Facial Expressions Track Depressive Symptoms in Old Age.

BackgroundDepressive symptoms are a serious public health problem that affects the mental health of older adults. However, current knowledge of the association between ADL disability and physical dysfunction and depressive symptoms in Chinese adults is insufficient. We intend to analyze the association between physical function, ADL, and depressive symptoms in older Chinese adults.MethodsThe data obtained from the China Health and Retirement Longitudinal Survey (2015 and 2018) (CHARLS). This includes 3,431 in 2015 and 3,258 in 2018 over the age of 60. Comparing 2015 and 2018 data, multivariate logistic regression models were used to explore the relationship between physical function, ADL, and depressive symptoms in urban and rural older adults, adjusting for sociodemographic factors associated with depression in older adults.ResultsThe prevalence of depressive symptoms among older adults in China was 33.8 percent in 2015 and 50.6 percent in 2018. In baseline data from 2015 and 2018, residence, gender, marital status, drinking, physical function, ADL, and self-rated health were all found to be significantly associated with depressive symptoms in older adults. The differences in physical function, ADL and depressive symptoms among older adults in 2015 and 2018 were further analyzed based on urban and rural stratification. Both physical dysfunction and ADL disability were significantly associated with depressive symptoms in rural older adults in 2015 and 2018. And in urban areas, ADL was found to be significantly associated with depressive symptoms in urban older adults. Multivariate logistic regression analysis demonstrated that ADL disability was significantly associated with depressive symptoms among older adults in both urban and rural areas. Physical dysfunction was only significant in rural areas with depressive symptoms. The alpha level was instead set to 0.05 for all statistical tests.ConclusionRural, female, 60–70 years of age, primary school or below, married, non-smoking, non-drinking, physical dysfunction, ADL disability and self-rated poor health make-up a higher proportion of depressed older adults. ADL disability and physical dysfunction were more likely to be associated with depressive symptoms in rural Chinese older adults. Therefore, the physical and mental health of rural elderly should be of concern. The rural older adults should receive additional support from the government and society.

Nearly 35% of Mexican older adults (OA) are diagnosed with mild depression. Exercise has shown positive effects on reducing depression symptoms in OA. The correlation between physical function, body composition and mild depression risk in healthy OA has been neglected in Mexico. PURPOSE: To determine the effect of a concurrent-training exercise program (CTEP) on mild depression in Mexican female OA. A secondary aim was to determine the correlation between physical function, body composition and depressive symptoms in OA following a CTEP. METHODS: Twenty-one females (age= 64.0 ± 5.38 yr., weight= 72.0 ± 12.6 kg, BMI= 29.0 ± 4.7 kg/m2) participated in the study. Before (Pre) and after (Post) the CTEP, participants were measured on depression by the Hamilton Depression Rating Scale (HAM-D), body fat, muscle mass [MM]), physical function by the Senior Fitness Test, and aerobic capacity by the 6-min walking test (6MWT). The CTEP consisted in two days of aerobic exercise and one day of resistance training performed for 50-min at moderate intensity (12 to 14 on Borg’s RPE scale) for 12-weeks. Paired t-tests were computed to compare pre- to post-CTEP effects, and Spearman correlations studied the association between body composition, physical function and depression scores using the GraphPad PRISM 5.0 software. RESULTS: The CTEP reduced HAM-D scores (Pre= 15.7 ± 4.5 vs. Post= 10.3 ± 5.3 pts., p=0.0001), improved upper-body strength (Pre= 15.1 ± 2.6 vs. Post= 18.9 ± 3.0 reps, p=0.0001), lower-body strength (Pre= 12.0 ± 2.4 vs. Post= 14.5 ± 2.9 reps, p= 0.0001), agility (Pre= 6.5 ±0.9 vs. Post= 6.0 ± 0.9 s, p=0.0001), and MM (Pre= 21.8 ± 2.9 vs. Post= 22.26 ± 3.1 kg, p=0.002). No significant changes were found in aerobic capacity (Pre= 587.9 ± 164.4 vs. Post= 619.6 ±144.9 m, p=0.06) and body fat (Pre= 31.0 ± 8.8 vs. Post= 30.8 ± 9.1%, p > 0.05). The HAM-D scores were inversely correlated with upper-body strength (r= -0.53, p=0.002) and lower-body strength (r= -0.64, p= 0.002), and directly correlated to agility (r= 0.50, p= 0.0004). CONCLUSIONS: A CTEP reduced depressive symptoms in Mexican female OA in spite of lack of changes in body composition. The increased physical function relates to a reduction in depressive symptoms; thus, highlighting the importance of improving functionality in OA.

