Article

Comparison of depressive symptoms between homebound older adults and ambulatory older adults

School of Social Work, University of Texas at Austin, Austin, TX 78712-0358, USA.
Aging and Mental Health (Impact Factor: 1.78). 06/2007; 11(3):310-22. DOI: 10.1080/13607860600844614
Source: PubMed

ABSTRACT Due to the social isolation imposed by chronic illness and functional limitations, homebound older adults are more vulnerable to depression than their mobility-unimpaired peers. In this study, we compared 81 low-income homebound older adults, aged 60 and older, with their 130 ambulatory peers who attended senior centers, with respect to their depressive symptoms, depression risk and protective factors, and self-reported coping strategies. Even controlling for sociodemographics, health problems, and other life stressors, being homebound, as opposed to participating in senior centers, was significantly associated with higher depressive symptoms. However, when the coping resources-social support and engagement in frequent physical exercise, in particular-were added to the regression model, the homebound state was no longer a significant factor, showing that the coping resources buffered the effect of the homebound state on depressive symptoms. In terms of self-reported coping strategies, even among the depressed respondents, only a small proportion sought professional help, and that was largely limited to consulting their regular physician and social workers, who may not have had professional training in mental health interventions.

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    • "In a different publication, the Amsterdam group found that higher levels of cortisol were not associated with cognitive decline in older adults (N = 1,154) over a period of 6 years (Comijs et al., 2010). Salivary cortisol was measured in 40 healthy ethnicity (Killian, Turner, & Cain, 2005); living arrangements (Choi & McDougall, 2007), and memory complaints (Crane, Bogner, Brown, & Gallo, 2007; McDougall, 1995). This study examined the prevalence of depressive symptoms over time in a sample of community-residing older adults at baseline, 2 months, 6 months, and 14 months. "
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    ABSTRACT: We examined the prevalence of depressive symptoms over time in a sample of community-residing older adults at baseline, 2 months, 6 months, and 14 months. The nonprobability sample (N = 222) was 90% female, 87% Caucasian, 15% Hispanic, and 12% African American with an average age of 75 years. If depressive symptoms had been measured at only one time, 19% of the sample would have scored above the cutoff versus 39% scoring above the cutoff when measured at all 4 periods. The findings provide evidence that depressive symptoms in older adults are variable and fluctuate over time. The significance of this research was the longitudinal evaluation of depressive symptoms in community-residing elders.
    Archives of psychiatric nursing 04/2012; 26(2):e13-21. DOI:10.1016/j.apnu.2011.12.004 · 1.03 Impact Factor
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    • "Low-income homebound older adults are unlikely to seek and use treatment for their depression when managing their more-pressing disability and chronic medical conditions as well as paying for and taking medication for these conditions (Proctor et al. 2008). Having to take multiple medications for multiple medical problems may also raise their concerns about medication-interaction effects (Choi and Morrow–Howell 2007). The primary need factor was the level of depressive symptoms . "
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    ABSTRACT: Little research has been done on the use of antidepressants among homebound older adults, especially low-income homebound older adults, and their perceptions of the effectiveness of their medication. The purposes of this study were to examine self-reported use of antidepressants among depressed homebound older adults, class and type of antidepressants used, individual-level correlates of antidepressant use, and users' perceptions of the effectiveness of antidepressants. Data on self-reported use of antidepressants were obtained as part of a feasibility study of short-term telehealth problem-solving therapy for depressed low-income homebound adults (n = 162) aged 50 or older. The 24-item Hamilton Rating Scale for Depression (HAMD) was used to assess depression severity. The findings show that about half of the study participants were taking antidepressants, with 26.6% of those on antidepressants rating their medications very effective and 21.5% rating them effective. Female gender was positively, but older age and being Black/African American were negatively associated with the likelihood of antidepressant use. Perceived effectiveness of antidepressants was negatively associated with older age and the HAMD score. The findings suggest that personalized approaches to depression management may be needed in subgroups of depressed older adults, including culturally tailored medication counseling in Black/African-American older adults.
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    • "Some studies have found that senior center participants have better psychological well-being across several measures than nonparticipants, including perceived social and health benefits (Gitelson et al., 2005), depression (Choi & McDougall, 2007), friendships (Aday, Kehoe, & Farney, 2006), and stress levels (Farone, Fitzpatrick, & Tran, 2005; Maton, 2002). Aday et al. (2006) found that women who lived alone were most likely to participate in senior centers, develop friendships, and expand their social networks outside of the senior center. "
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