,611) were also included in the analysis as a comparison group. The study first compared the differences in characteristics at baseline and depression levels at four waves between widowed and continuously married adults using the χ2 test for independence and t-test. Then, paired-samples t-tests were conducted to compare five key continuous variables at baseline and immediate wave after for both widowed and continuously married adults. Next, a latent class growth analysis was conducted to identify possible depression trajectories of adults in both widowed and continuously married groups. I then compared differences across four trajectory groups for both widowed and continuously married adults. Finally, sequential multinomial logistic regressions were computed to identify demographic variables and contextual factors that differentiate respondents in distinct depression trajectory groups. The comparison between widowed adults and continuously married adults shows distinct group differences. Compared to continuously married adults, widowed adults were more likely to be older, female, non-White, and with lower socioeconomic status and worse health conditions. Furthermore, the widowed adults were less close with their spouse at baseline, and they reported lower scores on positive and higher scores on negative social support from various resources. The findings support the hypothesis that heterogeneity exists in the adjustments to the death of a spouse. Four groups of adults with distinct depression trajectories in widowhood were identified: {\textquotedblleft}No Depression Group,{\textquotedblright} {\textquotedblleft}Increasing Depression Group,{\textquotedblright} {\textquotedblleft}Decreasing Depression Group,{\textquotedblright} and {\textquotedblleft}Chronic Depression Group.{\textquotedblright} Except for education level, all the other demographic variables did not differentiate widowed adults from different depression trajectories. Furthermore, the findings show that health status, functional limitations, and negative social support could significantly differentiate widowed adults from distinct depression trajectories. The findings of this study deepen the understanding of distinct depression trajectories in the transition to widowhood and the effects of demographic variables and contextual factors on these depression trajectories. The findings are also of great significance for early professional intervention for adults experiencing increasing and chronic depression after the death of a spouse. In addition, to improve the quality of emotional support and avoid relationship strain, support for widowed adults should also focus on improving self-care and health promotion. This is especially essential for those who are initially in poor health and hence are most vulnerable to long-term and intense psychological distress.}, keywords = {depression, Widowhood}, url = {https://lib.dr.iastate.edu/cgi/viewcontent.cgi?article=9442\&context=etd}, author = {Zhao, Feng} } @article {11025, title = {Depression worsens over time for older caregivers of newly diagnosed dementia patients}, journal = {Michigan News}, year = {2020}, address = {Ann Arbor, MI}, abstract = {Caring for a partner or spouse with a new diagnosis of Alzheimer{\textquoteright}s or related dementia is associated with a 30\% increase in depressive symptoms, compared to older adults who don{\textquoteright}t have a spouse with dementia{\textemdash}and these symptoms are sustained over time, a new University of Michigan study found.}, keywords = {Alzheimer disease, Caregivers, Dementia, depression}, url = {https://news.umich.edu/depression-worsens-over-time-for-older-caregivers-of-newly-diagnosed-dementia-patients/}, author = {Bailey, Laura} } @article {Reedebnurs-2019-103246, title = {Depressive symptoms in the last year of life: early screening and varied treatment pathways needed}, journal = {Evidence-Based Nursing}, year = {2020}, abstract = {Depression is linked to poor quality of life as individuals near the end of life.1 This study examines the epidemiology of depressive symptoms in the year prior to death, assessing sociodemographic and clinical factors and their impact on the trajectory of depressive symptoms.}, keywords = {depression}, issn = {1367-6539}, doi = {10.1136/ebnurs-2019-103246}, url = {https://ebn.bmj.com/content/early/2020/02/07/ebnurs-2019-103246}, author = {Reed, Jacqueline} } @article {10.1093/geront/gnz187, title = {Does Sexual Orientation Relate to Health and Well-Being? Analysis of Adults 50+ Years of Age}, journal = {Gerontologist}, volume = {60}, year = {2020}, pages = {1282-1290}, abstract = {Based on the Minority Stress Theory, this article examines the associations between sexual orientation and self-reported measures of physical, mental, and cognitive health, as well as health risk behaviors.The analytical sample included members of the 2016 wave of the Health and Retirement Study aged 50+ years. Binary and ordered logistic regressions were conducted to assess whether being a sexual minority was associated with poorer self-rated physical, mental, and cognitive health, as well as being more likely to engage in health risk behaviors.In analyses using overall and propensity-matched samples, lesbian, gay, and bisexual (LGB) participants were about twice as likely to report ever having depression as their heterosexual counterparts but were also more likely to report better self-rated health. The LGB group was more likely to report ever having smoked but were not significantly different in any of the other health risk behaviors.LGB individuals appear to be at greater risk of ever experiencing depression than heterosexual individuals but, at the same time, report better physical health. This may suggest a tendency for resilience. Differences in health risk behavior may also exist. Mental health and other medical professionals should receive special training to better understand the unique problems of LGB individuals.}, keywords = {depression, LGB, Minority Stress Theory}, issn = {0016-9013}, doi = {10.1093/geront/gnz187}, author = {Nelson, Christi L and Andel, Ross} } @article {11312, title = {The Dyadic Effects of Perceived Support on Depression in Spousal Care Partners}, journal = {Innovation in Aging}, volume = {4}, year = {2020}, pages = {354}, abstract = {Relationship quality is an important factor affecting care partners{\textquoteright} health and wellbeing. Supportive marital relationships are associated with better physical and subjective health, whereas strain is associated with poorer health. Recent studies now indicate a dyadic effect of relationship quality on health outcomes, such that an individual{\textquoteright}s perceptions of their relationship also affects their partner{\textquoteright}s outcomes. Few studies have examined the dyadic effects of relationship quality on mental health among older cognitively intact caregiving couples. To address the lack of dyadic research about how perceived support from one{\textquoteright}s spouse related to experiences of depression for individuals and their care partners, we apply cross-sectional actor partner interdependence models (APIMs) to data from the Health and Retirement Study (HRS) (N=490 dyads). APIM regression models controlled for participant demographic characteristics, relationship length, and care recipient functional ability. Findings showed that positive perceived support from a spouse had a stronger negative association with one{\textquoteright}s own depression for care recipients than for caregivers. Similarly, greater negative perceived support from a partner was associated with higher levels of depression; whether the partner was the caregiver or care recipient did not make a difference in this model. Although there are hundreds of caregiver interventions to address caregivers{\textquoteright} mental health, few have demonstrated improvement in care recipient outcomes. Observation of both actor and partner effects in this study suggests there may be opportunities to improve care recipient and caregiver mental health by targeting interventions to promote high quality relationships with caregivers or both members of the care dyad.}, keywords = {depression, dyadic effects, perceived support, Spouses}, isbn = {2399-5300}, doi = {10.1093/geroni/igaa057.1139}, author = {Meyer, Kylie and Patel, Neela and White, Carole} } @article {10927, title = {Early Cognitive Decline and Its Impact On Spouse{\textquoteright}s Loneliness}, journal = {Research in Human DevelopmentResearch in Human Development}, volume = {17}, year = {2020}, pages = {78 - 93}, abstract = {Loneliness is common in dementia caregivers as cognitive impairment (CI) alters marital and social relationships. Unexplored is how an individual{\textquoteright}s loneliness is affected at earlier, more ambiguous, periods of their spouse{\textquoteright}s CI. Using the Health and Retirement Study, our study participants included 2,206 coupled individuals with normal cognitive function at the 2006/8 baseline. Loneliness outcomes at baseline, 4-year, and 8-year follow-up are assessed by the status of transition to cognitive impairment no dementia (TCIND) (2010/12 \& 2014/16) using linear mixed models. Individual{\textquoteright}s loneliness was stable when their spouse{\textquoteright}s cognition remained normal, but increased with the spouse{\textquoteright}s TCIND. The increase in loneliness did not vary by gender. Loneliness, a key risk factor for reduced life quality and increased depression, increases even at early stages of a partner{\textquoteright}s CIND. This work suggests the potential impact of early intervention and social support for partners of individuals with CIND.}, keywords = {cognition impairment, depression, Loneliness, Spouses}, isbn = {1542-7609}, doi = {10.1080/15427609.2020.1750293}, author = {Amanda N Leggett and Choi, Hwajung and William J. Chopik and Hui Liu and Gonzalez, Richard} } @article {10702, title = {An examination of potential mediators of the relationship between polygenic scores of BMI and waist circumference and phenotypic adiposity}, journal = {Psychology \& Health}, year = {2020}, note = {PMID: 32275177}, type = {Journal}, abstract = {AbstractObjective: The present study examined whether physical activity, personality, cognition, education, and depressive symptoms mediate the association between polygenic scores (PGS) for body mass index (BMI) and waist circumference and the corresponding phenotypic adiposity measures.Design: Participants were 9,139 individuals aged 50 to 107 years (57\% women; Mean Age: 68.17, SD: 10.06) from the Health and Retirement Study who were genotyped. Trained staff measured their height, weight, and waist circumference, and participants answered questions on physical activity, personality, education, cognitive function, and depressive symptoms.Main Outcome Measures: BMI and waist circumference.Results: A higher PGS for both BMI and waist circumference were related to higher phenotypic BMI and waist circumference, respectively, in part through their association with lower physical activity, conscientiousness, education, and higher depressive symptoms but not cognition. The mediators accounted for 6.6\% of the association between PGS and BMI and 9.6\% of the association between PGS and waist circumference.Conclusion: The present study provides new evidence on the multiple, distinct pathways through which genetic propensity to higher BMI and waist circumference may lead to higher adiposity in adulthood. Individuals with a higher genetic predisposition to obesity may gain more weight through less adaptive behavioral, personality and educational profiles.}, keywords = {BMI, depression, Education, Personality, Physical activity, polygenic score, Waist Circumference}, doi = {10.1080/08870446.2020.1743839}, url = {https://www.ncbi.nlm.nih.gov/pubmed/32275177}, author = {Yannick Stephan and Angelina R Sutin and Martina Luchetti and Pauline Caille and Antonio Terracciano} } @article {BERGMANS2020113033, title = {Examining associations of food insecurity with major depression among older adults in the wake of the Great Recession}, journal = {Social Science \& Medicine}, volume = {258}, year = {2020}, abstract = {Abstract: As a psychosocial stressor, the degree to which food insecurity impacts depression may be dependent on macro-level context, which can be examined in the wake of the Great Recession. The objective of this study was to determine (1) whether food insecurity transition status (i.e. initially food insecure, becoming food insecure, and remaining food insecure vs. not food insecure) was associated with major depression in older adults, and; (2) whether this association was moderated by macrolevel context. Data came from the United States Health and Retirement Study, 2008-2016. Multivariable logistic regression across all years revealed that major depression was associated with any exposure to food insecurity, however; this association was moderated by time period. Remaining food insecure was associated with major depression during all time periods. In contrast, becoming food insecure was associated with major depression in the years during and immediately following the Recession, but not in later time periods. Findings suggest that associations of food insecurity with major depression among older adults are moderated by macro-level context, consistent with theories of social comparison and relative disadvantage. Food insecurity may represent an important risk factor for major depression and mental health disparities across socioeconomic strata among older adults. Thus, policies that increase access to food assistance programs or improve the quality of local food environments may buffer against the impact of food insecurity on depression and associated complications in old age.}, keywords = {depression, Food insecurity, Life transitions, Older Adults, Recession, relative disadvantage, social comparison, stress process}, issn = {0277-9536}, doi = {10.1016/j.socscimed.2020.113033}, author = {Rachel S. Bergmans and Riley Wegryn-Jones} } @article {PAK2020105871, title = {Food stamps, food insecurity, and health outcomes among elderly Americans}, journal = {Preventive Medicine}, volume = {130}, year = {2020}, abstract = {This study examined associations between very low food security and health outcomes in older adults, and tested whether participation in the Supplemental Nutrition Assistance Program (SNAP) mitigates adverse health consequences associated with very low food security. Data were drawn from the 1998{\textendash}2014 waves of the Health and Retirement Study (N = 148,138 from 27,281 persons). A longitudinal analysis of the relationship between very low food security and health condition depending on SNAP participation was conducted using the individual fixed effects regression. Respondents{\textquoteright} health status was assessed by self-rated health, grip strength, and depressive symptoms. The correlations between very low food security and physical health outcomes were negatively significant prior to SNAP enrollment (p < 0.05) but became insignificant upon participation, indicating that SNAP may have prevented poor physical health resulting from very low food security. However, results concerning mental health showed that SNAP enrollment does not modify the association between very low food security and depression; very low food security remained a significant risk factor of depressive symptoms conditional on SNAP enrollment (p < 0.001). Further analyses showed that SNAP participation is correlated with negative self-attitudes (p < 0.05), and that the correlation between SNAP and depression becomes insignificant after controlling for self-attitudes. These results suggest that a stigma effect arising from welfare use may have reduced self-esteem and resulted in depressive moods. Future research needs to delve into whether reforms to the food assistance program aimed at reducing stigma can help alleviate emotional distress among welfare recipients.}, keywords = {depression, Food assistance, Mental Health, Self-esteem, Stigma, Supplemental Nutrition Assistance Program}, issn = {0091-7435}, doi = {https://doi.org/10.1016/j.ypmed.2019.105871}, url = {http://www.sciencedirect.com/science/article/pii/S0091743519303470}, author = {Tae-Young Pak and GwanSeon Kim} } @article {10620, title = {Gender differences in health in Havana versus in Mexico City and in the US Hispanic population}, journal = {European Journal of Ageing}, year = {2020}, month = {2020/03/16}, type = {Journal}, abstract = {Health progress in the 1960s and 1970s placed Cuba at the vanguard of longevity in Latin America and the Caribbean. This success has often been attributed to equity of access to the health care system and its cost-effectiveness in the country. Cuba also has a small gender gap in life expectancy. In this study, we examined how this pattern is reflected in the gender differences in health among the population aged 60+ in Havana. We compared gender differences in health in samples drawn from Havana, Mexico City, and the US Hispanic population: three geographic settings with very different political, health care, and social systems. The data come from the Survey on Health, Well-Being, and Aging in Latin America and the Caribbean and the 2000 Health and Retirement Study. Age-adjusted prevalence and logistic regressions were estimated for poor self-rated health, limitations on activities of daily living, depression, and mobility limitations. While an absolute female disadvantage in health was apparent in all three populations, the relative gender differences were inconsistent across all four health domains. Gender differences were most pronounced in Havana, even after adjusting for age, socio-economic status, family characteristics, and smoking behaviour. Despite having higher overall life expectancy and more equitable and universal access to primary care and preventive medicine, women in Havana appear to have a larger burden of ill health than women in less equitable societies. The study provides indirect evidence that Cuba faces challenges in combating the health threats posed by chronic diseases and other diseases and conditions common among the population aged 60+.}, keywords = {Cuba, depression, Female disadvantage, Physical disability, Self-reported health}, isbn = {1613-9380}, doi = {10.1007/s10433-020-00563-w}, url = {https://link.springer.com/article/10.1007/s10433-020-00563-w$\#$Abs1}, author = {K{\"u}hn, Mine and D{\'\i}az-Venegas, Carlos and Jasilionis, Domantas and Oksuzyan, Anna} } @mastersthesis {10750, title = {Health Effects of Spousal Caregiving Among Elderly Americans}, volume = {Bachelor of Arts}, year = {2020}, school = {Willam and Mary }, address = {Williamsburg}, abstract = {I examine the mental health and general health effects of providing informal care for one{\textquoteright}s spouse using data from the Health and Retirement Study in the United States. Prior research has focused on children providing care for parents. In this paper, I provide the first analysis of these health effects among U.S. adults who provide care for their spouses. Using propensity score matching, I find that caregiving leads to an increase in depressive symptoms. Results are particularly strong and significant for female caregivers. I find that symptoms of depression increase with the intensity of caregiving. I find no evidence that caregiving leads to worse self-assessed health. This research is relevant to understanding the net benefit of informal caregiving in the context of the U.S. healthcare system.}, keywords = {depression, health, Informal care, Long-term Care}, url = {https://scholarworks.wm.edu/cgi/viewcontent.cgi?article=2498\&context=honorstheses}, author = {Renee Garrow} } @article {10959, title = {How the Affordable Care Act Is Helping Fight the Coronavirus Outbreak}, journal = {The Conversation: Health}, year = {2020}, publisher = {The Conversation }, address = {Boston}, abstract = {Ten years after the passage of the Affordable Care Act, the Trump administration is now asking the Supreme Court to overturn it. Yet it{\textquoteright}s now clear that the ACA has brought significant improvements to the lives of millions of Americans. Today, they enjoy more health care coverage, with greater access, better outcomes and less cost.}, keywords = {Affordable Care Act, Coronavirus, COVID-19, depression, Health Insurance, Medicare, Pandemic}, url = {https://theconversation.com/obamacares-unexpected-bonus-how-the-affordable-care-act-is-helping-middle-aged-americans-during-the-pandemic-139267}, author = {Marc A Cohen and Jane Tavares} } @article {11189, title = {MARITAL QUALITY, LONELINESS, AND DEPRESSIVE SYMPTOMS LATER IN LIFE: THE MODERATING ROLE OF OWN AND SPOUSAL FUNCTIONAL LIMITATIONS}, journal = {Research in Human Development}, year = {2020}, abstract = {Loneliness is a mechanism through which marital quality relates to older adults? mental health. Links between marital quality, loneliness, and depressive symptoms, however, are often examined independent of older adults? functional health. The current study therefore examines whether associations between marital quality, loneliness, and depressive symptoms are contextually dependent on individuals? own (or their spouse?s) functional limitations, as well as on gender. Data came from couples (N = 1084) who participated in the Health and Retirement Study (HRS), a nationally representative dataset of older adults (age 50+). We utilized data from the 2014 leave-behind psychosocial questionnaire to measure spousal support/strain and loneliness, and interview data from 2014 to measure baseline depressive symptoms and demographic covariates (e.g., race and education). Depressive symptoms in 2016 served as the focal outcome variable. Findings from a series of path models estimated in MPLUS indicated that loneliness is a mechanism through which spousal support predicts older adults? depressive symptoms. Such linkages, however, were dependent on individuals? own functional limitations and gender. For functionally limited males in particular, spousal support was shown to reduce depressive symptoms insofar as it was associated with lower levels of loneliness; otherwise, it was associated with higher levels of depressive symptoms. Such findings reinforce the importance of taking a contextualized approach when examining associations between support and emotional well-being later in life.}, keywords = {depression, Loneliness, Marriage}, isbn = {1542-7609}, doi = {https://doi.org/10.1080/15427609.2020.1837598}, author = {Marini, Christina M. and Ashley E. Ermer and Fiori, Katherine L. and Amy Rauer and Proulx, Christine M.} } @article {10787, title = {The price of mental well-being in later life: the role of financial hardship and debt}, journal = {Aging \& Mental Health}, year = {2020}, note = {PMID: 32426995}, pages = {1-7}, abstract = {Objective: This study investigated the associations between various financial hardship and debt indicators and mental health status among older adults. Methods: Using data from the Health and Retirement Study (HRS), we considered the association between different forms of financial hardship and debt of those who were identified as having high levels of depressive symptoms (N = 7678) and anxiety (N = 8079). Financial hardship indicators: difficulty paying bills, food insecurity, and medication need; debt indicators: credit card and medical debt. Associations were tested using multiple logistic regression analyses and are reported as relative risk (RR) ratios and 95\% confidence intervals (CIs). Results: Participants who had difficulty paying bills were more likely to have high levels of depressive symptoms (RR = 2.06, CI = 1.75{\textendash}2.42, p < 0.001) and anxiety (RR = 1.46, CI = 1.02{\textendash}2.05, p < 0.001) compared to those who did not have financial difficulty. Similarly, medical debt was associated with depressive symptoms (RR = 1.43, CI = 1.14{\textendash}1.74, p < 0.01) and anxiety (RR = 1.20, CI = 0.96{\textendash}1.50, p < 0.01). Credit card debt was not significantly associated with either mental health outcome. Conclusion: Indicators of financial hardship and medical debt were associated with depressive symptoms and anxiety in a cohort of older adults. In contrast, the influence of credit card debt appeared to be more complex and vary by individual. These findings indicate that doing without meeting personal salient needs has a particularly adverse effect on psychological well-being.}, keywords = {Anxiety, Debt, depression, Financial hardship, Mental Health}, doi = {10.1080/13607863.2020.1758902}, author = {Gillian L Marshall and Eva Kahana and William T Gallo and Kim L. Stansbury and Stephen M Thielke} } @mastersthesis {11232, title = {Psychological Adjustment to Disability: Heterogeneous Trajectories of Resilience and Depression Following Physical Impairment or Amputation}, volume = {Doctor of Philosophy}, year = {2020}, school = {Columbia University}, address = {New York, New York}, abstract = {Adjustment to disability is a foundational concept within rehabilitation psychology and constitutes an important public health problem given the adverse outcomes associated with maladjustment. While the disability literature has highlighted depressive elevations in response to functional impairment, resilience and alternative patterns of psychological adjustment have received substantially less empirical inquiry. This dissertation is comprised of three papers, the first two of which are longitudinal studies utilizing distinct samples of individuals with acquired disabilities: a population-sample of physically impaired older adults, and a convenience sample of individuals with newly acquired amputations. The third paper summarizes current data science and statistical findings regarding disability adjustment for patients and their providers. The two longitudinal studies share a common statistical methodology, latent growth mixture modeling (LGMM), allowing for the identification of distinct subgroups (classes) of individuals who share similar symptom profiles over time. LGMM is well-poised to resolve fundamental questions about whether psychological functioning after disability is best described by a population-level archetypal response (i.e., distress and depression that remits over time), or alternatively, whether the data suggest a variety of definable subgroups with distinct psychological trajectories. Results of empirical papers 1 and 2 provide strong empirical evidence that the process of disability adjustment is heterogeneous, with multiple pathways of symptom development and remission. The third paper demonstrates how findings from current rehabilitation science can be utilized to inform psychoeducational materials for practitioners and their patients with recent limb loss. This chapter addresses gaps in dissemination of knowledge by describing various patterns of psychological outcomes encountered by individuals following amputation surgery, as supported by Study 2 and the broader resilience literature. }, keywords = {depression, Disability onset, Latent Growth Mixture Modeling (LGMM), Trajectories}, doi = {https://doi.org/10.7916/d8-24by-d053}, author = {McGiffin, Jed N.} } @mastersthesis {10883, title = {Psychosocial Factors and Risk of Incident Cardiovascular Disease Among Middle-Aged and Older Adults}, volume = {Doctor of Philosophy}, year = {2020}, school = {Harvard University}, address = {Cambridge, MA}, abstract = {Cardiovascular diseases (CVD) are among the most common causes of disability and mortality worldwide, encompassing a wide range of disorders including myocardial infarction, coronary heart disease, stroke and heart failure. Prior meta-analyses have found that depressive symptoms and loneliness are independent risk factors for the incidence of CVD. Most studies examining depression and incident CVD assess depressive symptoms at only a single time point. However, depressive symptoms are not static but rather dynamic over time. Furthermore, the pathways linking depressive symptoms to CVD include both short-term mechanisms and longer-term increases in risk, thus different longitudinal trajectories of depressive symptoms may be associated with differential risk of incident CVD. Preliminary studies have shown that loneliness is also associated with higher risk for CVD, yet evidence is limited. Among the few studies examining loneliness and incident CVD, most have primarily focused on assessing loneliness at one time point. Yet, loneliness is not necessarily stable or constant throughout old age. The effects of changes in loneliness over time on risk of incident CVD are not well understood. In Chapter 1, I examined the association between depressive symptom patterns measured across 4 time points on the risk of incident stroke over a 10-year follow-up period in the Health and Retirement Study (HRS). Depressive symptom patterns were categorized as consistently low, decreasing, fluctuating, increasing and consistently high. Trajectories of depressive symptoms patterned by high levels of symptoms at multiple time points, were associated with increased stroke risk. However, a trajectory with depressive symptoms that started high but decreased over time was not associated with a higher risk of stroke. In Chapter 2, I examined the association between loneliness and risk of incident stroke in the HRS, through two sets of analyses assessing baseline loneliness scores and changes in loneliness over two time points. Baseline loneliness was associated with increased risk of incident stroke, and chronically lonely respondents over time were at higher risk of stroke compared to those who had chronically low loneliness scores. Increasing or decreasing loneliness patterns were not associated with risk of incident stroke. In Chapter 3, I explored the association between depressive symptom changes across two time points and incident CVD in Japan. We defined four depressive symptoms (consistently low, remitting, recent onset and consistently high) across the two exposure assessments. Elevated depressive symptoms were associated with increased risk of incident CVD in Japan across all depressive symptom change groups, compared to the consistently low group. In summary, findings from each of these chapters contribute new scientific evidence regarding the relationship between depressive symptoms, loneliness and incident CVD. Furthermore, these findings may help inform policies on preventative efforts to reduce risk of incident CVD among middle-aged and older populations.}, keywords = {Cardiovascular disease, depression, Loneliness}, url = {https://dash.harvard.edu/handle/1/42676033}, author = {Soh, Yenee} } @article {10388, title = {Structural Social Support and Changes in Depression during the Retirement Transition: "I Get by With a Little Help from My Friends".}, journal = {Journals of Gerontology Series B Psychological Sciences and Social Sciences}, volume = {75}, year = {2020}, pages = {2040-2049}, abstract = {

OBJECTIVES: This study evaluated whether (a) retirement was associated with increased depressive symptoms, (b) four sources social support were associated with decreased depressive symptoms, and (c) whether the relationship between retirement and depressive symptoms varied across four sources social support.

METHOD: Health and Retirement Study data were used to assess whether four measures of structural support moderated the association between transitioning to full retirement (relative to remaining in full time work) and symptoms of depression.

RESULTS: Results from two stage mixed-effects multilevel models indicated (a) on average retirement was associated with a small but significant increase in depressive symptoms after adjusting for pre-retirement social support, (b) on average, social support not associated with changes in symptoms of depression, but (c) social support from friends moderates the association between retirement and symptoms of depression such that at low levels of social support, retirement was associated with a sizeable increase in depressive symptoms, but this association decreased as level of social support from friends increased.

DISCUSSION: Results suggest people with low levels of social support may benefit from actively cultivating friendships in retirement to help mitigate some of deleterious effects of retirement.

}, keywords = {depression, Retirement, Social Support}, issn = {1758-5368}, doi = {10.1093/geronb/gbz126}, author = {Ben Lennox Kail and Dawn C Carr} } @article {11210, title = {Subjective well-being among male veterans in later life: The enduring effects of early life adversity.}, journal = {Aging \& Mental Health}, year = {2020}, abstract = {

OBJECTIVES: This study investigated the association between childhood and young adult adversities and later-life subjective well-being among older male veterans. We also explored whether early-life parent-child relationships and later-life social engagement served as moderators and mediators, respectively.

METHODS: Data were from the 2008 to 2012 waves of the Health and Retirement Study for male veterans ( = 2026). Subjective well-being measures included depressive symptoms, self-rated health, and life satisfaction. Linear regression with the macro was employed to estimate the relationships.

RESULTS: Adverse childhood experiences (ACEs) were positively associated with number of depressive symptoms and negatively related to life satisfaction. Combat exposure, a young adulthood adversity experience, was positively associated with depressive symptoms, but not with self-rated health or life satisfaction. Later-life social engagement mediated the relationship between ACEs and subjective well-being indices. Parent-child relationship quality did not moderate the association between the measures of adversity and any measure of subjective well-being.

DISCUSSION: Childhood adversity and combat exposure were related to worse later life subjective well-being. Also, later-life social engagement mediated the association of two early life adversity measures and subjective well-being. Future research should examine subjective well-being and early life adversity for female veterans and should employ more detailed information about combat exposure.

}, keywords = {Adversity, depression, Life Satisfaction, Military service, Self-rated health}, issn = {1364-6915}, doi = {10.1080/13607863.2020.1842999}, author = {Mai See Yang and Lien Quach and Lee, Lewina O and Avron Spiro III and Jeffrey A Burr} } @article {DAS2020100341, title = {Women{\textquoteright}s greater late-life depression: Traumatic experiences or GxE?}, journal = {Advances in Life Course Research}, volume = {45}, year = {2020}, pages = {100341}, abstract = {Objectives This study examined the role of traumatic life experiences, and their interaction with genetic risk, in explaining gender differences in late life depression. Methods Data were from the 2008-through-2014 waves of the Health and Retirement Study, nationally representative of U.S. adults over age 50. Analysis was restricted to white participants. Newly available polygenic risk scores indexed genetic propensity for depression. Linear growth models examined gender effects on depression, as well as their mediation by environmental and genetic risk. Results Across-person results suggested greater depression among older white women than men. No disparities were found in within-person change. Women also did not have more traumatic life experiences. Nor did the few factors they reported more than men influence depression, or mediate the gender difference in this outcome. The sole exception was childhood parental physical abuse. This early experience mediated about a quarter of the gender disparity{\textemdash}but only at mean or high genetic vulnerability. In contrast, adulthood traumas common among women interacted negatively with polygenic risk{\textemdash}such that they mediated the gender effect only at low levels of the latter. Discussion Traumatic life experiences and their genetic interactions appear to have minimal utility in explaining women{\textquoteright}s greater depression{\textemdash}at least among white older adults. Careful work is needed on the extent to which these factors underlie other social disparities in mental health.}, keywords = {depression, gender, Older Adults, polygenic risk, Trauma}, issn = {1040-2608}, doi = {10.1016/j.alcr.2020.100341}, author = {Aniruddha Das} } @article {10198, title = {Beyond Depression: Estimating 12-Months Prevalence of Passive Suicidal Ideation in Mid- and Late-Life in the Health and Retirement Study}, journal = {The American Journal of Geriatric Psychiatry}, year = {2019}, month = {07/2019}, pages = {1-12}, abstract = {Objectives:To provide valid estimates of the 12-month prevalence of passive suicidal ideation among older adults, without conditioning on depression status,using the Health and Retirement Study (HRS).Methods:Data come from the 2012 HRS (n = 17,434) and 2004/5 Baltimore Epidemiologic Catchment Area(ECA) Study (n = 755). In the HRS, passive suicidal ideation (i.e., thought a lot about death{\textemdash}your own, someone else{\textquoteright}s, or death in general) is only assessed on respondents who reported dysphoria/anhedonia; in the ECA, ideation is assessed on all respondents, regardless of depression. We compare two approaches to estimating the 12-month prevalence of passive suicidal ideation in the HRS without conditioning on depression symptoms: 1) a probit selection model within the HRS,and 2) a prediction model developed using appended ECA data applied to the HRS. Results: Using observed data alone on those who screened positive for depression, 6\% of older adults reported passive suicidal ideation in the past year.Depending on the approach used, between 5.4\% and 9.2\% of HRS respondents who screened negative for depression would have reported passive suicidal idea-tion had they been assessed. Correcting for this selection bias, between 10.9\% and 13.4\% of U.S. adults over age 50 experienced passive suicidal ideation in 2012.Conclusions:Population surveillance of suicidal ideation among older adults is biased by survey approaches that only assess ideation in the context of depression}, keywords = {Aging, depression, population-based, suicide, surveillance}, doi = { https://doi.org/10.1016/j.jagp.2019.06.015}, url = {https://www.sciencedirect.com/science/article/pii/S1064748119304221}, author = {Dong, Liming and Viktoryia A Kalesnikava and Gonzalez, Richard and Briana Mezuk} } @article {Parajuli2019, title = {Chronic conditions and depressive symptoms in older adults: the mediating role of functional limitations}, journal = {Aging and Mental Health}, volume = {25}, year = {2019}, pages = {243-249}, abstract = {Background: Depressive symptoms, chronic conditions, and functional limitations are common in older adults. Several studies have examined the relationship between chronic conditions or functional limitations and depressive symptoms separately. However, little is known about how much of the effect of chronic conditions on depressive symptoms is due to the functional limitations resulting from such conditions. Methods: This paper examined the longitudinal association of chronic conditions and functional limitations with depressive symptoms in older adults aged 65 and over in the USA using the data from the 2012 wave and 2014 wave of the Health and Retirement Study (HRS). Mediation analysis was used to examine the mediation effects of 2012 functional limitations on the relationship between 2012 chronic conditions and 2014 depressive symptoms controlling for other measures including gender, age, race, education, marital status, and BMI. Results: Results revealed that chronic conditions and functional limitations were significantly associated with depressive symptoms. There was a 13.7\% mediation effect when 2012 functional limitations were added as a mediator on the relationship between 2012 chronic conditions and 2014 depressive symptoms. Conclusion: Functional limitations mediate the relationship between chronic conditions and depressive symptoms. Preventing or managing functional limitations may help reduce depressive symptoms in older adults with chronic conditions. {\textcopyright} 2019, {\textcopyright} 2019 Informa UK Limited, trading as Taylor \& Francis Group.}, keywords = {Chronic conditions, Chronic Diseases, depression, Depressive symptoms, Functional limitations}, issn = {13607863}, doi = {10.1080/13607863.2019.1693971}, author = {Parajuli, J. and Berish, D. and Jao, Y.-L.} } @article {10454, title = {CROSS-COUNTRY COMPARISON OF INTERNET USE AND DEPRESSION BY GENDER: THE ROLE OF INTERGENERATIONAL FACTORS}, journal = {Innovation in Aging}, volume = {3}, year = {2019}, month = {2019/11/08}, pages = {S330 - S331}, abstract = {Technology may offer one approach to reducing depression as it provides medium to maintain connections (Cotton et al., 2014). Yet, depression, internet use, gender roles, and expectation of intergenerational interaction all differ across countries. Using nationally representative data from the U.S (Health and Retirement Study: HRS) and South Korea (Living Profiles of Older People Survey: LPOPS), the study examines 1) association between internet use and depressive symptoms by gender in two countries; 2) and whether intergenerational factors moderated this association. In the U.S., more than half of men and women aged 65+ used the internet, while approximately 30\% of women and 47\% of men used the internet in Korea. Using the internet was associated with lower depression for those living far from the closest child for women in the U.S., and for men in Korea. The findings indicate that the association of internet use on depressive symptoms can be influenced by intergenerational factors that may differentially affect men and women depending on the sociohistorical contexts.}, keywords = {depression, gender, Intergenerational ties, International}, isbn = {2399-5300}, url = {https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6840073/}, author = {Shim, Hyunju and Jennifer A Ailshire and Eileen M. Crimmins} } @article {10489, title = {Depression symptoms increase over last year of life}, journal = {Reuters}, year = {2019}, abstract = {Many people experience worsening depression symptoms over their final year of life, and a U.S. study suggests that women, younger adults and poor people may be especially vulnerable. For the study, researchers examined data on 3,274 adults who participated in the nationwide Health and Retirement Study and died within one year of the assessment. All of the participants had completed mental health questionnaires and provided information on any medical issues they had as well as demographic factors like income and education levels. Rates of depressive symptoms increased over the last year of life, particularly within the final months, the study found. By the last month of life, 59\% of the participants had enough symptoms to screen positive for a diagnosis of depression, although they were not formally evaluated and diagnosed by clinicians.}, keywords = {depression}, url = {https://www.reuters.com/article/us-health-terminalcare-depression/depression-symptoms-increase-over-last-year-of-life-idUSKBN1XN2N2} } @article {canady2019depression, title = {Depression symptoms increase sharply in last months of life}, journal = {Mental Health Weekly}, volume = {29}, year = {2019}, month = {12}, pages = {4{\textendash}5}, abstract = {Although depression impacts quality of life at all stages, not much is known about depressive symptoms in the year prior to death, according to researchers of a new study who say that patients with depression have worse survival outcomes than nondepressed patients. Consequently, depression becomes a critical issue to screen for and manage in the context of serious illness, they stated.}, keywords = {depression}, issn = {1058-1103}, doi = {10.1002/mhw.32154}, url = {https://doi.org/10.1002/mhw.32154}, author = {Canady, Valerie A.} } @article {King20191122, title = {Depressive Symptoms and the Buffering Effect of Resilience on Widowhood by Gender}, journal = {The Gerontologist}, volume = {59}, year = {2019}, note = {cited By 0}, pages = {1122-1130}, abstract = {BACKGROUND AND OBJECTIVES: Spousal loss is a stressful life event that often results in significant depressive symptoms, with men often experiencing more significant depressive symptoms than women. Recent research suggests that psychological resilience may play a role in shaping how well people recover from the loss of a spouse. This study examined the moderating effect of resilience on widowhood in relation to changes in depressive symptoms for men and women. RESEARCH DESIGN AND METHODS: This study used data from the Health and Retirement Study to examine a change in depressive symptoms for men and women who experience spousal loss compared to those who remain continuously married (N = 5,626). We used the Simplified Resilience Score, which is based on measures drawn from the psychosocial and lifestyle questionnaire. Ordinary least squares regression was used to assess depression following reported spousal loss for widows relative to their continuously married counterparts. RESULTS: Results show resilience moderated depressive symptoms following spousal loss, but these effects varied by gender. Resilience was significantly and negatively associated with depressive symptoms for married but not for widowed women. However, for widowed men, resilience was significantly and negatively associated with depressive symptoms, and a high resilience score buffered the effect of widowhood. DISCUSSION AND IMPLICATIONS: Our study suggests that having high levels of resilience prior to spousal loss may help offset persistent depressive symptoms, especially for men. Implications for future research and clinical practice are discussed. {\textcopyright} The Author(s) 2018. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.}, keywords = {depression, gender, Gender Differences, Widowhood, Widows}, issn = {17585341}, doi = {10.1093/geront/gny115}, url = {https://www.ncbi.nlm.nih.gov/pubmed/30247641}, author = {Brittany M. King and Dawn C Carr and Miles G Taylor} } @mastersthesis {10331, title = {Emergence of Disability in Late Life}, volume = {PhD}, year = {2019}, note = {Copyright - Database copyright ProQuest LLC; ProQuest does not claim copyright in the individual underlying works; Last updated - 2019-10-07}, pages = {156}, school = {University of Pittsburgh}, type = {phd}, abstract = {In 2050, the life expectancy is anticipated to be 82 years in the United States. This increased in life expectancy has raised questions as to whether a longer period of old age guarantees a longer period of good health. As of now, the potential for a healthy late life is tempered by disability {\textendash} the loss of independence with activities of daily living (ADL). Disability looms as a personal, family, and public health crisis. Older adults with disability have low autonomy, require assistance from loved ones, and often require costly health care services. Effective interventions to prevent disability are critical to support wellness in late life. We identified gaps in existing non-pharmacological interventions for the prevention of disability, suggesting that 1) these interventions are associated with modest to moderate effect sizes and 2) the most robust interventions are complex and include multiple {\textquotedblleft}active ingredients.{\textquotedblright} However, the best combination of {\textquotedblleft}active ingredients{\textquotedblright} remains unclear, and the combinations may vary based on clinical indicators. To better understand these variations, we examined selected indicators of change in brain health (depressive symptoms, cognitive complaints) and their associations with patterns of everyday activities in at-risk older adults (i.e., with a recent diagnosis of a chronic condition). We learned that changes in these indicators of brain health accelerated disablement in older adults with a newly-diagnosed Diabetes Mellitus. We also learned that indicators of brain health influenced patterns of everyday activities in older adults at-risk for disability (i.e., self-reported changes in daily routines); depressive symptoms were associated with engagement in fewer instrumental ADL, and cognitive complaints were associated with engagement in fewer leisure activities. This information gives insight to the risk architecture contributing to the onset of disability, as well as potential clinical indicators that could be explored in future clinical trials. Age-related disability is {\textquotedblleft}a situation without precedent.{\textquotedblright} The information gleaned from this dissertation may inform 1) studies to examine the health consequences of everyday activities patterns; 2) the identification of factors that may elucidate the complex disablement; and 3) the structure, timing, and dosage of future interventions that aim to prevent disability in late life.}, keywords = {0212:Therapy, 0498:Occupational Therapy, Cognition, depression, Intervention, Occupational therapy, Prevention, Therapy}, isbn = {9781085724814}, url = {http://d-scholarship.pitt.edu/36126/}, author = {Chao-Yi Wu} } @article {doi:10.1111/jgs.16197, title = {The Epidemiology of Depressive Symptoms in the Last Year of Life}, journal = {Journal of the American Geriatrics Society}, volume = {n/a}, year = {2019}, abstract = {BACKGROUND/OBJECTIVE Depression impacts quality of life at all life stages, but the epidemiology of depression in the last year of life is unknown. This study{\textquoteright}s objectives were to document the epidemiology of depressive symptoms in the year prior to death and to assess how the trajectory of depressive symptoms varies by sociodemographic and clinical factors. DESIGN Observational, cross-sectional, cohort study using the Health and Retirement Study. SETTING Population-based survey. PARTICIPANTS A total of 3274 individuals who died within 12 months after assessment. MEASURES Primary outcome: eight-item Center for Epidemiologic Studies Depression Scale (CESD-8). Covariates included sociodemographics, self-reported illnesses, and activity of daily living (ADL) limitations. RESULTS Average CESD-8 score increased over the last year of life, with 59.3\% screening positive for depression in the last month before death. Depression symptoms increased gradually from 12 to 4 months before death (increase of 0.05 points/month; 95\% confidence interval [CI] = 0.01-0.08 points/month) and then escalated from 4 to 1 months before death (increase of 0.29 points/month; 95\% CI = 0.16-0.39 points/month). Women, younger adults, and nonwhite adults all demonstrated higher rates of depressive symptoms. Individuals with cancer reported escalating rates of depressive symptoms at the end of life, while individuals with lung disease and ADL impairment demonstrated persistently high rates throughout the year before death. CONCLUSIONS This study revealed high rates of depressive symptoms in the last year of life as well as differences in the burden of depressive symptoms. A public health approach must be taken to screen for and appropriately treat symptoms of depression across the lifespan.}, keywords = {depression, end of lifemental health}, doi = {10.1111/jgs.16197}, url = {https://onlinelibrary.wiley.com/doi/abs/10.1111/jgs.16197}, author = {Kozlov, Elissa and Dong, XinQi and Amy Kelley and Claire K. Ankuda} } @article {Assari2019, title = {Gender, depressive symptoms, chronic medical conditions, and time to first psychiatric diagnosis among American older adults}, journal = {International Journal of Preventive Medicine}, volume = {10}, year = {2019}, abstract = {Background: To test whether gender moderates the effects of baseline depressive symptoms and chronic medical conditions (CMCs) on risk of receiving subsequent psychiatric diagnosis among older adults. Methods: Data came from ten waves of the Health and Retirement Study, a nationally representative longitudinal study. We followed 9794 individuals older than 52 years without any diagnosed psychiatric disorder at baseline for up to 18 years. Baseline depressive symptoms and CMC were the predictors, time to receiving an emotional diagnosis was the outcome, baseline demographics and socioeconomics were controls, and gender was the moderator. We used Cox proportional hazards models for data analysis. Results: In the pooled sample, female gender increased the effect of baseline depressive symptoms (hazard ratio [HR], 1.58; 95\% confidence interval [CI], 1.26-2.00) and reduced the effect of baseline CMC (HR, 0.78; 95\% CI, 0.63-0.97) on time to receiving a psychiatric diagnosis. Among men, baseline depressive symptoms (HR, 2.36; 95\% CI, 1.87-2.97) increased and baseline CMC (HR, 0.81; 95\% CI, 0.69-0.95) decreased time to receiving a psychiatric diagnosis. Among women, depressive symptoms (HR, 1.49; 95\% CI, 1.21-1.83) but not CMC (HR, 1.06; 95\% CI, 0.91-1.23) were associated with time to receiving a psychiatric diagnosis over time. Conclusions: Men and women differ in how depressive symptoms and CMC influence their risk of receiving a psychiatric diagnosis over time. Depressive symptoms are more salient promotor for men than women while CMC is only a barrier for men. {\textcopyright} 2019 International Journal of Preventive Medicine.}, keywords = {Chronic conditions, depression, Depressive symptoms, gender}, issn = {20087802}, doi = {10.4103/ijpvm.IJPVM_333_15}, author = {Shervin Assari and Dejman, M.} } @article {6488, title = {How Does Employment-Based Insurance Coverage Relate to Health After Early Retirement?}, journal = {J Gerontol B Psychol Sci Soc Sci}, volume = {74}, year = {2019}, month = {2019 Sep 15}, pages = {1211-1212}, keywords = {Activities of Daily Living, Age Factors, Aged, depression, Employment, Female, Health Benefit Plans, Employee, Humans, Male, Middle Aged, Retirement, United States}, issn = {1758-5368}, doi = {10.1093/geronb/gbw020}, url = {http://psychsocgerontology.oxfordjournals.org/content/early/2016/03/17/geronb.gbw020.short}, author = {Ben Lennox Kail} } @article {Xu2019, title = {Individualized prediction of depressive disorder in the elderly: A multitask deep learning approach}, journal = {International Journal of Medical Informatics}, volume = {132}, year = {2019}, note = {cited By 0}, abstract = {Introduction: Depressive disorder is one of the major public health problems among the elderly. An effective depression risk prediction model can provide insights on the disease progression and potentially inform timely targeted interventions. Therefore, research on predicting the onset of depressive disorder for elderly adults considering the sequential progression patterns is critically needed. Objective: This research aims to develop a state-of-the-art deep learning model for the individualized prediction of depressive disorder with a 22-year longitudinal survey data among elderly people in the United States. Methods: We obtain the 22-year longitudinal survey data from the University of Michigan Health and Retirement Study, which consists of information on 20,000 elderly people in the United States from 1992 to 2014. To capture temporal and high-order interactions among risk factors, the proposed deep learning model utilizes a recurrent neural network framework with a multitask structure. The C-statistic and the mean absolute error are used to evaluate the prediction accuracy of the proposed model and a set of baseline models. Results: The experiments with the 22-year longitudinal survey data indicate that (a) machine learning models can provide an accurate prediction of the onset of depressive disorder for elderly individuals; (b) the temporal patterns of risk factors are associated with the onset of depressive disorder; and (c) the proposed multitask deep learning model exhibits superior performance as compared with baseline models. Conclusion: The results demonstrate the capability of deep learning-based prediction models in capturing temporal and high-order interactions among risk factors, which are usually ignored by traditional regression models. This research sheds light on the use of machine learning models to predict the onset of depressive disorder among elderly people. Practically, the proposed methods can be implemented as a decision support system to help clinicians make decisions and inform actionable intervention strategies for elderly people.}, keywords = {deep learning, depression, Prediction}, doi = {10.1016/j.ijmedinf.2019.103973}, url = {https://www.ncbi.nlm.nih.gov/pubmed/31569007}, author = {Xu, Z. and Qingpeng Zhang and Wentian Li and Li, Mingyang and Yip, P.S.F.} } @article {10367, title = {The Longitudinal Association of Perceived Neighborhood Disorder and Lack of Social Cohesion With Depression Among Adults Aged 50 and Over: An Individual Participant Data Meta-Analysis From 16 High-Income Countries.}, journal = {American Journal of Epidemiology}, year = {2019}, month = {10/2019}, abstract = {

Although residential environment might be an important predictor of depression among older adults, systematic reviews point to a lack of longitudinal investigations and the generalizability of the findings is limited to a few countries. We used longitudinal data collected after 2012 in three surveys, including 15 European countries and the United States, and comprising 32,531 adults aged 50 and over. The risk of perceived neighborhood disorder and lack of social cohesion on depression was estimated using two-stage individual participant data metaanalysis; country-specific parameters were analyzed by meta-regression. We ran additional analyses on individuals reaching retirement. Neighborhood disorder [Odds Ratio (OR)=1.25] and lack of social cohesion (OR=1.76) were significantly associated with depression in the fully adjusted models. In retirement, the risk of depression was even higher (neighborhood disorder: OR=1.35; lack of social cohesion: OR=1.93). Heterogeneity across countries was low and significantly reduced by the addition of country-level income inequality and population density. Perceived neighborhood problems increased the overall risk of depression among adults aged 50 and over. Policies, especially in countries with stronger links between neighborhood and depression, should focus on improving physical environment and supporting social ties in communities, which can reduce depression and contribute to healthy ageing.