Depression is a common mental illness in elderly adults that is associated with substantial disability, medical comorbidity, and suicide risk. Factors associated with risk of depression in older adults are many, but the role of dietary and nutritional factors remains relatively unexplored. Accumulating evidence suggests that certain dietary patterns and micronutrients may have important protective effects.1-3 The present study used longitudinal data from 1,615 Chinese adults aged 55 to 93 from the Singapore Longitudinal Aging Study (SLAS)4, 5 to examine the association between amount of tea drinking and incident depressive symptoms from follow-up over an average period of 18 months. It was hypothesized that higher levels of tea consumption would be associated with lower risk of depressive symptoms at follow-up. The baseline recruitment and data collection in SLAS were completed from 2003 to 2005, and follow-up assessment of depressive symptoms was conducted from 2005 to 2007. The National University of Singapore institutional review board approved the study, and written informed consent was obtained from all participants. Trained research nurses administered the 15-item Geriatric Depression Scale (GDS-15)6 to measure depressive symptom severity. Depressive symptoms were defined as a GDS-15 total score of 5 or higher at follow-up assessment. Information on the consumption of green tea, Chinese oolong or black tea, and English black tea was collected at baseline (0 = never or rarely; 1 = <1 cup/wk; 2 = >1 cup/wk but < 1 cup/d; 3 = 1–2 cups/d; 4 = 3–5 cups/d; 5 = 6–9 cups/d; 6 = ≥10 cups/d). A participant was classified as a non-tea consumer if the sum of the scores of all three types of tea was 0. Low tea consumption was defined as a sum score from 1 to 2, medium consumption from 3 to 4, and high consumption 5 or more. Independent-sample t-tests and chi-square tests were used to compare differences in various characteristics of non-tea consumers and tea consumers and between participants with and without depression at follow-up. A variable was considered to be a potential confounder of the association between tea consumption and depressive symptoms if there was a statistically significant difference in both comparisons, and the variable was subsequently controlled for in multivariate analysis. Hierarchical multiple logistic regression was used to analyze the association between level of tea consumption and depressive symptoms at follow-up. All analyses were performed with SPSS version 19.0 (SPSS, Inc., Chicago, IL). Seventy-three participants had depressive symptoms at follow-up assessment. The proportion of participants with depression at follow-up decreased with increasing tea consumption (6.6%, 5.3%, 3.2%, and 1.8%, respectively). This linear association between tea consumption and depression was confirmed in multivariate analysis. In fully adjusted model (Table 1), the odds ratio of depressive symptoms at follow-up for participants with low, medium, and high tea consumption was 1.15, 0.55, and 0.37, respectively (P for linear trend = .01). The results remained essentially the same when all participants with cognitive impairment at baseline were excluded from the analysis. A similar linear trend of association between level of tea consumption and depressive symptoms at follow-up was observed in participants who were and were not depressed at baseline, although given small number of depression cases in each of the four categories of tea consumption, further multivariate analysis was not performed. This study provides the first evidence of a longitudinal association between tea consumption and clinically meaningful depressive symptoms in older adults. The results are consistent with an earlier report on the association between tea consumption and lower prevalence of depressive symptoms in community-living elderly adults3 and several studies that were conducted in study populations other than older adults.7, 8 These results support a cause-and-effect relationship between tea consumption and low risk of subsequent depressive symptoms. The underlying mechanisms may involve the antioxidant, anti-inflammatory, cerebrovascular protective, and antidepressant effects of bioactive compounds in tea leaves.9, 10 The role of tea consumption and tea bioactive compounds in the prevention of late-life depression deserves further study. SLAS was supported by research grants 03/1/21/17/214 and 08/1/21/19/567 from the Biomedical Research Council, Agency for Science, Technology and Research, Singapore. Conflicts of Interest: We have no financial support or relationships that may pose a conflict of interest. Author Contributions: Lei Feng formulated the hypothesis, reviewed the literature, performed the statistical analysis, and wrote the letter. Tze-Pin Ng designed the research as the principal investigator of the SLAS project. Tze-Pin Ng, Jialiang Li, Ee-Heok Kua, Tih-Shih Lee, Keng-Bee Yap, and A. John Rush reviewed the statistical analysis and revised the article. All authors read and commented on the final manuscript. Sponsor's Role: No commercial company sponsored or played any role in the design and methods of the study, participant recruitment, data collection and analysis, or preparation of this article.

