Late-life depression in the older adults living in an institution and at home

Year 2018, , 5 - 17, 01.01.2018

Mithat Durak

https://doi.org/10.5505/jaltc.2017.09797

Abstract

Psychological well-being in older adults is an important issue in Geropsychology and there is increasing interest about the older adults living in the community and at home. Understanding markers of well-being associated with either living in an institution or at home would help to explore certain unique variables that make the older adults’ life difficult. Among older adults, depression decreases the quality of life and affect the individual’s lifespan significantly. However, there have been few studies investigating institution-specific or home-specific markers of depression which are the aims of the current study. The present study aims to make a comparison between 924 the older adults residing in institutions to 846 the older adults residing at home in terms of socio-demographic and health-related variables. Women living at home had higher depression scores than women in the institution. Conversely, men living in institutions were more depressed than living at home while married older adults at home have lower depression scores. Education and income are inversely associated with depression scores. As the number of illnesses increases so does the level of depression. Finally, there is a negative relationship with perceptions of prognosis and perceptions of threat regarding their medical conditions and depression. The interaction of gender, income and residence type is discussed in detail within a cultural context. Possible implications are suggested to improve the psychological well-being of older adults and the specific needs of different populations of older adults based on their residence type are addressed.

Key Practitioners Message

• Investigating the influence of residence type (institution versus home) on the older adults’ psychological well-being helps practitioners to understand the psychological effect of the environment.
• Examining the association between socio-demographic variables (gender, education, income, marital status) or health-related variables (perceptions of prognosis and threat regarding their medical conditions) and late-life depression reveals individual markers in relation to depression.
• Older adults residing at home are more vulnerable to suffer from depression due to their difficulty in accessing health services and a tendency to disregard their health care needs.
• Older adults having physical illnesses had higher scores than their counterparts.
• Perceptions regarding physical illness might be one of the important topics for health care professionals.
• Perceptions about physical illness might be a focal point to explore a relationship with mental health.
  

Keywords

Older Adults, Depression, Residence Type, Gender, Education, Income, Marital Status, Health-Related Variables, Perceptions About Illness