}, keywords = {depression, neighborhood disorder, social cohesion}, issn = {1476-6256}, doi = {10.1093/aje/kwz209}, url = {https://www.ncbi.nlm.nih.gov/pubmed/31573028}, author = {Baranyi, Gerg{\H o} and Sieber, Stefan and Cullati, St{\'e}phane and Pearce, Jamie and Chris J.L. Dibben and Courvoisier, Delphine S} } @article {10619, title = {The Longitudinal Associations of Perceived Neighborhood Disorder and Lack of Social Cohesion With Depression Among Adults Aged 50 Years or Older: An Individual-Participant-Data Meta-Analysis From 16 High-Income Countries}, journal = {American Journal of Epidemiology }, year = {2019}, type = {Report}, abstract = {Although residential environment might be an important predictor of depression among older adults, systematic reviews point to a lack of longitudinal investigations, and the generalizability of the findings is limited to a few countries. We used longitudinal data collected between 2012 and 2017 in 3 surveys including 15 European countries and the United States and comprising 32,531 adults aged 50 years or older. The risk of depression according to perceived neighborhood disorder and lack of social cohesion was estimated using 2-stage individualparticipant-data meta-analysis; country-specific parameters were analyzed by meta-regression. We conducted additional analyses on retired individuals. Neighborhood disorder (odds ratio (OR) = 1.25) and lack of social cohesion (OR = 1.76) were significantly associated with depression in the fully adjusted models. In retirement, the risk of depression was even higher (neighborhood disorder: OR = 1.35; lack of social cohesion: OR = 1.93). Heterogeneity across countries was low and was significantly reduced by the addition of country-level data on income inequality and population density. Perceived neighborhood problems increased the overall risk of depression among adults aged 50 years or older. Policies, especially in countries with stronger links between neighborhood and depression, should focus on improving the physical environment and supporting social ties in communities, which can reduce depression and contribute to healthy aging.}, keywords = {Cohort Studies, depression, Mental Health, meta-analysis, multicenter studies, Residence Characteristics}, doi = {10.1093/aje/kwz209}, url = {https://www.researchgate.net/profile/Gergo_Baranyi/publication/336217860_The_Longitudinal_Association_of_Perceived_Neighborhood_Disorder_and_Lack_of_Social_Cohesion_With_Depression_Among_Adults_Aged_50_and_Over_An_Individual_Participant_Data_Meta-Analysis}, author = {Baranyi, Gerg{\H o} and Sieber, Stefan and Cullati, St{\'e}phane and Pearce, Jamie and Chris J.L. Dibben and Courvoisier, Delphine S} } @article {Xie2019, title = {Optimism and depressive symptoms following a diabetes diagnosis: Results from the Health and Retirement Study}, journal = {Journal of Health Psychology}, year = {2019}, note = {cited By 0}, abstract = {Depression is common among individuals with diabetes and contributes to poorer prognoses. Optimism is associated with enhanced mental health. Therefore, this study tested whether optimism buffered against increases in depressive symptoms following a diabetes diagnosis. Participants were drawn from the Health and Retirement Study (n = 328, Mage = 65.8). Optimism, assessed before diagnosis, was inversely associated with depressive symptoms within 2 (B = -.30, p =.004, ΔR2 =.02) and 6 (B = -.29, p =.008, ΔR2 =.02) years of a diabetes diagnosis. Results suggest that optimism is a protective factor for comorbid depressive symptoms. {\textcopyright} The Author(s) 2019.}, keywords = {depression, Depressive symptoms, Diabetes, Optimism}, issn = {13591053}, doi = {10.1177/1359105319883929}, url = {https://www.ncbi.nlm.nih.gov/pubmed/31642329}, author = {Xie, E.B. and Burns, R.J.} } @article {10503, title = {Perceived sleep quality, coping behavior, and associations with major depression among older adults}, journal = {Journal of Health Psychology}, year = {2019}, note = {doi: 10.1177/1359105319891650}, month = {2019/12/11}, pages = {1359105319891650}, abstract = {In older adults, we determined (1) the association of perceived sleep quality with stress-coping behaviors (drinking alcohol, smoking tobacco, medication/drug use, overeating, prayer, exercise, social support, and treatment from a health professional) and (2) whether coping behavior mediated the relationship of perceived sleep quality with depression. Data came from the US Health and Retirement Study 2008?2010 (n?=?1174). Using logistic regression, poor perceived sleep quality was associated with medication/drug use (odds ratio?=?2.9; 95\% confidence interval?=?1.4?6.0) and overeating (odds ratio?=?1.6; 95\% confidence interval?=?1.1?2.5). However, using structural equation modeling, coping behavior did not mediate the relationship of perceived sleep quality with depression symptomology (p?=?0.14).}, keywords = {depression, Sleep}, isbn = {1359-1053}, url = {https://doi.org/10.1177/1359105319891650}, author = {Rachel S. Bergmans and Zivin, Kara and Briana Mezuk} } @article {10442, title = {RACIAL-ETHNIC DIFFERENCES IN THE EFFECTS OF POSITIVE AND NEGATIVE AFFECT, AND DEPRESSION ON COGNITIVE TRAJECTORIES}, journal = {Innovation in Aging}, volume = {3}, year = {2019}, pages = {S652-S652}, abstract = {Purpose of study: This study investigated (1) whether positive affect(PA), negative affect(NA), and depression are related to trajectories of cognitive functioning among older adults, (2) whether PA or NA could moderate the relationship between depression and cognitive trajectories, and (3) whether there are racial/ethnic differences in the relationships among PA, NA, depression and cognitive trajectories. Design and Methods: Growth-curve modeling was conducted using the sample of 10,289 individuals in the U.S. aged 50 or older from the 2006-2014 Health and Retirement Study. Racial/ethnic groups in this study were non-Hispanic Whites (NHW, n=8.009), African Americans (AA, n=1,428), Hispanics (n=611), and others (n=241). Results: After adjusting for covariates, PA showed positive effect, and depression had negative effect on cognitive functioning trajectories (p < .05, z = 8.76, 95\% CI= 0.27, 0.43; p < .05, z = -6.38, 95\% CI= -0.19, -0.10). Racial/ethnic minorities (i.e., AA, Hispanics, others) exhibited lower cognitive functioning over time compared to NHW. PA significantly moderated the effect of depression on cognitive trajectories (p < .05, z = - 8.04, 95\% CI = -0.19, -0.11), and the protective effect of PA against cognitive decline was pronounced for AA (p < .05, z = 2.75, 95\% CI = 0.10, 0.63). Conclusion: Findings suggest that PA may protect against cognitive decline in older adults, providing a buffer against the negative effect of depression or racial/ethnic minority status on cognitive trajectories. Potential intervention strategies are discussed to assist older adults in maintaining and improving PA to promote cognitive health.}, keywords = {Cognition, cognitive trajectories, depression, race, race-ethnicity}, isbn = {2399-5300}, doi = {10.1093/geroni/igz038.2419}, author = {Park, Soohyun and Su Hyun Shin and Rebecca S Allen and Kim, Giyeon} } @article {10215, title = {The Relationship Between Depression and Frailty in Community-Dwelling Older People: A Systematic Review and Meta-Analysis of 84,351 Older Adults.}, journal = {Journal of Nursing Scholarship}, volume = {51}, year = {2019}, month = {2019 Sep}, pages = {547-559}, abstract = {

OBJECTIVES: In this study we investigated the correlation between depression and frailty in older adults. Additionally, correlations among study designs (prospective vs. cross-sectional), regions, depression indices, frailty indices, covariance corrections, and sexes were explored to support the analysis.

METHODS: A systematic literature review and meta-analysis were conducted. A total of 84,351 older adults, all 65 years of age or older, were analyzed. Both authors independently extracted and examined retrieved articles. Searched keywords included "depression" or "depressive"; "frailty" or "frail"; and "older people," "elderly," "geriatric," or "senior." Articles published between January 2000 and December 2016 were searched. A literature quality assessment was conducted in accordance with the guidelines of the Preferred Reporting Items for Systematic REVIEWS AND META-ANALYSES: Systematic literature searches were conducted on the Embase, PubMed, MEDLINE, Cumulative Index to Nursing and Allied Health Literature, and Cochrane Library databases, and collected studies were analyzed using a random effects model.

RESULTS: Fourteen studies on people 65 years of age or older were collected, and a correlation analysis was conducted for depression and frailty. According to the meta-analysis, the risk for frailty due to depression was nonsignificant among the subgroups for study design (p for heterogeneity = .149), region (p = .429), depression criteria (p = .934), covariate adjustment (p = .702), and frailty criteria (p = .661). Notably, the risk for frailty due to depression was significantly higher in men than in women (pooled odds ratios for men and women: 4.76 and 2.25, respectively; Qbetween χ = 9.93, p = .002).

CONCLUSION: Older adults with depression are more prone to frailty than are those without depression. Regardless of study design, region, depression index, frailty index, and covariance corrections, no significant differences were observed in the results of studies on depression and frailty in older adults. The only factor that had a significant influence was sex; older men with depression were at a higher risk for frailty than were older women with depression.

CLINICAL RELEVANCE: Depression and frailty are pertinent health concerns related to geriatric syndromes. Because older adults with depression have a high risk for frailty, nursing personnel should use a depression index as early as possible to screen for depression and further reduce the occurrence of frailty in older adults. Furthermore, based on the aforementioned differences between the sexes, special attention should be paid to older men with depression to reduce their risk for frailty.

}, keywords = {depression, Frailty, meta-analysis, systematic review}, issn = {1547-5069}, doi = {10.1111/jnu.12501}, url = {https://www.ncbi.nlm.nih.gov/pubmed/31328878}, author = {Chu, Wen and Chang, Shu-Fang and Ho, Hsu-Yu and Lin, Hsiang-Chun} } @article {10390, title = {Relationships between negative exchanges and depressive symptoms in older couples: The moderating roles of care and gender}, journal = {Journal of Social and Personal Relationships}, year = {2019}, note = {doi: 10.1177/0265407519879504}, month = {2019/10/13}, abstract = {Marital relationships have a significant impact on older adults? well-being. However, when contending with spousal illness or disability, negative exchanges may be particularly detrimental. This study examines the extent to which negative spousal exchanges have more impact on caregiving versus non-caregiving couples. Using dyadic analyses, this investigation compares three different groups consisting of (a) couples who did not provide or receive care, (b) couples in which husbands received care from their wives, and (c) couples in which wives received care from their husbands. We tested for gender differences in the effect of negative exchanges on depressive symptoms among caregivers and care recipients. Based on the 2012 and 2014 Health and Retirement Study, the sample consisted of 3,530 couples in which at least one of the spouses was aged 51 or over. Structural equation modeling was used to test the moderating effects of care and gender. Sociodemographic characteristics were included as control variables. Results indicated that there were significant differences in the magnitude of the path between negative exchanges and depressive symptoms across the subgroups. Among husbands, there was a stronger relationship between negative exchanges and depressive symptoms for care-receiving husbands than for caregiving husbands or husbands in non-caregiving relationships. Among wives, however, there was no significant difference in the path from negative exchanges with spouses to depressive symptoms across care status. We also found gender differences in the effect of negative exchanges on depressive symptoms among caregivers, but not among care recipients. Findings suggest that care status and gender of caregivers and care recipients have significant effects on the association between negative interactions within couples and mental health outcomes.}, keywords = {care, Couples, depression, gender, Relationships}, isbn = {0265-4075}, url = {https://doi.org/10.1177/0265407519879504}, author = {Kwak, Minyoung and Ingersoll-Dayton, Berit} } @article {DAS201942, title = {Widowhood, depression and blood pressure: A U.S.-England comparison}, journal = {Advances in Life Course Research}, volume = {39}, year = {2019}, pages = {42 - 50}, type = {Journal}, abstract = {Objectives This study queried associations of older adults{\textquoteright} widowhood with their systolic and diastolic blood pressure (BP), and mediation of these linkages by depression. Methods Data were from the 2008 and 2012 waves of two surveys: the U.S. Health and Retirement Study (HRS) and the English Longitudinal Study of Aging (ELSA). Analyses used lagged dependent variable models to examine widowhood effects, and a counterfactual approach to test mediation. Results Positive widowhood-BP linkages were found only among HRS women. Associations were negative for HRS men{\textquoteright}s systolic BP, and absent in ELSA. These sex- and societal differences seemed driven not by linkages of widowhood with depression{\textemdash}which remained constant across all subgroups{\textemdash}but by that of depression with BP. For both outcomes, the latter was positive for HRS women, negative for HRS men, and absent in ELSA. Accordingly, depression mediated over a third of HRS women{\textquoteright}s widowhood effects. A substantial proportion of this influence also seemed to bypass this psychological state. Discussion Results indicate a need for more sex-specific basic research into depression{\textquoteright}s physiological impact, and on non-distress mechanisms linking life events to physiology. They also suggest that single-country studies may lead to flawed conclusions on the biological implications of life course factors.}, keywords = {Blood pressure, Counterfactual analysis, depression, Widowhood effect}, issn = {1040-2608}, doi = {doi.org/10.1016/j.alcr.2018.11.001}, url = {http://www.sciencedirect.com/science/article/pii/S1040260818300698}, author = {Aniruddha Das} } @article {10.1093/geront/gny023, title = {Activity Patterns and Health Outcomes in Later Life: The Role of Nature of Engagement}, journal = {The Gerontologist}, volume = {59}, year = {2018}, month = {04}, pages = {698-708}, abstract = {The health benefit of activity participation at older ages is documented in the current literature. Many studies, however, only explored the health benefits of engaging in a few activities and did not examine mechanisms connecting activity participation to health. We investigated the pathway between activity and health by testing the mediation role of the nature of engagement (physical, cognitive, and social) on physical, mental, and cognitive health of older adults.We analyzed data of 6,044 older adults from the 2010 and 2012 Health and Retirement Study linked with 2011 Consumption and Activity Mail Survey. We used latent class analysis to identify the patterns of participating in 33 activities as well as patterns of nature of engagement, and examined how these patterns were associated with cognition, depressive symptoms, and self-rated health in later life.Meaningful patterns of activity (high, medium, low, passive leisure, and working) and the nature of activity engagement (full, partial, and minimal) were identified. High and working groups, compared to the passive leisure group, showed better health and cognition outcomes. The nature of engagement mediated the relationship between activity patterns and health, especially for older adults who were either full or partially engaged.The nature of engagement may play a more important role than the activity itself in relation to health. Identifying the heterogeneity in activity engagement in later life is critical for tailoring interventions and designing programs that can improve the health of older adults.}, keywords = {Activity engagement, Cognition, depression, Self-rated health}, issn = {0016-9013}, doi = {10.1093/geront/gny023}, url = {https://www.ncbi.nlm.nih.gov/pubmed/29659800}, author = {Chen, Yu-Chih and Putnam, Michelle and Lee, Yung Soo and Morrow-Howell, Nancy} } @article {8486, title = {Arthritis, Depression, and Falls Among Community-Dwelling Older Adults: Evidence From the Health and Retirement Study.}, journal = {J Appl Gerontol}, volume = {37}, year = {2018}, month = {2018 09}, pages = {1133-1149}, abstract = {

The aims of this study were to examine the association between different types of arthritis and falls and to investigate whether clinically significant depression symptoms (CSDS) moderate these relationships. The study used nationally representative data from the 2008 Health and Retirement Study ( n = 7,715, M age = 75, 62\% female, and 90\% White). Among the respondents, 42\% experienced at least one fall during the previous 2 years. About one third had some form of arthritis: 22\% osteoarthritis (OA), 4.8\% rheumatoid arthritis (RA), 2.3\% both OA and RA, and 7.9\% with other arthritis types. About one fifth of respondents had CSDS. OA and CSDS are associated with the odds of falling (17\% and 29\%, respectively), adjusting for socio-demographic characteristics, lifestyle, health conditions, and psychiatric medications. There was no statistically significant interaction between types of arthritis and CSDS. Health care providers should pay attention to managing arthritis, especially OA, and CSDS to prevent falls among older adults.

}, keywords = {Accidental Falls, Aged, Aged, 80 and over, Arthritis, Rheumatoid, Comorbidity, depression, Female, Health Surveys, Humans, Independent Living, Male, Osteoarthritis, United States}, issn = {1552-4523}, doi = {10.1177/0733464816646683}, url = {http://www.ncbi.nlm.nih.gov/pubmed/27178205}, author = {Lien Quach and Jeffrey A Burr} } @mastersthesis {10290, title = {The Association between Depression and Social Isolation among Older Adults}, volume = {Master of Science in Gerontology }, year = {2018}, note = {Copyright - Database copyright ProQuest LLC; ProQuest does not claim copyright in the individual underlying works; Last updated - 2018-05-08}, pages = {50}, school = {California State University}, type = {phd}, abstract = {The Health and Retirement Study (HRS) is a twenty-five-year longitudinal study that studies populations over the age of fifty. There is a lack of studies that examine depression and social isolation as comorbid conditions. The purpose of this study was to examine secondary data from the 2014 wave of the HRS regarding associations between depression, social isolation and demographic characteristics, including age (50{\textendash}104 years), gender, and marital status. Self-reported data from 18,289 participants (10,703 females and 7,586 males) suggested a positive association between depression and social isolation ( r = .365, p < .001) in that as levels of depression increase so do feelings of social isolation. Significantly more females than males reported having depression. Those who were married reported less depression and social isolation. Younger ages experienced depression and older ages social isolation. Further research should explore solutions to decreasing depression and social isolation among older adults in the United States.}, keywords = {depression, Health and environmental sciences, Health and Retirement Study, Mental Health, Older Adults, social isolation, Social Sciences}, isbn = {9780355650143}, url = {https://pqdtopen.proquest.com/doc/2015148276.html?FMT=ABS}, author = {Gelgur,Lauren A.} } @article {11563, title = {Genome-wide scan of depressive symptomatology in two representative cohorts in the United States and the United Kingdom.}, journal = {Journal of Psychiatric Research}, volume = {100}, year = {2018}, pages = {63-70}, abstract = {

Unlike the diagnosed Major Depressive Disorder, depressive symptomatology in the general population has received less attention in genome-wide association scan (GWAS) studies. Here we report a GWAS study on depressive symptomatology using a discovery-replication design and the following approaches: To improve the robustness of the phenotypic measure, we used longitudinal data and calculated mean scores for at least 3 observations for each individual. To maximize replicability, we used nearly identical genotyping platforms and identically constructed phenotypic measures in both the Discovery and Replication samples. We report one genome-wide significant hit; rs58682566 in the EPG5 gene was associated (p = 3.25E-08) with the mean of the depression symptom in the Discovery sample, without confirmation in the Replication sample. We also report 4 hits exceeding the genome-wide suggestive significance level with nominal replications. Rs11774887, rs4147527 and rs1379328, close to the SAMD12 gene, were associated with the mean depression symptom score (P-values in Discovery sample: 4.58E-06, 7.65E-06 and 7.66E-06; Replication sample: 0.049, 0.029 and 0.030, respectively). Rs13250896, located in an intergenic region, was associated with the mean score of the three somatic items of the depression symptoms score (p = 3.31E-07 and 0.042 for the Discovery and Replication samples). These results were not supported by evidence in the literature. We conclude that despite the strengths of our approach, using robust phenotypic measures and samples that maximize replicability potential, this study does not provide compelling evidence of a single genetic variant{\textquoteright}s significant role in depressive symptomatology.

}, keywords = {depression, ELSA, Genome-Wide Association Study}, issn = {1879-1379}, doi = {10.1016/j.jpsychires.2018.01.016}, author = {Mekli, Krisztina and Drystan F. Phillips and Thalida E. Arpawong and Vanhoutte, Bram and Tampubolon, Gindo and James Nazroo and Lee, Jinkook and Carol A Prescott and Stevens, Adam and Pendleton, Neil} } @article {8676, title = {Loneliness and depressive symptoms: the moderating role of the transition into retirement.}, journal = {Aging Ment Health}, volume = {22}, year = {2018}, month = {2018 Jan}, pages = {135-140}, abstract = {

OBJECTIVES: The transition to retirement implies significant changes in daily routine and in the social environment. More specifically, it requires more self-directed efforts in order to stay socially engaged. Hence, for those who suffer from loneliness, the transition to retirement could result in increased depressive symptoms due to the lack of structured daily routine.

METHODS: We used two waves of the Health and Retirement Study, and tested whether the transition to retirement between the two waves moderates the effects of loneliness on depressive symptoms.

RESULTS: The transition to retirement moderated the effect of loneliness in wave 1 on depressive symptoms in wave 2, such that for those who retired, the effect was stronger in comparison to those who stayed employed.

CONCLUSIONS: Although many manage to easily transition into retirement, lonely older workers are at increased risk for maladjustment and the experience of depressive symptoms following retirement. This group could perhaps benefit from interventions aimed at increasing daily social interactions and establishing a socially satisfying routine.

}, keywords = {Aged, depression, Female, Humans, Loneliness, Male, Middle Aged, Retirement}, issn = {1364-6915}, doi = {10.1080/13607863.2016.1226770}, author = {Dikla Segel-Karpas and Liat Ayalon and Margie E Lachman} } @article {https://doi.org/10.1002/hec.3579, title = {Mental health and retirement savings: Confounding issues with compounding interest}, journal = {Health Economics}, volume = {27}, year = {2018}, pages = {404-425}, abstract = {Summary The questionable ability of the U.S. pension system to provide for the growing elderly population combined with the rising number of people affected by depression and other mental health issues magnifies the need to understand how these household characteristics affect retirement. Mental health problems have a large and significant negative effect on retirement savings. Specifically, psychological distress is associated with decreasing the probability of holding retirement accounts by as much as 24 percentage points and decreasing retirement savings as a share of financial assets by as much as 67 percentage points. The magnitude of these effects underscores the importance of employer management policy and government regulation of these accounts to help ensure households have adequate retirement savings.}, keywords = {depression, household finance, Mental Health, retirement savings, Social Security}, doi = {https://doi.org/10.1002/hec.3579}, url = {https://onlinelibrary.wiley.com/doi/abs/10.1002/hec.3579}, author = {Bogan, Vicki L. and Fertig, Angela R.} } @article {8597, title = {Perceived Age Discrimination: A Precipitator or a Consequence of Depressive Symptoms?}, journal = {J Gerontol B Psychol Sci Soc Sci}, volume = {73}, year = {2018}, month = {2018 06 14}, pages = {860-869}, abstract = {

Objectives: The main purpose of the study was to examine a bidirectional temporal relationship between perceived age discrimination and depressive symptoms. A secondary goal was to examine whether the negative effects of perceived age discrimination on one{\textquoteright}s depressive symptoms are stronger among respondents older than 70 years old, compared with respondents between the ages of 51 and 70.

Methods: The Health and Retirement Study is a U.S. nationally representative sample of individuals over the age of 50 and their spouse of any age. A cross-lagged model was estimated to examine the reciprocal associations of depressive symptoms and perceived age discrimination, controlling for age, gender, education, ethnicity, marital status, employment status, satisfaction with financial status, number of medical conditions, mobility, strength and fine motor skills, and memory functioning.

Results: The baseline model for the overall sample resulted in adequate fit indices: CFI = .945, TLI = .940, RMSEA = .024 (90\% CI = .023, .025). The cross-lagged effect of perceived age discrimination on depressive symptoms was nonsignificant (B [SE] = -.01 [.04], p = .82), whereas the cross-lagged effect of depressive symptoms on perceived age discrimination was small, but significant (B [SE] = .04 [.02], p = .03). This implies that higher levels of depressive symptoms precede a greater likelihood of perceived age discrimination, net of sociodemographic and clinical variables. The cross-lagged effects did not vary according to age group (51-70 vs >70 years old).

Discussion: The subjective nature of perceived age discrimination is discussed.

}, keywords = {Age Factors, Aged, Ageism, depression, Female, Humans, Male, Middle Aged, Risk Factors, Surveys and Questionnaires}, issn = {1758-5368}, doi = {10.1093/geronb/gbw101}, url = {http://psychsocgerontology.oxfordjournals.org/lookup/doi/10.1093/geronb/gbw101}, author = {Liat Ayalon} } @mastersthesis {10304, title = {Religion/Spirituality and Disability in Older Adults}, volume = {PhD}, year = {2018}, note = {Copyright - Database copyright ProQuest LLC; ProQuest does not claim copyright in the individual underlying works; Last updated - 2018-05-19}, pages = {52}, school = {Fordham University}, type = {phd}, abstract = {A secondary data analysis was conducted using data from the Health and Retirement Study (HRS) to explore the relationships between physical disability, religion/spirituality (R/S), and mental health outcomes. The sample consisted of older adults randomly sampled from the United States. Ordinary least square regressions were done to test the proposed hypotheses that severity of disability would be associated with more R/S, more depression and more stress, and that R/S would be associated with less depression and less stress. The main effects were significant, and a mediation regression analysis was completed to determine if R/S significantly mediates the relationship of disability severity with depression and stress. The mediated effect was small but statistically significant, indicating that R/S potentially protects against negative mental health outcomes like depression and stress, as disabilities become more severe. Such findings have important research and practice implications in the treatment of older adults.}, keywords = {0201:Disability studies, 0318:Religion, 0347:Mental health, depression, Disability, Disability studies, Health and environmental sciences, Mental Health, Philosophy, Religion, religion and theology, Stress}, isbn = {9780355877892}, url = {https://fordham.bepress.com/dissertations/AAI10807818/}, author = {Cantin,Alyssa} } @mastersthesis {10245, title = {Three Essays in Health Care.}, volume = {Doctor of Philosophy}, year = {2018}, month = {2018}, pages = {213}, school = {University of Michigan}, address = {Ann Arbor, MI}, abstract = {This dissertation examines two common sources of increased health care costs {\textendash} readmissions and the co-occurrence of depression among patients with diabetes. The first paper examines hospital performance in the Hospital Readmissions Reduction Program to determine whether sources of incentive heterogeneity are associated with differences in improvements over multiple years. I find that hospitals seem to be responding to the main incentive in the program, as those that performed poorly in previous years improve significantly more than hospitals that have avoided penalties. Hospitals also are making improvements in conditions that have the highest marginal benefit from better performance. Payer mix does not seem to be correlated with hospital performance over time even though the financial incentives of the program only apply to future Medicare reimbursements. In the second paper I develop a model to predict the onset of depression among individuals with diabetes. Using data from the Health and Retirement Study and the National Health and Nutrition Examination Survey, I find that gender, body-mass index, hypertension, history of stroke, history of heart disease, and duration of diabetes are significant predictors of annual depression status. I then build this depression prediction algorithm into the Michigan Model for Diabetes, an existing microsimulation model that allows users to evaluate the progression of diabetes. In the final paper, I use the modified diabetes simulation model to evaluate the cost-effectiveness of the collaborative care intervention to treat depression among patients with diabetes. Trials suggest that the collaborative care intervention, a multidisciplinary approach to address the depressive symptoms of patients, can be cost-effective in the short-term when used to treat patients with diabetes and comorbid depression. Using simulation models allows us to evaluate the long-term cost-effectiveness as well as the influence of a variety of inputs on the value of the program. Only when the utility loss associated with depression is small or the intervention effectiveness is substantially decreased does the intervention require a higher willingness-to-pay to be considered cost-effective. Otherwise, our base-case analysis and other one-way sensitivity analyses support the conclusion that this intervention is cost-effective.}, keywords = {decision modeling, depression, Diabetes, Health Care, Health Economics, health policy, hospital readmissions}, url = {https://deepblue.lib.umich.edu/handle/2027.42/144000?show=full}, author = {Anup Das} } @article {12135, title = {An Analysis of Two Genome-wide Association Meta-analyses Identifies a New Locus for Broad Depression Phenotype.}, journal = {Biological Psychiatry}, volume = {82}, year = {2017}, pages = {322-329}, abstract = {

BACKGROUND: The genetics of depression has been explored in genome-wide association studies that focused on either major depressive disorder or depressive symptoms with mostly negative findings. A broad depression phenotype including both phenotypes has not been tested previously using a genome-wide association approach. We aimed to identify genetic polymorphisms significantly associated with a broad phenotype from depressive symptoms to major depressive disorder.

METHODS: We analyzed two prior studies of 70,017 participants of European ancestry from general and clinical populations in the discovery stage. We performed a replication meta-analysis of 28,328 participants. Single nucleotide polymorphism (SNP)-based heritability and genetic correlations were calculated using linkage disequilibrium score regression. Discovery and replication analyses were performed using a p-value-based meta-analysis. Lifetime major depressive disorder and depressive symptom scores were used as the outcome measures.

RESULTS: The SNP-based heritability of major depressive disorder was 0.21 (SE = 0.02), the SNP-based heritability of depressive symptoms was 0.04 (SE = 0.01), and their genetic correlation was 1.001 (SE = 0.2). We found one genome-wide significant locus related to the broad depression phenotype (rs9825823, chromosome 3: 61,082,153, p = 8.2 {\texttimes} 10) located in an intron of the FHIT gene. We replicated this SNP in independent samples (p = .02) and the overall meta-analysis of the discovery and replication cohorts (1.0 {\texttimes} 10).

CONCLUSIONS: This large study identified a new locus for depression. Our results support a continuum between depressive symptoms and major depressive disorder. A phenotypically more inclusive approach may help to achieve the large sample sizes needed to detect susceptibility loci for depression.

}, keywords = {Acid Anhydride Hydrolases, depression, Depressive Disorder, Genetic Loci, Genetic Predisposition to Disease, Genome-Wide Association Study, Humans, Neoplasm Proteins, Phenotype, Whites}, issn = {1873-2402}, doi = {10.1016/j.biopsych.2016.11.013}, author = {Nese Direk and Williams, Stephanie and Smith, Jennifer A and Ripke, Stephan and Air, Tracy and Amare, Azmeraw T and Amin, Najaf and Baune, Bernhard T and David A Bennett and Blackwood, Douglas H R and Dorret I Boomsma and Breen, Gerome and Buttensch{\o}n, Henriette N and Byrne, Enda M and B{\o}rglum, Anders D and Castelao, Enrique and Cichon, Sven and Clarke, Toni-Kim and Marilyn C Cornelis and Dannlowski, Udo and Philip L de Jager and Demirkan, Ayse and Domenici, Enrico and Cornelia M van Duijn and Dunn, Erin C and Johan G Eriksson and T{\~o}nu Esko and Jessica Faul and Luigi Ferrucci and Myriam Fornage and Eco J. C. de Geus and Gill, Michael and Gordon, Scott D and Hans-J{\"o}rgen Grabe and van Grootheest, Gerard and Hamilton, Steven P and Catharina A Hartman and Andrew C Heath and Karin Hek and Hofman, Albert and Homuth, Georg and Horn, Carsten and Jouke-Jan Hottenga and Sharon L R Kardia and Kloiber, Stefan and Karestan C Koenen and Kutalik, Zolt{\'a}n and Ladwig, Karl-Heinz and Lahti, Jari and Douglas F Levinson and Lewis, Cathryn M and Lewis, Glyn and Li, Qingqin S and David J Llewellyn and Lucae, Susanne and Kathryn L Lunetta and MacIntyre, Donald J and Pamela A F Madden and Nicholas G Martin and McIntosh, Andrew M and Andres Metspalu and Milaneschi, Yuri and Grant W Montgomery and Mors, Ole and Thomas H Mosley and Joanne M Murabito and M{\"u}ller-Myhsok, Bertram and Markus M N{\"o}then and Nyholt, Dale R and O{\textquoteright}Donovan, Michael C and Brenda W J H Penninx and Pergadia, Michele L and Perlis, Roy and Potash, James B and Preisig, Martin and Shaun M Purcell and Quiroz, Jorge A and Katri R{\"a}ikk{\"o}nen and Rice, John P and Rietschel, Marcella and Rivera, Margarita and Schulze, Thomas G and Shi, Jianxin and Shyn, Stanley and Sinnamon, Grant C and Johannes H Smit and Smoller, Jordan W and Snieder, Harold and Toshiko Tanaka and Tansey, Katherine E and Teumer, Alexander and Uher, Rudolf and Umbricht, Daniel and Van der Auwera, Sandra and Erin B Ware and David R Weir and Weissman, Myrna M and Gonneke Willemsen and Yang, Jingyun and Zhao, Wei and Henning Tiemeier and Patrick F. Sullivan} } @article {8701, title = {The association between antidepressant use and hemoglobin A1C in older adults.}, journal = {Geriatr Nurs}, volume = {38}, year = {2017}, month = {2017 Mar - Apr}, pages = {141-145}, abstract = {

Depression is known to increase diabetes risk and worsen glycemic control in older adults, who already experience high rates of diabetes. The independent impact of antidepressants on glucose control is less clear. Data was drawn from the Health and Retirement Study, a large nationally-representative longitudinal study of retired individuals. Crude and adjusted linear models stratified by diabetes status were used to examine the cross-sectional associations between antidepressant use categorized by subclass and continuous hemoglobin A1C. The sample included 1,153 individuals, most over the age of 70. Antidepressant use was not associated with hemoglobin A1C in any model whether stratified or in the total combined sample. Antidepressants as a class were also not associated with hemoglobin A1C. These findings add to the literature suggesting that antidepressants are not associated with diabetes risk or glycemic control. Prospective studies with larger sample sizes are needed to confirm this finding.

}, keywords = {Aged, Aged, 80 and over, Antidepressive Agents, Blood Glucose, Cross-Sectional Studies, depression, Diabetes Mellitus, Type 2, Female, Glycated Hemoglobin A, Humans, Longitudinal Studies, Male, Risk Factors, Surveys and Questionnaires}, issn = {1528-3984}, doi = {10.1016/j.gerinurse.2016.09.002}, author = {Kammer, Jamie and Akiko S Hosler and Leckman-Westin, Emily and A. Gregory DiRienzo} } @article {6462, title = {Associations Among Individuals{\textquoteright} Perceptions of Future Time, Individual Resources, and Subjective Well-Being in Old Age.}, journal = {J Gerontol B Psychol Sci Soc Sci}, volume = {72}, year = {2017}, month = {2017 May 01}, pages = {388-399}, abstract = {

OBJECTIVES: Perceptions of future time are of key interest to aging research because of their implications for subjective well-being. Interestingly, perceptions about future time are only moderately associated with age when looking at the second half of life, pointing to a vast heterogeneity in future time perceptions among older adults. We examine associations between future time perceptions, age, and subjective well-being across two studies, including moderations by individual resources.

METHOD: Using data from the Berlin Aging Study (N = 516; Mage = 85 years), we link one operationalization (subjective nearness to death) and age to subjective well-being. Using Health and Retirement Study data (N = 2,596; Mage = 77 years), we examine associations of another future time perception indicator (subjective future life expectancy) and age with subjective well-being.

RESULTS: Consistent across studies, perceptions of limited time left were associated with poorer subjective well-being (lower life satisfaction and positive affect; more negative affect and depressive symptoms). Importantly, individual resources moderated future time perception-subjective well-being associations with those of better health exhibiting reduced future time perception-subjective well-being associations.

DISCUSSION: We discuss our findings in the context of the Model of Strength and Vulnerability Integration.

}, keywords = {Affect, Age Factors, Aged, Aged, 80 and over, Aging, Attitude, depression, Female, Forecasting, Health Status, Humans, Male, Personal Satisfaction}, issn = {1758-5368}, doi = {10.1093/geronb/gbv063}, url = {http://psychsocgerontology.oxfordjournals.org/content/early/2015/10/05/geronb.gbv063.abstract}, author = {Christiane A Hoppmann and Frank J Infurna and Ram, Nilam and Denis Gerstorf} } @article {8670, title = {Caregiver stressors and depressive symptoms among older husbands and wives in the United States.}, journal = {J Women Aging}, volume = {29}, year = {2017}, month = {2017 Nov-Dec}, pages = {494-504}, abstract = {

Framed by Pearlin{\textquoteright}s Stress Process Model, this study prospectively examines the effects of primary stress factors reflecting the duration, amount, and type of care on the depressive symptoms of spousal caregivers over a2-year period, and whether the effects of stressors differ between husbands and wives. Data are from the 2004 and 2006 waves of the Health and Retirement Study and we included community-dwelling respondents providing activities of daily life (ADL) and/or instrumental activities of daily life (IADL) help to their spouses/partners (N = 774). Results from multivariate regression models indicate that none of the primary stressors were associated with depressive symptoms. However, wives providing only personal care had significantly more depressive symptoms than wives providing only instrumental care, while husbands providing different types of care showed no such differences. To illuminate strategies for reducing the higher distress experienced by wife caregivers engaged in personal care assistance, further studies are needed incorporating couples{\textquoteright} relational dynamics and gendered experiences in personal care.

}, keywords = {Activities of Daily Living, Aged, Caregivers, depression, Female, Humans, Independent Living, Longitudinal Studies, Male, Middle Aged, Multivariate Analysis, Prospective Studies, Regression Analysis, Sex Factors, Spouses, Stress, Psychological, United States}, issn = {1540-7322}, doi = {10.1080/08952841.2016.1223962}, author = {Kim, Min Hee and Ruth E Dunkle and Amanda J Lehning and Shen, Huei-Wern and Sheila Feld and Angela K Perone} } @article {8487, title = {Coping With Chronic Stress by Unhealthy Behaviors: A Re-Evaluation Among Older Adults by Race/Ethnicity.}, journal = {Journal of Aging and Health}, volume = {29}, year = {2017}, pages = {805-825}, abstract = {

OBJECTIVE: To assess the role of unhealthy behaviors in the relationship between chronic stress and significant depressive symptoms by race/ethnicity among older adults.

METHOD: Participant data from the 2006 to 2008 Health and Retirement Study were analyzed. Unhealthy behaviors included current smoking, excessive/binge drinking, and obesity. Chronic stress was defined by nine previously used factors. The eight-item Center for Epidemiologic Studies Depression (CES-D) Scale measured depressive symptoms, where >=4 symptoms defined significant. Multivariable logistic regression assessed the effects of chronic stress and unhealthy behaviors in 2006 on depressive symptoms in 2008.

RESULTS: A higher chronic stress index score predicted depressive symptoms in 2008 among African Americans, Latinos, and Whites (adjusted odds ratio [aOR] = 1.78, 95\% confidence interval [CI] = [1.48, 2.15]; aOR = 1.54, 95\% CI = [1.15, 2.05]; and aOR = 1.40, 95\% CI = [1.26, 1.56], respectively). Unhealthy behaviors moderated this relationship among Latinos (aOR = 1.54, 95\% CI = [1.02, 2.33]).

DISCUSSION: Unhealthy behaviors were not effective coping mechanisms for chronic stress in terms of preventing significant depressive symptoms. Instead, they strengthened the relationship between chronic stress and significant depressive symptoms among Latinos.

}, keywords = {Adaptation, Psychological, Aged, California, Chronic disease, Continental Population Groups, depression, Ethnic Groups, Female, Humans, Logistic Models, Longitudinal Studies, Male, Middle Aged, Minority Groups, Risk-Taking, Stress, Psychological, Surveys and Questionnaires}, issn = {1552-6887}, doi = {10.1177/0898264316645548}, author = {Rodriquez, Erik J and Gregorich, Steven E and Livaudais-Toman, Jennifer and Eliseo J Perez-Stable} } @article {8829, title = {Depressive Symptoms and Salivary Telomere Length in a Probability Sample of Middle-Aged and Older Adults.}, journal = {Psychosom Med}, volume = {79}, year = {2017}, month = {2017 Feb/Mar}, pages = {234-242}, abstract = {

OBJECTIVE: To examine the association between depressive symptoms and salivary telomere length in a probability sample of middle-aged and older adults, and to evaluate age and sex as potential moderators of this association and test whether this association was incremental to potential confounds.

METHODS: Participants were 3,609 individuals from the 2008 wave of the Health and Retirement Study. Telomere length assays were performed using quantitative real-time polymerase chain reaction on DNA extracted from saliva samples. Depressive symptoms were assessed via interview, and health and lifestyle factors, traumatic life events, and neuroticism were assessed via self-report. Regression analyses were conducted to examine the associations between predictor variables and salivary telomere length.

RESULTS: After adjusting for demographics, depressive symptoms were negatively associated with salivary telomere length (b = -.003; p = .014). Furthermore, this association was moderated by sex (b = .005; p = .011), such that depressive symptoms were significantly and negatively associated with salivary telomere length for men (b = - .006; p < .001) but not for women (b = - .001; p = .644). The negative association between depressive symptoms and salivary telomere length in men remained statistically significant after additionally adjusting for cigarette smoking, body mass index, chronic health conditions, childhood and lifetime exposure to traumatic life events, and neuroticism.

CONCLUSIONS: Higher levels of depressive symptoms were associated with shorter salivary telomeres in men, and this association was incremental to several potential confounds. Shortened telomeres may help account for the association between depression and poor physical health and mortality.