Although an inverse correlation between physical activity and depressive symptoms among older adults has been found in research, this relation has seldom been examined prospectively. Accordingly, the current study examined the reciprocal relations between physical activity and depressive symptoms in Estonian older adults over a 2-year period. A three-wave longitudinal model was tested using cross-lagged analysis for 195 individuals aged over 70years (mean = 72.1, SD = 2.1; 145 females). Results indicated that a cross-lagged model in which depressive symptoms predicted walking at subsequent time points (higher depressive symptoms were related to fewer walking steps), and walking predicted depressive symptoms at subsequent time points (higher walking steps were related to lower depressive symptoms) was most parsimonious and provided acceptable model fit. These results suggest that reduced physical activity may be a long-term consequence of depressive symptoms in older adults.

Sleep disturbance, neuro-immune markers, and depressive symptoms in older age: Conditional process analysis from the English Longitudinal Study of Aging (ELSA)

ObjectiveTo examine the association between 24-hour movement behaviors and depressive symptoms in older adults using compositional data analysis, and to investigate the dose-response characteristics of time reallocations between movement behaviors in relation to depressive symptoms.MethodsA cross-sectional study was conducted among 1093 urban-dwelling older adults aged 60 years and above in selected communities of Jinan City, Shandong Province, China, between April 2024 and September 2024. The Chinese version of the International Physical Activity Questionnaire-Long Form (IPAQ-LF) was used to estimate time spent in moderate to vigorous-intensity physical activity (MVPA), light-intensity physical activity (LPA), sedentary behavior (SB), and sleep (SLP) across a typical 24-hour day. The Chinese version of the Patient Health Questionnaire Depression Scale-9 item (PHQ-9) was applied to assess depressive symptoms. Compositional isotemporal substitution models were employed to explore the associations between time reallocations among 24-hour movement behaviors and depressive symptoms, accounting for the co-dependent nature of time-use data.Results(1) The geometric means of time spent in MVPA, LPA, SB, and SLP were 25.33 minutes, 141.26 minutes, 738.10 minutes, and 455.15 minutes, respectively. Variation matrix analysis revealed the highest log-ratio variance between MVPA and SB (0.168), and the lowest between SLP and SB (0.031). (2) The prevalence of screening-positive depressive symptoms was 16.29% among Chinese urban older adults. (3) Results from compositional linear regression models showed that time allocated to MVPA, LPA, and SLP (relative to the remaining movement behaviors) was negatively associated with depressive symptoms, while time spent in SB was positively associated. (4) Dose-response analysis further indicated that: (a) MVPA substitutions with other movement behaviors exhibited nonlinear and markedly asymmetric effects on depressive symptoms; (b) replacing MVPA with LPA, SB, or SLP resulted in increasingly larger changes in predicted scores as substitution duration increased, whereas the reverse substitution (MVPA for other movement behaviors) produced progressively smaller changes; and (c) substitutions between SB and LPA displayed linear and symmetrical effects.ConclusionsThe findings provide evidence of an association between 24-hour movement behaviors and depressive symptoms in Chinese urban-dwelling older adults and reinforce the importance of achieving a balance between different types of movement behaviors over a 24-hour period for mental health.

