Older adults with existing depression show resilience during the pandemic
August 19, 2020
Science Daily/University of California - Los Angeles Health Sciences
A study involving older adults with pre-existing major depressive disorder living in Los Angeles, New York, Pittsburgh, and St Louis found no increase in depression and anxiety during the COVID-19 pandemic.
Researchers from five institutions, including UCLA, found that the older adults, who were already enrolled in ongoing studies of treatment resistant depression, also exhibited resilience to the stress of physical distancing and isolation. The findings were published in peer-reviewed journal, The American Journal of Geriatric Psychiatry.
"We thought they would be more vulnerable to the stress of COVID because they are, by CDC definition, the most vulnerable population," said Helen Lavretsky, MD, a professor-in-residence of psychiatry and biobehavioral sciences at the Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA. "But what we learned is that older adults with depression can be resilient. They told use that coping with chronic depression taught them to be resilient"
For the study, researchers conducted interviews with the participants, all of whom were over the age of 60, with an average age of 69, during the first two months of the pandemic. Using two screening assessments of depression and anxiety, PHQ-9 and PROMIS, researchers found no changes in the participants' depression, anxiety or suicidality scores before and during the pandemic.
Researchers further determined that:
Participants were more concerned about the risk of contracting the virus than the risks of isolation.
While all maintained physical distance, most did not feel socially isolated and were using virtual technology to connect with friends and family.
While they were coping, many participants said their quality of life was lower, and they worry their mental health will suffer with continued physical distancing.
Participants were upset by the inadequate governmental response to the pandemic.
Based on the findings, the study authors wrote that policies and interventions to provide access to medical services and opportunities for social interaction are needed to help older adults maintain mental health and quality of life as the pandemic continues.
Lavretsky said many participants reported their quality of life to be lower, and they worried that their mental health will suffer with continued physical distancing. She said further research is needed to determine the impact of the pandemic over time.
She added that the findings offer takeaways for others while weathering the pandemic. "These older persons living with depression have been under stress for a longer time than many of the rest of us. We could draw upon their resilience and learn from it."
The study identified several self-care and coping strategies used by the participants, which included maintaining regular schedules; distracting themselves from negative emotions with hobbies, chores, work or exercise; and using mindfulness to focus on immediate surroundings and needs without thinking beyond the present.
The authors further emphasized that access to mental health care and support groups, and continued social interaction are needed to help older adults whether the pandemic.
https://www.sciencedaily.com/releases/2020/08/200819170223.htm
Number of depressed over-65s unchanged but antidepressant use soars
October 7, 2019
Science Daily/University of East Anglia
The proportion of people aged over 65 on antidepressants has more than doubled in two decades -- according to new research led by the University of East Anglia.
Despite a rise in antidepressant use, there was little change in the number of older people diagnosed with depression.
The findings are based on the Cognitive Function and Ageing Studies, conducted at two time points -- between 1991 and 1993, and between 2008 and 2011.
Researchers interviewed more than 15,000 over 65s in England and Wales to see whether the prevalence of depression and antidepressant use is changing.
Lead author Prof Antony Arthur, from UEA's School of Health Sciences, said: "Depression is a leading cause of poor quality of life worldwide and we know that older people may be less likely than other age groups to go to their GP with symptoms of depression.
"Until now, little was known about how the relationship between the prevalence of depression and antidepressant use among older people has changed over time. The Cognitive Function and Ageing Studies led by the University of Cambridge have the ability to exam changes in the health needs of older people across generations based on random sampling and diagnostic methods held constant over time.
"We asked participants about their health, daily activities, use of health and social care services, and the medications they were taking.
"We used a standardised interview process to ascertain the presence or absence of symptoms of depression and then applied diagnostic criteria to see whether the participant was considered to have 'case level' depression, a level of depression more severe than that characterised by minor mood symptoms, such as loss of energy, interest or enjoyment."
The study's lead investigator Prof Carol Brayne, director of the Cambridge Institute of Public Health, said: "Our research has previously shown a dramatic age-for-age drop in dementia occurrence across generations. This new work reveals that depression has not shown the same reduction even in the presence of dramatically increased prescribing, itself not without concern given potential adverse effects we have also shown that are associated with polypharmacy."
Key findings
· The proportion of older people receiving anti-depressant medication more than doubled over two decades -- from 4.2 per cent in the early nineties to 10.7 per cent 20 years later.
· The estimated prevalence of depression among over 65s in the early 1990s was 7.9 per cent, compared to 6.8 per cent 20 years later.
· Depression and antidepressant use was more common in women than men at both time points.
· Depression was associated with living in a more deprived area.
· The proportion of over 65s living in care homes declined, but prevalence of depression in care homes remained unchanged -- affecting around one in ten residents.
· Across both time periods, most people with case-level depression were not on antidepressants, while most of those on antidepressants did not have depression.
Prof Arthur said: "Depression affects one in 15 people aged over 65, and its impact is felt by the individual, their families and friends.
"Between two comparable samples interviewed 20 years apart (1990-93 and 2008-11) we found little change in the prevalence of depression, but the proportion of participants taking antidepressants rose from 4 per cent to almost 11 per cent. This could be due to improved recognition and treatment of depression, overprescribing, or use of antidepressants for other conditions.
"Whatever the explanation, substantial increases in prescribing has not reduced the prevalence of depression in the over-65 population. The causes of depression in older people, the factors that perpetuate it, and the best ways to manage it remain poorly understood and merit more attention."
The research was led by the University of East Anglia in collaboration with the University of Cambridge, the University of Newcastle and the University of Nottingham.
'Changing prevalence and treatment of depression among the over-65s over two decades: findings from the Cognitive Function and Ageing Studies' is published in the British Journal of Psychiatry.
https://www.sciencedaily.com/releases/2019/10/191007100414.htm