}, keywords = {Aged, Anxiety Disorders, Body Mass Index, Chronic disease, depression, Female, Humans, Life Style, Male, Middle Aged, Neuroticism, Psychological Trauma, Saliva, Sex Factors, Smoking, Telomere Shortening}, issn = {1534-7796}, doi = {10.1097/PSY.0000000000000383}, url = {http://content.wkhealth.com/linkback/openurl?sid=WKPTLP:landingpage\&an=00006842-900000000-98910}, author = {Mark A Whisman and Emily D Richardson} } @article {8575, title = {Feeling Older and the Development of Cognitive Impairment and Dementia.}, journal = {J Gerontol B Psychol Sci Soc Sci}, volume = {72}, year = {2017}, month = {2017 Oct 01}, pages = {966-973}, abstract = {

Objective: Subjective age is a biopsychosocial marker of aging associated with a range of outcomes in old age. In the domain of cognition, feeling older than one{\textquoteright}s chronological age is related to lower cognitive performance and steeper cognitive decline among older adults. The present study examines whether an older subjective age is associated with the risk of incident cognitive impairment and dementia.

Method: Participants were 5,748 individuals aged 65 years and older drawn from the Health and Retirement Study. Measures of subjective age, cognition, and covariates were obtained at baseline, and follow-up cognition was assessed over a 2- to 4-year period. Only participants without cognitive impairment were included at baseline. At follow-up, participants were classified into one of the three categories: normal functioning, cognitive impairment without dementia (CIND), and dementia.

Results: An older subjective age at baseline was associated with higher likelihood of CIND (odds ratio [OR] = 1.18; 1.09-1.28) and dementia (OR = 1.29; 1.02-1.63) at follow-up, controlling for chronological age, other demographic factors, and baseline cognition. Physical inactivity and depressive symptoms partly accounted for these associations.

Conclusion: An older subjective age is a marker of individuals{\textquoteright} risk of subsequent cognitive impairment and dementia.

}, keywords = {Aged, Aged, 80 and over, Aging, Alzheimer disease, Cognitive Dysfunction, depression, disease progression, Female, Health Behavior, Humans, Life Style, Likelihood Functions, Logistic Models, Longitudinal Studies, Male, Risk Factors, Self Concept}, issn = {1758-5368}, doi = {10.1093/geronb/gbw085}, url = {https://www.ncbi.nlm.nih.gov/pubmed/27436103}, author = {Yannick Stephan and Angelina R Sutin and Martina Luchetti and Antonio Terracciano} } @article {8655, title = {Genome-Wide Association Study of Loneliness Demonstrates a Role for Common Variation.}, journal = {Neuropsychopharmacology}, volume = {42}, year = {2017}, month = {2017 Mar}, pages = {811-821}, abstract = {

Loneliness is a complex biological trait that has been associated with numerous negative health outcomes. The measurement and environmental determinants of loneliness are well understood, but its genetic basis is not. Previous studies have estimated the heritability of loneliness between 37 and 55\% using twins and family-based approaches, and have explored the role of specific candidate genes. We used genotypic and phenotypic data from 10 760 individuals aged ⩾50 years that were collected by the Health and Retirement Study (HRS) to perform the first genome-wide association study of loneliness. No associations reached genome-wide significance (p>5 {\texttimes} 10). Furthermore, none of the previously published associations between variants within candidate genes (BDNF, OXTR, RORA, GRM8, CHRNA4, IL-1A, CRHR1, MTHFR, DRD2, APOE) and loneliness were replicated (p>0.05), despite our much larger sample size. We estimated the chip heritability of loneliness and examined coheritability between loneliness and several personality and psychiatric traits. Our estimates of chip heritability (14-27\%) support a role for common genetic variation. We identified strong genetic correlations between loneliness, neuroticism, and a scale of {\textquoteright}depressive symptoms.{\textquoteright} We also identified weaker evidence for coheritability with extraversion, schizophrenia, bipolar disorder, and major depressive disorder. We conclude that loneliness, as defined in this study, is a modestly heritable trait that has a highly polygenic genetic architecture. The coheritability between loneliness and neuroticism may reflect the role of negative affectivity that is common to both traits. Our results also reflect the value of studies that probe the common genetic basis of salutary social bonds and clinically defined psychiatric disorders.

}, keywords = {Aged, depression, Extraversion, Psychological, Female, Genome-Wide Association Study, Humans, Loneliness, Male, Mental Disorders, Middle Aged, Neuroticism, Phenotype}, issn = {1740-634X}, doi = {10.1038/npp.2016.197}, url = {http://www.nature.com/doifinder/10.1038/npp.2016.197}, author = {Gao, Jianjun and Lea K. Davis and Amy B. Hart and Sanchez-Roige, Sandra and Han, Lide and John T. Cacioppo and Abraham A Palmer} } @article {8831, title = {Honest Labor Bears a Lovely Face: Will Late-Life Unemployment Impact Health and Satisfaction in Retirement?}, journal = {J Occup Environ Med}, volume = {59}, year = {2017}, month = {2017 02}, pages = {184-190}, abstract = {

OBJECTIVE: Unemployment among older adults during recessionary cycles has been tied to early retirement decisions and negative health outcomes. This study explored episodes of unemployment experienced between age 50 and retirement as predictors of retirement age and health outcomes.

METHODS: A total of 1540 participants from the U.S. Health and Retirement Study aged 50 years and older who transitioned from workforce to retirement were analyzed with descriptive statistics and multiple regression controlling for unemployment, demographics, and health status.

RESULTS: Late-life unemployment significantly related to earlier retirement age and lowered life satisfaction, independent of income effects. We found no main effect for late-life unemployment on physical health status.

CONCLUSIONS: Potential improvements in future life satisfaction might be gained if job search obstacles are removed for older unemployed adults, reducing reliance on involuntary early retirement as an income source.

}, keywords = {Age Factors, Aged, Chronic disease, depression, Female, Health Status, Health Surveys, Humans, Male, Mental Health, Middle Aged, Personal Satisfaction, Retirement, Unemployment, United States, Work}, issn = {1536-5948}, doi = {10.1097/JOM.0000000000000933}, url = {http://content.wkhealth.com/linkback/openurl?sid=WKPTLP:landingpage\&an=00043764-900000000-98945}, author = {Maren W Voss and Wendy Church Birmingham and Lori Wadsworth and Wei Chen and Bounsanga, Jerry and Gu, Yushan and Hung, Man} } @article {8700, title = {Perceived weight discrimination mediates the prospective relation between obesity and depressive symptoms in U.S. and U.K. adults.}, journal = {Health Psychol}, volume = {36}, year = {2017}, month = {2017 Feb}, pages = {112-121}, abstract = {

OBJECTIVE: Obesity has been shown to increase risk of depression. Persons with obesity experience discrimination because of their body weight. Across 3 studies, we tested for the first time whether experiencing (perceived) weight-based discrimination explains why obesity is prospectively associated with increases in depressive symptoms.

METHOD: Data from 3 studies, including the English Longitudinal Study of Ageing (2008/2009-2012/2013), the Health and Retirement Study (2006/2008-2010/2012), and Midlife in the United States (1995/1996-2004/2005), were used to examine associations between obesity, perceived weight discrimination, and depressive symptoms among 20,286 U.S. and U.K. adults.

RESULTS: Across all 3 studies, Class II and III obesity were reliably associated with increases in depressive symptoms from baseline to follow-up. Perceived weight-based discrimination predicted increases in depressive symptoms over time and mediated the prospective association between obesity and depressive symptoms in all 3 studies. Persons with Class II and III obesity were more likely to report experiencing weight-based discrimination, and this explained approximately 31\% of the obesity-related increase in depressive symptoms on average across the 3 studies.

CONCLUSION: In U.S. and U.K. samples, the prospective association between obesity (defined using body mass index) and increases in depressive symptoms in adulthood may in part be explained by perceived weight discrimination. (PsycINFO Database Record

}, keywords = {Adult, Aged, Body Weight, depression, Female, Humans, Longitudinal Studies, Male, Middle Aged, Obesity, Prejudice, Prospective Studies, United Kingdom, United States, Young Adult}, issn = {1930-7810}, doi = {10.1037/hea0000426}, author = {Robinson, Eric and Angelina R Sutin and Daly, Michael} } @article {8578, title = {The relationship between family support; pain and depression in elderly with arthritis.}, journal = {Psychol Health Med}, volume = {22}, year = {2017}, month = {2017 01}, pages = {75-86}, abstract = {

The prevalence and chronic nature of arthritis make it the most common cause of disability among U.S.A adults. Family support reduces the negative impact of chronic conditions generally but its role in pain and depression for arthritic conditions is not well understood. A total of 844 males (35.0\%) and 1567 females (65.0\%) with arthritic conditions (n~=~2411) were drawn from the 2012 Health and Retirement Study to examine the effect of family support on pain and depressive symptoms. Using regression analysis and controlling for age, ethnicity, gender, marital/educational status and employment/income, physical function/disability status, pain and antidepressant medications, and other clinical indicators of chronic health conditions, we examined the effects of family support (spouse, children, other) on pain and depression levels. Results indicated that depressive symptoms decreased significantly with strong family and spousal support (p~<~.05). Pain decreased as support levels increased, but was non-statistically significant. This study provides new insights into the relationship between family support, pain, and depression for individuals with arthritis. Future longitudinal studies are needed to evaluate family support and relationships over a wider spectrum of demographics.

}, keywords = {Aged, Aged, 80 and over, Aging, Arthralgia, Arthritis, depression, Family, Female, Humans, Male, Middle Aged, Social Support, United States}, issn = {1465-3966}, doi = {10.1080/13548506.2016.1211293}, url = {https://www.ncbi.nlm.nih.gov/pubmed/27427504}, author = {Hung, Man and Bounsanga, Jerry and Maren W Voss and Anthony B. Crum and Wei Chen and Wendy Church Birmingham} } @article {8818, title = {The Use of Life-Sustaining Procedures in the Last Month of Life Is Associated With More Depressive Symptoms in Surviving Spouses.}, journal = {J Pain Symptom Manage}, volume = {53}, year = {2017}, month = {2017 02}, pages = {178-187.e1}, abstract = {

CONTEXT: Family caregivers of individuals with serious illness who undergo intensive life-sustaining medical procedures at the end of life may be at risk of negative consequences including depression.

OBJECTIVES: The objective of this study was to determine the association between patients{\textquoteright} use of life-sustaining procedures at the end of life and depressive symptoms in their surviving spouses.

METHODS: We used data from the Health and Retirement Study, a longitudinal survey of U.S. residents, linked to Medicare claims data. We included married Medicare beneficiaries aged 65~years and older who died between 2000 and 2011 (n~=~1258) and their surviving spouses. The use of life-sustaining procedures (i.e., intubation/mechanical ventilation, tracheostomy, gastrostomy tube insertion, enteral/parenteral nutrition, and cardiopulmonary resuscitation) in the last month of life was measured via claims data. Using propensity score matching, we compared change in depressive symptoms of surviving spouses.

RESULTS: Eighteen percent of decedents underwent one or more life-sustaining procedures in the last month of life. Those whose spouses underwent life-sustaining procedures had a 0.32-point increase in depressive symptoms after death (scale range~=~0-8) and a greater likelihood of clinically significant depression (odds ratio~=~1.51) compared with a matched sample of spouses of those who did not have procedures (P~<~0.05).

CONCLUSION: Surviving spouses of those who undergo intensive life-sustaining procedures at the end of life experience a greater magnitude of increase in depressive symptoms than those whose spouses do not undergo such procedures. Further study of the circumstances and decision making surrounding these procedures is needed to understand their relationship with survivors{\textquoteright} negative mental health consequences and how best to provide appropriate support.

}, keywords = {Aged, Aged, 80 and over, Caregivers, depression, Female, Humans, Intubation, Longitudinal Studies, Male, Mental Health, Respiration, Artificial, Spouses, Survivors, Terminal Care}, issn = {1873-6513}, doi = {10.1016/j.jpainsymman.2016.08.023}, url = {http://linkinghub.elsevier.com/retrieve/pii/S0885392416307850http://api.elsevier.com/content/article/PII:S0885392416307850?httpAccept=text/plainhttp://api.elsevier.com/content/article/PII:S0885392416307850?httpAccept=text/xml}, author = {Katherine A Ornstein and Melissa D. Aldridge and Melissa M Garrido and Rebecca Jean Gorges and Bollens-Lund, Evan and Albert L Siu and Kenneth M. Langa and Amy Kelley} } @article {8386, title = {Accelerated increase and decrease in subjective age as a function of changes in loneliness and objective social indicators over a four-year period: results from the health and retirement study.}, journal = {Aging Ment Health}, volume = {20}, year = {2016}, note = {Export Date: 29 May 2015 Article in Press}, month = {2016 07}, pages = {743-51}, publisher = {20}, abstract = {

OBJECTIVES: The study examined the role of changes in loneliness and objective social indicators in the formation of changes in subjective age over a four-year period.

METHODS: The Health and Retirement Study is a US nationally representative study of older adults over 50 and their spouse of any age. We restricted the sample to individuals, 65 years of age and older (n = 2591). An accelerated increase in subjective age was defined as an increase in subjective age over the two waves greater than five years. An accelerated decrease in subjective age was defined as a difference that was lower than three years. These were examined against a change in subjective age in the range of three to five years (i.e., change consistent with the passage of time).

RESULTS: For 23.4\% of the sample, changes in subjective age were consistent with the passage of time. A total of 38.3\% had an accelerated decrease in subjective age, whereas 38.3\% had an accelerated increase. A decrease in loneliness over the two waves resulted in an accelerated decrease in subjective age, whereas an increase in depressive symptoms resulted in an accelerated increase in subjective age. Changes in objective social indicators, physical difficulties or medical comorbidity did not predict changes in subjective age.

CONCLUSIONS: This is one of very few studies that examined changes in subjective age over time. Changes in subjective age represent an important construct that corresponding to other changes in subjective experiences.

}, keywords = {Aged, Aged, 80 and over, Aging, depression, Female, Humans, Loneliness, Male, Retirement, Social Change}, issn = {1364-6915}, doi = {10.1080/13607863.2015.1035696}, url = {http://www.scopus.com/inward/record.url?eid=2-s2.0-84928654923andpartnerID=40andmd5=dc249d3a4a7b131281c68dbbc5ac5bb7}, author = {Liat Ayalon and Yuval Palgi and Sharon Avidor and Ehud Bodner} } @article {8333, title = {Antidepressant use and functional limitations in U.S. older adults.}, journal = {J Psychosom Res}, volume = {80}, year = {2016}, month = {2016 Jan}, pages = {31-6}, publisher = {80}, abstract = {

OBJECTIVE: The upsurge in prevalence and long-term use of antidepressants among older adults might have profound health implications beyond depressive symptom management. This study examined the relationship between antidepressant use and functional limitation onset in U.S. older adults.

METHODS: Study sample came from 2006 and 2008 waves of the Health and Retirement Study, in combination with data from 2005 and 2007 Prescription Drug Study. Self-reported antidepressant use was identified based on the therapeutic classification of Cerner Multum{\textquoteright}s Lexicon. Functional limitations were classified into those pertaining to physical mobility, large muscle function, activities of daily living, gross motor function, fine motor function, and instrumental activities of daily living. Cox proportional hazard models were performed to assess the effects of antidepressant use on future functional limitation onset by limitation category, antidepressant type, and length of use, adjusted by depression status and other individual characteristics.

RESULTS: Antidepressant use for one year and longer was associated with an increase in the risk of functional limitation by 8\% (95\% confidence interval=4\%-12\%), whereas the relationship between antidepressant use less than a year and function limitation was statistically nonsignificant. Antidepressant use was associated with an increase in the risk of functional limitation by 8\% (3\%-13\%) among currently nondepressed participants but not currently depressed participants.

CONCLUSION: Long-term antidepressant use in older adults should be prudently evaluated and regularly monitored to reduce the risk of functional limitation. Future research is warranted to examine the health consequences of extended and/or off-label antidepressant use in absence of depressive symptoms.

}, keywords = {Activities of Daily Living, Aged, Aged, 80 and over, Antidepressive Agents, depression, Drug Utilization, Female, Health Surveys, Humans, Longitudinal Studies, Male, Mobility Limitation, Muscle, Skeletal, Prevalence, Risk Factors, Socioeconomic factors, United States}, issn = {1879-1360}, doi = {10.1016/j.jpsychores.2015.11.007}, url = {http://www.sciencedirect.com/science/article/pii/S0022399915300167}, author = {An, Ruopeng and Lu, Lingyun} } @article {8548, title = {Are There Spillover Effects from the GI Bill? The Mental Health of Wives of Korean War Veterans.}, journal = {PLoS One}, volume = {11}, year = {2016}, month = {2016}, pages = {e0154203}, abstract = {

BACKGROUND: The Korean War GI Bill provided economic benefits for veterans, thereby potentially improving their health outcomes. However potential spillover effects on veteran wives have not been evaluated.

METHODS: Data from wives of veterans eligible for the Korean War GI Bill (N = 128) and wives of non-veterans (N = 224) from the Health and Retirement Study were matched on race and coarsened birth year and childhood health using coarsened exact matching. Number of depressive symptoms in 2010 (average age = 78) were assessed using a modified, validated Center for Epidemiologic Studies-Depression Scale. Regression analyses were stratified into low (mother < 8 years schooling / missing data, N = 95) or high (mother >= 8 years schooling, N = 257) childhood socio-economic status (cSES) groups, and were adjusted for birth year and childhood health, as well as respondent{\textquoteright}s educational attainment in a subset of analyses.

RESULTS: Husband{\textquoteright}s Korean War GI Bill eligibility did not predict depressive symptoms among veteran wives in pooled analysis or cSES stratified analyses; analyses in the low cSES subgroup were underpowered (N = 95, β = -0.50, 95\% Confidence Interval: (-1.35, 0.35), p = 0.248, power = 0.28).

CONCLUSIONS: We found no evidence of a relationship between husband{\textquoteright}s Korean War GI Bill eligibility and wives{\textquoteright} mental health in these data, however there may be a true effect that our analysis was underpowered to detect.

}, keywords = {Adult, Aged, depression, Female, Humans, Korean War, Male, Mental Disorders, Mental Health, Middle Aged, Odds Ratio, Population Surveillance, Social Class, Spouses, Veterans, Veterans Health}, issn = {1932-6203}, doi = {10.1371/journal.pone.0154203}, url = {https://www.ncbi.nlm.nih.gov/pubmed/27186983}, author = {Anusha M Vable and Ichiro Kawachi and Canning, David and M. Maria Glymour and Marcia P Jimenez and S. V. Subramanian} } @article {8596, title = {The Benefits of Social Technology Use Among Older Adults Are Mediated by Reduced Loneliness.}, journal = {Cyberpsychol Behav Soc Netw}, volume = {19}, year = {2016}, month = {2016 Sep}, pages = {551-6}, abstract = {

Technology has the ability to enhance and enrich the lives of older adults by facilitating better interpersonal relationships. However, few studies have directly examined associations between technology use for social reasons and physical and psychological health among older adults. The current study examines the benefits of technology use in 591 older adults from the 2012 wave of the Health and Retirement Study (Mage = 68.18, SD = 10.75; 55.5\% female). Social technology use was assessed through five technology-based behaviors (i.e., using e-mail, social networking sites, online video/phone calls, online chatting/instant messaging, using a smartphone). Attitudes toward the usability and benefits of technology use were also assessed. Older adults had generally positive attitudes toward technology. Higher social technology use was associated with better self-rated health, fewer chronic illnesses, higher subjective well-being, and fewer depressive symptoms. Furthermore, each of the links between social technology use and physical and psychological health was mediated by reduced loneliness. Close relationships are a large determinant of physical health and well-being, and technology has the potential to cultivate successful relationships among older adults.

}, keywords = {Aged, Aged, 80 and over, Attitude to Computers, depression, Female, Health Status, Humans, Interpersonal Relations, Loneliness, Male, Middle Aged, Personal Satisfaction, Social Networking, Telecommunications}, issn = {2152-2723}, doi = {10.1089/cyber.2016.0151}, url = {http://online.liebertpub.com/doi/10.1089/cyber.2016.0151}, author = {William J. Chopik} } @article {8400, title = {Can social policy influence socioeconomic disparities? Korean War GI Bill eligibility and markers of depression.}, journal = {Ann Epidemiol}, volume = {26}, year = {2016}, month = {2016 Feb}, pages = {129-135.e3}, publisher = {26}, abstract = {

PURPOSE: The Korean War GI Bill provided socioeconomic benefits to veterans; however, its association with health is unclear; we hypothesize GI Bill eligibility is associated with fewer depressive symptoms and smaller disparities.

METHODS: Data from 246 Korean War GI Bill eligible veterans and 240 nonveterans from the Health and Retirement Study were matched on birth year, southern birth, race, height, and childhood health using coarsened exact matching. Number of depressive symptoms in 2010 (average age = 78 years) was assessed using a modified, validated Center for Epidemiologic Studies-Depression Scale, dichotomized to reflect elevated depressive symptoms. Regression analyses were stratified into low (at least one parent < 8 years schooling/missing data, n = 167) or high (both parents >= 8 years schooling, n = 319) childhood socioeconomic status (cSES) groups.

RESULTS: Korean War GI Bill eligibility predicted fewer depressive symptoms among individuals from low cSES backgrounds [β = -0.64, 95\% confidence interval (CI) = (-1.18, -0.09), P = .022]. Socioeconomic disparities were smaller among veterans than nonveterans for number of depressive symptoms [β = -0.76, 95\% CI = (-1.33, -0.18), P = .010] and elevated depressive symptoms [β = -11.7, 95\% CI = (-8.2, -22.6), P = .035].

CONCLUSIONS: Korean War GI Bill eligibility predicted smaller socioeconomic disparities in depression markers.

}, keywords = {Aged, Aged, 80 and over, depression, Health Status Disparities, Humans, Korean War, Male, Public Policy, Residence Characteristics, Risk Factors, Socioeconomic factors, Veterans}, issn = {1873-2585}, doi = {10.1016/j.annepidem.2015.12.003}, url = {http://www.sciencedirect.com/science/article/pii/S1047279715300107}, author = {Anusha M Vable and Canning, David and M. Maria Glymour and Ichiro Kawachi and Marcia P Jimenez and S. V. Subramanian} } @article {8827, title = {Changes in Depressive Symptoms among Older Adults with Multiple Chronic Conditions: Role of Positive and Negative Social Support.}, journal = {Int J Environ Res Public Health}, volume = {14}, year = {2016}, month = {2016 12 26}, abstract = {

Depression severely affects older adults in the United States. As part of the social environment, significant social support was suggested to ameliorate depression among older adults. We investigate how varying forms of social support moderate depressive symptomatology among older adults with multiple chronic conditions (MCC). Data were analyzed using a sample of 11,400 adults, aged 65 years or older, from the 2006-2012 Health and Retirement Study. The current study investigated the moderating effects of positive or negative social support from spouse, children, other family, and friends on the association between MCC and depression. A linear mixed model with repeated measures was used to estimate the effect of MCC on depression and its interactions with positive and negative social support in explaining depression among older adults. Varying forms of social support played different moderating roles in depressive symptomatology among older adults with MCC. Positive spousal support significantly weakened the deleterious effect of MCC on depression. Conversely, all negative social support from spouse, children, other family, and friends significantly strengthened the deleterious effect of MCC on depression. Minimizing negative social support and maximizing positive spousal support can reduce depression caused by MCC and lead to successful aging among older adults.

}, keywords = {Aged, Aged, 80 and over, Aging, depression, Family, Female, Friends, Humans, Male, Multiple Chronic Conditions, Social Support, United States}, issn = {1660-4601}, doi = {10.3390/ijerph14010016}, url = {http://www.mdpi.com/1660-4601/14/1/16}, author = {Ahn, SangNam and Kim, Seonghoon and Zhang, Hongmei} } @article {8414, title = {Combat exposure, social relationships, and subjective well-being among middle-aged and older Veterans.}, journal = {Aging Ment Health}, volume = {20}, year = {2016}, month = {2016}, pages = {637-46}, publisher = {20}, abstract = {

OBJECTIVES: This study described the association of subjective well-being with combat exposure and social relationships among middle-aged and older Veteran men in the USA. The stress-buffering hypothesis, which predicts social relationships may moderate the association between combat exposure and subjective well-being, was also examined.

METHOD: Data from the 2008 Health and Retirement Study (N = 2961) were used to estimate logistic regression models, focusing on three measures of subjective well-being: depression, life satisfaction, and self-reported health.

RESULTS: In the fully adjusted models, there were no statistically significant relationships between combat exposure and the three indicators of subjective well-being. However, compared to Veterans who had lower scores on the social relationship index, Veterans who had higher scores were less likely to be depressed and less likely to report poor or fair health. Veterans who had higher scores on the social relationships index reported higher levels of life satisfaction than those Veterans who had lower scores. There was no evidence for a social relationships buffering effect.

CONCLUSION: The results of this study demonstrated that combat exposure did not have a long-term relationship with subjective well-being. Longitudinal research designs with more comprehensive indicators of combat exposure may help researchers better understand some of the underlying complexity of this relationship. Complementary research with samples of women Veterans, as well as samples of Hispanic, and non-Black, non-White Veterans, is also needed.

}, keywords = {Aged, Combat Disorders, depression, Health Status, Humans, Interpersonal Relations, Male, Middle Aged, Personal Satisfaction, United States, Veterans}, issn = {1364-6915}, doi = {10.1080/13607863.2015.1033679}, url = {http://www.scopus.com/inward/record.url?eid=2-s2.0-84928663859andpartnerID=40andmd5=1e37c22429f6fa6e7b41027ddedf9237}, author = {Mai See Yang and Jeffrey A Burr} } @article {8341, title = {A cross-lagged model of the reciprocal associations of loneliness and memory functioning.}, journal = {Psychol Aging}, volume = {31}, year = {2016}, month = {2016 05}, pages = {255-61}, publisher = {31}, abstract = {

The study was designed to evaluate the reciprocal associations of loneliness and memory functioning using a cross-lagged model. The study was based on the psychosocial questionnaire of the Health and Retirement Study, which is a U.S. nationally representative survey of individuals over the age of 50 and their spouses of any age. A total of 1,225 respondents had complete data on the loneliness measure in 2004 and at least in 1 of the subsequent waves (e.g., 2008, 2012) and were maintained for analysis. A cross-lagged model was estimated to examine the reciprocal associations of loneliness and memory functioning, controlling for age, gender, education, depressive symptoms, number of medical conditions, and the number of close social relationships. The model had adequate fit indices: χ2(860, N = 1,225) = 1,401.54, p < .001, Tucker-Lewis index = .957, comparative fit index = .963, and root mean square error of approximation = .023 (90\% confidence interval [.021, .025]). The lagged effect of loneliness on memory functioning was nonsignificant, B(SE) = -.11(.08), p = .15, whereas the lagged effect of memory functioning on loneliness was significant, B(SE) = -.06(.02), p = .01, indicating that lower levels of memory functioning precede higher levels of loneliness 4 years afterward. Further research is required to better understand the mechanisms responsible for the temporal association between reduced memory functioning and increased loneliness. (PsycINFO Database Record

}, keywords = {Aged, Aging, depression, Female, Humans, Loneliness, Male, Memory, Models, Psychological, Social Behavior, Spouses, Surveys and Questionnaires, Time Factors}, issn = {1939-1498}, doi = {10.1037/pag0000075}, url = {http://psycnet.apa.org/journals/pag/31/3/255/}, author = {Liat Ayalon and Sharon Shiovitz-Ezra and Roziner, Ilan} } @article {8364, title = {Depressed Mood in Middle-Aged and Older Adults in Europe and the United States: A Comparative Study Using Anchoring Vignettes.}, journal = {J Aging Health}, volume = {28}, year = {2016}, month = {2016 Feb}, pages = {95-117}, publisher = {28}, abstract = {

OBJECTIVE: To compare self-ratings of depressed mood in middle-aged and older adults in the United States and nine European countries after adjustment by anchoring vignettes.

METHOD: Samples were drawn from three large surveys of middle-aged and older adults: the U.S. Health and Retirement Study, the English Longitudinal Study of Aging (ELSA), and the Survey of Health, Ageing and Retirement in Europe. Self-ratings of depressed mood were compared across countries before and after adjustment by anchoring vignettes depicting cases with different levels of depressed mood.

RESULTS: Compared with Europeans as a group, Americans rated both the cases presented in the vignettes and themselves as more depressed. However, after adjustment by vignette ratings, Americans appeared to be less depressed than their counterparts in all but two European countries.

DISCUSSION: Cultural differences in mental health norms reflected in vignette rating may partly explain between-country differences in self-reported depressive symptoms and perhaps other psychiatric complaints.

}, keywords = {Aged, Cross-Cultural Comparison, depression, Europe, Female, Health Surveys, Humans, Longitudinal Studies, Male, Middle Aged, United States}, issn = {1552-6887}, doi = {10.1177/0898264315585506}, url = {http://jah.sagepub.com/content/early/2015/04/22/0898264315585506.abstract}, author = {Ramin Mojtabai} } @article {8478, title = {Depression and Frailty in Late Life: Evidence for a Common Vulnerability.}, journal = {J Gerontol B Psychol Sci Soc Sci}, volume = {71}, year = {2016}, month = {2016 07}, pages = {630-40}, abstract = {

OBJECTIVES: The study purpose is to estimate the correlation between depression and competing models of frailty, and to determine to what degree the comorbidity of these syndromes is determined by shared symptomology.

METHODS: Data come from the 2010 Health and Retirement Study. Analysis was limited to community-dwelling participants 65 and older (N = 3,453). Depressive symptoms were indexed by the 8-item Centers for Epidemiologic Studies Depression (CESD) scale. Frailty was indexed by 3 alternative conceptual models: (a) biological syndrome, (b) frailty index, and (c) functional domains. Confirmatory factor analysis (CFA) was used to estimate the correlation between depression and each model of frailty.

RESULTS: Each of the 3 frailty latent factors was significantly correlated with depression: biological syndrome (ρ = .68, p < .01), functional domains (ρ = .70, p < .01), and frailty index (ρ = .61, p < .01). Substantial correlation remained when accounting for shared symptoms between depression and the biological syndrome (ρ = .45) and frailty index (ρ = .56) models.

DISCUSSION: Results indicate that the correlation of frailty and depression in late life is substantial. The association between the two constructs cannot be fully explained by symptom overlap, suggesting that psychological vulnerability may be an important component of frailty.

}, keywords = {Activities of Daily Living, Aged, Aged, 80 and over, depression, Female, Frail Elderly, Geriatric Assessment, Humans, Independent Living, Interview, Psychological, Male}, issn = {1758-5368}, doi = {10.1093/geronb/gbu180}, url = {http://www.ncbi.nlm.nih.gov/pubmed/25617399}, author = {Matthew C. Lohman and Dumenci, Levent and Briana Mezuk} } @article {8384, title = {Effects of Recent Stress and Variation in the Serotonin Transporter Polymorphism (5-HTTLPR) on Depressive Symptoms: A Repeated-Measures Study of Adults Age 50 and Older.}, journal = {Behavior Genetics}, volume = {46}, year = {2016}, pages = {72-88}, publisher = {46}, abstract = {

Depending on genetic sensitivity to it, stress may affect depressive symptomatology differentially. Applying the stress-diathesis hypothesis to older adults, we postulate: (1) recent stress will associate with increased depressive symptom levels and (2) this effect will be greater for individuals with at least one short allele of the serotonin transporter gene promoter region (5-HTTLPR). Further, we employ a design that addresses specific limitations of many prior studies that have examined the 5-HTTLPR {\texttimes} SLE relation, by: (a) using a within-person repeated-measures design to address fluctuations that occur within individuals over time, increase power for detecting G~{\texttimes}~E, and address GE correlation; (b) studying reports of exogenous stressful events (those unlikely to be caused by depression) to help rule out reverse causation and negativity bias, and in order to assess stressors that are more etiologically relevant to depressive symptomatology in older adults. The sample is drawn from the Health and Retirement Study, a U.S. population-based study of older individuals (N~=~28,248; mean age~=~67.5; 57.3~\% female; 80.7~\% Non-Hispanic White, 14.9~\% Hispanic/Latino, 4.5~\% African American; genetic subsample~=~12,332), from whom measures of depressive symptoms and exogenous stressors were collected biannually (1994-2010). Variation in the 5-HTTLPR was characterized via haplotype, using two single nucleotide polymorphisms (SNPs). Ordered logit models were constructed to predict levels of depressive symptoms from 5-HTTLPR and stressors, comparing results of the most commonly applied statistical approaches (i.e., comparing allelic and genotypic models, and continuous and categorical predictors) used in the literature. All models were stratified by race/ethnicity. Overall, results show a main effect of recent stress for all ethnic groups, and mixed results for the variation in 5-HTTLPR~{\texttimes}~stress interaction, contingent upon statistical model used. Findings suggest there may be a differential effect of stressors and 5-HTTLPR on depressive symptoms by ethnicity, but further research is needed, particularly when using a haplotype to characterize variation in 5-HTTLPR in population-based sample with a diverse ethnic composition.

}, keywords = {Aged, Alleles, depression, Depressive Disorder, Ethnic Groups, Female, Gene-Environment Interaction, Genetic Association Studies, Genetic Predisposition to Disease, Haplotypes, Humans, Life Change Events, Male, Middle Aged, Polymorphism, Single Nucleotide, Promoter Regions, Genetic, Serotonin Plasma Membrane Transport Proteins, Stress, Psychological}, issn = {1573-3297}, doi = {10.1007/s10519-015-9740-8}, author = {Thalida E. Arpawong and Jinkook Lee and Drystan F. Phillips and Eileen M. Crimmins and Morgan E. Levine and Carol A Prescott} } @article {8618, title = {Genetic variants associated with subjective well-being, depressive symptoms, and neuroticism identified through genome-wide analyses.}, journal = {Nat Genet}, volume = {48}, year = {2016}, month = {2016 06}, pages = {624-33}, abstract = {

Very few genetic variants have been associated with depression and neuroticism, likely because of limitations on sample size in previous studies. Subjective well-being, a phenotype that is genetically correlated with both of these traits, has not yet been studied with genome-wide data. We conducted genome-wide association studies of three phenotypes: subjective well-being (n = 298,420), depressive symptoms (n = 161,460), and neuroticism (n = 170,911). We identify 3 variants associated with subjective well-being, 2 variants associated with depressive symptoms, and 11 variants associated with neuroticism, including 2 inversion polymorphisms. The two loci associated with depressive symptoms replicate in an independent depression sample. Joint analyses that exploit the high genetic correlations between the phenotypes (|ρ^| ≈ 0.8) strengthen the overall credibility of the findings and allow us to identify additional variants. Across our phenotypes, loci regulating expression in central nervous system and adrenal or pancreas tissues are strongly enriched for association.

}, keywords = {Anxiety Disorders, Bayes Theorem, depression, Genome-Wide Association Study, Humans, Neuroticism, Phenotype, Polymorphism, Single Nucleotide}, issn = {1546-1718}, doi = {10.1038/ng.3552}, author = {Okbay, Aysu and Baselmans, Bart M L and De Neve, Jan-Emmanuel and Turley, Patrick and Nivard, Michel G and Mark Alan Fontana and Meddens, S Fleur W and Richard Karlsson Linn{\'e}r and Cornelius A Rietveld and Derringer, Jaime and Gratten, Jacob and Lee, James J and Liu, Jimmy Z and de Vlaming, Ronald and Ahluwalia, Tarunveer S and Buchwald, Jadwiga and Cavadino, Alana and Frazier-Wood, Alexis C and Furlotte, Nicholas A and Garfield, Victoria and Geisel, Marie Henrike and Gonzalez, Juan R and Haitjema, Saskia and Karlsson, Robert and van der Laan, Sander W and Ladwig, Karl-Heinz and J. Lahti and Sven J van der Lee and Penelope A Lind and Tian Liu and Lindsay K Matteson and Mihailov, Evelin and Michael B Miller and Minica, Camelia C and Ilja M Nolte and Dennis O Mook-Kanamori and van der Most, Peter J and Christopher J Oldmeadow and Qian, Yong and Olli T Raitakari and Rawal, Rajesh and Realo, Anu and Rueedi, Rico and Schmidt, B{\"o}rge and Albert Vernon Smith and Stergiakouli, Evie and Toshiko Tanaka and Kent D Taylor and Wedenoja, Juho and J{\"u}rgen Wellmann and Westra, Harm-Jan and Willems, Sara M and Wei Zhao and Amin, Najaf and Bakshi, Andrew and Patricia A. Boyle and Cherney, Samantha and Cox, Simon R and Gail Davies and Davis, Oliver S P and Ding, Jun and Nese Direk and Eibich, Peter and Emeny, Rebecca T and Fatemifar, Ghazaleh and Jessica Faul and Luigi Ferrucci and Andreas J Forstner and Gieger, Christian and Gupta, Richa and Tamara B Harris and Harris, Juliette M and Holliday, Elizabeth G and Jouke-Jan Hottenga and Philip L de Jager and Marika A Kaakinen and Kajantie, Eero and Karhunen, Ville and Kolcic, Ivana and Kumari, Meena and Lenore J Launer and Lude L Franke and Li-Gao, Ruifang and Koini, Marisa and Loukola, Anu and Marques-Vidal, Pedro and Grant W Montgomery and Mosing, Miriam A and Paternoster, Lavinia and Pattie, Alison and Katja E Petrovic and Pulkki-Raback, Laura and Quaye, Lydia and Katri R{\"a}ikk{\"o}nen and Rudan, Igor and Rodney J Scott and Jennifer A Smith and Angelina R Sutin and Trzaskowski, Maciej and Anna A E Vinkhuyzen and Lei Yu and Zabaneh, Delilah and John R. Attia and David A Bennett and Klaus Berger and Bertram, Lars and Dorret I Boomsma and Snieder, Harold and Chang, Shun-Chiao and Francesco Cucca and Ian J Deary and Cornelia M van Duijn and Johan G Eriksson and B{\"u}ltmann, Ute and Eco J. C. de Geus and Groenen, Patrick J F and Gudnason, Vilmundur and Hansen, Torben and Catharina A Hartman and Haworth, Claire M A and Caroline Hayward and Andrew C Heath and Hinds, David A and Hypp{\"o}nen, Elina and Iacono, William G and J{\"a}rvelin, Marjo-Riitta and J{\"o}ckel, Karl-Heinz and Kaprio, Jaakko and Sharon L R Kardia and Keltikangas-J{\"a}rvinen, Liisa and Kraft, Peter and Laura D Kubzansky and Lehtim{\"a}ki, Terho and Patrik K E Magnusson and Nicholas G Martin and McGue, Matt and Andres Metspalu and Melinda C Mills and de Mutsert, Ren{\'e}e and Oldehinkel, Albertine J and Pasterkamp, Gerard and Nancy L Pedersen and Plomin, Robert and Polasek, Ozren and Power, Christine and Rich, Stephen S and Rosendaal, Frits R and Hester M. den Ruijter and Schlessinger, David and Schmidt, Helena and Svento, Rauli and Schmidt, Reinhold and Alizadeh, Behrooz Z and Thorkild I. A. S{\o}rensen and Timothy Spector and Andrew Steptoe and Antonio Terracciano and A. Roy Thurik and Nicholas J Timpson and Henning Tiemeier and Andr{\'e} G Uitterlinden and Vollenweider, Peter and Wagner, Gert G and David R Weir and Yang, Jian and Dalton C Conley and Hofman, Albert and Johannesson, Magnus and David I Laibson and Sarah E Medland and Meyer, Michelle N and Pickrell, Joseph K and T{\~o}nu Esko and Krueger, Robert F and Jonathan P. Beauchamp and Philipp D Koellinger and Daniel J. Benjamin and Bartels, Meike and Cesarini, David} } @article {8607, title = {GENOME-WIDE ASSOCIATION STUDY (GWAS) AND GENOME-WIDE BY ENVIRONMENT INTERACTION STUDY (GWEIS) OF DEPRESSIVE SYMPTOMS IN AFRICAN AMERICAN AND HISPANIC/LATINA WOMEN.}, journal = {Depress Anxiety}, volume = {33}, year = {2016}, month = {2016 Apr}, pages = {265-80}, abstract = {

BACKGROUND: Genome-wide association studies (GWAS) have made little progress in identifying variants linked to depression. We hypothesized that examining depressive symptoms and considering gene-environment interaction (GxE) might improve efficiency for gene discovery. We therefore conducted a GWAS and genome-wide by environment interaction study (GWEIS) of depressive symptoms.

METHODS: Using data from the SHARe cohort of the Women{\textquoteright}s Health Initiative, comprising African Americans (n = 7,179) and Hispanics/Latinas (n = 3,138), we examined genetic main effects and GxE with stressful life events and social support. We also conducted a heritability analysis using genome-wide complex trait analysis (GCTA). Replication was attempted in four independent cohorts.

RESULTS: No SNPs achieved genome-wide significance for main effects in either discovery sample. The top signals in African Americans were rs73531535 (located 20 kb from GPR139, P = 5.75 {\texttimes} 10(-8) ) and rs75407252 (intronic to CACNA2D3, P = 6.99 {\texttimes} 10(-7) ). In Hispanics/Latinas, the top signals were rs2532087 (located 27 kb from CD38, P = 2.44 {\texttimes} 10(-7) ) and rs4542757 (intronic to DCC, P = 7.31 {\texttimes} 10(-7) ). In the GEWIS with stressful life events, one interaction signal was genome-wide significant in African Americans (rs4652467; P = 4.10 {\texttimes} 10(-10) ; located 14 kb from CEP350). This interaction was not observed in a smaller replication cohort. Although heritability estimates for depressive symptoms and stressful life events were each less than 10\%, they were strongly genetically correlated (rG = 0.95), suggesting that common variation underlying self-reported depressive symptoms and stressful life event exposure, though modest on their own, were highly overlapping in this sample.

CONCLUSIONS: Our results underscore the need for larger samples, more GEWIS, and greater investigation into genetic and environmental determinants of depressive symptoms in minorities.

}, keywords = {African Americans, Aged, depression, Female, Gene-Environment Interaction, Genome-Wide Association Study, Hispanic Americans, Humans, Life Change Events, Middle Aged, Phenotype, Polymorphism, Single Nucleotide, Risk Factors, Self Report}, issn = {1520-6394}, doi = {10.1002/da.22484}, author = {Dunn, Erin C and Wiste, Anna and Radmanesh, Farid and Almli, Lynn M and Gogarten, Stephanie M and Sofer, Tamar and Jessica Faul and Sharon L R Kardia and Jennifer A Smith and David R Weir and Wei Zhao and Soare, Thomas W and Saira S Mirza and Karin Hek and Henning Tiemeier and Goveas, Joseph S and Sarto, Gloria E and Snively, Beverly M and Marilyn C Cornelis and Karestan C Koenen and Kraft, Peter and Shaun M Purcell and Ressler, Kerry J and Rosand, Jonathan and Wassertheil-Smoller, Sylvia and Smoller, Jordan W} } @article {8383, title = {Healthcare Stereotype Threat in Older Adults in the Health and Retirement Study.}, journal = {American Journal of Preventive Medicine}, volume = {50}, year = {2016}, pages = {191-198}, publisher = {50}, abstract = {

INTRODUCTION: Healthcare stereotype threat is the threat of being personally reduced to group stereotypes that commonly operate within the healthcare domain, including stereotypes regarding unhealthy lifestyles and inferior intelligence. The objective of this study was to assess the extent to which people fear being judged in healthcare contexts on several characteristics, including race/ethnicity and age, and to test predictions that experience of such threats would be connected with poorer health and negative perceptions of health care.

METHODS: Data were collected as part of the 2012 Health and Retirement Study (HRS). A module on healthcare stereotype threat, designed by the research team, was administered to a random subset (n=2,048 of the total 20,555) of HRS participants. The final sample for the present healthcare stereotype threat experiment consists of 1,479 individuals. Logistic regression was used to test whether healthcare stereotype threat was associated with self-rated health, reported hypertension, and depressive symptoms, as well as with healthcare-related outcomes, including physician distrust, dissatisfaction with health care, and preventative care use.

RESULTS: Seventeen percent of respondents reported healthcare stereotype threat with respect to one or more aspects of their identities. As predicted, healthcare stereotype threat was associated with higher physician distrust and dissatisfaction with health care, poorer mental and physical health (i.e., self-rated health, hypertension, and depressive symptoms), and lower odds of receiving the influenza vaccine.