The body of evidence supporting the beneficial effects of Tai Chi in reducing anxiety and depressive symptoms in older adults is steadily increasing. Nonetheless, there remains a scarcity of studies directly comparing the clinical effectiveness of various Tai Chi exercises in addressing anxiety and depressive symptoms in older adults. Thus, this study aimed to systematically review and analyze the therapeutic efficacy of four types of Tai Chi interventions in enhancing anxiety and depressive symptoms in older adults. During the period up to July 26, 2023, searches were conducted in the Web of Science, PubMed, the Cochrane Library, CNKI, and the Chinese Scientific Journal Database (VIP). The language scope encompassed both English and Chinese. Two independent reviewers conducted the literature review and data extraction. Review Manager 5.4 was employed for traditional meta-analysis and risk assessment, while version 15 of STATA software was used for generating evidence and funnel plots for network meta-analysis. This study was registered in PROSPERO number CRD 42023442270. In this analysis, a total of 20 studies were included, involving 1798 participants. The findings of the pairwise meta-analysis revealed that Tai Chi intervention was more effective than the control group in reducing anxiety (SMD: -1.19, 95% CI: -2.04, -0.34, p < 0.05) and depression (SMD: -0.65, 95% CI: -0.95, -0.65, p < 0.05) symptoms among older adults. The network meta-analysis specifically focused on anxiety symptoms and found that Yang-style Tai Chi (69.9%) had the most favorable outcome, followed by the 24-form Simplified Tai Chi (66.8%). In terms of depression symptoms, the Tai Chi Exercise Program (92.6%) had the highest performance, followed by Yang-style Tai Chi (77.9%). The findings of this study imply that Tai Chi can have beneficial outcomes in the reduction of anxiety and depressive symptoms among older individuals. Specifically, when examining various forms of Tai Chi interventions, it was observed that Yang-style Tai Chi exhibited a greater efficacy in alleviating anxiety symptoms, whereas Tai Chi exercise programs demonstrated a higher effectiveness in improving depressive symptoms. Nonetheless, it is strongly advised that older adults select an exercise program that aligns with their interests and preferences, as this can enhance social integration and overall well-being. https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023442270, identifier [CRD42023442270].

An analysis and evaluation of the literature regarding traditional treatment methods for depression among older adults compared the effectiveness of the results to the benefits of a treatment plan that integrates the narrative practices of storytelling and reflexive writing. Priority was given to peer-reviewed journal articles from 2008 forward, though some earlier information was used for clarification and foundation building. The formation and implementation of individual patient treatment plans for depression and depressive symptoms are impacted by many variables such as: Confusion surrounding provider treatment guidelines, social organizational context, organizational climate and the differing definitions of depression that exist among providers and patients. Patients often struggle to self-identify or put words to depressive symptoms and the process of reflexive writing is transformative and increases narrative competency, which strengthens a patient’s ability to give an account of oneself, aiding in self-discovery and personal symptom awareness. An imbalance of power exists in the clinical encounter and the practices and principles of the discipline of Narrative Medicine can have a positive impact on strengthening the therapeutic alliance and treatment outcomes. Older adults with depression and depressive symptoms have a lower quality of life and often feel less productive in their communities. Traditional pharmacologically based depression treatment plans are one-dimensional and often fail to address personal patient context and preference. Older adults living with diagnosed depression and depressive symptoms can be better served with treatment plans that include narrative techniques that increase alliance, affiliation, self-awareness and self-discovery.

Objectives To examine the symptom profiles of late-onset depressive symptoms in a sample of older adults. Method The sample included 1,192 participants from the National Alzheimer’s Coordinating Center Data Set. Participants were ≥65 years old, community-dwelling, and without cognitive impairment or a prior history of depression. Depressive symptoms were assessed using the Geriatric Depression Scale, 15-item (GDS-15). Latent class analysis (LCA) was used to identify and group participants based on profiles of depressive symptoms. Results LCA revealed three distinct symptom profiles: (1) an Anhedonia/Amotivation profile with a higher probability of endorsing a combination of low positive emotion and amotivation (6%), (2) an Amotivation/Withdrawal profile with a high probability of endorsing only amotivational depressive symptoms (35%), and (3) an asymptomatic profile with no probability of endorsing any depressive symptoms (59%). Amotivational depressive symptoms were observed across both symptomatic profiles, while depressed mood (e.g. sadness) did not predominantly characterize any profile in this sample. There were also significant differences among symptom profiles in terms of demographic and clinical characteristics. Conclusions Findings highlight the importance of understanding depression at the symptom pattern level. A profile-based diagnostic approach may help improve the recognition of depressive symptoms in older adults.