References

• Bellizzi, K. M., & Blank, T. O. (2006). Predicting posttraumatic growth in breast cancer survivors. Health Psychology, 25(1), 47-56.
• Blazer, D. G. (2005). Depression and social support in late life: A clear but not obvious relationship. Aging Ment Health, 9(6 ), 497-499.
• Casey, D. A. (2012). Depression in the elderly: A review and update. Asia-Pacific Psychiatry, 4(3), 160-167.
• Chen, Y. M. (2010). Perceived barriers to physical activity among older adults residing in long-term care institutions. Journal of Clinical Nursing, 19(3-4), 432-439.
• Costello, C. (1972). Depression: Loss of reinforcers of loss of reinforcer effectiveness? Behavior Therapy, 3(2), 240-247.
• Denkinger, M., Lukas, A., Herbolsheimer, F., & Nikolaus, T. (2012). Physical activity and other health-related factors predict health care utilization in older adults. Zeitschrift für Gerontologie und Geriatrie, 45(4), 290-297.
• Drayer, R. A., Mulsant, B. H., Lenze, E. J., Rollman, B. L., Dew, M. A., Kelleher, K., . . . Reynolds, C. F., (2005). Somatic symptoms of depression in elderly patients with medical comorbidities. International Journal of Geriatric Psychiatry, 20(10), 973-982.
• Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975). “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12(3), 189-198.
• Gungen, C., Ertan, T., Eker, E., Yasar, R., & Engin, F. (2002). Reliability and validity of the standardized Mini-Mental State Examination in the diagnosis of mild dementia in Turkish population. Turkish Journal of Psychiatry, 13(4), 273281.
• Hacihasanoglu, R., & Yildirim, A. (2009). Depression among the Elderly in Erzincan Nursing Home and Influential Factors. Turkish Journal of Geriatrics, 12(1), 25-30.
• Hawton, A., Green, C., Dickens, A. P., Richards, S. H., Taylor, R. S., Edwards, R., . . . Campbell, J. L. (2011). The impact of social isolation on the health status and health-related quality of life of older people. Quality of Life Research, 20(1), 57-67.
• Heun, R., & Hein, S. (2005). Risk factors of major depression in the elderly. European Psychiatry, 20(3), 199-204.
• Hughes, D. E., & Peake, T. H. (2002). Investigating the value of spiritual well-being and psychosocial development in mitigating senior adulthood depression. Activities, Adaptation & Aging, 26(3), 15-35.
• Javed, S. (2014). Role of sociocultural factors in depression among elderly of twin cities (Rawalpindi and Islamabad) of Pakistan. Current Gerontology and Geriatrics Research, 230737.
• Jongenelis, K., Pot, A., Eisses, A., Beekman, A., Kluiter, H., & Ribbe, M. (2004). Prevalence and risk indicators of depression in elderly nursing home patients: the AGED study. Journal of Affective Disorders, 83(2), 135-142.
• Keskinoglu, P., Ucku, R., Yener, G., Yaka, E., Kurt, P., & Tunca, Z. (2009). Reliability and validity of revised Turkish version of Mini-Mental State Examination (rMMSE-T) in community-dwelling educated and uneducated elderly. International Journal of Geriatric Psychiatry, 24(11), 1242-1250.
• Kotlikoff, L. J., & Morris, J. N. (1990). Why don’t the elderly live with their children? A new look Issues in the Economics of Aging (pp. 149172): University of Chicago Press.
• Lindner, R., Foerster, R., & von Renteln-Kruse, W. (2014). Physical distress and relationship problems: Exploring the psychosocial and intrapsychic world of suicidal geriatric patients. Zeitschrift für Gerontologie und Geriatrie, 47(6), 502-507.
• McDougall, F. A., Matthews, F. E., Kvaal, K., Dewey, M. E., & Brayne, C. (2007). Prevalence and symptomatology of depression in older people living in institutions in England and Wales. Age and Ageing, 36(5), 562-568.
• Molloy, D. W., & Standish, T. I. M. (1997). A guide to the Standardized Mini-Mental State Examination. International Psychogeriatrics, 9(S1), 87-94.
• Okabayashi, H., Liang, J., Krause, N., Akiyama, H., & Sugisawa, H. (2004). Mental health among older adults in Japan: Do sources of social support and negative interaction make a difference? Social Science & Medicine, 59(11), 2259-2270.
• Panza, F., Frisardi, V., Capurso, C., D’Introno, A., Colacicco, A. M., Imbimbo, B. P., . . . Solfrizzi, V. (2010). Late-life depression, mild cognitive impairment, and dementia: Possible continuum? American Journal of Geriatric Psychiatry, 18(2), 98-116.
• Rajkumar, A. P., Thangadurai, P., Senthilkumar, P., Gayathri, K., Prince, M., & Jacob, K. S. (2009). Nature, prevalence and factors associated with depression among the elderly in a rural south Indian community. International Psychogeriatrics, 21(2), 372-378.
• Rohde, P., Lewinsohn, P. M., Klein, D. N., Seeley, J. R., & Gau, J. M. (2012). Key characteristics of major depressive disorder occurring in childhood, adolescence, emerging adulthood, and adulthood. Clinical Psychological Science, 1 (1) 41-53.
• Sağduyu, A. (1997). Yaşlılar için Depresyon Ölçeği: Hamilton Depresyon Ölçeği ile karşılaştırmalı güvenilirlik ve geçerlilik çalışması. Türk Psikiyatri Dergisi, 8(1), 3-8.
• Senol-Durak, E., & Ayvasik, H. B. (2010). Factors associated with posttraumatic growth among myocardial infarction patients: perceived social support, perception of the event and coping. Journal of Clinical Psychology in Medical Settings, 17(2), 150-158.
• Sheehan, B., & Banerjee, S. (1999). Review: Somatization in the elderly. International Journal of Geriatric Psychiatry, 14(12), 1044-1049.
• Steffens, D. C., & Potter, G. G. (2007). Geriatric depression and cognitive impairment. Psychological Medicine, 38(2), 163-175.
• Tanaka, H., Sasazawa, Y., Suzuki, S., Nakazawa, M., & Koyama, H. (2011). Health status and lifestyle factors as predictors of depression in middle-aged and elderly Japanese adults: a seven-year follow-up of the Komo-Ise cohort study. BMC Psychiatry, 11, 20.
• van der Wurff, F. B., Beekman, A. T., Dijkshoorn, H., Spijker, J. A., Smits, C. H., Stek, M. L., & Verhoeff, A. (2004). Prevalence and risk-factors for depression in elderly Turkish and Moroccan migrants in the Netherlands. Journal of Affective Disorders, 83(1), 33-41.
• Wetherell, J. L. & Areán, P. A. (1997). Psychometric evaluation of the Beck Anxiety Inventory with older medical patients. Psychological Assessment, 9(2), 136.
• Yaka, E., Keskinoglu, P., Ucku, R., Yener, G. G., & TTunca, Z. (2014). Prevalence and risk factors of depression among community dwelling elderly. Archives of Gerontology and Geriatrics, 59(1), 150-154.
• Yesavage, J. A., Brink, T. L., Rose, T. L., Lum, O., Huang, V., Adey, M., & Leirer, V. O. (1983). Development and validation of a Geriatric Depression Screening Scale: A Preliminary report. J Psychiat Res, 17(1), 37-49.