CONCLUSIONS: The first of its kind, this study demonstrates that people can experience healthcare stereotype threat on the basis of various stigmatized aspects of social identity, and that these experiences can be linked with larger health and healthcare-related outcomes, thereby contributing to disparities among minority groups.

}, keywords = {Age Factors, Aged, Ageism, Attitude of Health Personnel, depression, Female, Health Status, Humans, Hypertension, Male, Mental Health, Middle Aged, Overweight, Physician-Patient Relations, Physicians, Prejudice, Racism, Sex Factors, Socioeconomic factors, Stereotyping}, issn = {1873-2607}, doi = {10.1016/j.amepre.2015.07.034}, author = {Cleopatra M Abdou and Adam W. Fingerhut and James S Jackson and Felicia V Wheaton} } @article {8583, title = {High Levels of Geriatric Palliative Care Needs in Hip Fracture Patients Before the Hip Fracture.}, journal = {J Pain Symptom Manage}, volume = {52}, year = {2016}, month = {2016 10}, pages = {533-538}, abstract = {

CONTEXT: Most hip fracture care models are grounded in curative models where the goal is to return the patient to independent function. In many instances, however, hip fractures contribute to continued functional decline and mortality. Although the negative impact of hip fractures is appreciated once they have occurred, what is less understood is what proportion of older adults have high illness burden before experiencing hip fracture and might benefit from geriatric palliative care.

OBJECTIVES: Using data from the Health and Retirement Study linked to Medicare claims (January 1992 through December 2010), we sought to understand the extent of premorbid illness burden before hip fracture.

METHODS: Characteristics were based on the interview before hip fracture. Features used to indicate need for geriatric palliative care included evidence of functional and medical vulnerability, pain, and depression.

RESULTS: Eight hundred fifty-six older adults who experienced a hip fracture were compared to 851 age-, gender-, and race-matched controls. Older adults with hip fractures had significantly more premorbid functional vulnerability (activities of daily living dependent 25.7\% vs. 16.1\% [P~<~0.001]; dementia 16.2\% vs. 7.3\% (P~<~0.001); use of helpers 41.2\% vs. 28.7\% [P~<~0.001]). They also experienced more medical vulnerability (multimorbidity 43\% vs. 29.8\% [P~<~0.001]; high health care utilization 30.0\% vs. 20.9\% [P~<~0.001]; and poor prognosis 36.1\% vs. 25.4\% [P~<~0.001] in controls). There was no difference in premorbid pain and depression between subsequent hip fracture patients and controls.

CONCLUSIONS: A significant proportion of older adults have evidence of functional and medical vulnerability before hip fracture. For these individuals, integration of geriatric palliative care may be particularly important for optimizing quality of life and addressing the high morbidity experienced by this population.

}, keywords = {Activities of Daily Living, Aged, 80 and over, Dementia, depression, Female, Hip Fractures, Humans, Interviews as Topic, Male, multimorbidity, pain, Palliative care, Patient Acceptance of Health Care, Prodromal Symptoms, Vulnerable Populations}, issn = {1873-6513}, doi = {10.1016/j.jpainsymman.2016.07.003}, url = {http://www.sciencedirect.com/science/article/pii/S0885392416302214}, author = {Christine S Ritchie and Amy Kelley and Irena Cenzer and Margaret Wallhagen and Kenneth E Covinsky} } @article {8480, title = {Older adults with poor self-rated memory have less depressive symptoms and better memory performance when perceived self-efficacy is high.}, journal = {Int J Geriatr Psychiatry}, volume = {31}, year = {2016}, month = {2016 07}, pages = {783-90}, abstract = {

OBJECTIVE: To investigate whether self-efficacy moderates the association between self-rated memory and depressive symptoms in a large sample of older adults. The influence of self-efficacy and depressive symptoms on memory performance was also examined in a subsample of individuals who reported poor memory.

METHODS: Non-demented participants (n = 3766) were selected from the 2012 wave of the Health and Retirement Study. Depressive symptomatology was assessed with the 8-item Center for Epidemiologic Studies Depression Scale. A modified version of the Midlife Developmental Inventory Questionnaire was used as the measure of self-efficacy. Participants were asked to rate their memory presently on a five-point scale from Excellent (1) to Poor (5). Immediate memory and delayed memory (after a 5-min interval) were measured by the number of correct words recalled from a 10-item word list.

RESULTS: Multiple regression analyses revealed that negative ratings of memory were significantly associated with greater levels of depressive symptoms, with this effect being greatest in those with low levels of self-efficacy. Additionally, greater self-efficacy was associated with optimal objective memory performances but only when depressive symptoms were low in individuals who reported poor memory function (n = 1196).

CONCLUSION: Self-efficacy moderates the relationship between self-rated memory function and depressive symptoms. Higher self-efficacy may buffer against the impact of subjective memory difficulty on one{\textquoteright}s mood and thereby mitigating the effect of depressive symptoms on memory. Interventions should focus on increasing perceived self-efficacy in older adults reporting poor memory function to potentially minimize memory impairment.

}, keywords = {Aged, Aged, 80 and over, depression, Female, Humans, Male, Memory, Middle Aged, Regression Analysis, Self Efficacy, Surveys and Questionnaires}, issn = {1099-1166}, doi = {10.1002/gps.4392}, url = {http://www.ncbi.nlm.nih.gov/pubmed/26679474}, author = {O{\textquoteright}Shea, Deirdre M and Vonetta M Dotson and Fieo, Robert A and Tsapanou, Angeliki and Laura B Zahodne and Stern, Yaakov} } @article {6440, title = {Physical, Cognitive, Social, and Emotional Mediators of Activity Involvement and Health in Later Life.}, journal = {Res Aging}, volume = {38}, year = {2016}, month = {2016 Oct}, pages = {791-815}, abstract = {

The current study tests the indirect effect of activity-related physical activity, cognitive activity, social interaction, and emotional exchange on the relationship between activity involvement and health (physical and emotional) in later life. Longitudinal data from the Health and Retirement Study (N = 5,442) were used to estimate a series of linear regression models. We found significant indirect effects for social interaction and benefit to others (emotional exchange) on emotional health (depressive symptoms) and indirect effects for use of body and benefit to others (physical) on physical health (frailty). The most potent indirect effect associated with emotional and physical health was experienced by those engaged in all four domains (use of body, use of mind, social interaction, and benefit to others). While effect sizes are small and results should be interpreted with caution, findings shed light on ways in which public health interventions aimed toward increasing role engagement in later life could be improved.

}, keywords = {Aged, depression, Efficiency, Employment, Exercise, Female, Health Status, Humans, Longitudinal Studies, Male, Middle Aged, Quality of Life, Volunteers}, issn = {1552-7573}, doi = {10.1177/0164027515606182}, url = {http://roa.sagepub.com/content/early/2015/09/30/0164027515606182.abstract}, author = {Matz-Costa, Christina and Dawn C Carr and Tay K. McNamara and Jacquelyn Boone James} } @article {8679, title = {Prevalence and Outcomes of Breathlessness in Older Adults: A National Population Study.}, journal = {J Am Geriatr Soc}, volume = {64}, year = {2016}, month = {2016 10}, pages = {2035-2041}, abstract = {

OBJECTIVES: To determine the prevalence and outcomes of breathlessness in older Americans.

SETTING: Community-dwelling older adults.

PARTICIPANTS: Individuals aged 70 and older in the nationally representative Health and Retirement Study (2008, follow-up through 2012) (N = 3,671; mean age 78).

MEASUREMENTS: Breathlessness was assessed by asking the question, "How often do you become short of breath while awake?" Responses of often or sometimes were considered to represent a level of breathlessness sufficient to warrant clinical attention. The prevalence of breathlessness is described overall and in subpopulations, then rates of associated symptoms, well-being, and health services use of participants who were breathless are compared with rates of those who were not. The risk of decline in activities of daily living (ADLs) and death through 2012 was estimated by creating a multivariable Cox proportional hazards model, adjusting for age, sex, race and ethnicity, and education.

RESULTS: Twenty-five percent of participants reported breathlessness. The prevalence of breathlessness was higher in certain subpopulations: chronic lung disease (63\%), multimorbidity (>=2 chronic conditions) (45\%), current smokers (38\%), heart disease (36\%), obesity (body mass index >=30.0 kg/m ) (33\%), and education less than high school (32\%). Breathlessness was associated with higher rates of depression, anxiety, and severe fatigue; lower ratings of well-being; and higher rates of clinic and emergency department visits and hospitalizations (all P < .001). Breathlessness predicted ADL decline over 5 years (adjusted hazard ratio (aHR) = 1.43, 95\% confidence interval (CI) = 1.22-1.68) and death (aHR 1.62, 95\% CI = 1.32-2.02).

CONCLUSION: One in four adults aged 70 and older in the United States experiences breathlessness, which is associated with lack of well-being, greater health services use, and a 40\% greater risk of worsened function and 60\% greater risk of death over the next 5 years.

}, keywords = {Activities of Daily Living, Aged, Aged, 80 and over, Anxiety, Chronic disease, Comorbidity, depression, Dyspnea, Female, Geriatric Assessment, Hospitalization, Humans, Male, Prevalence, Proportional Hazards Models, Risk Assessment, Risk Factors, Symptom Assessment, United States}, issn = {1532-5415}, doi = {10.1111/jgs.14313}, author = {David C. Currow and Amy P Abernethy and Miriam J Johnson and Yinghui Miao and W John Boscardin and Christine S Ritchie} } @article {8531, title = {The Protective Effects of Religiosity on Depression: A 2-Year Prospective Study.}, journal = {Gerontologist}, volume = {56}, year = {2016}, month = {2016 06}, pages = {421-31}, abstract = {

PURPOSE OF THE STUDY: Approximately 20\% of older adults are diagnosed with depression in the United States. Extant research suggests that engagement in religious activity, or religiosity, may serve as a protective factor against depression. This prospective study examines whether religiosity protects against depression and/or aids in recovery.

DESIGN AND METHODS: Study data are drawn from the 2006 and 2008 waves of the Health and Retirement Study. The sample consists of 1,992 depressed and 5,740 nondepressed older adults (mean age = 68.12 years), at baseline (2006), for an overall sample size of 7,732. Logistic regressions analyzed the relationship between organizational (service attendance), nonorganizational (private prayer), and intrinsic measures of religiosity and depression onset (in the baseline nondepressed group) and depression recovery (in the baseline depressed group) at follow-up (2008), controlling for other baseline factors.

RESULTS: Religiosity was found to both protect against and help individuals recover from depression. Individuals not depressed at baseline remained nondepressed 2 years later if they frequently attended religious services, whereas those depressed at baseline were less likely to be depressed at follow-up if they more frequently engaged in private prayer.

IMPLICATIONS: Findings suggest that both organizational and nonorganizational forms of religiosity affect depression outcomes in different circumstances (i.e., onset and recovery, respectively). Important strategies to prevent and relieve depression among older adults may include improving access and transportation to places of worship among those interested in attending services and facilitating discussions about religious activities and beliefs with clinicians.

}, keywords = {Adult, Aged, Aging, depression, Depressive Disorder, Female, Health Surveys, Humans, Male, Middle Aged, Prospective Studies, Religion, Religion and Psychology, Social Support, Spirituality, United States}, issn = {1758-5341}, doi = {10.1093/geront/gnu073}, url = {https://www.ncbi.nlm.nih.gov/pubmed/25063937}, author = {Corina R Ronneberg and Edward Alan Miller and Dugan, Elizabeth and Frank Porell} } @article {8532, title = {Relationship between marijuana and other illicit drug use and depression/suicidal thoughts among late middle-aged and older adults.}, journal = {Int Psychogeriatr}, volume = {28}, year = {2016}, month = {2016 Apr}, pages = {577-89}, abstract = {

BACKGROUND: Despite growing numbers of older-adult illicit drug users, research on this topic is rare. This study examined the relationship between marijuana and/or other illicit drug use and major depressive episode (MDE) and serious suicidal thoughts among those aged 50+ years in the USA.

METHODS: The public use files of the 2008 to 2012 US National Survey on Drug Use and Health (NSDUH) provided data on 29,634 individuals aged 50+ years. Logistic regression analysis was used to test hypothesized associations between past-year marijuana and/or other illicit drug use and MDE and serious suicidal thoughts.

RESULTS: Nearly 6\% of the 50+ years age group reported past-year marijuana and/or other illicit drug use. Compared to non-users of any illicit drug, the odds of past-year MDE among those who used marijuana only, other illicit drugs only, and marijuana and other illicit drugs were 1.54 (95\% CI = 1.17-2.03), 2.75 (95\% CI = 1.75-4.33), and 2.12 (95\% CI = 1.45-3.09), respectively. Those who used marijuana and other drugs also had higher odds (2.44, 95\% CI = 1.58-3.77) of suicidal thoughts than non-users of any illicit drug. However, among users of any illicit drug, no difference was found among users of marijuana only, marijuana and other illicit drugs, and other illicit drugs only. Among marijuana users, marijuana use frequency was a significant correlate of suicidal thoughts only among those with MDE.

CONCLUSIONS: Health and mental health (MH) service providers should pay close attention to the potential reciprocal effects of marijuana and other illicit drug use and MDE and suicidal thoughts among late middle-aged and older adults.

}, keywords = {Age Distribution, Aged, Cannabis, Cross-Sectional Studies, depression, Depressive Disorder, Major, Female, Health Surveys, Humans, Illicit Drugs, Male, Marijuana Abuse, Marijuana Smoking, Middle Aged, Regression Analysis, Self Report, Substance-Related Disorders, Suicidal Ideation, Suicide, Attempted, United States}, issn = {1741-203X}, doi = {10.1017/S1041610215001738}, url = {https://www.ncbi.nlm.nih.gov/pubmed/26542746}, author = {Namkee G Choi and DiNitto, Diana M and Marti, C Nathan and Bryan Y Choi} } @article {8534, title = {Somatic, positive and negative domains of the Center for Epidemiological Studies Depression (CES-D) scale: a meta-analysis of genome-wide association studies.}, journal = {Psychol Med}, volume = {46}, year = {2016}, month = {2016 06}, pages = {1613-23}, abstract = {

BACKGROUND: Major depressive disorder (MDD) is moderately heritable, however genome-wide association studies (GWAS) for MDD, as well as for related continuous outcomes, have not shown consistent results. Attempts to elucidate the genetic basis of MDD may be hindered by heterogeneity in diagnosis. The Center for Epidemiological Studies Depression (CES-D) scale provides a widely used tool for measuring depressive symptoms clustered in four different domains which can be combined together into a total score but also can be analysed as separate symptom domains.

METHOD: We performed a meta-analysis of GWAS of the CES-D symptom clusters. We recruited 12 cohorts with the 20- or 10-item CES-D scale (32 528 persons).

RESULTS: One single nucleotide polymorphism (SNP), rs713224, located near the brain-expressed melatonin receptor (MTNR1A) gene, was associated with the somatic complaints domain of depression symptoms, with borderline genome-wide significance (p discovery = 3.82 {\texttimes} 10-8). The SNP was analysed in an additional five cohorts comprising the replication sample (6813 persons). However, the association was not consistent among the replication sample (p discovery+replication = 1.10 {\texttimes} 10-6) with evidence of heterogeneity.

CONCLUSIONS: Despite the effort to harmonize the phenotypes across cohorts and participants, our study is still underpowered to detect consistent association for depression, even by means of symptom classification. On the contrary, the SNP-based heritability and co-heritability estimation results suggest that a very minor part of the variation could be captured by GWAS, explaining the reason of sparse findings.

}, keywords = {depression, Depressive Disorder, Major, Genome-Wide Association Study, Humans, Polymorphism, Single Nucleotide, Receptor, Melatonin, MT1, Somatoform Disorders}, issn = {1469-8978}, doi = {10.1017/S0033291715002081}, url = {https://www.ncbi.nlm.nih.gov/pubmed/26997408}, author = {Demirkan, A and J. Lahti and Nese Direk and Viktorin, A. and Kathryn L Lunetta and Antonio Terracciano and Michael A Nalls and Toshiko Tanaka and Karin Hek and Myriam Fornage and J{\"u}rgen Wellmann and Marilyn C Cornelis and Ollila, H. M. and Lei Yu and Luke C Pilling and Isaacs, A and Aarno Palotie and Wei Vivian Zhuang and Alan B Zonderman and Jessica Faul and Angelina R Sutin and Osorio Meirelles and Mulas, A and Hofman, A and Andr{\'e} G Uitterlinden and Fernando Rivadeneira and Markus Perola and Wei Zhao and Veikko Salomaa and Kristine Yaffe and Luik, A I and Yongmei Liu and Ding, J and Paul Lichtenstein and Land{\'e}n, M and Elisabeth Widen and David R Weir and David J Llewellyn and Murray, A and Sharon L R Kardia and Johan G Eriksson and Karestan C Koenen and Patrik K E Magnusson and Luigi Ferrucci and Thomas H Mosley and Francesco Cucca and Ben A Oostra and David A Bennett and Paunio, T. and Klaus Berger and Tamara B Harris and Nancy L Pedersen and Joanne M Murabito and Henning Tiemeier and Cornelia M van Duijn and Katri R{\"a}ikk{\"o}nen} } @article {8195, title = {Anchoring vignettes in the Health and Retirement Study: how do medical professionals and disability recipients characterize the severity of work limitations?}, journal = {PLoS One}, volume = {10}, year = {2015}, month = {2015}, pages = {e0126218}, publisher = {10}, abstract = {

PURPOSE: Recent studies report systematic differences in how individuals categorize the severity of identical health and work limitation vignettes. We investigate how health professionals and disability recipients characterize the severity of work limitations and whether their reporting patterns are robust to demographic, education, and health characteristics. We use the results to illustrate the potential impact of reporting heterogeneity on the distribution of work disability estimated from self-reported categorical health and disability data.

METHOD: Nationally representative data on anchoring disability vignettes from the 2004 Health and Retirement Study (HRS) are used to investigate how respondents with an occupation background in health and Social Security disability beneficiaries categorize work limitation vignettes. Using pain, cardiovascular health, and depression vignettes, we estimate generalized ordered probit models (N = 2,660 individuals or 39,681 person-vignette observations) that allow the severity thresholds to vary by respondent characteristics.

RESULTS: We find that health professionals (excluding nurses) and disability recipients tend to classify identical work limitations as more severe compared to non-health professional non-disabled respondents. For disability recipients, the differences are most pronounced and particularly visible in the tails of the work limitations distribution. For health professionals, we observe smaller differences, affecting primarily the classification of mildly and moderately severe work limitations. The patterns for health professionals (excluding nurses) are robust to demographics, education, and health conditions. The greater likelihood of viewing the vignette person as more severely work limited observed among disability recipients is mostly explained by the fact that these respondents also tend to be in poorer health which itself predicts a more inclusive scale.

CONCLUSIONS: Knowledge of reporting scales from health professionals and disabled individuals can benefit researchers in a broad range of applications in health and disability research. They may be useful as reference scales to evaluate disability survey data. Such knowledge may be beneficial when studying disability programs. Given the increasing availability of anchoring vignette data in surveys, this is a promising area for future evaluation research.

}, keywords = {Aged, Cardiovascular Diseases, depression, Disabled Persons, Female, Health Personnel, Humans, Male, Middle Aged, pain, Retirement, Self Report}, issn = {1932-6203}, doi = {10.1371/journal.pone.0126218}, url = {http://dx.doi.org/10.1371 2Fjournal.pone.0126218}, author = {Frank Heiland and Yin, Na} } @article {8258, title = {Association Between Hospice Use and Depressive Symptoms in Surviving Spouses.}, journal = {JAMA Intern Med}, volume = {175}, year = {2015}, note = {10.1001/jamainternmed.2015.1722}, month = {2015 Jul}, pages = {1138-46}, publisher = {175}, abstract = {

IMPORTANCE: Family caregivers of individuals with serious illness are at risk for depressive symptoms and depression. Hospice includes the provision of support services for family caregivers, yet evidence is limited regarding the effect of hospice use on depressive symptoms among surviving caregivers.

OBJECTIVE: To determine the association between hospice use and depressive symptoms in surviving spouses.

DESIGN, SETTING, AND PARTICIPANTS: We linked data from the Health and Retirement Study, a nationally representative longitudinal survey of community-dwelling US adults 50 years or older, to Medicare claims. Participants included a propensity score-matched sample of 1016 Health and Retirement Study decedents with at least 1 serious illness and their surviving spouses interviewed between August 2002 and May 2011. We compared the spouses of individuals enrolled in hospice with the spouses of individuals who did not use hospice, performing our analysis between January 30, 2014, and January 16, 2015.

EXPOSURES: Hospice enrollment for at least 3 days in the year before death.

MAIN OUTCOMES AND MEASURES: Spousal depressive symptom scores measured 0 to 2 years after death with the Center for Epidemiologic Studies Depression Scale, which is scored from 0 (no symptoms) to 8 (severe symptoms).

RESULTS: Of the 1016 decedents in the matched sample, 305 patients (30.0\%) used hospice services for 3 or more days in the year before death. Of the 1016 spouses, 51.9\% had more depressive symptoms over time (mean [SD] change, 2.56 [1.65]), with no significant difference related to hospice use. A minority (28.2\%) of spouses of hospice users had improved Center for Epidemiologic Studies Depression Scale scores compared with 21.7\% of spouses of decedents who did not use hospice, although the difference was not statistically significant (P = .06). Among the 662 spouses who were the primary caregivers, 27.3\% of spouses of hospice users had improved Center for Epidemiologic Studies Depression Scale scores compared with 20.7\% of spouses of decedents who did not use hospice; the difference was not statistically significant (P = .10). In multivariate analysis, the odds ratio for the association of hospice enrollment with improved depressive symptoms after the spouse{\textquoteright}s death was 1.63 (95\% CI, 1.00-2.65).

CONCLUSIONS AND RELEVANCE: After bereavement, depression symptoms increased overall for surviving spouses regardless of hospice use. A modest reduction in depressive symptoms was more likely among spouses of hospice users than among spouses of nonhospice users.

}, keywords = {Aged, Aged, 80 and over, Caregivers, depression, Female, Hospice Care, Hospices, Humans, Male, Prospective Studies, Spouses, Survivors}, issn = {2168-6114}, doi = {10.1001/jamainternmed.2015.1722}, url = {http://dx.doi.org/10.1001/jamainternmed.2015.1722}, author = {Katherine A Ornstein and Melissa D. Aldridge and Melissa M Garrido and Rebecca Jean Gorges and Diane E Meier and Amy Kelley} } @article {8323, title = {The association of depression, cognitive impairment without dementia, and dementia with risk of ischemic stroke: a cohort study.}, journal = {Psychosom Med}, volume = {77}, year = {2015}, month = {2015 Feb-Mar}, pages = {200-8}, publisher = {77}, abstract = {

OBJECTIVE: To determine if depression, cognitive impairment without dementia (CIND), and/or dementia are each independently associated with risk of ischemic stroke and to identify characteristics that could modify these associations.

METHODS: This retrospective-cohort study examined a population-based sample of 7031 Americans older than 50 years participating in the Health and Retirement Study (1998-2008) who consented to have their interviews linked to their Medicare claims. The eight-item Center for Epidemiologic Studies Depression Scale and/or International Classification of Disease, Ninth Revision, Clinical Modification (ICD-9-CM) depression diagnoses were used to identify baseline depression. The Modified Telephone Interview for Cognitive Status and/or ICD-9-CM dementia diagnoses were used to identify baseline CIND or dementia. Hospitalizations for ischemic stroke were identified via ICD-9-CM diagnoses.

RESULTS: After adjusting for demographics, medical comorbidities, and health-risk behaviors, CIND alone (odds ratio [OR] = 1.37, 95\% confidence interval [CI] = 1.11-1.69) and co-occurring depression and CIND (OR = 1.65, 95\% CI = 1.24-2.18) were independently associated with increased odds of ischemic stroke. Depression alone was not associated with odds of ischemic stroke (OR = 1.11, 95\% CI = 0.88-1.40) in unadjusted analyses. Neither dementia alone (OR = 1.09, 95\% CI = 0.82-1.45) nor co-occurring depression and dementia (OR = 1.25, 95\% CI = 0.89-1.76) were associated with odds of ischemic stroke after adjusting for demographics.

CONCLUSIONS: CIND and co-occurring depression and CIND are independently associated with increased risk of ischemic stroke. Individuals with co-occurring depression and CIND represent a high-risk group that may benefit from targeted interventions to prevent stroke.

}, keywords = {Aged, Aged, 80 and over, Cognitive Dysfunction, Cohort Studies, Dementia, depression, Female, Humans, Male, Middle Aged, Psychiatric Status Rating Scales, Retrospective Studies, Risk Factors, Stroke, United States}, issn = {1534-7796}, doi = {10.1097/PSY.0000000000000136}, author = {Dimitry S Davydow and Deborah A Levine and Zivin, Kara and Wayne J Katon and Kenneth M. Langa} } @article {8330, title = {Changes in Depressive Symptoms and Incidence of First Stroke Among Middle-Aged and Older US Adults.}, journal = {J Am Heart Assoc}, volume = {4}, year = {2015}, month = {2015 May 13}, publisher = {4}, abstract = {

BACKGROUND: Although research has demonstrated that depressive symptoms predict stroke incidence, depressive symptoms are dynamic. It is unclear whether stroke risk persists if depressive symptoms remit.

METHODS AND RESULTS: Health and Retirement Study participants (n=16 178, stroke free and noninstitutionalized at baseline) were interviewed biennially from 1998 to 2010. Stroke and depressive symptoms were assessed through self-report of doctors{\textquoteright} diagnoses and a modified Center for Epidemiologic Studies - Depression scale (high was >=3 symptoms), respectively. We examined whether depressive symptom patterns, characterized across 2 successive interviews (stable low/no, onset, remitted, or stable high depressive symptoms) predicted incident stroke (1192 events) during the subsequent 2 years. We used marginal structural Cox proportional hazards models adjusted for demographics, health behaviors, chronic conditions, and attrition. We also estimated effects stratified by age (>=65 years), race or ethnicity (non-Hispanic white, non-Hispanic black, Hispanic), and sex. Stroke hazard was elevated among participants with stable high (adjusted hazard ratio 2.14, 95\% CI 1.69 to 2.71) or remitted (adjusted hazard ratio 1.66, 95\% CI 1.22 to 2.26) depressive symptoms compared with participants with stable low/no depressive symptoms. Stable high depressive symptom predicted stroke among all subgroups. Remitted depressive symptoms predicted increased stroke hazard among women (adjusted hazard ratio 1.86, 95\% CI 1.30 to 2.66) and non-Hispanic white participants (adjusted hazard ratio 1.66, 95\% CI 1.18 to 2.33) and was marginally associated among Hispanics (adjusted hazard ratio 2.36, 95\% CI 0.98 to 5.67).

CONCLUSIONS: In this cohort, persistently high depressive symptoms were associated with increased stroke risk. Risk remained elevated even if depressive symptoms remitted over a 2-year period, suggesting cumulative etiologic mechanisms linking depression and stroke.

}, keywords = {Adult, Aged, Aged, 80 and over, Aging, depression, Female, Humans, Incidence, Longitudinal Studies, Male, Middle Aged, Proportional Hazards Models, Risk Factors, Sex Factors, Stroke, Time Factors}, issn = {2047-9980}, doi = {10.1161/JAHA.115.001923}, author = {Stefan Walter and Eric J. Tchetgen Tchetgen and Kristen K Patton and J Robin Moon and Benjamin D Capistrant and Jessica R Marden and Laura D Kubzansky and Paola Gilsanz and Ichiro Kawachi and M. Maria Glymour} } @article {8238, title = {Comparative genome-wide association studies of a depressive symptom phenotype in a repeated measures setting by race/ethnicity in the Multi-Ethnic Study of Atherosclerosis.}, journal = {BMC Genet}, volume = {16}, year = {2015}, month = {2015 Oct 12}, pages = {118}, publisher = {16}, abstract = {

BACKGROUND: Time-varying phenotypes have been studied less frequently in the context of genome-wide analyses across ethnicities, particularly for mood disorders. This study uses genome-wide association studies of depressive symptoms in a longitudinal framework and across multiple ethnicities to find common variants for depressive symptoms. Ethnicity-specific GWAS for depressive symptoms were conducted using three approaches: a baseline measure, longitudinal measures averaged over time, and a repeated measures analysis. We then used meta-analysis to jointly analyze the results across ethnicities within the Multi-ethnic Study of Atherosclerosis (MESA, n = 6,335), and then within ethnicity, across MESA and a sample from the Health and Retirement Study African- and European-Americans (HRS, n = 10,163).

METHODS: This study uses genome-wide association studies of depressive symptoms in a longitudinal framework and across multiple ethnicities to find common variants for depressive symptoms. Ethnicity-specific GWAS for depressive symptoms were conducted using three approaches: a baseline measure, longitudinal measures averaged over time, and a repeated measures analysis. We then used meta-analysis to jointly analyze the results across ethnicities within the Multi-ethnic Study of Atherosclerosis (MESA, n = 6,335), and then within ethnicity, across MESA and a sample from the Health and Retirement Study African- and European-Americans (HRS, n = 10,163).

RESULTS: Several novel variants were identified at the genome-wide suggestive level (5{\texttimes}10(-8) < p-value <= 5{\texttimes}10(-6)) in each ethnicity for each approach to analyzing depressive symptoms. The repeated measures analyses resulted in typically smaller p-values and an increase in the number of single-nucleotide polymorphisms (SNP) reaching genome-wide suggestive level.

CONCLUSIONS: For phenotypes that vary over time, the detection of genetic predictors may be enhanced by repeated measures analyses.

}, keywords = {Atherosclerosis, Black or African American, depression, ethnicity, Female, Genome-Wide Association Study, Humans, Male, Meta-Analysis as Topic, Middle Aged, Phenotype, Racial Groups, Statistics, Nonparametric, White People}, issn = {1471-2156}, doi = {10.1186/s12863-015-0274-0}, author = {Erin B Ware and Mukherjee, Bhramar and Yan V Sun and Ana V. Diez-Roux and Sharon L R Kardia} } @article {8617, title = {Comprehensive gene- and pathway-based analysis of depressive symptoms in older adults.}, journal = {J Alzheimers Dis}, volume = {45}, year = {2015}, month = {2015}, pages = {1197-206}, abstract = {

Depressive symptoms are common in older adults and are particularly prevalent in those with or at elevated risk for dementia. Although the heritability of depression is estimated to be substantial, single nucleotide polymorphism-based genome-wide association studies of depressive symptoms have had limited success. In this study, we performed genome-wide gene- and pathway-based analyses of depressive symptom burden. Study participants included non-Hispanic Caucasian subjects (n = 6,884) from three independent cohorts, the Alzheimer{\textquoteright}s Disease Neuroimaging Initiative (ADNI), the Health and Retirement Study (HRS), and the Indiana Memory and Aging Study (IMAS). Gene-based meta-analysis identified genome-wide significant associations (ANGPT4 and FAM110A, q-value = 0.026; GRM7-AS3 and LRFN5, q-value = 0.042). Pathway analysis revealed enrichment of association in 105 pathways, including multiple pathways related to ERK/MAPK signaling, GSK3 signaling in bipolar disorder, cell development, and immune activation and inflammation. GRM7, ANGPT4, and LRFN5 have been previously implicated in psychiatric disorders, including the GRM7 region displaying association with major depressive disorder. The ERK/MAPK signaling pathway is a known target of antidepressant drugs and has important roles in neuronal plasticity, and GSK3 signaling has been previously implicated in Alzheimer{\textquoteright}s disease and as a promising therapeutic target for depression. Our results warrant further investigation in independent and larger cohorts and add to the growing understanding of the genetics and pathobiology of depressive symptoms in aging and neurodegenerative disorders. In particular, the genes and pathways demonstrating association with depressive symptoms may be potential therapeutic targets for these symptoms in older adults.

}, keywords = {Aged, Cohort Studies, depression, European Continental Ancestry Group, Female, Genotyping Techniques, Humans, Male, Psychiatric Status Rating Scales}, issn = {1875-8908}, doi = {10.3233/JAD-148009}, author = {Nho, Kwangsik and Vijay K Ramanan and Horgusluoglu, Emrin and Sungeun Kim and Mark H Inlow and Shannon L Risacher and Brenna C McDonald and Martin R Farlow and Tatiana Foroud and Gao, Sujuan and Christopher M. Callahan and Hugh C Hendrie and Alexander B Niculescu and Andrew J Saykin} } @article {8207, title = {Depressive symptoms, psychiatric medication use, and risk of type 2 diabetes: results from the Health and Retirement Study.}, journal = {Gen Hosp Psychiatry}, volume = {37}, year = {2015}, month = {2015 Sep-Oct}, pages = {420-6}, publisher = {37}, abstract = {

OBJECTIVE: This prospective study investigates the relationships between depressive symptoms, psychiatric medication use, and their interaction on risk of developing type 2 diabetes.

METHOD: Data come from the 1998-2010 waves of the Health and Retirement Study, a US nationally representative cohort of adults aged 51 years and older. Analysis is restricted to participants <65 years old who did not have diabetes in 1998 (N=8704). Depressive symptoms were assessed using the 8-item Center for Epidemiologic Studies-Depression Scale. Risk of diabetes over the 12-year follow-up period was assessed using Cox proportional hazard models with time-varying covariates.

RESULTS: After adjusting for covariates, both depressive symptoms [hazard ratio (HR): 1.06, 95\% confidence interval (CI): 1.02-1.09] and psychiatric medication use (HR: 1.57, 95\% CI: 1.25-1.96) were associated with development of diabetes. The interaction between depressive symptoms and medication use was significant (beta=-0.240, P=.049), indicating that the association between elevated depressive symptoms and diabetes was higher among respondents not taking medications. The associations between depressive symptoms and medication use were also attenuated by increasing body mass index.

CONCLUSION: Findings highlight the complex relationship between depressive symptoms and psychiatric medications on diabetes risk and the need for a nuanced understanding of these factors.

}, keywords = {Antidepressive Agents, Cohort Studies, depression, Diabetes Mellitus, Type 2, Female, Humans, Male, Middle Aged, Risk Assessment, Surveys and Questionnaires}, issn = {1873-7714}, doi = {10.1016/j.genhosppsych.2015.05.008}, url = {http://www.sciencedirect.com/science/article/pii/S0163834315001334}, author = {Scott M Ratliff and Briana Mezuk} } @article {8205, title = {Historical improvements in well-being do not hold in late life: Birth- and death-year cohorts in the United States and Germany.}, journal = {Dev Psychol}, volume = {51}, year = {2015}, note = {Times Cited: 0 0}, month = {2015 Jul}, pages = {998-1012}, publisher = {51}, abstract = {

One key objective of life span research is to examine how individual development is shaped by the historical time people live in. Secular trends favoring later-born cohorts on fluid cognitive abilities have been widely documented, but findings are mixed for well-being. It remains an open question whether secular increases in well-being seen in earlier phases of life also manifest in the last years of life. To examine this possibility, we made use of longitudinal data obtained from the mid-1980s until the late 2000s in 2 large national samples in the United States (Health and Retirement Study [HRS]) and Germany (German Socio-Economic Panel [SOEP]). We operationally defined historical time from 2 complementary perspectives: birth-year cohorts based on the years in which people were born (earlier: 1930s vs. later: 1940s) and death-year cohorts based on the years in which people died (earlier: 1990s vs. later: 2000s). To control for relevant covariates, we used case-matched groups based on age (at death) and education and covaried for gender, health, and number of observations. Results from both countries revealed that well-being in old age was indeed developing at higher levels among later-born cohorts. However, for later-deceased cohorts, no evidence for secular increases in well-being was found. To the contrary, later-dying SOEP participants reported lower levels of well-being at age 75 and 2 years prior to death and experienced steeper late-life declines. Our results suggest that secular increases in well-being observed in old age do not manifest in late life, where "manufactured" survival may be exacerbating age- and mortality-related declines.

}, keywords = {Aged, Aging, Cohort Effect, depression, Epidemiologic Research Design, Female, Germany, Health Status, Health Surveys, Humans, Longitudinal Studies, Male, Propensity Score, United States}, issn = {1939-0599}, doi = {10.1037/a0039349}, author = {H{\"u}l{\"u}r, Gizem and Ram, Nilam and Denis Gerstorf} } @article {8176, title = {The "long arm" of childhood health: linking childhood disability to late midlife mental health.}, journal = {Res Aging}, volume = {37}, year = {2015}, month = {2015 Jan}, pages = {82-102}, publisher = {37}, abstract = {

A growing body of research underscores the early origins of health in later life; however, relatively little is known about the relationship between childhood physical health and adult mental health. This research explores the relationship between childhood disability and depressive symptoms among a nationally representative sample of late midlife adults (N = 3,572). Using data from Waves 8-10 (2006-2010) of the Health and Retirement Study, a series of ordinary least squares regression models were created to assess the number of depressive symptoms. Childhood disability was significantly associated with higher levels of depressive symptoms; however, late midlife social and health factors accounted for differences between those with and without childhood disability. Late midlife physical health appeared to be a particularly salient mediator. Individuals who experience childhood disability may accumulate more physical impairment over the life course, thus experiencing worse mental health such as greater depressive symptoms in late midlife.

}, keywords = {Child, depression, Female, Health Status, Humans, Male, Middle Aged, Risk Factors, Surveys and Questionnaires, Time Factors, United States}, issn = {1552-7573}, doi = {10.1177/0164027514522276}, url = {http://roa.sagepub.com/content/early/2014/02/23/0164027514522276.abstract}, author = {Kenzie Latham} } @article {8615, title = {Polygenic risk, stressful life events and depressive symptoms in older adults: a polygenic score analysis.}, journal = {Psychol Med}, volume = {45}, year = {2015}, month = {2015 Jun}, pages = {1709-20}, abstract = {

BACKGROUND: Previous studies suggest that the relationship between genetic risk and depression may be moderated by stressful life events (SLEs). The goal of this study was to assess whether SLEs moderate the association between polygenic risk of major depressive disorder (MDD) and depressive symptoms in older adults.

METHOD: We used logistic and negative binomial regressions to assess the associations between polygenic risk, SLEs and depressive symptoms in a sample of 8761 participants from the Health and Retirement Study. Polygenic scores were derived from the Psychiatric Genomics Consortium genome-wide association study of MDD. SLEs were operationalized as a dichotomous variable indicating whether participants had experienced at least one stressful event during the previous 2 years. Depressive symptoms were measured using an eight-item Center for Epidemiologic Studies Depression Scale subscale and operationalized as both a dichotomous and a count variable.

RESULTS: The odds of reporting four or more depressive symptoms were over twice as high among individuals who experienced at least one SLE (odds ratio 2.19, 95\% confidence interval 1.86-2.58). Polygenic scores were significantly associated with depressive symptoms (β = 0.21, p ⩽ 0.0001), although the variance explained was modest (pseudo r 2 = 0.0095). None of the interaction terms for polygenic scores and SLEs was statistically significant.

CONCLUSIONS: Polygenic risk and SLEs are robust, independent predictors of depressive symptoms in older adults. Consistent with an additive model, we found no evidence that SLEs moderated the association between common variant polygenic risk and depressive symptoms.

}, keywords = {depression, Depressive Disorder, Major, Female, Genetic Predisposition to Disease, Humans, Life Change Events, Male, Middle Aged, Multifactorial Inheritance, Odds Ratio, Risk Factors, United States}, issn = {1469-8978}, doi = {10.1017/S0033291714002839}, author = {Musliner, Katherine L. and Seiffudin, Fayaz and Judy, J. A. and Pirooznia, Mehdi and Goes, Fernando S. and Zandi, Peter P.} } @article {8302, title = {Spouses and depressive symptoms in older adulthood.}, journal = {Sci Rep}, volume = {5}, year = {2015}, note = {Times Cited: 0 0}, month = {2015 Feb 26}, pages = {8594}, publisher = {5}, abstract = {

Depressive symptoms may co-occur within couples and follow similar trajectories, but relatively little is known about this process in old age. This study thus examined the association between some spousal characteristics (spouse{\textquoteright}s depressive symptoms, age difference between spouses) and the trajectory of depressive symptoms in older adults. Participants >= 65 years old were drawn from the Health and Retirement Study (N = 12,010; Mean age = 70.60 and 69.16 for target husbands and wives, respectively). Depressive symptoms were measured with a short form of the Center for Epidemiological Studies Depression (CES-D) scale. Hierarchical Linear Modeling was used to model up to 9 assessments of depressive symptoms of target spouses (Mean number of CESD assessments per target spouse = 3, range 1-9). Depressive symptoms between spouses were correlated; convergence over time was modest. For both husbands and wives, having a younger spouse was associated with more depressive symptoms at age 65. These results suggest that there is concordance between spouses{\textquoteright} depressive symptoms and that the age difference between spouses contribute to depressive symptoms as couples enter old age. The association between spouses{\textquoteright} depressive symptoms is nearly as strong as the effect of each decade increase in age.

}, keywords = {Aged, depression, Female, Humans, Longitudinal Studies, Male, Sex Distribution, Spouses}, issn = {2045-2322}, doi = {10.1038/srep08594}, author = {Pradeep, Neeti and Angelina R Sutin} } @article {8239, title = {Substance-use coping and self-rated health among US middle-aged and older adults.}, journal = {Addict Behav}, volume = {42}, year = {2015}, note = {Export Date: 20 January 2015}, month = {2015 Mar}, pages = {96-100}, publisher = {42}, abstract = {

The prevalence of alcohol, drug, and tobacco use among US middle-aged and older adults is increasing. A subset of this population uses substances to cope with stress, but the characteristics of these individuals, and the association between substance-use coping and health outcomes remain unclear. We identified correlates of substance-use coping and measured its association with self-rated health in a community-based sample of adults aged 54-99 in the Health and Retirement Study (HRS). In the 2008 HRS, 1351 participants reported their frequency of prescription/other drug-, alcohol-, and cigarette-use coping with stress and reported self-rated health (excellent/very good, good, or fair/poor); 1201 of these participants also reported self-rated health in 2010. One in six participants frequently used substances to cope. The oldest participants were least likely to engage in frequent alcohol-use coping. Those with elevated depressive symptoms were more likely to frequently engage in cigarette- and prescription/other drug-use coping. In multivariable-adjusted analyses, participants who frequently used cigarettes (compared to participants who infrequently used cigarettes) to cope had 2.7 times (95\% CI=1.1-6.7) the odds of poor (vs. excellent) self-rated health. Relative to participants who infrequently used prescription/other drugs to cope, participants who frequently used prescription/other drugs to cope had 2.4 times (95\% CI=1.1-5.1) the odds of reporting poor self-rated health. The association between prescription/other drug-use coping in 2008 and self-rated health in 2010 was statistically significant (relative OR=3.5, 95\% CI=1.7-7.2). Participants engaging in substance-use coping likely have particular demographic and clinical characteristics. Interventions to reduce substance-use coping may prevent adverse health outcomes.

}, keywords = {Adaptation, Psychological, Aged, Aged, 80 and over, Alcohol Drinking, depression, Female, Health Status, Humans, Male, Middle Aged, Smoking, Substance-Related Disorders, United States}, issn = {1873-6327}, doi = {10.1016/j.addbeh.2014.10.031}, author = {Pia M Mauro and Sarah L. Canham and Silvia S Martins and Adam P Spira} } @article {8162, title = {What can genes tell us about the relationship between education and health?}, journal = {Soc Sci Med}, volume = {127}, year = {2015}, month = {2015 Feb}, pages = {171-80}, publisher = {127}, abstract = {

We use genome wide data from respondents of the Health and Retirement Study (HRS) to evaluate the possibility that common genetic influences are associated with education and three health outcomes: depression, self-rated health, and body mass index. We use a total of 1.7 million single nucleotide polymorphisms obtained from the Illumina HumanOmni2.5-4v1 chip from 4233 non-Hispanic white respondents to characterize genetic similarities among unrelated persons in the HRS. We then used the Genome Wide Complex Trait Analysis (GCTA) toolkit, to estimate univariate and bivariate heritability. We provide evidence that education (h(2)~=~0.33), BMI (h(2)~=~0.43), depression (h(2)~=~0.19), and self-rated health (h(2)~=~0.18) are all moderately heritable phenotypes. We also provide evidence that some of the correlation between depression and education as well as self-rated health and education is due to common genetic factors associated with one or both traits. We find no evidence that the correlation between education and BMI is influenced by common genetic factors.