BackgroundSubclinical depressive symptoms increase the risk of developing Alzheimer’s disease (AD). The neurobiological mechanisms underlying this link may involve stress system dysfunction, notably related to the hippocampus which is particularly sensitive to AD. We aimed to investigate the links between blood stress markers and changes in brain regions involved in the stress response in older adults with or without subclinical depressive symptoms.MethodsThis cross-sectional study was conducted using baseline data from the Age-Well trial. Cognitively unimpaired (CU) older adults with (DepS; n = 73) or without (NoDepS; n = 58) subclinical depressive symptoms (defined using the 15-item Geriatric Depression Scale) were included in the analyses. Blood cortisol, epinephrine and norepinephrine were measured; as well as the resting-state functional connectivity (rs-FC) between, and gray matter (GM) volume of, the hypothalamus, hippocampus and hippocampal subfields. Blood stress markers levels and neuroimaging measures were compared between groups; then regression analyses were conducted between these measures.ResultsDepS participants showed higher plasma epinephrine levels, which was associated with greater rs-FC between the CA1 and Subiculum hippocampal subfields and the hypothalamus. Lower GM volume in the CA1 and DG/CA2-3–4 subfields was also found in DepS. No between-group differences were observed for blood cortisol and norepinephrine.ConclusionsOur findings show that subclinical depressive symptoms are associated with increased sympatho-adrenomedullary axis activity, together with lower GM volume in a hippocampal subfield (i.e., CA1) particularly sensitive to AD. While causation cannot be inferred, these results suggest that screening and treating subclinical depressive symptoms in CU older adults could reduce AD risk.Trial registrationClinicalTrials.gov Identifier: NCT02977819, Registration Date: 2016–11-25.

Religiosity and depressive symptoms in older adults compared to younger adults: Moderation by age

Does physical activity mediate the reduction of depressive symptoms in older adults treated with behavioural activation? A secondary analysis of a cluster randomised trial.

Depressive symptoms are highly prevalent in older adults and may contribute to functional impairment at old age. Animal-assisted interventions (AAIs), including interventions involving dog visiting, are increasingly recognized as an innovative approach to ameliorate social, behavioral, psychological, and physical outcomes among older adults. However, available data on their potential to manage depressive symptoms in the aging population are not clear cut. The aim of this review was to conduct a meta-analysis of all prospective controlled studies evaluating the effects of dog visiting on depressive symptoms in older adults. A comprehensive literature search was conducted on the electronic databases PubMed and Scopus. Included articles were published between 1980 and 2017 and report controlled empirical studies of dog visiting interventions to ameliorate depressive symptoms in older adults. There was substantial heterogeneity between included studies, which varied in their methodological quality, sample size, and other key features. Notwithstanding such methodological variety, results all go in the same direction and indicate a large beneficial effect of interventions involving dog visiting on depressive symptoms. This analysis confirms the potential value of dog visiting in ameliorating depressive symptoms in institutionalized and noninstitutionalized older adults. This is in line with previous research indicating AAIs as promising complementary programs for preserving/enhancing emotional and behavioral function in aged individuals. More research is still needed to allow AAIs to be effectively introduced in clinical practice.

During the pre-pandemic era, around 280 million people worldwide were diagnosed with depression. Depression is one of the leading causes of disability, affecting 5.7 per cent of people aged 60 and over during the pre-pandemic period. The COVID-19 pandemic has resulted in a significant increase in the incidence of depression, with an estimated increase of 28.1 per cent worldwide, with a significant impact on older adults. The consequences of the increase in depressive symptoms can have a long-term impact and, in this sense, this problem is a global challenge for mental health professionals. Knowing the impact of COVID-19 on depressive symptoms in older adults will allow mental health professionals to be better prepared for a future pandemic crisis and to develop interventions aimed at reducing depressive symptoms in this population. The development of interventions that promote mental health is crucial now and, in the future, so knowing the impact of the pandemic crisis on depressive symptoms is useful in pursuing this goal. The aim of this article is to describe some recent results on the impact of COVID-19 on depressive symptoms in older adults, and to discuss possible future perspectives.

Vision impairment is prevalent and it is strongly associated with depressive symptoms in older adults. This study aimed to investigate the mediating roles of functional limitations and social support on the relationship between vision impairment and depressive symptoms in older adults. This study used data from a probability-based sample of 1,093 adults aged 60 and older in Shanghai, China. Structural equation models were used to examine the structural relationships among sets of variables simultaneously, including vision impairment, activities of daily living ADLs, instrumental ADLs (IADLs), friends support, family support, relatives support and depressive symptoms. The bootstrapping method and the program PRODCLIN were used to test the indirect effects of these variables. This study found that vision impairment was directly associated with a higher level of depressive symptoms, and the association was partially mediated by functional limitations (IADLs) and social support (friends support). The study demonstrates that improving social support from friends and enhancing social participation for visually impaired older adults can reduce depressive symptoms. More importantly, this study contributes to the knowledge of mediating mechanisms between vision impairment and depressive symptoms.