}, keywords = {Aged, Aged, 80 and over, Body Mass Index, Computer Simulation, depression, Educational Status, Female, Gene-Environment Interaction, Genetic Predisposition to Disease, Genome-Wide Association Study, Health Status, Health Status Disparities, Humans, Male, Phenotype, Polymorphism, Single Nucleotide, Social determinants of health, Socioeconomic factors, White People}, issn = {1873-5347}, doi = {10.1016/j.socscimed.2014.08.001}, url = {http://www.sciencedirect.com/science/article/pii/S0277953614005188}, author = {Jason D Boardman and Benjamin W Domingue and Daw, Jonathan} } @article {8142, title = {Depression and risk of hospitalization for pneumonia in a cohort study of older Americans.}, journal = {J Psychosom Res}, volume = {77}, year = {2014}, note = {Times Cited: 0 0}, month = {2014 Dec}, pages = {528-34}, publisher = {77}, abstract = {

OBJECTIVE: The aim of this study is to determine if depression is independently associated with risk of hospitalization for pneumonia after adjusting for demographics, medical comorbidity, health-risk behaviors, baseline cognition and functional impairments.

METHODS: This secondary analysis of prospectively collected data examined a population-based sample of 6704 Health and Retirement Study (HRS) (1998-2008) participants>50years old who consented to have their interviews linked to their Medicare claims and were without a dementia diagnosis. The eight-item Center for Epidemiologic Studies Depression Scale and/or International Classification of Disease, Ninth Revision, Clinical Modification (ICD-9-CM) depression diagnoses were used to identify baseline depression. ICD-9-CM diagnoses were used to identify hospitalizations for which the principal discharge diagnosis was for bacterial or viral pneumonia. The odds of hospitalization for pneumonia for participants with depression relative to those without depression were estimated using logistic regression models. Population attributable fractions were calculated to determine the extent that hospitalizations for pneumonia could be attributable to depression.

RESULTS: After adjusting for demographic characteristics, clinical factors, and health-risk behaviors, depression was independently associated with increased odds of hospitalization for pneumonia (odds ratio [OR]: 1.28, 95\% confidence interval [95\%CI]: 1.08, 1.53). This association persisted after adjusting for baseline cognition and functional impairments (OR: 1.24, 95\%CI: 1.03, 1.50). In this cohort, 6\% (95\%CI: 2\%, 10\%) of hospitalizations for pneumonia were potentially attributable to depression.

CONCLUSION: Depression is independently associated with increased odds of hospitalization for pneumonia. This study provides additional rationale for integrating mental health care into medical settings in order to improve outcomes for older adults.

}, keywords = {Aged, Aged, 80 and over, Cohort Studies, Comorbidity, depression, Depressive Disorder, Female, Hospitalization, Humans, Logistic Models, Male, Middle Aged, Odds Ratio, Pneumonia, Risk Assessment, Risk Factors, United States}, issn = {1879-1360}, doi = {10.1016/j.jpsychores.2014.08.002}, author = {Dimitry S Davydow and Catherine L Hough and Zivin, Kara and Kenneth M. Langa and Wayne J Katon} } @article {7982, title = {Does duration of spousal caregiving affect risk of depression onset? Evidence from the Health and Retirement Study.}, journal = {Am J Geriatr Psychiatry}, volume = {22}, year = {2014}, note = {Times Cited: 0}, month = {2014 Aug}, pages = {766-70}, publisher = {22}, abstract = {

OBJECTIVES: To assess the association of current and long-term spousal caregiving with risk of depression in a nationally (U.S.) representative sample of older adults.

METHODS: We studied married and depression-free Health and Retirement Study respondents aged 50 years and older (n~= 9,420) at baseline from 2000 to 2010. Current (>=14 hours per week of help with instrumental/activities of daily living for a spouse in the most recent biennial survey) and long-term caregiving (care at two consecutive surveys) were used to predict onset of elevated depressive symptoms (>=3 on a modified Centers for Epidemiologic Studies Depression scale) with discrete-time hazards models and time-updated exposure and covariate information.

RESULTS: Current caregiving was associated with significant elevations in risk of depression onset (hazard ratio: 1.64; Wald χ(2), 1 df: 28.34; p~<0.0001). Effect estimates for long-term caregiving were similar (hazard ratio: 1.52, Wald χ(2), 1 df: 3.63; p~= 0.06).

CONCLUSIONS: Current spousal caregiving significantly predicted onset of depression; the association was not exacerbated by longer duration of caregiving.

}, keywords = {Aged, Caregivers, depression, Female, Health Surveys, Humans, Longitudinal Studies, Male, Middle Aged, Retirement, Risk Factors, Spouses, Time Factors, United States}, issn = {1545-7214}, doi = {10.1016/j.jagp.2013.01.073}, author = {Benjamin D Capistrant and Lisa F Berkman and M. Maria Glymour} } @article {8105, title = {Dysphoria and anhedonia as risk factors for disability or death in older persons: implications for the assessment of geriatric depression.}, journal = {Am J Geriatr Psychiatry}, volume = {22}, year = {2014}, note = {Times Cited: 0}, month = {2014 Jun}, pages = {606-13}, publisher = {22}, abstract = {

OBJECTIVES: Either dysphoria (sadness) or anhedonia (loss of interest in usually pleasurable activities) is required for a diagnosis of major depression. Although major depression is a known risk factor for disability in older persons, few studies have examined the relationship between the two core symptoms of major depression and disability or mortality. Our objective was to examine the relationship between these two core symptoms and time to disability or death.

METHODS: In a longitudinal cohort study, we used the nationally representative Health and Retirement Study to examine this relationship in 11,353 persons older than 62 years (mean: 73 years) followed for up to 13 years. Dysphoria and anhedonia were assessed with the Short Form Composite International Diagnostic Interview. Our outcome measure was time to either death or increased disability, defined as the new need for help in a basic activity of daily living. We adjusted for a validated disability risk index and other confounders.

RESULTS: Compared with subjects without either dysphoria or anhedonia, the risk for disability or death was not elevated in elders with dysphoria without anhedonia (adjusted hazard ratio [HR]: 1.11; 95\% confidence interval [CI]: 0.91-1.36). The risk was elevated in those with anhedonia without dysphoria (HR: 1.30; 95\% CI: 1.06-1.60) and those with both anhedonia and dysphoria (HR: 1.28; 95\% CI: 1.13-1.46).

CONCLUSION: Our results highlight the need for clinicians to learn whether patients have lost interest in usually pleasurable activities, even if they deny sadness.

}, keywords = {Age Factors, Aged, Aged, 80 and over, Anhedonia, depression, Disabled Persons, Female, Humans, Interview, Psychological, Longitudinal Studies, Male, Middle Aged, Mortality, Risk Factors}, issn = {1545-7214}, doi = {10.1016/j.jagp.2012.12.001}, author = {Kenneth E Covinsky and Irena Cenzer and Kristine Yaffe and Sarah O{\textquoteright}Brien and Dan G. Blazer} } @article {8098, title = {Longitudinal predictors of self-rated health and mortality in older adults.}, journal = {Prev Chronic Dis}, volume = {11}, year = {2014}, note = {Times Cited: 0}, month = {2014 Jun 05}, pages = {E93}, publisher = {11}, abstract = {

INTRODUCTION: Few studies have compared the effects of demographic, cognitive, and behavioral factors of health and mortality longitudinally. We examined predictors of self-rated health and mortality at 3 points, each 2 years apart, over 4 years.

METHODS: We used data from the 2006 wave of the Health and Retirement Study and health and mortality indicators from 2006, 2008, and 2010. We analyzed data from 17,930 adults (aged 50-104 y) to examine predictors of self-rated health and data from a subgroup of 1,171 adults who died from 2006 through 2010 to examine predictors of mortality.

RESULTS: Time 1 depression was the strongest predictor of self-rated health at all points, independent of age and education. Education, mild activities, body mass index, delayed word recall, and smoking were all associated with self-rated health at each point and predicted mortality. Delayed word recall mediated the relationships of mild activity with health and mortality. Bidirectional mediation was found for the effects of mild activity and depression on health.

CONCLUSION: Medical professionals should consider screening for depression and memory difficulties in addition to conducting medical assessments. These assessments could lead to more effective biopsychosocial interventions to help older adults manage risks for mortality.

}, keywords = {Age Factors, Aged, Aged, 80 and over, Body Mass Index, Chronic disease, depression, Educational Status, Female, Health Behavior, Health Status Indicators, Humans, Longitudinal Studies, Male, Mental Recall, Middle Aged, Proportional Hazards Models, Psychometrics, Retirement, Self Report, Survival Analysis, United States}, issn = {1545-1151}, doi = {10.5888/pcd11.130241}, author = {Diane C Wagner and Jerome L Short} } @article {7967, title = {Neuropsychiatric disorders and potentially preventable hospitalizations in a prospective cohort study of older Americans.}, journal = {J Gen Intern Med}, volume = {29}, year = {2014}, note = {Export Date: 6 August 2014 Article in Press}, month = {2014 Oct}, pages = {1362-71}, publisher = {29}, abstract = {

BACKGROUND: The relative contributions of depression, cognitive impairment without dementia (CIND), and dementia to the risk of potentially preventable hospitalizations in older adults are not well understood.

OBJECTIVE(S): To determine if depression, CIND, and/or dementia are each independently associated with hospitalizations for ambulatory care-sensitive conditions (ACSCs) and rehospitalizations within 30 days after hospitalization for pneumonia, congestive heart failure (CHF), or myocardial infarction (MI).

DESIGN: Prospective cohort study.

PARTICIPANTS: Population-based sample of 7,031 Americans > 50 years old participating in the Health and Retirement Study (1998-2008).

MAIN MEASURES: The eight-item Center for Epidemiologic Studies Depression Scale and/or International Classification of Disease, Ninth Revision, Clinical Modification (ICD-9-CM) depression diagnoses were used to identify baseline depression. The Modified Telephone Interview for Cognitive Status and/or ICD-9-CM dementia diagnoses were used to identify baseline CIND or dementia. Primary outcomes were time to hospitalization for an ACSC and presence of a hospitalization within 30 days after hospitalization for pneumonia, CHF, or MI.

KEY RESULTS: All five categories of baseline neuropsychiatric disorder status were independently associated with increased risk of hospitalization for an ACSC (depression alone: Hazard Ratio [HR]: 1.33, 95\% Confidence Interval [95\%CI]: 1.18, 1.52; CIND alone: HR: 1.25, 95\%CI: 1.10, 1.41; dementia alone: HR: 1.32, 95\%CI: 1.12, 1.55; comorbid depression and CIND: HR: 1.43, 95\%CI: 1.20, 1.69; comorbid depression and dementia: HR: 1.66, 95\%CI: 1.38, 2.00). Depression (Odds Ratio [OR]: 1.37, 95\%CI: 1.01, 1.84), comorbid depression and CIND (OR: 1.98, 95\%CI: 1.40, 2.81), or comorbid depression and dementia (OR: 1.58, 95\%CI: 1.06, 2.35) were independently associated with increased odds of rehospitalization within 30 days after hospitalization for pneumonia, CHF, or MI.

CONCLUSIONS: Depression, CIND, and dementia are each independently associated with potentially preventable hospitalizations in older Americans. Older adults with comorbid depression and cognitive impairment represent a particularly at-risk group that could benefit from targeted interventions.

}, keywords = {Aged, Aged, 80 and over, Cognition Disorders, Cohort Studies, Dementia, depression, Female, Hospitalization, Humans, Male, Mental Disorders, Prospective Studies, Risk Factors, United States}, issn = {1525-1497}, doi = {10.1007/s11606-014-2916-8}, author = {Dimitry S Davydow and Zivin, Kara and Wayne J Katon and Gregory M Pontone and Lydia Chwastiak and Kenneth M. Langa and Theodore J Iwashyna} } @article {7806, title = {Adults with cardiovascular disease who help others: a prospective study of health outcomes.}, journal = {J Behav Med}, volume = {36}, year = {2013}, note = {Copyright - Springer Science Business Media New York 2013 Last updated - 2013-04-30 DOI - 2922261571; 76454332; 69709; BVMD; 22481214; SPVLBVMD108653629414}, month = {2013 Apr}, pages = {199-211}, publisher = {36}, abstract = {

Little is known about the health impact of helping behaviors among individuals with high-risk chronic diseases such as cardiovascular disease (CVD). Using a nationally representative, longitudinal survey, we examined the subsequent health of adults with CVD (n~=~4,491) who spent time providing non-paid assistance to family and friends outside of their households compared with those who had provided no assistance. After both adjusting for baseline characteristics and using propensity score matching methods, spending up to 200~h over the prior 12~months helping others was associated with lower odds of experiencing a new CVD event or dying in the subsequent 2~years. Providing up to 100~h of assistance was associated with reporting fewer depressive symptoms. This threshold effect raises the question of whether assistance beyond a certain number of hours may impose a burden that mitigates health benefits from helping others. Health care providers could play an important role exploring ways that patients with CVD can provide beneficial levels of assistance to others in their own social networks or communities, thereby possibly also improving their own health.

}, keywords = {Activities of Daily Living, Aged, Cardiovascular Diseases, depression, Female, Health Status, Helping Behavior, Humans, Longitudinal Studies, Male, Middle Aged, Prospective Studies, Time Factors}, issn = {1573-3521}, doi = {10.1007/s10865-012-9414-4}, url = {http://search.proquest.com.proxy.lib.umich.edu/docview/1318045378?accountid=14667}, author = {Michele M Heisler and Choi, Hwajung and John D Piette and Ann Marie Rosland and Kenneth M. Langa and Stephanie Brown} } @article {7796, title = {Does the association between depressive symptoms and cardiovascular mortality risk vary by race? Evidence from the Health and Retirement Study.}, journal = {Ethn Dis}, volume = {23}, year = {2013}, month = {2013 Spring}, pages = {155-60}, publisher = {23}, abstract = {

OBJECTIVE: To test whether the association between depressive symptoms and cardiovascular disease (CVD) mortality is stronger among Blacks than Whites.

DESIGN, SETTING AND PARTICIPANTS: 2,638 Black and 15,132 White participants from a prospective, observational study of community-dwelling Health and Retirement Study participants (a nationally representative sample of U.S. adults aged > or = 50). Average follow-up was 9.2 years.

OUTCOME MEASURE: Cause of death (per ICD codes) and month of death were identified from National Death Index linkages.

METHODS: The associations between elevated depressive symptoms and mortality from stroke, ischemic heart disease (IHD), or total CVD were assessed using Cox proportional hazards models to estimate adjusted hazard ratios (HRs). We used interaction terms for race by depressive symptoms to assess effect modification (multiplicative scale).

RESULTS: For both Whites and Blacks, depressive symptoms were associated with a significantly elevated hazard of total CVD mortality (Whites: HR=1.46; 95\% CI: 1.33, 1.61; Blacks: HR=1.42, 95\% CI: 1.10, 1.83). Adjusting for health and socioeconomic covariates, Whites with elevated depressive symptoms had a 13\% excess hazard of CVD mortality (HR=1.13, 95\% CI: 1.03, 1.25) compared to Whites without elevated depressive symptoms. The HR in Blacks was similar, although the confidence interval included the null (HR=1.12, 95\% CI: .86, 1.46). The hazard associated with elevated depressive symptoms did not differ significantly by race (P>.15 for all comparisons). Patterns were similar in analyses restricted to respondents age > or =65.

CONCLUSION: Clinicians should consider the depressive state of either Black or White patients as a potential CVD mortality risk factor.

}, keywords = {Aged, Black or African American, Cardiovascular Diseases, depression, Female, Humans, Male, Middle Aged, Proportional Hazards Models, Risk Assessment, Risk Factors, White People}, issn = {1049-510X}, author = {Benjamin D Capistrant and Paola Gilsanz and J Robin Moon and Anna Kosheleva and Kristen K Patton and M. Maria Glymour} } @article {7801, title = {Functional disability, cognitive impairment, and depression after hospitalization for pneumonia.}, journal = {Am J Med}, volume = {126}, year = {2013}, month = {2013 Jul}, pages = {615-24.e5}, abstract = {

OBJECTIVE: The study objective was to examine whether hospitalization for pneumonia is associated with functional decline, cognitive impairment, and depression, and to compare this impairment with that seen after known disabling conditions, such as myocardial infarction or stroke.

METHODS: We used data from a prospective cohort of 1434 adults aged more than 50 years who survived 1711 hospitalizations for pneumonia, myocardial infarction, or stroke drawn from the Health and Retirement Study (1998-2010). Main outcome measures included the number of Activities and Instrumental Activities of Daily Living requiring assistance and the presence of cognitive impairment and substantial depressive symptoms.

RESULTS: Hospitalization for pneumonia was associated with 1.01 new impairments in Activities and Instrumental Activities of Daily Living (95\% confidence interval [CI], 0.71-1.32) among patients without baseline functional impairment and 0.99 new impairments in Activities and Instrumental Activities of Daily Living (95\% CI, 0.57-1.41) among those with mild-to-moderate baseline limitations, as well as moderate-to-severe cognitive impairment (odds ratio, 2.46; 95\% CI, 1.60-3.79) and substantial depressive symptoms (odds ratio, 1.63; 95\% CI, 1.06-2.51). Patients without baseline functional impairment who survived pneumonia hospitalization had more subsequent impairments in Activities and Instrumental Activities of Daily Living than those who survived myocardial infarction hospitalization. There were no significant differences in subsequent moderate-to-severe cognitive impairment or substantial depressive symptoms between patients who survived myocardial infarction or stroke and those who survived pneumonia.

CONCLUSIONS: Hospitalization for pneumonia in older adults is associated with subsequent functional and cognitive impairment. Improved pneumonia prevention and interventions to ameliorate adverse sequelae during and after hospitalization may improve outcomes.

}, keywords = {Activities of Daily Living, Aged, Aged, 80 and over, Cognitive Dysfunction, depression, Hospitalization, Humans, Logistic Models, Longitudinal Studies, Middle Aged, Myocardial Infarction, Pneumonia, Stroke}, issn = {1555-7162}, doi = {10.1016/j.amjmed.2012.12.006}, author = {Dimitry S Davydow and Catherine L Hough and Deborah A Levine and Kenneth M. Langa and Theodore J Iwashyna} } @article {7936, title = {Heterogeneity in multidimensional health trajectories of late old years and socioeconomic stratification: a latent trajectory class analysis.}, journal = {J Gerontol B Psychol Sci Soc Sci}, volume = {68}, year = {2013}, month = {2013 Mar}, pages = {290-7}, publisher = {68}, abstract = {

OBJECTIVES: This study examines (a) the heterogeneity in individual multidimensional health trajectories and (b) the socioeconomic stratification of individual multidimensional health trajectories during the late older years.

METHOD: This study used prospective data from 1,945 adults, 75 to 85 years old, collected over an 8-year period from the Health and Retirement Study. To examine inconsistent findings in the research literature, a latent trajectory class analysis was performed.

RESULTS: Multidimensional overall health trajectories showed three heterogeneous latent classes (maintaining, persistently high, and deteriorating), and profiles of ascribed and achieved socioeconomic characteristics of multidimensional health trajectory classes showed a significant social and racial/ethnic stratification in late older years.

DISCUSSION: Past adverse socioeconomic circumstances, including childhood and adulthood adversity, are potential sources of unobserved heterogeneity of multidimensional health trajectories even in late older years. The identification of members of latent trajectory health classes and the associated antecedents linked to health class membership are consistent with a life-course conceptual framework. Thus, multidimensional health capturing the full range of health problems needs to be investigated for proper examination of socioeconomic correlates of health. This facilitates the understanding of the associations between life-course experiences and health in late old age that ultimately have implications for prevention and intervention.

}, keywords = {Activities of Daily Living, Age Factors, Aged, Aged, 80 and over, depression, Female, Health Status, Health Transition, Humans, Longitudinal Studies, Male, Marriage, Memory Disorders, Middle Aged, Socioeconomic factors}, issn = {1758-5368}, doi = {10.1093/geronb/gbs111}, url = {http://psychsocgerontology.oxfordjournals.org/content/68/2/290.full.pdf html}, author = {Kandauda Wickrama and Jay A. Mancini and Kwag, Kyunghwa and Kwon, Josephine} } @article {7839, title = {Symptoms of depression in survivors of severe sepsis: a prospective cohort study of older Americans.}, journal = {Am J Geriatr Psychiatry}, volume = {21}, year = {2013}, month = {2013 Sep}, pages = {887-97}, publisher = {21}, abstract = {

OBJECTIVES: To examine if incident severe sepsis is associated with increased risk of subsequent depressive symptoms and to assess which patient characteristics are associated with increased risk of depressive symptoms.

DESIGN: Prospective longitudinal cohort study.

SETTING: Population-based cohort of older U.S. adults interviewed as part of the Health and Retirement Study (1998-2006).

PARTICIPANTS: A total of 439 patients who survived 471 hospitalizations for severe sepsis and completed at least one follow-up interview.

MEASUREMENTS: Depressive symptoms were assessed with a modified version of the Center for Epidemiologic Studies Depression Scale. Severe sepsis was identified using a validated algorithm in Medicare claims.

RESULTS: The point prevalence of substantial depressive symptoms was 28\% at a median of 1.2~years before sepsis, and remained 28\% at a median of 0.9 years after sepsis. Neither incident severe sepsis (relative risk [RR]: 1.00; 95\% confidence interval [CI]:~0.73, 1.34) nor severe sepsis-related clinical characteristics were significantly associated with subsequent depressive symptoms. These results were robust to potential threats from missing data or alternative outcome definitions. After adjustment, presepsis substantial depressive symptoms (RR: 2.20; 95\% CI: 1.66, 2.90) and worse postsepsis functional impairment (RR: 1.08 per new limitation; 95\% CI: 1.03, 1.13) were independently associated with substantial depressive symptoms after sepsis.

CONCLUSIONS: The prevalence of substantial depressive symptoms in severe sepsis survivors is high but is not increased relative to their presepsis levels. Identifying this large subset of severe sepsis survivors at increased risk for major depression, and beginning interventions before hospital discharge, may improve outcomes.

}, keywords = {Aged, Aged, 80 and over, Cohort Studies, depression, Female, Hospitalization, Humans, Longitudinal Studies, Male, Poisson Distribution, Prospective Studies, Regression Analysis, Risk Factors, Sepsis, Severity of Illness Index, Survivors, United States}, issn = {1545-7214}, doi = {10.1016/j.jagp.2013.01.017}, author = {Dimitry S Davydow and Catherine L Hough and Kenneth M. Langa and Theodore J Iwashyna} } @article {7911, title = {Trends in depressive symptom burden among older adults in the United States from 1998 to 2008.}, journal = {J Gen Intern Med}, volume = {28}, year = {2013}, month = {2013 Dec}, pages = {1611-9}, publisher = {28}, abstract = {

CONTEXT: Diagnosis and treatment of depression has increased over the past decade in the United States. Whether self-reported depressive symptoms among older adults have concomitantly declined is unknown.

OBJECTIVE: To examine trends in depressive symptoms among older adults in the US between 1998 and 2008.

DESIGN: Serial cross-sectional analysis of six biennial assessments.

SETTING: Health and Retirement Study (HRS), a nationally-representative survey. PATIENTS OR OTHER PARTICIPANTS Adults aged 55 and older (N = 16,184 in 1998).

MAIN OUTCOME MEASURE: The eight-item Center for Epidemiologic Studies Depression scale (CES-D8) assessed three levels of depressive symptoms (none = 0, elevated = 4+, severe = 6+), adjusting for demographic and clinical characteristics.

RESULTS: Having no depressive symptoms increased over the 10-year period from 40.9~\% to 47.4~\% (prevalence ratio [PR]: 1.16, 95 \% CI: 1.13-1.19), with significant increases in those aged >= 60 relative to those aged 55-59. There was a 7~\% prevalence reduction of elevated symptoms from 15.5~\% to 14.2~\% (PR: 0.93, 95 \% CI: 0.88-0.98), which was most pronounced among those aged 80-84 in whom the prevalence of elevated symptoms declined from 14.3~\% to 9.6~\%. Prevalence of having severe depressive symptoms increased from 5.8~\% to 6.8~\% (PR: 1.17, 95 \% CI: 1.06-1.28); however, this increase was limited to those aged 55-59, with the probability of severe symptoms increasing from 8.7~\% to 11.8~\%. No significant changes in severe symptoms were observed for those aged >= 60.

CONCLUSIONS: Overall late-life depressive symptom burden declined significantly from 1998 to 2008. This decrease appeared to be driven primarily by greater reductions in depressive symptoms in the oldest-old, and by an increase in those with no depressive symptoms. These changes in symptom burden were robust to physical, functional, demographic, and economic factors. Future research should examine whether this decrease in depressive symptoms is associated with improved treatment outcomes, and if there have been changes in the treatment received for the various age cohorts.

}, keywords = {Age Factors, Aged, Aged, 80 and over, Cohort Studies, Cost of Illness, Cross-Sectional Studies, depression, Female, Humans, Male, Middle Aged, United States}, issn = {1525-1497}, doi = {10.1007/s11606-013-2533-y}, author = {Zivin, Kara and Paul A Pirraglia and Ryan J McCammon and Kenneth M. Langa and Sandeep Vijan} } @article {7880, title = {Urban neighbourhood unemployment history and depressive symptoms over time among late middle age and older adults.}, journal = {J Epidemiol Community Health}, volume = {67}, year = {2013}, month = {2013 Feb}, pages = {153-8}, publisher = {67}, abstract = {

BACKGROUND: Little is known about how a neighbourhood{\textquoteright}s unemployment history may set the stage for depressive symptomatology. This study examines the effects of urban neighbourhood unemployment history on current depressive symptoms and subsequent symptom trajectories among residentially stable late middle age and older adults. Contingent effects between neighbourhood unemployment and individual-level employment status (ie, cross-level interactions) are also assessed.

METHODS: Individual-level survey data are from four waves (2000, 2002, 2004 and 2006) of the original cohort of the nationally representative US Health and Retirement Study. Neighbourhoods are operationalised with US Census tracts for which historical average proportion unemployed between 1990 and 2000 and change in proportion unemployed between 1990 and 2000 are used to characterise the neighbourhood{\textquoteright}s unemployment history. Hierarchical linear regressions estimate three-level (time, individual and neighbourhood) growth models.

RESULTS: Symptoms in 2000 are highest among those residing in neighbourhoods characterised by high historical average unemployment beginning in 1990 and increasing unemployment between 1990 and 2000, net of a wide range of socio-demographic controls including individual-level employment status. These neighbourhood unemployment effects are not contingent upon individual-level employment status in 2000. 6-year trajectories of depressive symptoms decrease over time on average but are not significantly influenced by the neighbourhood{\textquoteright}s unemployment history.

CONCLUSIONS: Given the current US recession, future studies that do not consider historical employment conditions may underestimate the mental health impact of urban neighbourhood context. The findings suggest that exposure to neighbourhood unemployment earlier in life may be consequential to mental health later in life.

}, keywords = {Age Factors, depression, Female, Humans, Logistic Models, Longitudinal Studies, Male, Middle Aged, Multilevel Analysis, Residence Characteristics, Retirement, Risk Factors, Socioeconomic factors, Stress, Psychological, Surveys and Questionnaires, Time Factors, Unemployment, United States, Urban Population}, issn = {1470-2738}, doi = {10.1136/jech-2012-201537}, author = {Richard G Wight and Carol S Aneshensel and Barrett, Christopher and Michelle J Ko and Joshua Chodosh and Arun S Karlamangla} } @article {7741, title = {Vascular depression: an early warning sign of frailty.}, journal = {Aging Ment Health}, volume = {17}, year = {2013}, month = {2013}, pages = {85-93}, abstract = {

OBJECTIVES: Frailty is a common geriatric disorder associated with activities of daily living (ADL) impairment, hospitalization, and death. Phenomenological evidence suggests that late-life depression (Katz, 2004 ), particularly vascular depression, may be a risk factor for frailty. This study tests that hypothesis.

METHODS: We identified a sample of stroke-free women over the age of 80 from the Health and Retirement Survey. The sample included 984 respondents in 2000 (incidence sample). Of these, 459 were non-frail at baseline and still alive in 2004 (prevalence sample). Frail respondents experienced at least three of the following: wasting, exhaustion, weakness, slowness, and falls. Vascular depression was represented using two dummy variables. The first represented respondents with either high cerebrovascular burden (CVB; at least two cerebrovascular risk factors) or probable depression (score >=3 on the 8-item Center for Epidemiological Studies Depression Scale (CES-D)), and the second represented respondents with both high CVB and probable depression.

RESULTS: At baseline, the prevalence of frailty was 31.5\%. Over four years the incidence of frailty was 31.8\%. After controlling for age, education, ADL and IADL disability, arthritis, pulmonary disorders, cancer, and self-rated health, respondents with either high CVB or probable depression were more likely to be frail at baseline, and those with both were at even higher risk. Of those who were not frail at the 2000 wave, respondents who reported both high CVB and probable depression were more likely to become frail by 2004.

DISCUSSION: These findings suggest that vascular depression is a prodrome for frailty.

}, keywords = {Activities of Daily Living, Aged, Aged, 80 and over, Aging, Cerebrovascular Disorders, depression, Disabled Persons, Female, Follow-Up Studies, Frail Elderly, Geriatric Assessment, Health Status, Humans, Incidence, Logistic Models, Male, Prevalence, Psychiatric Status Rating Scales, Risk Factors, Socioeconomic factors, United States}, issn = {1364-6915}, doi = {10.1080/13607863.2012.692767}, author = {Daniel Paulson and Peter A Lichtenberg} } @article {7944, title = {Work stress and depressive symptoms in older employees: impact of national labour and social policies.}, journal = {BMC Public Health}, volume = {13}, year = {2013}, month = {2013 Nov 21}, pages = {1086}, publisher = {13}, abstract = {

BACKGROUND: Maintaining health and work ability among older employees is a primary target of national labour and social policies (NLSP) in Europe. Depression makes a significant contribution to early retirement, and chronic work-related stress is associated with elevated risks of depression. We test this latter association among older employees and explore to what extent indicators of distinct NLSP modify the association between work stress and depressive symptoms. We choose six indicators, classified in three categories: (1) investment in active labour market policies, (2) employment protection, (3) level of distributive justice.

METHODS: We use data from three longitudinal ageing studies (SHARE, HRS, ELSA) including 5650 men and women in 13 countries. Information on work stress (effort-reward imbalance, low work control) and depressive symptoms (CES-D, EURO-D) was obtained. Six NLSP indicators were selected from OECD databases. Associations of work stress (2004) with depressive symptoms (2006) and their modification by policy indicators were analysed using logistic multilevel models.

RESULTS: Risk of depressive symptoms at follow-up is higher among those experiencing effort-reward imbalance (OR: 1.55 95\% CI 1.27-1.89) and low control (OR: 1.46 95\% CI 1.19-1.79) at work. Interaction terms indicate a modifying effect of a majority of protective NLSP indicators on the strength of associations of effort - reward imbalance with depressive symptoms.

CONCLUSIONS: Work stress is associated with elevated risk of prospective depressive symptoms among older employees from 13 European countries. Protective labour and social policies modify the strength of these associations. If further supported findings may have important policy implications.

}, keywords = {depression, Employment, Europe, Female, Humans, Male, Middle Aged, Psychiatric Status Rating Scales, Public Policy, Risk Factors, Stress, Psychological, Surveys and Questionnaires}, issn = {1471-2458}, doi = {10.1186/1471-2458-13-1086}, author = {Lunau, T. and Morten Wahrendorf and Dragano, N. and Johannes Siegrist} } @article {7838, title = {Is working later in life good or bad for health? An investigation of multiple health outcomes.}, journal = {J Gerontol B Psychol Sci Soc Sci}, volume = {68}, year = {2013}, month = {2013 Sep}, pages = {807-15}, publisher = {68}, abstract = {

OBJECTIVES: To examine the mutual influences between changes in work status and multiple dimensions of health outcomes (immediate memory, physical disability, and depressive symptoms) over later years.

METHODS: We used a subsample of 8,524 older adults who participated in the Health and Retirement Study from 1998 to 2008 and were 62 years or older in 1998 to examine work status and health outcomes after controlling for age and background characteristics.

RESULTS: We present results of cross-lagged auto-regressive models. Work status (level of work) predicted subsequent residual changes in immediate memory over time, whereas immediate memory predicted subsequent residual changes in work status over time, even after controlling for physical disability and depressive symptoms. Similar results were indicated for the associations between work status and physical disability and depressive symptoms over time.

DISCUSSION: Consistent with social causation and social selection traditions, the findings support bi-directional associations among changes in work status (the level of work), immediate memory, physical disability, and depressive symptoms in later years. Practical implications are discussed.

}, keywords = {Activities of Daily Living, Age Factors, Aged, depression, Educational Status, Employment, Female, Health Status, Humans, Longitudinal Studies, Male, Memory, Short-Term, Middle Aged, Neuropsychological tests, Psychiatric Status Rating Scales, Sex Factors}, issn = {1758-5368}, doi = {10.1093/geronb/gbt069}, author = {Kandauda Wickrama and Catherine W. O{\textquoteright}Neal and Kyung H. Kwag and Lee, Tae K.} } @article {7771, title = {Depressive symptoms and psychosocial stress at work among older employees in three continents.}, journal = {Global Health}, volume = {8}, year = {2012}, month = {2012 Jul 20}, pages = {27}, publisher = {8}, abstract = {

BACKGROUND: To assess whether an association of psychosocial stress at work with depressive symptoms among older employees is evident in a set of comparable empirical studies from Europe, North America and Asia.

METHODS: Cross-sectional and longitudinal multivariate regression analyses of data from 4 cohort studies with elder workers (2004 and 2006) testing associations of psychosocial stress at work ({\textquoteright}effort-reward imbalance{\textquoteright}; {\textquoteright}low control{\textquoteright}) with depressive symptoms.

RESULTS: Cross-sectional analyses from 17 countries with 14.236 participants reveal elevated odds ratios of depressive symptoms among people experiencing high work stress compared to those with low or no work stress. Adjusted odds ratios vary from 1.64 (95\% CI 1.02-2.63) in Japan to 1.97 (95\% CI 1.75-2.23) in Europe and 2.28 (95\% CI 1.59-3.28) in the USA. Odds ratios from additional longitudinal analyses (in 13 countries) controlling for baseline depression are smaller, but remain in part significant.

CONCLUSION: Findings indicate that psychosocial stress at work might be a relevant risk factor for depressive symptoms among older employees across countries and continents. This observation may call for global policy efforts to improve quality of work in view of a rapidly aging workforce, in particular in times of economic globalization.

}, keywords = {Asia, Cross-Sectional Studies, Data collection, depression, Europe, Female, Humans, Longitudinal Studies, Male, Middle Aged, North America, Prevalence, Regression Analysis, Risk Factors, Stress, Psychological, Work}, issn = {1744-8603}, doi = {10.1186/1744-8603-8-27}, author = {Johannes Siegrist and Lunau, T. and Morten Wahrendorf and Dragano, N.} } @article {7709, title = {Depressive symptoms in spouses of older patients with severe sepsis.}, journal = {Crit Care Med}, volume = {40}, year = {2012}, month = {2012 Aug}, pages = {2335-41}, abstract = {

OBJECTIVE: To examine whether spouses of patients with severe sepsis are at increased risk for depression independent of the spouse{\textquoteright}s presepsis history, whether this risk differs by sex, and is associated with a sepsis patient{\textquoteright}s disability after hospitalization.

DESIGN: Prospective longitudinal cohort study.

SETTING: Population-based cohort of U.S. adults over 50 yrs old interviewed as part of the Health and Retirement Study (1993-2008).

PATIENTS: Nine hundred twenty-nine patient-spouse dyads comprising 1,212 hospitalizations for severe sepsis.

MEASUREMENTS AND MAIN RESULTS: Severe sepsis was identified using a validated algorithm in Medicare claims. Depression was assessed with a modified version of the Center for Epidemiologic Studies Depression Scale. All analyses were stratified by gender. The prevalence of substantial depressive symptoms in wives of patients with severe sepsis increased by 14 percentage points at the time of severe sepsis (from 20\% at a median of 1.1 yrs presepsis to 34\% at a median of 1 yr postsepsis) with an odds ratio of 3.74 (95\% confidence interval: 2.20, 6.37), in multivariable regression. Husbands had an 8 percentage point increase in the prevalence of substantial depressive symptoms, which was not significant in multivariable regression (odds ratio 1.90, 95\% confidence interval 0.75, 4.71). The increase in depression was not explained by bereavement; women had greater odds of substantial depressive symptoms even when their spouse survived a severe sepsis hospitalization (odds ratio 2.86, 95\% confidence interval 1.06, 7.73). Wives of sepsis survivors who were disabled were more likely to be depressed (odds ratio 1.35 per activities of daily living limitation of sepsis survivor, 95\% confidence interval 1.12, 1.64); however, controlling for patient disability only slightly attenuated the association between sepsis and wives{\textquoteright} depression (odds ratio 2.61, 95\% confidence interval 0.93, 7.38).

CONCLUSIONS: Older women may be at greater risk for depression if their spouse is hospitalized for severe sepsis. Spouses of patients with severe sepsis may benefit from greater support and depression screening, both when their loved one dies and when their loved one survives.

}, keywords = {Age Factors, Aged, depression, Female, Hospitalization, Humans, Male, Multivariate Analysis, Prospective Studies, Psychiatric Status Rating Scales, Sepsis, Sex Factors, Spouses, Time Factors, United States}, issn = {1530-0293}, doi = {10.1097/CCM.0b013e3182536a81}, author = {Dimitry S Davydow and Catherine L Hough and Kenneth M. Langa and Theodore J Iwashyna} } @article {7690, title = {Elevated depressive symptoms and incident stroke in Hispanic, African-American, and White older Americans.}, journal = {J Behav Med}, volume = {35}, year = {2012}, month = {2012 Apr}, pages = {211-20}, publisher = {35}, abstract = {

Although depressive symptoms have been linked to stroke, most research has been in relatively ethnically homogeneous, predominantly white, samples. Using the United States based Health and Retirement Study, we compared the relationships between elevated depressive symptoms and incident first stroke for Hispanic, black, or white/other participants (N~=~18,648) and estimated the corresponding Population Attributable Fractions. The prevalence of elevated depressive symptoms was higher in blacks (27\%) and Hispanics (33\%) than whites/others (18\%). Elevated depressive symptoms prospectively predicted stroke risk in the whites/other group (HR~=~1.53; 95\% CI: 1.36-1.73) and among blacks (HR~=~1.31; 95\% CI: 1.05-1.65). The HR was similar but only marginally statistically significant among Hispanics (HR~=~1.33; 95\% CI: 0.92-1.91). The Population Attributable Fraction, indicating the percent of first strokes that would be prevented if the incident stroke rate in those with elevated depressive symptoms was the same as the rate for those without depressive symptoms, was 8.3\% for whites/others, 7.8\% for blacks, and 10.3\% for Hispanics.

}, keywords = {Age Factors, Aged, Black or African American, depression, Female, Health Surveys, Hispanic or Latino, Humans, Incidence, Longitudinal Studies, Male, Middle Aged, Predictive Value of Tests, Prevalence, Risk Factors, Stroke, United States, White People}, issn = {1573-3521}, doi = {10.1007/s10865-011-9356-2}, author = {M. Maria Glymour and Jessica J. Yen and Anna Kosheleva and J Robin Moon and Benjamin D Capistrant and Kristen K Patton} } @article {7692, title = {Loneliness, health, and mortality in old age: a national longitudinal study.}, journal = {Soc Sci Med}, volume = {74}, year = {2012}, month = {2012 Mar}, pages = {907-14}, publisher = {74}, abstract = {

This study examined the relationship between loneliness, health, and mortality using a U.S. nationally representative sample of 2101 adults aged 50 years and over from the 2002 to 2008 waves of the Health and Retirement Study. We estimated the effect of loneliness at one point on mortality over the subsequent six years, and investigated social relationships, health behaviors, and health outcomes as potential mechanisms through which loneliness affects mortality risk among older Americans. We operationalized health outcomes as depressive symptoms, self-rated health, and functional limitations, and we conceptualized the relationships between loneliness and each health outcome as reciprocal and dynamic. We found that feelings of loneliness were associated with increased mortality risk over a 6-year period, and that this effect was not explained by social relationships or health behaviors but was modestly explained by health outcomes. In cross-lagged panel models that tested the reciprocal prospective effects of loneliness and health, loneliness both affected and was affected by depressive symptoms and functional limitations over time, and had marginal effects on later self-rated health. These population-based data contribute to a growing literature indicating that loneliness is a risk factor for morbidity and mortality and point to potential mechanisms through which this process works.

}, keywords = {Aged, Aged, 80 and over, Aging, Cohort Studies, depression, Female, Health Behavior, Health Status, Humans, Interpersonal Relations, Loneliness, Longitudinal Studies, Male, Middle Aged, Mortality, Social Support, Socioeconomic factors, United States}, issn = {1873-5347}, doi = {10.1016/j.socscimed.2011.11.028}, url = {http://proquest.umi.com.proxy.lib.umich.edu/pqdweb?did=2601961601andFmt=7andclientId=17822andRQT=309andVName=PQD}, author = {Ye Luo and Louise C Hawkley and Linda J. Waite and John T. Cacioppo} } @article {7767, title = {Presepsis depressive symptoms are associated with incident cognitive impairment in survivors of severe sepsis: a prospective cohort study of older Americans.}, journal = {J Am Geriatr Soc}, volume = {60}, year = {2012}, month = {2012 Dec}, pages = {2290-6}, publisher = {60}, abstract = {

OBJECTIVES: To test the hypothesis that presepsis depressive symptoms are associated with risk of new cognitive impairment in survivors of severe sepsis.

DESIGN: Prospective longitudinal cohort study.

SETTING: Population-based cohort of older U.S. adults interviewed as part of the Health and Retirement Study (1998-2006).

PARTICIPANTS: Four hundred forty-seven individuals with normal presepsis cognition who survived 540 hospitalizations for severe sepsis and completed at least one follow-up interview.

MEASUREMENTS: Severe sepsis was identified using a validated algorithm in Medicare claims. Depressive symptoms were assessed prospectively using a modified version of the Center for Epidemiologic Studies Depression Scale. Cognitive function was assessed using versions of the Telephone Interview for Cognitive Status (TICS). Logistic regression with robust standard errors was used to examine associations between substantial depressive symptoms at any interview before sepsis and incident cognitive impairment (mild or moderate to severe cognitive impairment) at any interview after sepsis.

RESULTS: The prevalence of substantial depressive symptoms in participants with normal cognition before sepsis was 38\% (95\% confidence interval (CI) = 34-42\%). After severe sepsis, 18\% (95\% CI = 15-20\%) of survivors had incident cognitive impairment. In unadjusted analyses, presepsis substantial depressive symptoms were associated with postsepsis incident cognitive impairment (odds ratio (OR) = 2.56, 95\% CI = 1.53-4.27). After adjustment for demographics, health-risk behaviors, clinical characteristics of the sepsis episode, and presepsis TICS scores, substantial presepsis depressive symptoms remained the strongest factor associated with postsepsis incident cognitive impairment (OR = 2.58, 95\% CI = 1.45-4.59).

CONCLUSION: Substantial presepsis depressive symptoms are independently associated with incident postsepsis cognitive impairment. Depressed older adults may be particularly at risk of developing cognitive impairment after a serious medical illness.

}, keywords = {Aged, Aged, 80 and over, Cognition Disorders, Cohort Studies, depression, Female, Humans, Longitudinal Studies, Male, Sepsis, Survivors}, issn = {1532-5415}, doi = {10.1111/jgs.12001}, author = {Dimitry S Davydow and Catherine L Hough and Kenneth M. Langa and Theodore J Iwashyna} } @article {7715, title = {Self- and other-oriented potential lifetime traumatic events as predictors of loneliness in the second half of life.}, journal = {Aging Ment Health}, volume = {16}, year = {2012}, month = {2012}, pages = {423-30}, publisher = {16}, abstract = {

OBJECTIVES: This study examined the relationship between self- and other-oriented potential lifetime traumatic events (PLTE) and loneliness at the second half of life.

METHOD: The sample was comprised of 7446 respondents who completed the Health and Retirement Study (HRS) 2006 psychosocial questionnaire. PLTE were classified into self-oriented PLTE, defined as traumatic events that primarily inflict the self (e.g., being abused by parents) and other-oriented PLTE, defined as events that affect the self by primarily targeting others (e.g., death of one{\textquoteright}s child). We evaluated the role of self- and other-oriented PLTE as predictors of loneliness, as evaluated by the short R-UCLA. Analyses were stratified by age at which trauma happened categorized into four life periods (0-17, 18-30, 31-49, 50+).

RESULTS: The results showed that PLTE is positively related to loneliness. Moreover, the number of other-oriented PLTE, and even more pronouncedly self-oriented PLTE, that happened up until adulthood were the strongest predictors of loneliness at the second half of life.

CONCLUSION: The study suggests that self- and other-oriented PLTE reported to have occurred early in life are associated with perceived loneliness in the second half of life.

}, keywords = {Age Factors, Aged, Aged, 80 and over, Child, Child Abuse, Cross-Sectional Studies, depression, Female, Forecasting, Humans, Life Change Events, Loneliness, Male, Middle Aged, Self Psychology, Wounds and Injuries}, issn = {1364-6915}, doi = {10.1080/13607863.2011.638903}, author = {Yuval Palgi and Amit Shrira and Menachem Ben-Ezra and Sharon Shiovitz-Ezra and Liat Ayalon} } @article {7665, title = {Depression and the onset of chronic illness in older adults: a 12-year prospective study.}, journal = {J Behav Health Serv Res}, volume = {38}, year = {2011}, month = {2011 Jul}, pages = {373-82}, publisher = {38}, abstract = {

The relationship between depression and development of chronic illness among older adults is not well understood. This study uses data from the Health and Retirement Study to evaluate the relationship between depression at baseline and new onset of chronic illnesses including cancer, heart problems, arthritis, and diabetes. Analysis controlling for demographics (age, gender, race, education), health risk indicators (BMI and smoking), functional limitations (gross motor index, health limitations for work), and income show that working-age older people (ages 50-62) with depression at baseline are at significantly higher risk to develop diabetes, heart problems, and arthritis during the 12-year follow-up. No significant association was found between depression and cancer. Prevention efforts aimed at chronic illnesses among the elderly should recognize the mind-body interaction and focus on preventing or alleviating depression.

}, keywords = {Activities of Daily Living, Age Distribution, Aged, Chronic disease, depression, Female, Follow-Up Studies, Humans, Male, Middle Aged, Prospective Studies, Psychiatric Status Rating Scales, Risk Factors, Sex Distribution, Socioeconomic factors, United States}, issn = {1556-3308}, doi = {10.1007/s11414-011-9234-2}, author = {Mustafa C. Karakus and Lisa C Patton} } @article {7608, title = {Does informal care attenuate the cycle of ADL/IADL disability and depressive symptoms in late life?}, journal = {J Gerontol B Psychol Sci Soc Sci}, volume = {66}, year = {2011}, month = {2011 Sep}, pages = {585-94}, publisher = {66B}, abstract = {

OBJECTIVE: Prior studies have extensively examined the reciprocal relation between disability and depressive symptoms in late life, but little is known about whether informal care attenuates the reciprocal relation over time. This study examined whether disability and depressive symptoms mobilize informal care and whether informal care, once mobilized, protects older adults against the progression of disability and depressive symptoms.

METHODS: The analysis was based on 6,454 community-dwelling older adults who were interviewed in one or more waves of the Health and Retirement Study between 1998 and 2006. Extending an autoregressive cross-lagged model, we constructed 3 cycles of the relations among disability, depressive symptoms, and informal care. Comparing the relations across 3 cycles informs us about the attenuating effect of informal care on the relation between disability and depressive symptoms over time.

RESULTS: Although older adults{\textquoteright} disability and depressive symptoms mobilized informal care initially, worsening disability and depressive symptoms often exhausted support. Receipt of care generally increased, rather than decreased, disability and depressive symptoms, and the detrimental effects remained the same over time.

DISCUSSION: We need to better understand the linkage between disability and depressive symptoms and seek effective interventions to reduce caregiver strain and enhance care receivers{\textquoteright} well-being.

}, keywords = {Activities of Daily Living, Aged, Aged, 80 and over, Caregivers, Cohort Studies, Cost of Illness, depression, Disability Evaluation, Female, Humans, Longitudinal Studies, Male, Models, Psychological, United States}, issn = {1758-5368}, doi = {10.1093/geronb/gbr060}, author = {Lin, I-Fen and Wu, Hsueh-Sheng} } @article {7605, title = {Dynamic links between memory and functional limitations in old age: longitudinal evidence for age-based structural dynamics from the AHEAD study.}, journal = {Psychol Aging}, volume = {26}, year = {2011}, month = {2011 Sep}, pages = {546-58}, publisher = {26}, abstract = {

This study examined competing substantive hypotheses about dynamic (i.e., time-ordered) links between memory and functional limitations in old age. We applied the Bivariate Dual Change Score Model to 13-year longitudinal data from the Asset and Health Dynamics Among the Oldest Old Study (AHEAD; N = 6,990; ages 70 - 95). Results revealed that better memory predicted shallower increases in functional limitations. Little evidence was found for the opposite direction that functional limitations predict ensuing changes in memory. Spline models indicated that dynamic associations between memory and functional limitations were substantively similar between participants aged 70-79 and those aged 80-95. Potential covariates (gender, education, health conditions, and depressive symptoms) did not account for these differential lead-lag associations. Applying a multivariate approach, our results suggest that late-life developments in two key components of successful aging are intrinsically interrelated. Our discussion focuses on possible mechanisms why cognitive functioning may serve as a source of age-related changes in health both among the young-old and the old-old.

}, keywords = {Activities of Daily Living, Aged, Aged, 80 and over, Aging, Cognition, depression, Female, Health Status, Humans, Interviews as Topic, Longitudinal Studies, Male, Memory, Memory Disorders, Memory, Episodic, Models, Statistical, Neuropsychological tests}, issn = {1939-1498}, doi = {10.1037/a0023023}, author = {Frank J Infurna and Denis Gerstorf and Lindsay H Ryan and Jacqui Smith} } @article {7649, title = {Effects of smoking cessation on pain in older adults.}, journal = {Nicotine Tob Res}, volume = {13}, year = {2011}, note = {Shi, Yu Hooten, W Michael Warner, David O U01AG009740/AG/NIA NIH HHS/United States Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov{\textquoteright}t England Nicotine and tobacco research : official journal of the Society for Research on Nicotine and Tobacco Nicotine Tob Res. 2011 Oct;13(10):919-25. Epub 2011 May 12.}, month = {2011 Oct}, pages = {919-25}, publisher = {13}, abstract = {

INTRODUCTION: Smokers are at increased risk of developing chronic pain and suffering higher pain intensity. However, nicotine has analgesic properties, and smokers may view smoking as a means to cope with pain. Smoking cessation is clearly beneficial to the long-term health of smokers. However, it is not known how abstinence from smoking affects pain. The aim of this study was to determine the association between smoking cessation and changes in pain symptoms by secondary analysis of a large longitudinal dataset of older adults.

METHODS: Secondary analyses were performed of longitudinal biennial survey data (1992 through 2006) from the nationally representative Health and Retirement Study of United States adults older than 50 years. Multivariate logistic regressions were utilized to determine the relationship between the changes in smoking status and changes in pain symptoms, controlling for demographics, depression, self-rated health, history of arthritis, and body mass index.

RESULTS: In multivariate analyses, among the 4,695 smokers who reported no pain or mild pain at enrollment, smoking status was not independently associated with exacerbation of pain (odds ratio [OR]: 0.95, 95\% CI: 0.84, 1.08). Among the 1,118 smokers who reported moderate to severe pain at enrollment, smoking status was not independently associated with improvement of pain (OR: 0.87, 95\% CI: 0.70, 1.08).

CONCLUSIONS: Smoking cessation was not independently associated with changes in pain symptoms in older adults. These results suggest that concerns regarding the effects of abstinence from smoking on pain should not pose a barrier to offering tobacco use interventions to smokers with chronic pain.

}, keywords = {Aged, Body Mass Index, depression, Female, Follow-Up Studies, Humans, Interviews as Topic, Logistic Models, Longitudinal Studies, Male, Middle Aged, Odds Ratio, pain, Pain Perception, Smoking, Smoking cessation, Smoking Prevention}, issn = {1469-994X}, doi = {10.1093/ntr/ntr097}, author = {Yu Shi and Hooten, W Michael and David O. Warner} } @article {7626, title = {Health and medical services use: a matched case comparison between CCRC residents and national health and retirement study samples.}, journal = {J Gerontol Soc Work}, volume = {54}, year = {2011}, note = {Gaines, Jean M Poey, Judith L Marx, Katherine A Parrish, John M Resnick, Barbara England Journal of gerontological social work J Gerontol Soc Work. 2011 Nov;54(8):788-802. doi: 10.1080/01634372.2011.595476.}, month = {2011 Nov}, pages = {788-802}, publisher = {54}, abstract = {

Little is known about the health status of adults living in continuing care retirement communities (CCRC). Using matched-case control, 458 adults from the Health and Retirement Study (HRS) or a CCRC-based sample were compared on total comorbidity, self-rated health, home health services use, and hospitalizations. At year 2, the CCRC sample reported more comorbidities (96\%) but significantly better self-rated health (96\% good/excellent) than the HRS sample (93\% comorbidity, 73\% good/excellent; p < .01). There were no significant differences in frequency of home health use or hospitalization. Living in a CCRC appears to be associated with higher self-ratings of health in this sample.

}, keywords = {Activities of Daily Living, Age Factors, Aged, Aged, 80 and over, Aging, Case-Control Studies, Chronic disease, depression, Female, Geriatric Assessment, Health Services, Health Services for the Aged, Health Status, Home Care Services, Hospitalization, Humans, Interview, Psychological, Male, Middle Aged, Multivariate Analysis, Psychometrics, Retirement}, issn = {1540-4048}, doi = {10.1080/01634372.2011.595476}, author = {Gaines, Jean M and Judith L Poey and Marx, Katherine A and J. M. Parrish and Resnick, Barbara} } @article {7633, title = {Increasing and decreasing alcohol use trajectories among older women in the U.S. across a 10-year interval.}, journal = {Int J Environ Res Public Health}, volume = {8}, year = {2011}, note = {Bobo, Janet Kay Greek, April A AA016534/AA/NIAAA NIH HHS/United States R24 HD042828-10/HD/NICHD NIH HHS/United States Research Support, N.I.H., Extramural Switzerland International journal of environmental research and public health Int J Environ Res Public Health. 2011 Aug;8(8):3263-76. Epub 2011 Aug 5.}, month = {2011 Aug}, pages = {3263-76}, publisher = {8}, abstract = {

Older women who routinely drink alcohol may experience health benefits, but they are also at risk for adverse effects. Despite the importance of their drinking patterns, few studies have analyzed longitudinal data on changes in drinking among community-based samples of women ages 50 and older. Reported here are findings from a semi-parametric group-based model that used data from 4,439 randomly sampled U.S. women who enrolled in the Health and Retirement Study (HRS) and completed >= 3 biannual alcohol assessments during 1998-2008. The best-fitting model based on the drinks per day data had four trajectories labeled as "Increasing Drinkers" (5.3\% of sample), "Decreasing Drinkers" (5.9\%), "Stable Drinkers" (24.2\%), and "Non/Infrequent Drinkers" (64.6\%). Using group assignments generated by the trajectory model, one adjusted logistic regression analysis contrasted the groups with low alcohol intake in 1998 (Increasing Drinkers and Non/Infrequent Drinkers). In this model, baseline education, physical activity, cigarette smoking, and binge drinking were significant factors. Another analysis compared the groups with higher intake in 1998 (Decreasing Drinkers versus Stable Drinkers). In this comparison, baseline depression, cigarette smoking, binge drinking, and retirement status were significant. Findings underscore the need to periodically counsel all older women on the risks and benefits of alcohol use.

}, keywords = {Aged, Alcohol Drinking, Alcoholic Intoxication, Alcoholism, Cohort Studies, depression, Ethanol, Female, Follow-Up Studies, Humans, Longitudinal Studies, Middle Aged, Retirement, Risk Factors, Smoking, Surveys and Questionnaires, United States}, issn = {1660-4601}, doi = {10.3390/ijerph8083263}, author = {Janet Kay Bobo and April A Greek} } @article {7546, title = {Job loss and depression: the role of subjective expectations.}, journal = {Soc Sci Med}, volume = {72}, year = {2011}, month = {2011 Feb}, pages = {576-83}, publisher = {72}, abstract = {

Although the importance of expectations is well documented in the decision-making literature, a key shortcoming of the empirical research into effects of involuntary job loss on depression is perhaps its neglect of the subjective expectations of job loss. Using data from the US Health and Retirement Study surveys we examine whether the impact of job loss on mental health is influenced by an individual{\textquoteright}s subjective expectations regarding future displacement. Our results imply that, among older workers in the age range of 55-65 year, subjective expectations are as significant predictors of depression as job loss itself, and ignoring them can bias the estimate of the impact of job loss on mental health.

}, keywords = {Adaptation, Psychological, Aged, Bias, depression, Empirical Research, Health Surveys, Humans, Mental Health, Middle Aged, Stress, Psychological, Unemployment, United States}, issn = {1873-5347}, doi = {10.1016/j.socscimed.2010.11.014}, author = {Mandal, Bidisha and Padmaja Ayyagari and William T Gallo} } @article {7609, title = {Memory predicts changes in depressive symptoms in older adults: a bidirectional longitudinal analysis.}, journal = {J Gerontol B Psychol Sci Soc Sci}, volume = {66}, year = {2011}, month = {2011 Sep}, pages = {571-81}, publisher = {66B}, abstract = {

OBJECTIVES: Although research indicates that depressive symptoms and memory performance are related in older adults, the temporal associations between these variables remain unclear. This study examined whether depressive symptoms predicted later memory change and whether memory predicted later change in depressive symptoms.

METHODS: The sample consisted of more than 14,000 adults from the Health and Retirement Study, a biannual longitudinal study of health and retirement in Americans older than age 50 years. Measures of delayed recall and depressive symptoms served as the main study variables. We included age, sex, education, and history of vascular diseases as covariates.

RESULTS: Using dynamic change models with latent difference scores, we found that memory performance predicted change in depressive symptoms 2 years later. Depressive symptoms did not predict later change in memory. The inclusion of vascular health variables diminished the size of the observed relationship, suggesting that biological processes may partially explain the effect of memory on depressive symptoms.

IMPLICATIONS: Future research should explore both biological and psychological processes that may explain the association between worse memory performance and subsequent increases in depressive symptoms.

}, keywords = {Aged, Aged, 80 and over, Comorbidity, Dementia, Vascular, depression, Female, Geriatric Assessment, Humans, Longitudinal Studies, Male, Mental Recall, Middle Aged, Models, Psychological, Retirement, Statistics as Topic, United States}, issn = {1758-5368}, doi = {10.1093/geronb/gbr035}, author = {Jajodia, Archana and Borders, Ashley} } @article {7659, title = {Mortgage delinquency and changes in access to health resources and depressive symptoms in a nationally representative cohort of Americans older than 50 years.}, journal = {Am J Public Health}, volume = {101}, year = {2011}, month = {2011 Dec}, pages = {2293-8}, publisher = {101}, abstract = {

OBJECTIVES: We evaluated associations between mortgage delinquency and changes in health and health-relevant resources over 2 years, with data from the Health and Retirement Study, a longitudinal survey representative of US adults older than 50 years.

METHODS: In 2008, participants reported whether they had fallen behind on mortgage payments since 2006 (n = 2474). We used logistic regression to compare changes in health (incidence of elevated depressive symptoms, major declines in self-rated health) and access to health-relevant resources (food, prescription medications) between participants who fell behind on their mortgage payments and those who did not.

RESULTS: Compared with nondelinquent participants, the mortgage-delinquent group had worse health status and less access to health-relevant resources at baseline. They were also significantly more likely to develop incident depressive symptoms (odds ratio [OR] = 8.60; 95\% confidence interval [CI] = 3.38, 21.85), food insecurity (OR = 7.53; 95\% CI = 3.01, 18.84), and cost-related medication nonadherence (OR = 8.66; 95\% CI = 3.72, 20.16) during follow-up.

CONCLUSIONS: Mortgage delinquency was associated with significant elevations in the incidence of mental health impairments and health-relevant material disadvantage. Widespread mortgage default may have important public health implications.

}, keywords = {depression, Drug Costs, Economic Recession, Female, Health Services Accessibility, Health Status, Housing, Humans, Male, Medication Adherence, Middle Aged, Socioeconomic factors, Stress, Psychological, United States}, issn = {1541-0048}, doi = {10.2105/AJPH.2011.300245}, author = {Dawn E Alley and Jennifer Lloyd and Jos{\'e} A Pag{\'a}n and Craig E Pollack and Michelle Shardell and Carolyn Cannuscio} } @article {7636, title = {Multiple trajectories of depressive symptoms in middle and late life: racial/ethnic variations.}, journal = {Psychol Aging}, volume = {26}, year = {2011}, note = {Liang, Jersey Xu, Xiao Quinones, Ana R Bennett, Joan M Ye, Wen 5P30AG024824/AG/NIA NIH HHS/United States R01-AG015124/AG/NIA NIH HHS/United States R01-AG028116/AG/NIA NIH HHS/United States UL1RR024986/RR/NCRR NIH HHS/United States Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov{\textquoteright}t Research Support, U.S. Gov{\textquoteright}t, Non-P.H.S. United States Psychology and aging Psychol Aging. 2011 Dec;26(4):761-77. Epub 2011 Aug 29.}, month = {2011 Dec}, pages = {761-77}, publisher = {26}, abstract = {

This research aims to identify distinct courses of depressive symptoms among middle-aged and older Americans and to ascertain how these courses vary by race/ethnicity. Data came from the 1995-2006 Health and Retirement Study which involved a national sample of 17,196 Americans over 50 years of age with up to six repeated observations. Depressive symptoms were measured by an abbreviated version of the Center for Epidemiologic Studies Depression scale. Semiparametric group based mixture models (Proc Traj) were used for data analysis. Six major trajectories were identified: (a) minimal depressive symptoms (15.9\%), (b) low depressive symptoms (36.3\%), (c) moderate and stable depressive symptoms (29.2\%), (d) high but decreasing depressive symptoms (6.6\%), (e) moderate but increasing depressive symptoms (8.3\%), and (f) persistently high depressive symptoms (3.6\%). Adjustment of time-varying covariates (e.g., income and health conditions) resulted in a similar set of distinct trajectories. Relative to White Americans, Black and Hispanic Americans were significantly more likely to be in trajectories of more elevated depressive symptoms. In addition, they were more likely to experience increasing and decreasing depressive symptoms. Racial and ethnic variations in trajectory groups were partially mediated by SES, marital status, and health conditions, particularly when both interpersonal and intrapersonal differences in these variables were taken into account.

}, keywords = {Age Factors, Aged, Black or African American, depression, disease progression, Female, Health Status Disparities, Hispanic or Latino, Humans, Longitudinal Studies, Male, Middle Aged, Models, Statistical, Socioeconomic factors, Time Factors, United States, White People}, issn = {1939-1498}, doi = {10.1037/a0023945}, author = {Jersey Liang and Xiao Xu and Ana R Qui{\~n}ones and Joan M. Bennett and Wen Ye} } @article {7639, title = {The relationships between major lifetime discrimination, everyday discrimination, and mental health in three racial and ethnic groups of older adults.}, journal = {Aging Ment Health}, volume = {15}, year = {2011}, note = {Ayalon, Liat Gum, Amber M U01AG009740/AG/NIA NIH HHS/United States Evaluation Studies Research Support, N.I.H., Extramural England Aging and mental health Aging Ment Health. 2011 Jul 1;15(5):587-94.}, month = {2011 Jul 01}, pages = {587-94}, publisher = {15}, abstract = {

OBJECTIVES: To evaluate the relationships between perceived exposure to major lifetime discrimination, everyday discrimination, and mental health in three racial/ethnic groups of older adults.

DESIGN: The Health and Retirement Study is a nationally representative sample of individuals 50 years and older living in the United States. A total of 6455 Whites, 716 Latinos, and 1214 Blacks were eligible to complete a self-report psychosocial questionnaire in the year 2006.

RESULTS: Whereas 30\% of the general population reported at least one type of major lifetime discrimination, almost 45\% of Black older adults reported such discrimination. Relative to the other two racial/ethnic groups (82\% Whites, 82.6\% Blacks), Latinos were significantly less likely to report any everyday discrimination (64.2\%), whereas Blacks reported the greatest frequency of everyday discrimination. Whites reported the highest levels of life satisfaction and the lowest levels of depressive symptoms. Relative to major lifetime discrimination, everyday discrimination had a somewhat stronger correlation with mental health indicators. The relationships between discrimination and mental health outcomes were stronger for White compared to Black older adults, although everyday discrimination was still significantly associated with outcomes for Black older adults.

CONCLUSIONS: Black older adults experience the greatest number of discriminative events, but weaker associated mental health outcomes. This could be because they have become accustomed to these experiences, benefit from social or cultural resources that serve as buffers, or selective survival, with the present sample capturing only the most resilient older adults who have learned to cope with the deleterious effects of discrimination.

}, keywords = {Adaptation, Psychological, Aged, Aged, 80 and over, Asian, Black or African American, Cross-Cultural Comparison, depression, Discrimination, Psychological, ethnicity, Hispanic or Latino, Humans, Longitudinal Studies, Mental Health, Middle Aged, Personal Satisfaction, Prejudice, Prevalence, Social Perception, Socioeconomic factors, Surveys and Questionnaires, United States, White People}, issn = {1364-6915}, doi = {10.1080/13607863.2010.543664}, author = {Liat Ayalon and Amber M Gum} } @article {7672, title = {Spousal associations between functional limitation and depressive symptom trajectories: Longitudinal findings from the study of Asset and Health Dynamics Among the Oldest Old (AHEAD).}, journal = {Health Psychol}, volume = {30}, year = {2011}, note = {Hoppmann, Christiane A Gerstorf, Denis Hibbert, Anita U01 AG009740-12/AG/NIA NIH HHS/United States U01AG009740/AG/NIA NIH HHS/United States Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov{\textquoteright}t United States Nihms256806 Health Psychol. 2011 Mar;30(2):153-62.}, month = {2011 Mar}, pages = {153-62}, publisher = {30}, abstract = {

OBJECTIVE: To examine spousal associations between functional limitation and depressive symptom trajectories in a national sample of older long-term married couples.

DESIGN: We used 14.5-year longitudinal data on functional limitations and depressive symptoms from 1,704 couples participating in the Study of Asset and Health Dynamics Among the Oldest Old (AHEAD).

MAIN OUTCOME MEASURES: Activities of daily living and a short version of the Center for Epidemiologic Studies Depression scale were used.

RESULTS: Between-person difference findings corroborate previous research by showing that levels and changes in functional limitations and depressive symptoms are closely interrelated among wives and husbands. Our results further demonstrate sizable associations in levels and changes in functional limitations and depressive symptoms between spouses. For example, functional limitation levels in one spouse were associated with depressive symptom levels in the other spouse. Spousal associations remained after controlling for individual (age, education, cognition) and spousal covariates (marriage duration, number of children) and did not differ between women and men.

CONCLUSION: Our findings highlight the important role of marital relationships in shaping health trajectories in old age because they show that some of the well-documented between-person differences in functional limitations and depressive symptoms are in fact related to spouses.

}, keywords = {Activities of Daily Living, Aged, Aged, 80 and over, Aging, depression, Female, Humans, Longitudinal Studies, Male, Psychometrics, Spouses, United States}, issn = {1930-7810}, doi = {10.1037/a0022094}, author = {Christiane A Hoppmann and Denis Gerstorf and Anita Hibbert} } @article {7531, title = {Depression among older adults in the United States and England.}, journal = {Am J Geriatr Psychiatry}, volume = {18}, year = {2010}, month = {2010 Nov}, pages = {1036-44}, publisher = {11}, abstract = {

CONTEXT: Depression negatively affects health and well being among older adults, but there have been no nationally representative comparisons of depression prevalence among older adults in England and the United States.

OBJECTIVE: The authors sought to compare depressive symptoms among older adults in these countries and identify sociodemographic and clinical correlates of depression in these countries.

DESIGN AND SETTING: The authors assessed depressive symptoms in non-Hispanic whites aged 65 years and older in 2002 in two nationally representative, population-based studies: the U.S. Health and Retirement Study and English Longitudinal Study of Ageing.

PARTICIPANTS: A total of 8,295 Health and Retirement Study respondents and 5,208 English Longitudinal Study of Ageing respondents.

MAIN OUTCOME MEASURES: The authors measured depressive symptoms using the eight-item Center for Epidemiologic Studies Depression Scale. The authors determined whether depressive symptom differences between the United States and England were associated with sociodemographic characteristics, chronic health conditions, and health behaviors.

RESULTS: Significant depressive symptoms (Center for Epidemiologic Studies Depression Scale score >=4) were more prevalent in English than U.S. adults (17.6\% versus 14.6\%, adjusted Wald test F([1, 1593]) = 11.4, p < 0.001). Adjusted rates of depressive symptoms in England were 19\% higher compared with the United States (odds ratio: 1.19, 95\% confidence interval: 1.01-1.40). U.S. adults had higher levels of education, and net worth, but lower levels of activities of daily living/instrumental activities of daily living impairments, tobacco use, and cognitive impairment, which may have contributed to relatively lower levels of depressive symptoms in the United States.

CONCLUSIONS: Older adults in the United States had lower rates of depressive symptoms than their English counterparts despite having more chronic health conditions. Future cross-national studies should identify how depression treatment influences outcomes in these populations.

}, keywords = {Aged, Aged, 80 and over, depression, England, Female, Health Behavior, Health Status, Health Surveys, Humans, Male, Prevalence, Risk Factors, United States, White People}, issn = {1545-7214}, doi = {10.1097/JGP.0b013e3181dba6d2}, author = {Zivin, Kara and David J Llewellyn and Iain A Lang and Sandeep Vijan and Mohammed U Kabeto and Erin M Miller and Kenneth M. Langa} } @article {7468, title = {Depressive symptoms in middle age and the development of later-life functional limitations: the long-term effect of depressive symptoms.}, journal = {J Am Geriatr Soc}, volume = {58}, year = {2010}, month = {2010 Mar}, pages = {551-6}, publisher = {58}, abstract = {

OBJECTIVES: To determine whether middle-aged persons with depressive symptoms are at higher risk for developing activity of daily living (ADL) and mobility limitations as they advance into older age than those without.

DESIGN: Prospective cohort study.

SETTING: The Health and Retirement Study (HRS), a nationally representative sample of people aged 50 to 61.

PARTICIPANTS: Seven thousand two hundred seven community living participants in the 1992 wave of the HRS.

MEASUREMENTS: Depressive symptoms were measured using the 11-item Center for Epidemiologic Studies Depression Scale (CES-D 11), with scores of 9 or more (out of 33) classified as significant depressive symptoms. Difficulty with five ADLs and basic mobility tasks (walking several blocks or up one flight of stairs) was measured every 2 years through 2006. The primary outcome was persistent difficulty with ADLs or mobility, defined as difficulty in two consecutive waves.

RESULTS: Eight hundred eighty-seven (12\%) subjects scored 9 or higher on the CES-D 11 and were classified as having significant depressive symptoms. Over 12 years of follow-up, subjects with depressive symptoms were more likely to reach the primary outcome measure of persistent difficulty with mobility or difficulty with ADL function (45\% vs 23\%, Cox hazard ratio (HR)=2.33, 95\% confidence interval (CI)=2.06-2.63). After adjusting for age, sex, measures of socioeconomic status, comorbid conditions, high body mass index, smoking, exercise, difficulty jogging 1 mile, and difficulty climbing several flights of stairs, the risk was attenuated but still statistically significant (Cox HR=1.44, 95\% CI=1.25-1.66).

CONCLUSION: Depressive symptoms independently predict the development of persistent limitations in ADLs and mobility as middle-aged persons advance into later life. Middle-aged persons with depressive symptoms may be at greater risk for losing their functional independence as they age.

}, keywords = {Activities of Daily Living, depression, Female, Humans, Kaplan-Meier Estimate, Male, Middle Aged, Mobility Limitation, Proportional Hazards Models, Prospective Studies, Risk Factors, United States}, issn = {1532-5415}, doi = {10.1111/j.1532-5415.2010.02723.x}, author = {Kenneth E Covinsky and Kristine Yaffe and Lindquist, Karla and Cherkasova, Elena and Yelin, Edward and Dan G. Blazer} } @article {7541, title = {Depressive symptoms predict incident stroke independently of memory impairments.}, journal = {Neurology}, volume = {75}, year = {2010}, note = {Glymour, M M Maselko, J Gilman, S E Patton, K K Avendano, M 1R01MH087544/MH/NIMH NIH HHS/United States 1R21 AG34385-01A1/AG/NIA NIH HHS/United States 1R21AG037889-01/AG/NIA NIH HHS/United States 1R21HD066312-01/HD/NICHD NIH HHS/United States 1RC4MH092707-01/MH/NIMH NIH HHS/United States 5R03MH083335/MH/NIMH NIH HHS/United States Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov{\textquoteright}t United States Neurology Neurology. 2010 Dec 7;75(23):2063-70.}, month = {2010 Dec 07}, pages = {2063-70}, publisher = {75}, abstract = {

BACKGROUND: We evaluated whether depressive symptoms predict the onset of first stroke independently of memory impairment. We conceptualized memory impairment as a marker of preexisting cerebrovascular disease. We hypothesized that if depressive symptoms are causally related to stroke through mechanisms unrelated to cerebrovascular disease, depressive symptoms should predict stroke independently of memory impairment.

METHODS: Incidence of first stroke was assessed with self or proxy reports from 19,087 participants in the Health and Retirement Study cohort (1,864 events). Elevated depressive symptoms (3+ on an 8-item Centers for the Epidemiologic Study of Depression scale) and memory impairment (score of <=6 on a combined immediate and delayed recall of a 10-word list) were used as predictors of incident stroke in Cox survival models with adjustment for sociodemographic and cardiovascular risk factors.

RESULTS: After adjustment for sociodemographic and cardiovascular risk factors, elevated depressive symptoms (hazard ratio = 1.25; 95\% confidence interval 1.12-1.39) and memory impairment (hazard ratio = 1.26; 95\% confidence interval 1.13-1.41) each predicted stroke incidence in separate models. Hazard ratios were nearly unchanged and remained significant (1.23 for elevated depressive symptoms and 1.25 for memory impairment) when models were simultaneously adjusted for both elevated depressive symptoms and memory impairment. Elevated depressive symptoms also predicted stroke when restricting analyses to individuals with median memory score or better.

CONCLUSIONS: Memory impairments and depressive symptoms independently predict stroke incidence. Memory impairment may reflect undiagnosed cerebrovascular disease. These results suggest that depressive symptoms might be directly related to stroke rather than merely indicating preexisting cerebrovascular disease.

}, keywords = {Aged, Aged, 80 and over, depression, Female, Health Surveys, Humans, Incidence, Kaplan-Meier Estimate, Longitudinal Studies, Male, Memory Disorders, Middle Aged, Neuropsychological tests, Predictive Value of Tests, Risk Factors, Statistics, Nonparametric, Stroke, United States}, issn = {1526-632X}, doi = {10.1212/WNL.0b013e318200d70e}, author = {M. Maria Glymour and J Maselko and Gilman, S E and Kristen K Patton and Mauricio Avendano} } @article {7477, title = {Functional declines, social support, and mental health in the elderly: does living in a state supportive of home and community-based services make a difference?}, journal = {Soc Sci Med}, volume = {70}, year = {2010}, month = {2010 Apr}, pages = {1050-8}, publisher = {70}, abstract = {

This study examines how acute and chronic stresses associated with functional declines in seniors and their spouses are moderated by their informal and formal support contexts. In the United States, states vary greatly in their support for home and community-based services (HCBS) for seniors with disabilities. This state-to-state variation allowed us to examine mental health effects of living in a society supportive of HCBS for the oldest old, who are at high risk for low or declining functions in daily activities and cognitive abilities. Using a ten-year panel study of a nationally representative sample of the oldest old (>or=70 years old) covering the period 1993-2002, we conducted mixed-effects logistic regression analysis to incorporate time-varying characteristics of persons and states. As expected, low and declining functions in daily living and cognition constituted significant stressors among seniors and their spouse. Results demonstrated the important role of informal support available from non-spouse family/friends in lowering depression. Living in a state supportive of HCBS was associated with lower depression among seniors experiencing consistently low levels of function or recent functional declines, especially among those without informal support. Our findings were consistent with moderating or buffering models of formal support, suggesting that state HCBS support is effective mainly under conditions of high levels of stressors. Political will is needed to prepare US society to collectively support community-based long-term needs, given the difficulty of preparing ourselves fully for common, but often unexpected, functional declines in later life.

}, keywords = {Activities of Daily Living, Aged, Cognition, Community Health Services, depression, Disabled Persons, Female, Home Care Services, Humans, Logistic Models, Male, Mental Health, Multilevel Analysis, Risk Factors, Social Support, Spouses, State Government, Stress, Psychological, United States}, issn = {1873-5347}, doi = {10.1016/j.socscimed.2009.12.005}, author = {Muramatsu, Naoko and yin, Hongjun and Hedeker, Donald} } @article {7489, title = {Health outcomes of Experience Corps: a high-commitment volunteer program.}, journal = {Soc Sci Med}, volume = {71}, year = {2010}, note = {Using Smart Source Parsing pp. Jul Elsevier Science, Amsterdam The Netherlands}, month = {2010 Jul}, pages = {414-420}, publisher = {71}, abstract = {

Experience Corps (EC) is a high-commitment US volunteer program that brings older adults into public elementary schools to improve academic achievement of students. It is viewed as a health promotion program for the older volunteers. We evaluated the effects of the EC program on older adults{\textquoteright} health, using a quasi-experimental design. We included volunteers from 17 EC sites across the US. They were pre-tested before beginning their volunteer work and post-tested after two years of service. We compared changes over time between the EC participants (n = 167) and a matched comparison group of people from the US Health and Retirement Study (2004, 2006). We developed the comparison group by using the nearest available Mahalanobis metric matching within calipers combined with the boosted propensity scores of those participating in the EC. We corrected for clustering effects via survey regression analyses with robust standard errors and calculated adjusted post-test means of health outcomes, controlling for all covariates and the boosted propensity score of EC participants. We found that compared to the comparison group, the EC group reported fewer depressive symptoms and functional limitations after two years of participation in the program, and there was a statistical trend toward the EC group reporting less decline in self-rated health. Results of this study add to the evidence supporting high-intensity volunteering as a social model of health promotion for older adults.

}, keywords = {Activities of Daily Living, Aged, Aged, 80 and over, depression, Female, Health Promotion, Health Status, Humans, Male, Middle Aged, Program Evaluation, Regression Analysis, Self Concept, Volunteers}, issn = {1873-5347}, doi = {10.1016/j.socscimed.2010.04.009}, author = {S I Hong and Morrow-Howell, Nancy} } @article {7514, title = {Migration and psychological well-being among older adults: a growth curve analysis based on panel data from the Health and Retirement Study, 1996-2006.}, journal = {J Aging Health}, volume = {22}, year = {2010}, month = {2010 Oct}, pages = {882-913}, publisher = {22}, abstract = {

PURPOSE: A vibrant body of research examines migration among older adults. Existing research, however, grants scarce attention to the implications of later-life migration for the migrants themselves. Our research focuses on the impacts of migration on depressive symptomatology among older U.S. adults.

METHODS: Our analysis employs six waves of panel data from the Health and Retirement Study, 1996-2006. Growth curve modeling techniques are employed.

RESULTS: Net of other stressful life events, migration effects appear to vary significantly across persons. Findings highlight the particularly depressive impact of moves motivated by negative life events or circumstances. Results further suggest that later life moves may be especially stressful for women and as individuals age.

DISCUSSION: The stress of moving late in life may depend on social integration at destination. Further research should pursue this issue. Study limitations and additional directions for further research are delineated.

}, keywords = {Adaptation, Psychological, Age Factors, Aging, depression, Female, Happiness, Health Status, Humans, Life Change Events, Male, Mental Health, Middle Aged, Models, Psychological, Models, Theoretical, Multivariate Analysis, Psychometrics, Retirement, Stress, Psychological, Transients and Migrants}, issn = {1552-6887}, doi = {10.1177/0898264310368430}, author = {Don E Bradley and Van Willigen, Marieke} } @article {7544, title = {Modifiable risk factors for incidence of pain in older adults.}, journal = {Pain}, volume = {151}, year = {2010}, month = {2010 Nov}, pages = {366-371}, publisher = {151}, abstract = {

Pain symptoms in aging populations have significant public health impact. The aim of this study was to determine risk factors for the incidence of pain in older adults, focusing on those factors that can be modified. Secondary analyses were performed of survey data from the nationally representative Health and Retirement Study of US adults older than 50 years. Generalized estimating equations logistic regressions were used to evaluate the effect of selected variables on the incidence of pain using biennial (1992 through 2006) data, determining the relationship between the incidence of pain and the potential risk factors. Of the 18,439 survey respondents in 2006, 34.1\% (95\% CI: 33.2\%, 35.0\%) reported that they were often troubled by pain; 24.3\% reported having moderate to severe pain; and 22.3\% reported that their daily life was affected by pain. Between 1992 and 2006, 7967 individuals reported new onset of pain in 169,762 person-years of follow-up, an incidence of 4.69 (4.59, 4.80) per 100 person-years. Depression and being overweight were independent predictors associated with an increased likelihood of incident pain. Current smoking increased the likelihood of incident pain only in those subjects who also reported depression. In conclusion, pain is a common symptom in older adults. Depression, smoking, and overweight are potentially modifiable risk factors and could be considered in the prevention and management of pain in older adults.

}, keywords = {Age Factors, Aged, Aged, 80 and over, Cross-Sectional Studies, Demography, depression, Female, Humans, Incidence, Longitudinal Studies, Male, Middle Aged, Overweight, pain, Prevalence, Retrospective Studies, Risk Assessment, Risk Factors, Smoking, United States}, issn = {1872-6623}, doi = {10.1016/j.pain.2010.07.021}, author = {Yu Shi and Hooten, W Michael and Rosebud O. Roberts and David O. Warner} } @article {12659, title = {Neighborhood disadvantage and self-assessed health, disability, and depressive symptoms: longitudinal results from the health and retirement study.}, journal = {Ann Epidemiol}, volume = {20}, year = {2010}, month = {2010 Nov}, pages = {856-61}, abstract = {

PURPOSE: By using a longitudinal cohort, we assessed the association between neighborhood disadvantage and incidence of poor health and function in three domains.

METHODS: More than 4,000 enrollees aged 55 to 65 years in the national Health and Retirement Study were assessed biennially from 1998 through 2006 for incidence of fair/poor self-rated health, elevated depressive symptoms, and limitations in six basic activities of daily living (disability). Each analysis was restricted to subjects without that condition in 1994 or 1996. Neighborhoods (census tracts, time-updated for moves), were considered disadvantaged if they fell below the 25th percentile in an index comprising six socioeconomic status indicators. Repeated measures logistic regressions, inverse probability weighted to account for individual confounders, selective survival, and loss to follow-up were used to estimate odds ratios (ORs) for incidence of each outcome in the wave after exposure to disadvantaged neighborhood.

RESULTS: After covariate adjustment, neighborhood disadvantage predicted onset of fair/poor SRH (OR, 1.36; 95\% confidence interval, 1.15-1.59) but not disability (OR, 0.97; 0.81-1.16) or elevated depressive symptoms (OR, 0.97; 0.81-1.16).

CONCLUSIONS: Results confirmed previous findings that neighborhood disadvantage predicts self-rated health in a longitudinal context but did not support an association between neighborhood disadvantage and onset of disability or elevated depressive symptoms.

}, keywords = {Activities of Daily Living, Age Factors, Aged, Confidence Intervals, depression, Disabled Persons, Female, Health Status Disparities, Humans, Incidence, Logistic Models, Longitudinal Studies, Male, Middle Aged, Odds Ratio, Poverty, Residence Characteristics, Risk, Self-Assessment, Socioeconomic factors, Time Factors}, issn = {1873-2585}, doi = {10.1016/j.annepidem.2010.08.003}, author = {M. Maria Glymour and Mujahid, Mahasin and Wu, Qiong and White, Kellee and Tchetgen Tchetgen, Eric J} } @article {7445, title = {Obesity, physical activity, and depressive symptoms in a cohort of adults aged 51 to 61.}, journal = {J Aging Health}, volume = {22}, year = {2010}, month = {2010 Apr}, pages = {384-98}, publisher = {22}, abstract = {

OBJECTIVE: To determine associations between changes in obesity and vigorous physical activity (PA) status and depressive symptoms in a cohort aged 51 to 61 years at baseline.

METHOD: Two waves (1992, 1998) of Health and Retirement Study data were used to divide participants into four obesity and four vigorous PA status categories based on change in or maintenance of their 1992 status in 1998. Depressive symptoms were defined as the upper quintile score (women >/= 4, men >/= 3) on the eight-item Center for Epidemiologic Studies-Depression Scale. Logistic regression determined adjusted odds ratios for depressive symptoms associated with obesity and vigorous PA status.

RESULTS: Among men, no significant associations were found. Among women, decreasing from high vigorous PA status and maintenance of obese status were independently associated with increased odds for depressive symptoms in 1998.

DISCUSSION: The findings illustrate the importance of examining gender differences in studies of risk factors for depression.

}, keywords = {Activities of Daily Living, Age Factors, Aging, Chi-Square Distribution, Cohort Studies, Confidence Intervals, depression, Female, Health Status, Humans, Logistic Models, Male, Middle Aged, Motor Activity, Multivariate Analysis, Obesity, Odds Ratio, Psychometrics, Self Report, Sex Factors, United States}, issn = {1552-6887}, doi = {10.1177/0898264309359421}, author = {Dianna D Carroll and Heidi M Blanck and Mary K. Serdula and David R Brown} } @article {7458, title = {Physical health and depression: a dyadic study of chronic health conditions and depressive symptomatology in older adult couples.}, journal = {J Gerontol B Psychol Sci Soc Sci}, volume = {65}, year = {2010}, month = {2010 Jul}, pages = {438-48}, abstract = {

This study examined the associations among chronic health conditions, sociodemographic factors, and depressive symptomatology in older married couples. Data from the 2004 wave of the Health and Retirement Study (n = 2,184 couples) were analyzed. Results indicated a reciprocal relationship in depressive symptoms between spouses. Additionally, post hoc analyses indicated that husbands{\textquoteright} stroke and high blood pressure were related to increased depressive symptomatology among wives. Beyond the reciprocal relationship, husbands were unaffected by wives{\textquoteright} health. These results suggest sex differences underlying psychological distress in the context of physical health among older adults and that older women with husbands who have high levels of depressive symptomatology, high blood pressure, or a history of stroke may be at particular risk of experiencing depressive symptoms.

}, keywords = {Age Factors, Aged, Chi-Square Distribution, Chronic disease, Cohort Studies, depression, Female, Health Status, Humans, Hypertension, Least-Squares Analysis, Male, Marriage, Middle Aged, Psychiatric Status Rating Scales, Risk Factors, Sex Factors, Socioeconomic factors, Spouses, Stroke}, issn = {1758-5368}, doi = {10.1093/geronb/gbq033}, author = {Brian J Ayotte and Frances Margaret Yang and Richard N Jones} } @article {7494, title = {Predicting positive well-being in older men and women.}, journal = {Int J Aging Hum Dev}, volume = {70}, year = {2010}, month = {2010}, pages = {181-97}, publisher = {70}, abstract = {

The purpose of this study was to examine the effects of background, psychological, and social variables on older adults{\textquoteright} well-being, and how this may differ for men and women. Participants included 800 adults from the 2002 Health and Retirement Study (HRS), aged 60 to 101 years old (M = 71.22, SD = 8.46), who completed the optional positive well-being module. Gender-based regression models revealed that for men, marital status, self-rated health, and depression were significant predictors and accounted for 32\% of the variability in positive well-being. Similar to men, self-rated health and depression were significant predictors of well-being for women. Additional significant predictors for women included age, the importance of religion, and volunteer work. Combined, these variables explained 35\% of the variance in women{\textquoteright}s positive well-being. These results can help us understand which variables are important to target when developing interventions to improve the well-being of older men and women.

}, keywords = {Aged, Aged, 80 and over, Aging, depression, Female, Health Status, Humans, Male, Marriage, Middle Aged, Personal Satisfaction, Predictive Value of Tests, Quality of Life, Regression Analysis, Religion and Psychology, Self Concept, Sex Distribution, Social Behavior, Surveys and Questionnaires, Volunteers}, issn = {0091-4150}, doi = {10.2190/AG.70.3.a}, author = {Erin L. Waddell and Joy M Jacobs-Lawson} } @article {7437, title = {The role of health behaviors in mediating the relationship between depressive symptoms and glycemic control in type 2 diabetes: a structural equation modeling approach.}, journal = {Soc Psychiatry Psychiatr Epidemiol}, volume = {45}, year = {2010}, month = {2010 Jan}, pages = {67-76}, publisher = {45}, abstract = {

OBJECTIVES: We investigated the longitudinal association between depressive symptoms and glycemic control (HbA1c) in adults with type 2 diabetes, and the extent to which that association was explained by health behaviors.

METHODS: This study assessed data on 998 adults (aged 51 and above) with type 2 diabetes in the US nationally representative Health and Retirement Study and its diabetes-specific mail survey. Participants{\textquoteright} depressive symptoms and baseline health behaviors (exercise, body weight control, and smoking status) were collected in 1998. Follow-up health behaviors and the glycemic control outcome were measured at a 2- and 5-year intervals, respectively.

RESULTS: Nearly one in four of participants (23\%) reported moderate or high levels of depressive symptoms at baseline (CES-D score >or=3). Adults with higher levels of depressive symptoms at baseline showed lower scores on baseline and follow-up health behaviors as well as higher HbA1c levels at a 5-year follow-up. Structural equation models (SEM) reveal that health behaviors accounted for 13\% of the link between depressive symptoms and glycemic control.

CONCLUSIONS: The long-term relationship between depressive symptoms and glycemic control was supported in the present study. Health behaviors, including exercise, body weight control, and smoking status, explained a sizable amount of the association between depressive symptoms and glycemic control. More comprehensive diabetes self-care behaviors should be examined with available data. Other competing explicators for the link, such as endocrinological process and antidepressant effects, also warrant further examination.

}, keywords = {Adult, Aged, Blood Glucose, Body Weight, Comorbidity, depression, Diabetes Mellitus, Type 2, Female, Follow-Up Studies, Glycated Hemoglobin, Glycemic Index, Health Behavior, Health Surveys, Humans, Life Style, Longitudinal Studies, Male, Middle Aged, Models, Statistical, Self Care, Smoking, United States}, issn = {1433-9285}, doi = {10.1007/s00127-009-0043-3}, author = {Chiu, Ching-Ju and Linda A. Wray and Elizabeth A Beverly and Oralia G Dominic} } @article {7446, title = {Urban neighborhood context and mortality in late life.}, journal = {J Aging Health}, volume = {22}, year = {2010}, month = {2010 Mar}, pages = {197-218}, publisher = {22}, abstract = {

OBJECTIVE: To examine the contextual effects of urban neighborhood characteristics on mortality among older adults.

METHOD: Data are from the Study of Assets and Health Dynamics Among the Oldest Old (AHEAD). Death is assessed between the baseline assessment (1993) and the first follow-up interview (1995). Neighborhood data are from the 1990 Census.

RESULTS: The log odds of dying between the two time points are higher in high proportion Hispanic neighborhoods, net of individual-level sociodemographic variables, but this effect is partly mediated by individual-level health. The log odds of dying are significantly (p < .05) lower in affluent neighborhoods, controlling for all individual-level variables and neighborhood proportion Hispanic.

DISCUSSION: There are survival-related benefits of living in an affluent urban neighborhood, which we posit may be manifested through the diffusion of innovations in health care and health-promotion activities.

}, keywords = {Age Factors, Aged, Aging, Cognition, Confidence Intervals, depression, Female, Health Status, Humans, Los Angeles, Male, Middle Aged, Mortality, Odds Ratio, Poverty, Psychometrics, Residence Characteristics, Self Report, Socioeconomic factors, Statistics as Topic, Urban Population}, issn = {1552-6887}, doi = {10.1177/0898264309355980}, author = {Richard G Wight and Janet R. Cummings and Arun S Karlamangla and Carol S Aneshensel} } @article {7379, title = {The aftermath of hip fracture: discharge placement, functional status change, and mortality.}, journal = {Am J Epidemiol}, volume = {170}, year = {2009}, month = {2009 Nov 15}, pages = {1290-9}, publisher = {170}, abstract = {

The authors prospectively explored the consequences of hip fracture with regard to discharge placement, functional status, and mortality using the Survey on Assets and Health Dynamics Among the Oldest Old (AHEAD). Data from baseline (1993) AHEAD interviews and biennial follow-up interviews were linked to Medicare claims data from 1993-2005. There were 495 postbaseline hip fractures among 5,511 respondents aged >or=69 years. Mean age at hip fracture was 85 years; 73\% of fracture patients were white women, 45\% had pertrochanteric fractures, and 55\% underwent surgical pinning. Most patients (58\%) were discharged to a nursing facility, with 14\% being discharged to their homes. In-hospital, 6-month, and 1-year mortality were 2.7\%, 19\%, and 26\%, respectively. Declines in functional-status-scale scores ranged from 29\% on the fine motor skills scale to 56\% on the mobility index. Mean scale score declines were 1.9 for activities of daily living, 1.7 for instrumental activities of daily living, and 2.2 for depressive symptoms; scores on mobility, large muscle, gross motor, and cognitive status scales worsened by 2.3, 1.6, 2.2, and 2.5 points, respectively. Hip fracture characteristics, socioeconomic status, and year of fracture were significantly associated with discharge placement. Sex, age, dementia, and frailty were significantly associated with mortality. This is one of the few studies to prospectively capture these declines in functional status after hip fracture.

}, keywords = {Activities of Daily Living, Aged, Aged, 80 and over, depression, Female, Health Status, Health Status Indicators, Hip Fractures, Humans, Interviews as Topic, Iowa, Length of Stay, Logistic Models, Medicare, Patient Discharge, Prospective Studies, Psychometrics, Socioeconomic factors, Time Factors, Treatment Outcome, United States}, issn = {1476-6256}, doi = {10.1093/aje/kwp266}, author = {Suzanne E Bentler and Li Liu and Maksym Obrizan and Elizabeth A Cook and Kara B Wright and John F Geweke and Elizabeth A Chrischilles and Claire E Pavlik and Robert B Wallace and Robert L. Ohsfeldt and Michael P Jones and Gary E Rosenthal and Frederic D Wolinsky} } @article {7387, title = {Doing well: a SEM analysis of the relationships between various activities of daily living and geriatric well-being.}, journal = {J Genet Psychol}, volume = {170}, year = {2009}, month = {2009 Sep}, pages = {213-26}, publisher = {170}, abstract = {

An existing large data set, the Health and Retirement Study (HRS) with the subsequent addition of the Consumption and Activities Mail Survey (CAMS) data, provides a rich data set for the examination of the activities of older adults. In this study HRS and CAMS data are used to examine relationships between various activities of daily living (ADLs) and well-being in older adults. Using structural equation modeling, influences of direct and indirect factors that affect older individuals{\textquoteright} cognitive and emotional well-being are analyzed. The data suggest ability to perform ADLs has little to do with cognitive well-being, but is an influential factor in determining emotional well-being.

}, keywords = {Activities of Daily Living, Adaptation, Psychological, Aged, Cognition, depression, Humans, Models, Psychological, Socioeconomic factors, United States}, issn = {0022-1325}, doi = {10.1080/00221320903218190}, author = {James A Katt and Speranza, Linda and Shore, Wendy and Karen H. Saenz and E. Lea Witta} } @article {7311, title = {The effect of depression and cognitive impairment on enrollment in Medicare Part D.}, journal = {J Am Geriatr Soc}, volume = {57}, year = {2009}, month = {2009 Aug}, pages = {1433-40}, publisher = {57}, abstract = {

OBJECTIVES: To examine concerns that vulnerable populations, such as depressed or cognitively impaired beneficiaries would have challenges accessing Part D coverage.

DESIGN: Logistic regression analysis was used to assess whether elderly Medicare beneficiaries with depression or cognitive impairment differentially planned to and actually signed up for Part D.

SETTING: 2004 and 2006 data from the Health and Retirement Study (HRS) were used, including a subsample that completed the Prescription Drug Study (PDS) in 2005.

PARTICIPANTS: Nine thousand five hundred ninety-three HRS respondents and 3,567 PDS respondents.

MEASUREMENTS: The outcome variables of interest were planned and actual enrollment in Part D. The independent variables were depression and cognitive impairment status. The analyses were adjusted using clinical and demographic predictors including age, sex, race or ethnicity, educational attainment, net worth, marital status, health status, number of health conditions being treated with prescription medications, and presence of a caregiver.

RESULTS: Although having depression or cognitive impairment was associated with a higher likelihood of planning to and actually signing up for Part D in unadjusted analyses, in adjusted analyses, having depression or cognitive impairment was not significantly associated with whether Medicare beneficiaries planned to enroll in or actually enrolled in Part D.

CONCLUSION: Vulnerable Medicare beneficiaries with depression or cognitive impairment were able to access Part D benefits to the same extent as nonvulnerable beneficiaries. More research is needed to determine how well Part D meets the needs of these populations.

}, keywords = {Aged, Aged, 80 and over, Chi-Square Distribution, Cognition Disorders, depression, Female, Humans, Logistic Models, Longitudinal Studies, Male, Medicare Part D, Middle Aged, Patient Participation, Risk Factors, United States}, issn = {1532-5415}, doi = {10.1111/j.1532-5415.2009.02348.x}, author = {Zivin, Kara and Mohammed U Kabeto and Helen C Kales and Kenneth M. Langa} } @article {7386, title = {The effects of developing a dual sensory loss on depression in older adults: a longitudinal study.}, journal = {J Aging Health}, volume = {21}, year = {2009}, month = {2009 Dec}, pages = {1179-99}, publisher = {21}, abstract = {

OBJECTIVE: To determine the effect of developing a dual sensory loss (DSL) on depression over time and evaluate the impact of preexisting single sensory loss on this effect.

METHOD: Multilevel modeling was used to analyze data (N = 2,689) from the Health and Retirement Study.

RESULTS: A significant increase in depression at the first report of DSL occurred, and depression increased at a significantly faster rate following DSL, in a curvilinear pattern. In addition, persons who eventually developed DSL began the study with a depression score significantly higher than persons who did not experience sensory loss. A preexisting single sensory loss did not alter the effect of DSL on depression.

DISCUSSION: Two sources of disparity in depression between persons with and without DSL were identified: preexisting differences and differences that occurred due to the DSL. The relationship exhibited between depression and developing a DSL indicated an adjustment process.

}, keywords = {Adaptation, Psychological, Adult, Aged, Aged, 80 and over, Black or African American, depression, Depressive Disorder, Female, Health Surveys, Hearing loss, Hispanic or Latino, Humans, Longitudinal Studies, Male, Middle Aged, Models, Statistical, Multivariate Analysis, Rehabilitation, Retirement, Risk Factors, Sensation Disorders, United States, Vision Disorders, White People}, issn = {0898-2643}, doi = {10.1177/0898264309350077}, author = {Michele Capella McDonnall} } @article {7396, title = {Memory and depressive symptoms are dynamically linked among married couples: longitudinal evidence from the AHEAD study.}, journal = {Dev Psychol}, volume = {45}, year = {2009}, note = {PMID: 19899917}, month = {2009 Nov}, pages = {1595-610}, publisher = {45}, abstract = {

This study examined dyadic interrelations between episodic memory and depressive symptom trajectories of change in old and advanced old age. The authors applied dynamic models to 10-year incomplete longitudinal data of initially 1,599 married couples from the study of Asset and Health Dynamics Among the Oldest Old (M(age) = 75 years at Time 1). The authors found domain-specific lead-lag associations (time lags of 2 years) among wives and husbands as well as between spouses. For memory, better performance among husbands protected against subsequent memory decline among wives, with no evidence of a directed effect in the other direction. For depressive symptoms, wives{\textquoteright} scores predicted subsequent depression increase and memory decline among husbands. Possible individual covariates (age, education, functional limitations) and spousal covariates (length of marriage, number of children, and whether the couple remained intact over the study period) did not account for differential lead-lag associations. The findings of antecedent-consequent relations between wives and husbands are consistent with life-span notions that individual development both influences and is influenced by contextual factors such as close social relationships.

}, keywords = {Adaptation, Psychological, Aged, Aged, 80 and over, Aging, Cognition, depression, Female, Health Status, Humans, Interpersonal Relations, Longitudinal Studies, Male, Marriage, Mental Recall, Models, Psychological, Quality of Life, Spouses}, issn = {1939-0599}, doi = {10.1037/a0016346}, author = {Denis Gerstorf and Christiane A Hoppmann and Kelly M Kadlec and John J McArdle} } @article {7331, title = {Urban neighborhood context and change in depressive symptoms in late life.}, journal = {J Gerontol B Psychol Sci Soc Sci}, volume = {64}, year = {2009}, month = {2009 Mar}, pages = {247-51}, publisher = {64B}, abstract = {

OBJECTIVES: This study examines associations between urban neighborhood sociodemographic characteristics and change over time in late-life depressive symptoms.

METHODS: Survey data are from three waves (1993, 1995, and 1998) of the Study of Assets and Health Dynamics Among the Oldest Old, a U.S. national probability sample of noninstitutionalized persons aged 70 years or older in 1993. Neighborhoods are 1990 U.S. Census tracts. Hierarchical linear regression is used to estimate multilevel models.

RESULTS: The average change over time in depressive symptoms varies significantly across urban neighborhoods. Change in depressive symptoms is significantly associated with neighborhood-level socioeconomic disadvantage and ethnic composition in unadjusted models but not in models that control for individual-level characteristics.

CONCLUSIONS: Findings indicate that apparent neighborhood-level effects on change in depressive symptoms over time among urban-dwelling older adults reflect, for the most part, differences in characteristics of the neighborhood residents.

}, keywords = {Aged, Aged, 80 and over, Aging, Cultural Diversity, depression, Disability Evaluation, Educational Status, Female, Humans, Longitudinal Studies, Los Angeles, Male, Personality Inventory, Poverty, Psychosocial Deprivation, Residence Characteristics, Risk Factors, Urban Population}, issn = {1758-5368}, doi = {10.1093/geronb/gbn016}, author = {Richard G Wight and Janet R. Cummings and Arun S Karlamangla and Carol S Aneshensel} } @article {7399, title = {Work expectations, realizations, and depression in older workers.}, journal = {J Ment Health Policy Econ}, volume = {12}, year = {2009}, note = {Journal Article}, month = {2009 Dec}, pages = {175-86}, publisher = {12}, abstract = {

AIMS OF THE STUDY: In this study, we explore whether ex ante work expectations, conditional on work force status at age 62, affect self-reported depressive symptoms at age 62.

METHODS: Our sample includes 4,387 participants of the Health and Retirement Study, a national longitudinal survey of individuals born between 1931 and 1941, and their spouses. The sample is composed of workers who were less than 62 years of age at the study baseline (1992), and who had reached age 62 by the current study endpoint (2004). This sample enables comparison of realized work status with prior expectations. We estimate the impact of expected work status on self-reported depressive symptoms using negative binomial and logistic regression methods. Sex-stratified regressions are estimated according to full-time work status at age 62. The primary outcome is a summary measure of self-reported depressive symptoms based on a short form of the Center for Epidemiologic Studies-Depression (CES-D) scale. The explanatory variable of interest is the subjective probability of working full-time at the age of 62, reported by participants at the 1992 HRS baseline. We control for baseline socioeconomic and demographic variables as well as life events and changes in macroeconomic conditions that occur within the study timeframe.

RESULTS: Among participants who were not working full time at age 62, we find that men who provided a higher ex ante likelihood of full-time employment at 62 had significantly worse self-reported depressive symptoms than men who provided a lower ex ante likelihood. A similar effect was not found for women. Among participants who were working full time at age 62, we do not find a statistical relationship between ex ante expectations and age-62 self-reported depressive symptoms, for either men or women.

DISCUSSION: The results suggest that an earlier-than-anticipated work exit is detrimental to mental health for men nearing normal retirement age. Previous research has demonstrated that stress is a causal factor in depression, and a premature labor force departure, which is inconsistent with an individual{\textquoteright}s cognitive judgment of a suitably timed exit from work, is a psychologically stressful transition that could realistically induce depression. This may be especially true of men, who in this cohort, have stronger labor force attachment than women and tend to define their roles by their occupation. The advantages of the study include nationally representative data, a baseline depression control that circumscribes the effect of endogeneity, and a reasonably long follow-up. Despite our efforts to infer causality, unmeasured factors may account for part of the observed relationship. IMPLICATIONS FOR HEALTH POLICY AND RESEARCH: Depression is a disease that, if untreated, may have serious consequences for behavioral, medical, and social well-being. Our results suggest that further research should aim to estimate the magnitude of clinically severe and mild depression in populations of those who retire earlier than expected, especially for men. Such information could help health care planners and policy makers to direct resources to the mental health needs of men who retire prematurely.

}, keywords = {Age Factors, depression, Employment, Female, Health Behavior, Humans, Longitudinal Studies, Male, Middle Aged, Psychometrics, Retirement, Sex Factors, Stress, Psychological}, issn = {1091-4358}, url = {URL:http://www.icmpe.org/test1/journal/journal.htm Publisher{\textquoteright}sURL}, author = {Tracy Falba and Jody L Sindelar and William T Gallo} } @article {7225, title = {Depression and retirement in late middle-aged U.S. workers.}, journal = {Health Serv Res}, volume = {43}, year = {2008}, month = {2008 Apr}, pages = {693-713}, publisher = {43}, abstract = {

OBJECTIVE: To determine whether late middle-aged U.S. workers with depression are at an increased risk for retirement.

DATA SOURCE: Six biennial waves (1992-2002) of the Health and Retirement Study, a nationally representative panel survey of noninstitutionalized 51-61-year-olds and their spouses started in 1992.

STUDY DESIGN: Workers aged 53-58 years in 1994 were followed every 2 years thereafter, through 2002. Depression was coded as lagged time-dependent variables measuring active depression and severity of depression. The main outcome variable was a transition to retirement which was measured using two distinct definitions to capture different stages in the retirement process: (1) Retirement was defined as a transition out of the labor force in the sample of all labor force participants (N=2,853); (2) In addition a transition out of full time work was used as the retirement definition in the subset of labor force participants who were full time workers (N=2,288).

PRINCIPAL FINDINGS: In the sample of all labor force participants, the presence of active depression significantly increased the hazard of retirement in both late middle-aged men (adjusted OR: 1.37 [95 percent CI 1.05, 1.80]) and women (adjusted OR: 1.40 [95 percent CI 1.10, 1.78]). For women, subthreshold depression was also a significant predictor of retirement. In the sample of full time workers, the relationship between depression and retirement was considerably weaker for women yet remained strong for men.

CONCLUSIONS: Depression and depressive symptoms were significantly associated with retirement in late middle-aged U.S. workers. Policymakers must consider the potentially adverse impact of these labor market outcomes when estimating the cost of untreated depression and evaluating the value of interventions to improve the diagnosis and treatment of depression.

}, keywords = {Activities of Daily Living, Comorbidity, depression, Employment, Female, Humans, Male, Middle Aged, Retirement, Severity of Illness Index, Sex Factors, Socioeconomic factors, United States}, issn = {0017-9124}, doi = {10.1111/j.1475-6773.2007.00782.x}, author = {Jalpa A Doshi and Cen, Liyi and Daniel Polsky} } @article {7217, title = {Impact of functional limitations and medical comorbidity on subsequent weight changes and increased depressive symptoms in older adults.}, journal = {J Aging Health}, volume = {20}, year = {2008}, month = {2008 Jun}, pages = {367-84}, publisher = {20}, abstract = {

OBJECTIVE: The primary goal of this study was to determine the effect of the onset of major medical comorbidity and functional decline on subsequent weight change and increased depressive symptoms.

METHODS: The sample included a prospective cohort of 53 to 63 year olds (n = 10,150) enrolled in the Health and Retirement Study. Separate lagged covariate models for men and women were used to study the impact of functional decline and medical comorbidity on subsequent increases in depressive symptoms and weight change 2 years later.

RESULTS: Functional decline and medical comorbidity were individual predictors of subsequent weight changes but not increased depressive symptoms. Most specific incident medical comorbidities or subtypes of functional decline predicted weight changes in both directions.

DISCUSSION: The elevated risk of weight gain subsequent to functional decline or onset of medical comorbidities may require the receipt of preventive measures to reduce further weight-related complications.

}, keywords = {Activities of Daily Living, Age Factors, Arthritis, Comorbidity, depression, Depressive Disorder, Diabetes Complications, Diabetes Mellitus, Disabled Persons, Female, Health Surveys, Heart Diseases, Humans, Hypertension, Lung Diseases, Male, Mental Disorders, Middle Aged, Neoplasms, Obesity, Risk Factors, Sex Factors, Stroke, United States, Weight Gain}, issn = {0898-2643}, doi = {10.1177/0898264308315851}, author = {Valerie L Forman-Hoffman and Kelly K Richardson and Jon W. Yankey and Stephen L Hillis and Robert B Wallace and Frederic D Wolinsky} } @article {7262, title = {Job loss, retirement and the mental health of older Americans.}, journal = {J Ment Health Policy Econ}, volume = {11}, year = {2008}, month = {2008 Dec}, pages = {167-76}, publisher = {11}, abstract = {

BACKGROUND: Millions of older individuals cope with physical limitations, cognitive changes, and various losses such as bereavement that are commonly associated with aging. Given increased vulnerability to various health problems during aging, work displacement might exacerbate these due to additional distress and to possible changes in medical coverage. Older Americans are of increasing interest to researchers and policymakers due to the sheer size of the Baby Boom cohort, which is approaching retirement age, and due to the general decline in job security in the U.S. labor market.

AIMS OF THE STUDY: This research compares and contrasts the effect of involuntary job loss and retirement on the mental health of older Americans. Furthermore, it examines the impact of re-employment on the depressive symptoms.

METHODS: There are two fundamental empirical challenges in isolating the effect of employment status on mental health. The first is to control for unobserved heterogeneity--all latent factors that could impact mental health so as to establish the correct magnitude of the effect of employment status. The second challenge is to verify the direction of causality. First difference models are used to control for latent effects and a two-stage least squares regression is used to account for reverse causality.

RESULTS: We find that involuntary job loss worsens mental health, and re-employment recaptures the past mental health status. Retirement is found to improve mental health of older Americans.

DISCUSSION: With the use of longitudinal data from the Health and Retirement Study surveys and the adoption of proper measures to control for the possibility of reverse causality, this study provides strong evidence of elevating depressive symptoms with involuntary job displacement even after controlling for other late-life events. Women suffer from greater distress levels than men after job loss due to business closure or lay-off. However, women also exhibit better psychological well-being than men following retirement. The present study is the first to report that the re-employment of involuntary job-loss sufferers leads to a recapturing of past mental health status. Additionally, we find that re-entering the labor force is psychologically beneficial to retirees as well.

IMPLICATIONS FOR HEALTH CARE PROVISION: It is well established that out-of-pocket expenditures on all forms of health care for seniors with self-diagnosed depression significantly exceeds expenditures for seniors with other common ailments such as hypertension and arthritis in the U.S. Thus, our research suggests that re-employment of older Americans displaced from the labor force will be cost-effective with regard to personal mental health outcomes.

IMPLICATIONS FOR HEALTH POLICIES: That re-employment of involuntary job loss sufferers leads to a recapturing of past mental health status illuminates one potential policy trade off - increased resources dedicated to job training and placement for older U.S. workers could reap benefits with regard to reduced private and public mental health expenditures.

IMPLICATIONS FOR FURTHER RESEARCH: Further research could more clearly assess the degree to which the mental health benefits of employment among older Americans would warrant the expansion of job training and employment programs aimed at this group.

}, keywords = {depression, Female, Health Status, Humans, Insurance Coverage, Insurance, Health, Life Change Events, Longitudinal Studies, Male, Mental Health, Middle Aged, Retirement, Socioeconomic factors, Stress, Psychological, Unemployment, United States}, issn = {1091-4358}, doi = {10.2139/ssrn.991134}, author = {Mandal, Bidisha and Roe, Brian} } @article {7263, title = {Measurement differences in depression: chronic health-related and sociodemographic effects in older Americans.}, journal = {Psychosom Med}, volume = {70}, year = {2008}, month = {2008 Nov}, pages = {993-1004}, publisher = {70}, abstract = {

OBJECTIVE: To evaluate the influence of five chronic health conditions (high blood pressure, heart conditions, stroke, diabetes, and lung diseases) and four sociodemographic characteristics (age, gender, education, and race/ethnicity) on the endorsement patterns of depressive symptoms in a sample of community-dwelling older adults.

METHOD: Participants were adults aged >or=65 years from the 2004 Health and Retirement Study (n = 9448). Depressive symptoms were measured with a nine-item Center for Epidemiologic Studies-Depression scale. Measurement differences attributable to health and sociodemographic factors were assessed with a multidimensional model based on item response theory.

RESULTS: Evidence for unidimensionality was equivocal. We used a bifactor model to express symptom endorsement patterns as resulting from a general factor and three specific factors ("dysphoria," "psychosomatic," and "lack of positive affect"). Even after controlling for the effects of health on the psychosomatic factor, heart conditions, stroke, diabetes, and lung diseases had significant positive effects on the general factor. Significant effects due to gender and educational levels were observed on the "lack of positive affect" factor. Older adults self-identifying as Latinos had higher levels of general depression. On the symptom level, meaningful measurement noninvariance due to race/ethnic differences were found in the following five items: depressed, effort, energy, happy, and enjoy life.

CONCLUSIONS: The increased tendency to endorse depressive symptoms among persons with specific health conditions is, in part, explained by specific associations among symptoms belonging to the psychosomatic domain. Differences attributable to the effects of health conditions may reflect distinct phenomenological features of depression. The bifactor model serves as a vehicle for testing such hypotheses.

}, keywords = {Aged, Aged, 80 and over, Chronic disease, Cohort Studies, Comorbidity, Confounding Factors, Epidemiologic, Culture, depression, Diabetes Mellitus, Educational Status, ethnicity, Factor Analysis, Statistical, Female, Heart Diseases, Humans, Hypertension, Interviews as Topic, Lung Diseases, Male, Self-Assessment, Sex Factors, Stroke, United States}, issn = {1534-7796}, doi = {10.1097/PSY.0b013e31818ce4fa}, author = {Frances Margaret Yang and Richard N Jones} } @article {7258, title = {Memory decline and depressive symptoms in a nationally representative sample of older adults: the Health and Retirement Study (1998-2004).}, journal = {Dement Geriatr Cogn Disord}, volume = {25}, year = {2008}, month = {2008}, pages = {266-71}, publisher = {25}, abstract = {

BACKGROUND/AIMS: Inconsistencies in the relationship between depression and cognitive decline may exist because the expected cognitive domains at risk have not been specified in previous study designs. We aimed to examine the relationship between depressive symptoms and verbal episodic memory functioning over time.

METHODS: Data from a prospective cohort study (Health and Retirement Study; 1998-2004; n = 18,465), a multistage national probability sample of older adults in the United States, were analyzed. Verbal learning and memory of a 10-word list learning task were the main outcomes. Depressive symptoms (Center for Epidemiologic Studies - Depression Scale) constituted the main predictor.

RESULTS: Depressive symptoms were associated with significantly lower immediate (-0.05; p < 0.001) and delayed (-0.06; p < 0.001) word list recall scores after controlling for demographics and baseline and time-varying cardiovascular disease risks and diseases.

CONCLUSIONS: In this US national study of older adults, elevated depressive symptoms were associated with declines in episodic learning and memory over time. These associations were little affected by the demographic or medical conditions considered in this study. The results suggest that learning and memory decline may be a long-term feature associated with depressive symptoms among the nation{\textquoteright}s older adult population.

}, keywords = {Aged, Aged, 80 and over, depression, Female, Health Status, Humans, Incidence, Male, Memory Disorders, Neuropsychological tests, Prevalence, Retirement, United States}, issn = {1421-9824}, doi = {10.1159/000115976}, author = {Hector M Gonz{\'a}lez and Mary E Bowen and Gwenith G Fisher} } @article {7223, title = {Productive activities and psychological well-being among older adults.}, journal = {J Gerontol B Psychol Sci Soc Sci}, volume = {63}, year = {2008}, month = {2008 Mar}, pages = {S64-72}, publisher = {63B}, abstract = {

OBJECTIVES: The purpose of this study was to test whether paid work and formal volunteering reduce the rate of mental health decline in later life.

METHODS: Using four waves of Health and Retirement Study data collected from a sample of 7,830 individuals aged 55 to 66, I estimated growth curve models to assess the effects of productive activities on mental health trajectories. The analytical strategy took into account selection processes when examining the beneficial effects of activities. The analyses also formally attended to the sample attrition problem inherent in longitudinal studies.

RESULTS: The results indicated that activity participants generally had better mental health at the beginning of the study. Full-time employment and low-level volunteering had independent protective effects against decline in psychological well-being. Joint participants of both productive activities enjoyed a slower rate of mental health decline than single-activity participants.

DISCUSSION: The results are consistent with activity theory and further confirm the role accumulation perspective. The finding that full-time work combined with low-level volunteering is protective of mental health reveals the complementary effect of volunteering to formal employment. Methodological and theoretical implications are discussed.

}, keywords = {Activities of Daily Living, Aged, Cohort Studies, depression, Employment, Female, Health Status, Humans, Male, Mental Health, Middle Aged, Models, Psychological, Psychological Theory, Psychomotor Performance, Quality of Life, Social Environment, Volunteers}, issn = {1079-5014}, doi = {10.1093/geronb/63.2.s64}, author = {Hao, Yanni} } @article {7239, title = {Retirement and weight changes among men and women in the health and retirement study.}, journal = {J Gerontol B Psychol Sci Soc Sci}, volume = {63}, year = {2008}, month = {2008 May}, pages = {S146-53}, publisher = {63B}, abstract = {

OBJECTIVES: Older adults may experience weight changes upon retirement for a number of reasons, such as being less physically active; having less structured meal times; and consuming food in response to losing personal identity, the potential for social interactions, or the sense of accomplishment derived from working. The purpose of this study was to determine whether retirement was associated with either weight gain or weight loss.

METHODS: We used the 1994-2002 Health and Retirement Study to determine whether retirement between biennial interviews was associated with weight change, separately for men (n = 1,966) and women (n = 1,759). We defined weight change as a 5\% increase or decrease in body mass index between interviews.

RESULT: . We did not find a significant association between retirement and weight change among men. Women who retired were more likely to gain weight than women who continued to work at least 20 hr per week (odds ratio [OR] = 1.24, 95\% confidence interval [CI] = 1.04-1.48). We found a significant relationship between retirement and weight gain only for women who were normal weight upon retiring (OR = 1.30, 95\% CI = 1.01-1.69) and who retired from blue-collar jobs (OR = 1.58, 95\% CI = 1.13-2.21).

DISCUSSION: Public health interventions may be indicated for women, particularly those working in blue-collar occupations, in order to prevent weight gain upon retirement.

}, keywords = {Aged, Aging, Body Mass Index, Body Weight, Demography, depression, Female, Health Behavior, Health Status, Humans, Interviews as Topic, Male, Middle Aged, Obesity, Retirement}, issn = {1079-5014}, doi = {10.1093/geronb/63.3.s146}, author = {Valerie L Forman-Hoffman and Kelly K Richardson and Jon W. Yankey and Stephen L Hillis and Robert B Wallace and Frederic D Wolinsky} } @article {7151, title = {Age group differences in depressive symptoms among older adults with functional impairments.}, journal = {Health Soc Work}, volume = {32}, year = {2007}, month = {2007 Aug}, pages = {177-88}, publisher = {32}, abstract = {

This study used data from the 2000 interview wave of the Health and Retirement Study to examine age group differences in the likelihood of self-reported depressive symptomatology among a nationally representative sample of 3,035 adults age 55 years or older who had at least one activities of daily living (ADL) or instrumental activities of daily living (IADL) limitation. Depression was defined as scoring three points or higher on the eight-point Center for Epidemiological Studies Depression Scale. The results show that respondents age 75 years or older with one ADL/IADL impairment or more were significantly less likely to be depressed than were those between ages 55 and 64 with the same degree of functional impairment. It is recommended that doctors, social workers, and other health care and social services providers pay special attention to younger old adults with health problems and functional limitations because they have a greater risk of being depressed.

}, keywords = {Activities of Daily Living, Age Factors, Aged, Aged, 80 and over, Demography, depression, Disabled Persons, Female, Health Status, Humans, Interviews as Topic, Logistic Models, Male, Middle Aged, United States}, issn = {0360-7283}, doi = {10.1093/hsw/32.3.177}, author = {Namkee G Choi and Kim, Johnny S.} } @article {7176, title = {Change in depression of spousal caregivers of dementia patients following patient{\textquoteright}s death.}, journal = {Omega (Westport)}, volume = {56}, year = {2007}, month = {2007-2008}, pages = {217-28}, publisher = {56}, abstract = {

Caring for an elderly spouse with dementia places a heavy burden on spousal caregivers and often results in chronic depression. Little has been written about change in depression caregivers experience from before to after the death of the spouse with dementia. This longitudinal study examines change in depression of spousal caregivers that occurs following death of the dementia patient. Two theoretical models, the Relief and Stress Models, are discussed in terms of caregiver depression after the death of the dementia-patient care-recipient spouse. These two theoretical models were tested using longitudinal data from the National Institute on Aging sponsored Health and Retirement Study. Both male and female spousal caregivers report an increase in depression after the death of the dementia-patient care-recipient spouse. As time passed following the spouse{\textquoteright}s death, the conjugally bereaved husbands showed a decrease in depression while the conjugally bereaved wives continued to report increased depression.

}, keywords = {Adaptation, Psychological, Aged, Aged, 80 and over, Bereavement, Caregivers, Dementia, depression, Female, Humans, Life Change Events, Long-term Care, Longitudinal Studies, Male, Sex Factors, Spouses, Surveys and Questionnaires, United States}, issn = {0030-2228}, doi = {10.2190/om.56.3.a}, author = {Tweedy, Maureen P. and Charles A Guarnaccia} } @article {7174, title = {Health of previously uninsured adults after acquiring Medicare coverage.}, journal = {JAMA}, volume = {298}, year = {2007}, month = {2007 Dec 26}, pages = {2886-94}, publisher = {298}, abstract = {

CONTEXT: Uninsured near-elderly adults, particularly those with cardiovascular disease or diabetes, experience worse health outcomes than insured adults. However, the health benefits of providing insurance coverage for uninsured adults have not been clearly demonstrated.

OBJECTIVE: To assess the effect of acquiring Medicare coverage on the health of previously uninsured adults.

DESIGN AND SETTING: We conducted quasi-experimental analyses of longitudinal survey data from 1992 through 2004 from the nationally representative Health and Retirement Study. We compared changes in health trends reported by previously uninsured and insured adults after they acquired Medicare coverage at age 65 years.

PARTICIPANTS: Five thousand six adults who were continuously insured and 2227 adults who were persistently or intermittently uninsured from ages 55 to 64 years.

MAIN OUTCOME MEASURES: Differential changes in self-reported trends after age 65 years in general health, change in general health, mobility, agility, pain, depressive symptoms, and a summary measure of these 6 domains; and adverse cardiovascular outcomes (all trend changes reported in health scores per year).

RESULTS: Compared with previously insured adults, previously uninsured adults reported significantly improved health trends after age 65 years for the summary measure (differential change in annual trend, +0.20; P = .002) and several component measures. Relative to previously insured adults with cardiovascular disease or diabetes, previously uninsured adults with these conditions reported significantly improved trends in summary health (differential change in annual trend, +0.26; P = .006), change in general health (+0.02; P = .03), mobility (+0.04; P = .05), agility (+0.08; P = .003), and adverse cardiovascular outcomes (-0.015; P = .02) but not in depressive symptoms (+0.04; P = .32). Previously uninsured adults without these conditions reported differential improvement in depressive symptoms (+0.08; P = .002) but not in summary health (+0.10; P = .17) or any other measure. By age 70 years, the expected difference in summary health between previously uninsured and insured adults with cardiovascular disease or diabetes was reduced by 50\%.

CONCLUSION: In this study, acquisition of Medicare coverage was associated with improved trends in self-reported health for previously uninsured adults, particularly those with cardiovascular disease or diabetes.

}, keywords = {Aged, Cardiovascular Diseases, depression, Diabetes Mellitus, Female, Health Status, Health Surveys, Humans, Longitudinal Studies, Male, Medically Uninsured, Medicare, Middle Aged, Outcome Assessment, Health Care, United States}, issn = {1538-3598}, doi = {10.1001/jama.298.24.2886}, author = {J. Michael McWilliams and Meara, Ellen and Alan M. Zaslavsky and John Z. Ayanian} } @article {7127, title = {Participation in food assistance programs modifies the relation of food insecurity with weight and depression in elders.}, journal = {J Nutr}, volume = {137}, year = {2007}, month = {2007 Apr}, pages = {1005-10}, publisher = {137}, abstract = {

The relation of food insecurity in elders with outcomes such as overweight and depression, and the influence of participation in food assistance programs on these relations, has not been established. The aim of this study was to examine the relation between food insecurity and weight and depression in elders, and determine whether participation in food assistance programs modifies the effect of food insecurity on weight and depression. Two longitudinal data sets were used: the Health and Retirement Study (1996-2002) and the Asset and Health Dynamics Among the Oldest Old (1995-2002). The relation of food insecurity and participation in food assistance programs was assessed by multilevel linear regression analysis. Food insecurity was positively related to weight and depression among elders. Some analyses supported that food-insecure elders who participated in food assistance programs were less likely to be overweight and depressed than those who did not participate in food assistance programs. This finding implies that food assistance programs can have both nutritional and non-nutritional impacts. The positive impact of participation in food assistance programs of reducing or preventing poor outcomes resulting from food insecurity will improve elders{\textquoteright} quality of life, save on their healthcare expenses, and help to meet their nutritional needs.

}, keywords = {Aged, depression, Female, Food Services, Food Supply, Health Surveys, Humans, Linear Models, Longitudinal Studies, Male, Middle Aged, Models, Theoretical, Overweight, Public Assistance, United States}, issn = {0022-3166}, doi = {10.1093/jn/137.4.1005}, author = {Kim, Kirang and Edward A Frongillo} } @article {7130, title = {Predicting the changes in depressive symptomatology in later life: how much do changes in health status, marital and caregiving status, work and volunteering, and health-related behaviors contribute?}, journal = {J Aging Health}, volume = {19}, year = {2007}, month = {2007 Feb}, pages = {152-77}, publisher = {19}, abstract = {

This study examined the unique effects of four variable groups on changes in older adults{\textquoteright} depressive symptoms for a 2-year period: (1) baseline health and disability status, (2) changes in health and disability since baseline, (3) stability and changes in marital and caregiving status and in work and volunteering, and (4) stability and changes in health-related behaviors. With data from the 1998 and 2000 interview waves of the Health and Retirement Study, the authors used gender-separate multistep (hierarchical) residualized regression analyses in which the Center for Epidemiological Studies Depression scale (CES-D) score at follow-up is modeled as a function of the effect of each group of independent variables. As hypothesized, changes in health, disability, marital, and caregiving status explained a larger amount of variance than the existing and stable conditions, although each group of variables explained a relatively small amount (0.3-3.4\%) of variance in the follow-up CES-D score.

}, keywords = {Aged, Caregivers, depression, Employment, Female, Forecasting, Health Behavior, Health Status, Humans, Male, Marital Status, Middle Aged, Netherlands, Regression Analysis, Sweden, United States, Volunteers}, issn = {0898-2643}, doi = {10.1177/0898264306297602}, author = {Namkee G Choi and Bohman, Thomas M.} } @article {7115, title = {The effect of recurrent involuntary job loss on the depressive symptoms of older US workers.}, journal = {Int Arch Occup Environ Health}, volume = {80}, year = {2006}, month = {2006 Nov}, pages = {109-16}, publisher = {80}, abstract = {

OBJECTIVES: The objective of this study was to assess whether recurrent involuntary job loss among US workers nearing retirement resulted in increasingly less severe changes in depressive symptoms with successive job losses.

METHODS: With data drawn from the US Health and Retirement Survey (HRS), we used repeated measures longitudinal analysis to investigate the effect of recurrent job loss on follow-up depressive symptoms, measured up to 2 years following job loss. Study participants include 617 individuals, aged 51-61 years at the 1992 study baseline, who had at least one job loss between 1990 and 2000. Our primary outcome variable was a continuous measure of depressive symptoms, constructed from the 8-item Center for Epidemiologic Studies-Depression (CES-D) battery administered at every HRS wave. A second, dichotomous outcome, derived from the continuous measure, measured clinically relevant depressive symptoms. The exposure (recurrent job loss) was defined by binary dummy variables representing two and three/four job losses. All job losses were the result of either plant closing or layoff.

RESULTS: Our main finding indicates that, after relevant covariates are controlled, compared to one job loss, two job losses result in a modest increase in the level depressive symptoms (not significant) at two-year follow-up. Three or more job losses result, on average, in a decline in depressive symptoms to a level near pre-displacement assessment (not significant). Somewhat in contrast, two job losses were found to be associated with increased risk of clinically relevant depressive symptoms.

CONCLUSIONS: The principal finding confirms our hypothesis that, among US workers nearing retirement, repeated exposure to job separation results in diminished effects on mental health. Adaptation to the job loss stressor may underlie the observed response, although other explanations, including macroeconomic developments, are possible.

}, keywords = {Adaptation, Physiological, depression, Employment, Female, Humans, Life Change Events, Longitudinal Studies, Male, Middle Aged, Retirement, Stress, Psychological, United States}, issn = {0340-0131}, doi = {10.1007/s00420-006-0108-5}, author = {William T Gallo and Elizabeth H Bradley and Teng, Hsun-Mei and Stanislav V Kasl} } @article {7070, title = {Effects of retirement and grandchild care on depressive symptoms.}, journal = {Int J Aging Hum Dev}, volume = {62}, year = {2006}, month = {2006}, pages = {1-20}, publisher = {62}, abstract = {

This study explores how grandchild care in conjunction with grandparents{\textquoteright} retirement affects depressive symptoms, using data from the Health and Retirement Survey. The findings demonstrate that retirement moderates the influence of grandchild care obligations on well-being, measured by depressive symptoms. For retired men, freedom from grandchild care obligations is associated with heightened well-being. Among women, continued employment seems to protect against potential negative effects of extensive grandchild care obligations on well-being. The results for men seem most in line with the argument that family care obligations spoil retirement, whereas the results for women suggest a scenario that is most compatible with the role enhancement thesis.

}, keywords = {Aged, Aging, Child, Child Rearing, depression, Family Characteristics, Female, Holistic health, Humans, Intergenerational Relations, Leisure activities, Longitudinal Studies, Male, Middle Aged, Retirement, Sex Factors, Social Responsibility, Surveys and Questionnaires, United States}, issn = {0091-4150}, doi = {10.2190/8Q46-GJX4-M2VM-W60V}, author = {Maximiliane E Szinovacz and Adam Davey} } @article {7117, title = {Loneliness as a specific risk factor for depressive symptoms: cross-sectional and longitudinal analyses.}, journal = {Psychol Aging}, volume = {21}, year = {2006}, month = {2006 Mar}, pages = {140-51}, publisher = {21}, abstract = {

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.

}, keywords = {Aged, Cross-Sectional Studies, depression, Female, Follow-Up Studies, Health Status, Hostility, Humans, Loneliness, Male, Middle Aged, Risk Factors, Severity of Illness Index, Social Support, Stress, Psychological, Surveys and Questionnaires}, issn = {0882-7974}, doi = {10.1037/0882-7974.21.1.140}, author = {John T. Cacioppo and Mary Elizabeth Hughes and Linda J. Waite and Louise C Hawkley and Ronald A. Thisted} } @article {7019, title = {The impact of own and spouse{\textquoteright}s urinary incontinence on depressive symptoms.}, journal = {Soc Sci Med}, volume = {60}, year = {2005}, month = {2005 Jun}, pages = {2537-48}, publisher = {60}, abstract = {

This study investigated the impact of own and spouse{\textquoteright}s urinary incontinence on depressive symptoms. Attention was paid to the possibility that gender and caregiving might be important factors in understanding significant effects. We used negative binomial regression to analyze survey data for 9974 middle-aged and older respondents to the Health and Retirement Study in the USA. Results supported the hypothesis that the respondents{\textquoteright} own urinary incontinence was associated with depressive symptoms (unadj. IRR = 1.73, 95\% CIs = 1.53, 1.95 for men; unadj. IRR = 1.50, 95\% CIs = 1.38, 1.63 for women). Controlling sociodemographic and health variables reduced this relationship, but it remained statistically significant for both men and women. Having an incontinent wife put men at greater risk for depressive symptoms (unadj. IRR = 1.13, 95\% CIs = 1.02, 1.25), although this relation became nonsignificant with the addition of control variables. No relation between women{\textquoteright}s depressive symptoms and husbands{\textquoteright} (in)continence status was found. Caregiving was not a significant variable in the adjusted analyses, but spouses{\textquoteright} depressive symptoms emerged as a significant predictor of the respondents{\textquoteright} own depressive symptoms. Health care providers must be sensitive to the emotional impact of urinary incontinence. Our findings also suggest the importance of considering the patient{\textquoteright}s mental health within a wider context, particularly including the physical and mental health of the patient{\textquoteright}s spouse.

}, keywords = {Aged, Caregivers, Cohort Studies, depression, Female, Humans, Male, Middle Aged, United States, Urinary incontinence}, issn = {0277-9536}, doi = {10.1016/j.socscimed.2004.11.019}, author = {Fultz, Nancy H. and Kristi Rahrig Jenkins and Truls Ostbye and Donald H. Taylor Jr. and Mohammed U Kabeto and Kenneth M. Langa} } @article {7035, title = {Labor market, financial, insurance and disability outcomes among near elderly Americans with depression and pain.}, journal = {J Ment Health Policy Econ}, volume = {8}, year = {2005}, month = {2005 Dec}, pages = {219-28}, publisher = {8}, abstract = {

BACKGROUND: The economic burden of depression has been documented, but the role of comorbid conditions is unclear. Depression and comorbid pain are particularly common, are associated with worse clinical outcomes and require different care than "pure{\textquoteright}{\textquoteright} depression. Does this comorbidity account for a large share of the adverse social outcomes attributed to depression?

AIMS OF STUDY: We analyzed the relationship between depression and comorbid pain, and labor market, financial, insurance and disability outcomes among Americans aged 55-65.

METHODS: Cross-sectional data were used from Wave 3 of the Health and Retirement Survey, a nationally representative sample of individuals aged 55-65 surveyed in 1996. Multivariate regression analyses, controlling for socio-demographics and chronic health conditions, estimated the associations between depression and pain, and economic outcomes. Outcomes included: employment and retirement status, household income, total medical expenditures, government health insurance, social security, limitations in activities of daily living (ADLs), and health limitations affecting work. Primary explanatory variables included the presence of severe pain, mild/moderate pain, or absence of pain, with or without depression.

RESULTS: Compared to depression alone, depression and comorbid pain was associated with worse labor market (non-employment, retirement), financial (total medical expenditures), insurance (government insurance, social security) and disability outcomes (limitations in ADLs, health limitations affecting work), after covariate adjustment (p

IMPLICATIONS FOR HEALTH CARE PROVISION AND USE: The depressed with comorbid pain appear to experience greater burden through increased costs and worse functioning and may require different management than those with depression alone. The depressed with comorbid pain may benefit from treatment practices and guidelines that address the duality of these conditions throughout the process of care. IMPLICATION FOR HEALTH POLICIES: The depressed with comorbid pain were more likely to receive government support than depression alone. Given the central role of employer-sponsored health insurance in the U.S., they may have worse access to health care because they leave employment or retire earlier. With the evolving state of Medicare, broad formulary access to mental health treatments might be considered.

IMPLICATIONS FOR FURTHER RESEARCH: Further research should focus on causality of depression and comorbid pain on economic outcomes. Depression research should consider the heterogeneity of this disorder in outcomes assessment.

}, keywords = {Aged, Cost of Illness, Cross-Sectional Studies, depression, Employment, Female, Humans, Male, Middle Aged, pain, United States}, issn = {1091-4358}, author = {Tian, Haijun and Robinson, Rebecca L. and Sturm, Roland} } @article {7043, title = {Longitudinal analysis of the reciprocal effects of self-assessed global health and depressive symptoms.}, journal = {J Gerontol B Psychol Sci Soc Sci}, volume = {60}, year = {2005}, month = {2005 Nov}, pages = {P296-P303}, publisher = {60}, abstract = {

This study examined whether a reciprocal relationship exists between measures of self-assessed global health and depressive symptoms, net of covariates that included chronic illness, functional disability, education, income, gender, race, and age. Analyses of five waves of data from the Rand version of the Health and Retirement Survey (N=7,475), using an autoregressive, cross-lagged panel design, indicated that self-assessed overall health had a modest but statistically significant and consistent effect on depressive symptoms. In contrast, the level of depressive symptoms had a statistically nonsignificant effect on self-assessed health. There has been growing interest in identifying the factors that inform self-assessments of overall health. The present findings indicate that self-assessed global health is not simply a manifestation of depressed affect.

}, keywords = {Aged, Analysis of Variance, Attitude to Health, Chronic disease, depression, Disabled Persons, Female, Health Surveys, Humans, Longitudinal Studies, Male, Middle Aged, Personality Inventory, Psychometrics, Reproducibility of Results, Self-Assessment, Statistics as Topic}, issn = {1079-5014}, doi = {10.1093/geronb/60.6.p296}, author = {Karl Kosloski and Stull, Donald E. and Kercher, Kyle and VanDussen, Daniel J.} } @article {6996, title = {The significance of nonmarital cohabitation: marital status and mental health benefits among middle-aged and older adults.}, journal = {J Gerontol B Psychol Sci Soc Sci}, volume = {60}, year = {2005}, month = {2005 Jan}, pages = {S21-9}, publisher = {60B}, abstract = {

OBJECTIVES: According to the 2000 Census, about 1.2 million persons over age 50 are currently cohabiting. Do these unmarried cohabiting partnerships provide adults with mental health benefits that are similar to those enjoyed by marrieds? We extended prior work on marital status and depression by including cohabitation in our conceptualization of marital status.

METHODS: We used data from the 1998 Health and Retirement Study (N = 18,598) to examine the relationship between marital status and depressive symptoms among adults over age 50. We also examined gender differences in this association.

RESULTS: We found that cohabitors report more depressive symptoms, on average, than do marrieds, net of economic resources, social support, and physical health. Additional analyses revealed that only among men do cohabitors report significantly higher depression scores. Cohabiting and married women as well as cohabiting men experience similar levels of depression, and all of these groups report levels that are significantly higher than married men{\textquoteright}s.

DISCUSSION: Our findings demonstrate the importance of accounting for nontraditional living arrangements among persons aged 50 and older. Cohabitation appears to be more consequential for men{\textquoteright}s than women{\textquoteright}s depressive symptoms.

}, keywords = {Aged, depression, Female, Humans, Insurance Benefits, Male, Marital Status, Mental Health Services, Middle Aged, Sexual Partners, Social Support, United States}, issn = {1079-5014}, doi = {10.1093/geronb/60.1.s21}, author = {Susan L. Brown and Jennifer R. Bulanda and Lee, Gary R.} } @article {7053, title = {Supplemental private health insurance and depressive symptoms in older married couples.}, journal = {Int J Aging Hum Dev}, volume = {61}, year = {2005}, month = {2005}, pages = {293-312}, publisher = {61}, abstract = {

Stress process theory is applied to examine lack of supplemental private health insurance as a risk factor for depressive symptomatology among older married couples covered by Medicare. Dyadic data from 130 African-American couples and 1,429 White couples in the 1993 Asset and Health Dynamics Among the Oldest-Old Survey were analyzed using hierarchical generalized linear modeling. Lack of supplemental insurance is operationalized at the household level in terms of neither spouse covered, one spouse covered, or both spouses covered. Controlling for covariates at both individual and couple levels, supplemental insurance has significant impact on depression, but the pattern differs by race. White couples report the highest depression when neither spouse is covered by private health insurance; African-American couples report the highest depression when only one spouse is covered. Results suggest lack of supplemental private health insurance coverage is a stressor that significantly affects depressive symptoms.

}, keywords = {Aged, Aged, 80 and over, Analysis of Variance, Black People, Chi-Square Distribution, depression, Female, Humans, Insurance Coverage, Insurance, Health, Linear Models, Male, Risk Factors, Spouses, United States, White People}, issn = {0091-4150}, doi = {10.2190/21LA-XQCE-BKJF-MC17}, author = {Min, Meeyoung O. and Aloen L. Townsend and Baila Miller and Rovine, Michael J.} } @article {6924, title = {The effect of spousal mental and physical health on husbands{\textquoteright} and wives{\textquoteright} depressive symptoms, among older adults: longitudinal evidence from the Health and Retirement Survey.}, journal = {J Aging Health}, volume = {16}, year = {2004}, month = {2004 Jun}, pages = {398-425}, publisher = {16}, abstract = {

OBJECTIVE: To estimate the effect of spousal depressive symptoms and physical health on respondents{\textquoteright} depressive symptoms in a national sample of older married couples.

METHOD: We used data on 5,035 respondent husbands and wives from the 1992 and 1994 waves of the Health and Retirement Survey. Multivariate regression models were estimated to examine the impact of spousal depressive symptoms and physical health on respondents{\textquoteright} depressive symptoms.

RESULTS: Adjusting for respondent mental and physical health and sociodemographic traits, having a spouse with more depressive symptoms was associated with significantly higher follow-up depressive symptoms in the respondent (p < .001). Controlling for spousal depressive symptoms, a decline in the spouses{\textquoteright} physical health was associated with a significant reduction in respondent depressive symptoms (p < .05).

DISCUSSION: Our findings suggest that health care providers treating older adults should be sensitive to the possibility that spouses may be affected when clients suffer poor mental or physical health.

}, keywords = {Aged, Caregivers, depression, Female, Health Status, Humans, Male, Mental Health, Models, Theoretical, Spouses, United States}, issn = {0898-2643}, doi = {10.1177/0898264304264208}, author = {Michele J. Siegel and Elizabeth H Bradley and William T Gallo and Stanislav V Kasl} } @article {6933, title = {Elevated depressive symptoms among caregiving grandparents.}, journal = {Health Serv Res}, volume = {39}, year = {2004}, month = {2004 Dec}, pages = {1671-89}, publisher = {39}, abstract = {

OBJECTIVE: To determine whether caregiving grandparents are at an increased risk for depressive symptoms.

DATA SOURCE: National sample (n=10,293) of grandparents aged 53-63 years in 1994, and their spouse/partners, who took part in the Health and Retirement Study (HRS).

STUDY DESIGN: Grandparents were surveyed in 1994 and resurveyed every two years thereafter, through 2000. Over that period, 977 had a grandchild move in or out of their home. These grandparents served as their own controls to assess the impact of having a grandchild in the home. Data Extraction. Depressive symptoms were measured using an abbreviated form of the Center for Epidemiologic Studies-Depression (CES-D) scale, scored 1-8, with a score > or =4 associated with depression "caseness".

PRINCIPAL FINDINGS: At the time of the 1994 interview, 8.2 percent of grandparents had a grandchild in their home. However, there was substantial variation across demographic groups (e.g., 29.4 percent of single nonwhite grandmothers, but only 2.0 percent of single white grandfathers had a grandchild in residence). The impact of having a grandchild in the home varied by grandparent demographic group, with single grandparents and those without coresident adult children experiencing the greatest probability of elevation in depressive symptoms when a grandchild was in residence. For example, single nonwhite grandmothers experienced an 8 percentage point increase in the probability of having a CES-D score > or =4 when a grandchild was in their home, compared to when a grandchild was not in their home, controlling for changes in health care, income, and household composition over time (95 percent CI=0.1 to 15.0 percentage points).

CONCLUSIONS: Grandparents have a greater probability of elevated depressive symptoms when a grandchild is in their home, versus when a grandchild is not in their home. Single women of color bear a disproportionate burden of the depression associated with caring for grandchildren. Since an increasing number of grandparents function as a de facto safety net keeping their grandchildren out of formal foster care, identifying strategies to support the health and well-being of caregiving grandparents is an emerging priority.

}, keywords = {Child, Data collection, depression, Family, Humans, Intergenerational Relations, Interviews as Topic, Middle Aged, Socioeconomic factors, United States}, issn = {0017-9124}, doi = {10.1111/j.1475-6773.2004.00312.x}, author = {Blustein, J. and Sewin Chan and Guanais, F.C.} } @article {6928, title = {Honeymoons and joint lunches: effects of retirement and spouse{\textquoteright}s employment on depressive symptoms.}, journal = {J Gerontol B Psychol Sci Soc Sci}, volume = {59}, year = {2004}, month = {2004 Sep}, pages = {P233-45}, publisher = {59B}, abstract = {

With hypotheses derived from a life course perspective in conjunction with life event stress and role theories, we examine whether a spouse{\textquoteright}s employment and length of retirement affect a person{\textquoteright}s postretirement depressive symptoms and whether such effects differ by gender. Analyses use pooled data from Waves 1-4 of the Health and Retirement Survey, using a subsample of married individuals who either remained continuously employed over time or completely retired since the Wave 1 interviews (N = 2,695). Recently retired men seem to be negatively affected by their spouses{\textquoteright} continuous employment when compared with men whose wives were continuously not employed. In contrast, spouses{\textquoteright} joint retirement has a beneficial influence on both recently retired and longer-retired men. However, for recently retired men, the positive effect of wives{\textquoteright} retirement seems to be contingent on spouses{\textquoteright} enjoyment of joint activities. Among women, effects of spouses{\textquoteright} employment occur only among very recently retired wives (0-6 months). These wives report more depressive symptoms if their spouses were already nonemployed prior to wives{\textquoteright} retirement. These results demonstrate the complexity of retirement adaptation processes and suggest that marital context plays an important role in retirement well-being.

}, keywords = {Adaptation, Psychological, Aged, Aging, Data collection, depression, Employment, Female, Humans, Life Change Events, Longitudinal Studies, Male, Mental Health, Middle Aged, Retirement, Sex Factors, Spouses}, issn = {1079-5014}, doi = {10.1093/geronb/59.5.p233}, author = {Maximiliane E Szinovacz and Adam Davey} } @article {6934, title = {Life course transitions and depressive symptoms among women in midlife.}, journal = {Int J Aging Hum Dev}, volume = {58}, year = {2004}, month = {2004}, pages = {241-65}, publisher = {58}, abstract = {

This study examined the relationship between three midlife transitions and depressive symptoms among 952 women 50 to 59 years of age. Using longitudinal data from women interviewed for the 1992 and 2000 Health and Retirement Study, the study described changes in marital status, change to a parental caregiving role, and changes in perceived health across the eight years. Further, it examined the impact of these changes on mental health. The findings indicate that becoming widowed, becoming a caregiver, and perceiving health declines significantly increased depressive symptoms in the year 2000, even when controlling for pre-transition levels of depressive symptoms. The findings are consistent with the lifecourse perspective that individual development occurs in context and across the lifespan. The findings confirm and add to current midlife research literature.

}, keywords = {Caregivers, depression, Female, Health Status, Humans, Interviews as Topic, Life Change Events, Longitudinal Studies, Marital Status, Middle Aged, Quality of Life}, issn = {0091-4150}, doi = {10.2190/4CUU-KDKC-2XAD-HY0W}, author = {M Jean Turner and Timothy S Killian and Rebekah Cain} } @article {6926, title = {Retirement transitions and spouse disability: effects on depressive symptoms.}, journal = {J Gerontol B Psychol Sci Soc Sci}, volume = {59}, year = {2004}, month = {2004 Nov}, pages = {S333-42}, publisher = {59B}, abstract = {

OBJECTIVES: The purpose of this study was to investigate the effects of type of retirement (forced, early, abrupt) and spouse{\textquoteright}s disability on longitudinal change in depressive symptoms.

METHODS: The analyses rely on Waves 1-4 of the Health and Retirement Survey (N = 2,649). Generalized estimating equations models with bootstrapped standard errors and adjustment for survey design and non-independence of dyad members estimate effects of retirement, type of retirement, and spouse{\textquoteright}s disability on depressive symptoms, controlling for relevant covariates.

RESULTS: The results suggest that depressive symptoms increase when retirement is abrupt and perceived as too early or forced. Women retirees who stopped employment and were either forced into retirement or perceived their retirement as too early report significantly more depressive symptoms with increasing spouse activities of daily living (ADLs) limitations. There is no similar effect for men. In contrast, for working retirees who retired on time, depressive symptoms decrease with increasing spouse ADLs.

DISCUSSION: These results highlight the importance of retirement context on postretirement well-being. They suggest that both type of retirement transition and marital contexts such as spouse{\textquoteright}s disability influence postretirement well-being, and these effects differ by gender.

}, keywords = {Activities of Daily Living, Adaptation, Psychological, Aged, Caregivers, Demography, depression, Disabled Persons, Female, Follow-Up Studies, Humans, Male, Middle Aged, Retirement, Spouses, Surveys and Questionnaires}, issn = {1079-5014}, doi = {10.1093/geronb/59.6.s333}, author = {Maximiliane E Szinovacz and Adam Davey} } @article {6863, title = {Additive and interactive effects of comorbid physical and mental conditions on functional health.}, journal = {J Aging Health}, volume = {15}, year = {2003}, month = {2003 Aug}, pages = {465-81}, publisher = {15}, abstract = {

OBJECTIVE: To understand the role of cognitive impairment and depressive symptoms on functional outcomes of stroke and diabetes. Evaluation approaches to functional outcomes have rarely focused on the presence of specific comorbidities, particularly those involving mental health disorders.

METHODS: Data are from the AHEAD cohort of the Health and Retirement Study (HRS), a nationally representative panel of persons 70+ years of age in 1993. Analyses are limited to 5,646 self-respondents for whom functional outcome data are available in 1995. Additive and interactive multiple regression models are compared for each outcome and focal condition combination.

RESULTS: The additive model is sufficient for the majority of outcome and focal condition combinations. The interaction term is significant in 4 of 12 comparisons.

DISCUSSION: Stroke, diabetes, cognitive impairment, and depressive symptoms exhibit strong independent effects on physical functioning. Support for the hypothesis that cognitive impairment and depression exacerbate the impact of stroke and diabetes is more limited.

}, keywords = {Activities of Daily Living, Aged, Aging, Black or African American, Cognition Disorders, depression, Diabetes Complications, Educational Status, Health Surveys, Hispanic or Latino, Humans, Stroke, United States, White People}, issn = {0898-2643}, doi = {10.1177/0898264303253502}, author = {Fultz, Nancy H. and Mary Beth Ofstedal and A. Regula Herzog and Robert B Wallace} } @article {6848, title = {Additive effects of cognitive function and depressive symptoms on mortality in elderly community-living adults.}, journal = {J Gerontol A Biol Sci Med Sci}, volume = {58}, year = {2003}, month = {2003 May}, pages = {M461-7}, publisher = {58A}, abstract = {

BACKGROUND: Poor cognitive function and depressive symptoms are common in the elderly, frequently coexist, and are interrelated. Both risk factors are independently associated with mortality. Few studies have comprehensively described how the combination of poor cognitive function and depressive symptoms affect the risk for mortality. Our aim was to examine whether the combination of varying levels of cognitive function and depressive symptoms affect the risk of mortality in community-living elderly adults.

METHODS: We studied 6301 elderly adults (mean age, 77 years; 62\% women; 81\% white) enrolled in the Asset and Health Dynamics Among the Oldest Old (AHEAD) study, a prospective study of community-living participants conducted from 1993 to 1995. Cognitive function and depressive symptoms were measured using two validated measures developed for the AHEAD study. On each measure, participants were divided into tertiles representing the best, middle, and worst scores, and then placed into one of nine mutually exclusive groups ranging from best functioning on both measures to worst functioning on both measures. Mortality rates were assessed in each of the nine groups. Cox proportional hazards models were used to control for potentially confounding characteristics such as demographics, education, income, smoking, alcohol consumption, comorbidity, and baseline functional impairment.

RESULTS: During 2 years of follow-up, 9\% (548) of the participants died. Together, cognitive function and depressive symptoms differentiated between elderly adults at markedly different risk for mortality, ranging from 3\% in those with the best function on both measures to 16\% in those with the worst function on both measures (p <.001). Furthermore, for each level of cognitive function, more depressive symptoms were associated with higher mortality rates, and for each level of depressive symptoms, worse cognitive function was associated with higher mortality rates. In participants with the best cognitive function, mortality rates were 3\%, 5\%, and 9\% in participants with low, middle, and high depressive symptoms, respectively (p <.001 for trend). The corresponding rates were 6\%, 7\%, and 12\% in participants with the middle level of cognitive function (p <.001 for trend), and 10\%, 13\%, and 16\% in participants with the worst level of cognitive function (p <.001 for trend). After adjustment for confounders, participants with the worst function on both measures remained at considerably higher risk for death than participants with the best function on both measures (adjusted hazard ratio, 3.1; 95\% confidence interval, 2.0-4.7).

CONCLUSIONS: Cognitive function and depressive symptoms can be used together to stratify elderly adults into groups that have significantly different rates of death. These two risk factors are associated with an increased risk in mortality in a progressive, additive manner.

}, keywords = {Aged, Cognition, depression, Female, Humans, Male, Mortality, Proportional Hazards Models, Risk Factors}, issn = {1079-5006}, doi = {10.1093/gerona/58.5.m461}, author = {Kala M. Mehta and Kristine Yaffe and Kenneth M. Langa and Laura Sands and Whooley, Mary and Kenneth E Covinsky} } @article {6878, title = {Caregiver stress and noncaregiver stress: exploring the pathways of psychiatric morbidity.}, journal = {Gerontologist}, volume = {43}, year = {2003}, month = {2003 Dec}, pages = {817-27}, publisher = {43}, abstract = {

PURPOSE: This study examines depressive symptoms among adult children of elderly parents; it views the parents{\textquoteright} care needs and child{\textquoteright}s care activities as two separate stressors, different combinations of which may affect both caregiving and noncaregiving family members.

DESIGN AND METHODS: A sample of 4,380 women and 3,965 men from the first wave of the Health and Retirement Study was analyzed by use of four alternative forms of multiple regression analysis. Using the Center for Epidemiological Studies Depression scale, respondents reported on their depressive symptoms, as well as on parental disability and care provided by themselves, their spouses, and siblings.

RESULTS: Noncaregivers reporting severe parental disability were significantly more likely to experience depression symptoms. Evidence of increased manifestations of depression was not found among those caring for severely disabled relatives; nor was it found among those providing care in the absence of severe parental care needs. Having a caregiving sibling was associated with increased CES-D scores among noncaregivers.

IMPLICATIONS: In the current literature, personal care needs of a close relative are named among significant disturbances in the lives of caregivers. By extending this approach to members of a family network regardless of caregiver status, this study allows us to distinguish the magnitude of negative outcomes of serious parental care needs while clarifying the impact uniquely attributable to caregiving activities.

}, keywords = {Caregivers, depression, Female, Humans, Male, Middle Aged, Regression Analysis, Risk Factors, Stress, Psychological}, issn = {0016-9013}, doi = {10.1093/geront/43.6.817}, author = {Amirkhanyan, Anna A. and Douglas A. Wolf} } @article {6877, title = {County-level income inequality and depression among older Americans.}, journal = {Health Serv Res}, volume = {38}, year = {2003}, month = {2003 Dec}, pages = {1863-83}, publisher = {38}, abstract = {

OBJECTIVES: To examine (1) whether county-level income inequality is associated with depression among Americans aged 70 and older, taking into consideration county-level mean household income and individual-level socioeconomic status (SES), demographic characteristics, and physical health, and (2) whether income inequality effects are stronger among people with lower SES and physical health.

DATA SOURCES: The individual-level data from the first wave of the Assets and Health Dynamics among the Oldest Old survey (1993-1994) were linked with the county-level income inequality and mean household income data from the 1990 Census.

STUDY DESIGN: Multilevel analysis was conducted to examine the association between income inequality (the Gini coefficient) and depression.

PRINCIPAL FINDINGS: Income inequality was significantly associated with depression among older Americans. Those living in counties with higher income inequality were more depressed, independent of their demographic characteristics, SES, and physical health. The association was stronger among those with more illnesses.

CONCLUSIONS: While previous empirical research on income inequality and physical health is equivocal, evidence for income inequality effects on mental health seems to be strong.

}, keywords = {Age Factors, Aged, Aged, 80 and over, depression, Female, Health Status Indicators, Humans, Income, Male, Socioeconomic factors, United States}, issn = {0017-9124}, doi = {10.1111/j.1475-6773.2003.00206.x}, author = {Muramatsu, Naoko} } @article {6897, title = {Immigrant status, living arrangements, and depressive symptoms among middle-aged and older adults.}, journal = {J Gerontol B Psychol Sci Soc Sci}, volume = {58}, year = {2003}, month = {2003 Sep}, pages = {S305-13}, publisher = {58B}, abstract = {

OBJECTIVES: This research draws from social integration theory to explain the relationship between living arrangements and depressive symptoms among middle-aged and older adults. Particular attention is given to identifying differences between nonimmigrants and immigrants.

METHODS: The data come from the baseline and first 2-year follow-up of the Health and Retirement Study, which were collected in 1992 and 1994. The analysis is based on 6,391 primary respondents who were aged 51 to 61 at the baseline. Descriptive statistics, cross-sectional ordinary least squares regression models, and longitudinal residualized regression models are estimated for the entire sample and by immigrant status.

RESULTS: Living arrangements and immigrant status interact to influence depressive symptoms. The results confirm that depressive symptoms are higher among those who live alone, particularly among immigrants. Living with family or others is related to higher cross-sectional levels of depressive symptoms, especially for immigrants, and greater longitudinal increases in depressive symptoms among nonimmigrants.

DISCUSSION: The results highlight the important influence of social integration on mental health while demonstrating that context shapes the effect of social integration. They suggest that interventions should promote social integration, particularly among older adults living alone or with family or others. However, those programs should be sensitive to the unique needs of native-born and immigrant populations.

}, keywords = {Acculturation, Aged, Cross-Sectional Studies, depression, Emigration and Immigration, Female, Follow-Up Studies, Humans, Male, Middle Aged, Quality of Life, Residence Characteristics}, issn = {1079-5014}, doi = {10.1093/geronb/58.5.s305}, author = {Janet M Wilmoth and Pei-Chun Chen} } @article {6903, title = {Urinary incontinence and depression in middle-aged United States women.}, journal = {Obstet Gynecol}, volume = {101}, year = {2003}, month = {2003 Jan}, pages = {149-56}, publisher = {101}, abstract = {

OBJECTIVE: To determine the correlates of incontinence in middle-aged women and to test for an association between incontinence and depression.

METHODS: This was a population-based cross-sectional study of 5701 women who were residents of the United States, aged 50-69 years, and participated in the third interview of the Health and Retirement Study. The primary outcome measure was self-reported urinary incontinence. Depression was ascertained based on criteria set by the Diagnostic and Statistical Manual of Mental Disorders, using a short form of the Composite International Diagnostic Interview. In addition, depressive symptoms were assessed using the revised Center for Epidemiologic Studies Depression Scale. Multivariable logistic regression models were constructed to determine the independent association between incontinence and depression, after adjusting for confounders.

RESULTS: Approximately 16\% reported either mild-moderate or severe incontinence. Depression, race, age, body mass index, medical comorbidities, and limited activities of daily living were associated with incontinence. After adjusting for medical morbidity, functional status, and demographic variables, women with severe and mild-moderate incontinence were 80\% (odds ratio [OR] 1.82; 95\% confidence interval [CI] 1.26, 2.63) and 40\% (OR 1.41; 95\% CI 1.06, 1.87) more likely, respectively, to have depression than continent women. The association did not hold for depressive symptoms measured by the revised Center for Epidemiologic Studies Depression Scale after adjusting for covariates.

CONCLUSION: Depression and incontinence are associated in middle-aged women. The strength of the association depends on the instrument used to classify depression. This reinforces the need to screen patients presenting for treatment of urinary incontinence for depression.

}, keywords = {Activities of Daily Living, Aged, Comorbidity, Cross-Sectional Studies, depression, Female, Humans, Logistic Models, Middle Aged, United States, Urinary incontinence}, issn = {0029-7844}, doi = {10.1016/s0029-7844(02)02519-x}, author = {Ingrid E Nygaard and Carolyn L. Turvey and Burns, Trudy L. and Elizabeth A Chrischilles and Robert B Wallace} } @article {6835, title = {Prevalence and correlates of depressive symptoms in a community sample of people suffering from heart failure.}, journal = {J Am Geriatr Soc}, volume = {50}, year = {2002}, month = {2002 Dec}, pages = {2003-8}, publisher = {50}, abstract = {

OBJECTIVES: To examine the rates and correlates of depressive symptoms and syndromal depression in people with self-reported heart failure participating in a community study of people aged 70 and older.

DESIGN: Cross-sectional.

SETTING: Community-based epidemiological study of older people from the continental United States.

PARTICIPANTS: Six thousand one hundred twenty-five older people participating in the longitudinal study of Assets and Health Dynamics. Participants had to be born in 1923 or earlier.

MEASUREMENTS: The short-form Composite International Diagnostic Interview assessed syndromal depression, and a revised version of the Center for Epidemiologic Studies-Depression scale assessed depressive symptoms. Medical illness was based on self-report. The authors compared the rates of syndromal depression and individual depressive symptoms in people with self-reported heart failure (n = 199) with those in people with other heart conditions (n = 1,856) and with no heart conditions (n = 4,070).

RESULTS: Eleven percent of those with heart failure met criteria for syndromal depression, compared with 4.8\% of people with other heart conditions and 3.2\% of those with no heart conditions. The association between heart failure and depression held even after controlling for disability, reported fatigue and breathlessness, and number of comorbid chronic illnesses.

CONCLUSION: Community-living older people with self-reported heart failure were at approximately twice the risk for syndromal depression of the rest of the community. Although fatigue and functional disability were also related to depression in this sample, these variables did not account for the association between syndromal depression and self-reported heart failure.

}, keywords = {Aged, depression, Female, Heart Failure, Humans, Longitudinal Studies, Male, Prevalence, United States}, issn = {0002-8614}, doi = {10.1046/j.1532-5415.2002.50612.x}, author = {Carolyn L. Turvey and Schultz, K. and Arndt, Stephan and Robert B Wallace and A. Regula Herzog} } @article {6783, title = {Caregiver report of hallucinations and paranoid delusions in elders aged 70 or older.}, journal = {Int Psychogeriatr}, volume = {13}, year = {2001}, month = {2001 Jun}, pages = {241-9}, publisher = {13}, abstract = {

This study examined the demographic, medical, and psychiatric correlates of hallucinations and paranoid delusions reported by proxy informants for 822 elders aged 70 or older. This sample comprised people who were deemed unable to complete a direct interview in a large nationwide study of aging. Marital status, trouble with vision, and cognitive impairment were associated with report of both paranoid delusions and hallucinations. Depressive symptoms and stroke were associated with hallucinations only. These results suggest that inadequate external stimulation in the elderly leads to psychotic experiences.

}, keywords = {Aged, Aged, 80 and over, Aging, Caregivers, Cognition Disorders, Cohort Studies, Delusions, depression, Female, Follow-Up Studies, Hallucinations, Humans, Male, Marital Status, Paranoid Disorders, Risk Factors, Stroke, Surveys and Questionnaires, United States, Vision Disorders}, issn = {1041-6102}, doi = {10.1017/s1041610201007621}, author = {Carolyn L. Turvey and Schultz, Susan K. and Arndt, Stephan and Ellingrod, Vicki and Robert B Wallace and A. Regula Herzog} } @article {6764, title = {Changes in driving patterns and worsening depressive symptoms among older adults.}, journal = {J Gerontol B Psychol Sci Soc Sci}, volume = {56}, year = {2001}, month = {2001 Nov}, pages = {S343-51}, publisher = {56B}, abstract = {

OBJECTIVES: This study examined whether changes in driving patterns-driving cessation and reduction-have negative consequences for the depressive symptoms of older Americans and whether these consequences are mitigated for people with a spouse who drives.

METHODS: The project used data from 3 waves of the Asset and Health Dynamics Among the Oldest Old (AHEAD) study. Depressive symptoms were assessed with an abbreviated Center for Epidemiologic Studies-Depression scale. Using 2 models, the project examined how driving cessation and reduction that occurred between Waves 1 and 2 contributed to increases in depressive symptoms between Waves 2 and 3. The first model included the entire sample (N = 5,239), and the second model focused on drivers only (n = 3,543). A third model added interaction terms to the analysis to consider whether respondents who stopped driving but had a spouse who drove were less at risk of worsening depressive symptoms.

RESULTS: Respondents who stopped driving had greater risk of worsening depressive symptoms. Drivers who restricted their driving distances before the study began also had greater risk of worsening depressive symptoms, but seemingly less so than the respondents who stopped driving altogether. For respondents who stopped driving, having a spouse available to drive them did not mitigate the risk of worsening symptoms.

DISCUSSION: Changes in driving patterns can be deleterious for older people{\textquoteright}s depressive symptoms. Initiatives for assisting older people should focus on strategies that help them retain driving skills, that prepare them for the possible transition from driver to ex-driver, and that ensure that they have access to mental health therapies if driving changes are imminent.

}, keywords = {Activities of Daily Living, Adaptation, Psychological, Aged, Aged, 80 and over, Automobile Driving, depression, Female, Humans, Male, Quality of Life, Risk Factors, Social Environment}, issn = {1079-5014}, doi = {10.1093/geronb/56.6.s343}, author = {Stephanie J. Fonda and Robert B Wallace and A. Regula Herzog} } @article {6748, title = {Childlessness and the psychological well-being of older persons.}, journal = {J Gerontol B Psychol Sci Soc Sci}, volume = {56}, year = {2001}, month = {2001 Sep}, pages = {S311-20}, publisher = {56B}, abstract = {

OBJECTIVES: Rapid growth in the size of the childless elderly population has prompted concerns about the negative effects of childlessness on psychological well-being. This study adds to this line of inquiry by examining the effects of childlessness on two important dimensions of elderly persons{\textquoteright} psychological well-being: loneliness and depression.

METHODS: Using the 1993 Asset and Health Dynamics Among the Oldest Old data set, the authors estimated logistic and ordinary least squares regression models of psychological well-being for a nationally representative sample of people aged 70 and older (N = 6,517).

RESULTS: Childlessness per se did not significantly increase the prevalence of loneliness and depression at advanced ages, net of other factors. There also was no statistical evidence for the hypothesis that childlessness increases loneliness and depression for divorced, widowed, and never married elderly persons. Sex, however, altered how childlessness and marital status influenced psychological well-being. Divorced, widowed, and never married men who were childless had significantly higher rates of loneliness compared with women in comparable circumstances; divorced and widowed men who were childless also had significantly higher rates of depression than divorced and widowed women.

DISCUSSION: The findings suggest that it is important to understand the consequences of childlessness in the context of marital status and sex.

}, keywords = {Aged, Aged, 80 and over, depression, Family Planning Services, Female, Geriatric Assessment, Humans, Loneliness, Male, Marital Status, Risk Factors, Sex Factors}, issn = {1079-5014}, doi = {10.1093/geronb/56.5.s311}, author = {Zhang, Zhenmei and Mark D Hayward} } @article {6672, title = {A comparison of correlates of cognitive functioning in older persons in Taiwan and the United States.}, journal = {J Gerontol B Psychol Sci Soc Sci}, volume = {54}, year = {1999}, month = {1999 Sep}, pages = {S291-301}, publisher = {54B}, abstract = {

OBJECTIVES: This article compares patterns of association between cognitive functioning and a number of sociodemographic and health correlates among older persons in Taiwan and the United States.

METHODS: The study uses data from the 1993 Survey of Health and Living Status of the Elderly in Taiwan and the 1993 Study of Asset and Health Dynamics Among the Oldest Old in the United States. Separate multivariate regression models are employed for each country to examine the effects of sociodemographic and health factors on cognitive functioning, and to examine the marginal impact of cognitive functioning on activities of daily living (ADL) and instrumental ADL (IADL) functioning.

RESULTS: Results of the multivariate analyses show similar patterns of association across the two countries and replicate findings from previous studies. Increasing age, female gender, lower education, depression, and selected health conditions are associated with lower cognitive functioning. In addition, although a significant predictor of both ADL and IADL impairments, cognitive functioning is more powerful with respect to explaining IADL impairments.

DISCUSSION: Study findings suggest that the cognitive measures are capturing similar dimensions in Taiwan and the United States, and that factors associated with cognitive functioning and its consequences with respect to physical functioning are similar in the two countries.

}, keywords = {Activities of Daily Living, Age Factors, Aged, Aged, 80 and over, Cognition, Cross-Cultural Comparison, depression, Educational Status, Female, Geriatric Assessment, Health Status, Humans, Male, Multivariate Analysis, Regression Analysis, Sex Factors, Socioeconomic factors, Surveys and Questionnaires, Taiwan, United States}, issn = {1079-5014}, doi = {10.1093/geronb/54b.5.s291}, author = {Mary Beth Ofstedal and Zachary Zimmer and Hui-Sheng Lin} } @article {6646, title = {Conjugal loss and syndromal depression in a sample of elders aged 70 years or older.}, journal = {Am J Psychiatry}, volume = {156}, year = {1999}, month = {1999 Oct}, pages = {1596-601}, publisher = {156}, abstract = {

OBJECTIVE: The goal of this study was to describe the association between conjugal loss and both syndromal depression and depressive symptoms in a prospective cohort study of people aged 70 years or older.

METHOD: A measure of syndromal depression, the shortform Composite International Diagnostic Interview (CIDI), and a revised version of the Center for Epidemiologic Studies--Depression Scale (CES-D Scale) were administered to a group of 5,449 elders in a longitudinal cohort study. The authors compared the rates of syndromal depression (CIDI diagnosis) and depressive symptoms (six CES-D Scale symptoms) in married participants and those who lost spouses between the first and second waves of assessment.

RESULTS: The rate of syndromal depression in the newly bereaved was nearly nine times as high as the rate for married individuals, and the rate of depressive symptoms was nearly four times as high. The percentage of the bereaved respondents who had scores above threshold on the revised CES-D Scale was higher for those interviewed up to 2 years after loss of a spouse than for married respondents. Age, sex, prior psychiatric history, and the expectedness of the death did not differ between depressed and nondepressed newly bereaved subjects.

CONCLUSIONS: Recent bereavement is a significant risk factor for syndromal depression in the elderly. Some widows and widowers experienced high levels of depressive symptoms up to 2 years after the loss of their spouses. Neither demographic variables nor variables concerning the nature of the spouse{\textquoteright}s death predicted bereavement-related depression.

}, keywords = {Age Factors, Aged, Aged, 80 and over, Bereavement, Cohort Studies, depression, Depressive Disorder, Female, Humans, Logistic Models, Longitudinal Studies, Male, Marital Status, Odds Ratio, Psychiatric Status Rating Scales, Risk Factors, Sex Factors, Widowhood}, issn = {0002-953X}, doi = {10.1176/ajp.156.10.1596}, author = {Carolyn L. Turvey and Carney, C. and Arndt, Stephan and Robert B Wallace and A. Regula Herzog} } @article {6660, title = {Multiple roles and well-being among midlife women: testing role strain and role enhancement theories.}, journal = {J Gerontol B Psychol Sci Soc Sci}, volume = {54}, year = {1999}, month = {1999 Nov}, pages = {S329-38}, publisher = {54B}, abstract = {

OBJECTIVE: Research on women{\textquoteright}s multiple roles frequently adopts one of two perspectives: role strain, which argues that assuming multiple roles is detrimental to mental well-being, or role enhancement, which argues that engaging in multiple roles enhances mental well-being. We argue that the relationship between role occupancy and well-being is manifested through multiple dimensions of role experiences. We investigate the association between depressive symptomatology and various dimensions of the roles of wife, mother, paid worker, and informal caregiver to aging parents.

METHODS: Data are from the 1992 wave of the Health and Retirement Study. Depressive symptomatology, measured by a subset of the CES-D scale, is the dependent variable. To assess the robustness of findings relative to different functional forms of the dependent variable, we estimate multiple regression, log-linear regression, and multinomial logit models. Independent variables include demographic characteristics, measures of role occupancy, role demands, and role satisfaction.

RESULTS: Although the number of roles women assume affects their reports of depressive symptoms, once the demand and satisfaction associated with these roles is controlled, number has no effect; that is, the effect of the number of roles is indirect.

DISCUSSION: Our results highlight the importance of women{\textquoteright}s perceptions of the quality of their roles in relation to their overall well-being. Future investigations of women{\textquoteright}s multiple roles should examine how roles may provide rewards, impose constraints, or generate conflict, as well as the extent to which the willingness to assume multiple roles and the reported levels of role satisfaction and mental well-being may be jointly endogenous.

}, keywords = {Caregivers, depression, Employment, Female, Humans, Marriage, Middle Aged, Personal Satisfaction, Psychological Theory, Role, Women{\textquoteright}s Health}, issn = {1079-5014}, doi = {10.1093/geronb/54b.6.s329}, url = {https://pubmed.ncbi.nlm.nih.gov/10625968/}, author = {Reid, Jennifer and Melissa A. Hardy} } @article {6638, title = {Racial differences in the multiple social roles of older women: implications for depressive symptoms.}, journal = {Gerontologist}, volume = {39}, year = {1999}, month = {1999 Aug}, pages = {465-72}, publisher = {39}, abstract = {

The relationship between multiple role participation and depressive symptoms experienced by African American (n = 547) and White (n = 2,152) women aged 55-61 was explored. Data were obtained from the Health and Retirement Study (HRS). Racial differences in the social roles of marriage, employment, grandmother, care provider, and volunteer and their influence on level of depressive symptoms were examined. African Americans reported higher levels of depressive symptoms than Whites. Additionally, marriage, employment, and total number of social roles were the most powerful predictors of depressive symptoms for both African American and White women. However, employment was more important in diminishing depressive symptoms among African American than White women occupying multiple social roles.

}, keywords = {Analysis of Variance, Black or African American, Chi-Square Distribution, Cross-Sectional Studies, Demography, depression, Female, Humans, Middle Aged, Regression Analysis, Self Concept, Social Environment, Social Support, White People, women}, issn = {0016-9013}, doi = {10.1093/geront/39.4.465}, author = {Cochran, Donna and Brown, Diane R. and McGregor, Karl C.} } @article {6647, title = {A revised CES-D measure of depressive symptoms and a DSM-based measure of major depressive episodes in the elderly.}, journal = {Int Psychogeriatr}, volume = {11}, year = {1999}, month = {1999 Jun}, pages = {139-48}, publisher = {11}, abstract = {

This study examines the psychometric properties of two new abbreviated versions of standard measures of depression, a revised eight-item Center for Epidemiological Studies-Depression Scale (CES-D) and a short-form Composite International Diagnostic Interview (short-form CIDI). A sample of 6,133 elders, age 70 years or older, completed both measures as part of the Asset and Health Dynamics Study of the Oldest Old. The revised CES-D had an internal consistency and factor structure comparable to that of prior versions of the CES-D. The sources of discordance between the two measures were examined and the two measures were compared on self-report of four clinical variables: medical illness, physician diagnosis, psychiatric treatment, and antidepressant or tranquilizer use. Both measures were associated with self-report of physician diagnosis and psychiatric treatment. Respondents positive for depression on the CES-D reported higher rates of antidepressant use. Respondents positive on the short-form CIDI only did not report more antidepressant use than nondepressed respondents.

}, keywords = {Aged, Antidepressive Agents, depression, Depressive Disorder, Major, Diagnosis, Differential, Female, Humans, Male, Prospective Studies, Psychiatric Status Rating Scales, Psychometrics, Severity of Illness Index, Surveys and Questionnaires}, issn = {1041-6102}, doi = {10.1017/s1041610299005694}, url = {https://pubmed.ncbi.nlm.nih.gov/11475428/}, author = {Carolyn L. Turvey and Robert B Wallace and A. Regula Herzog} }