Successful Aging and Longevity in Older Old Women: The Role of Depression and Cognition

Department of Psychology and Institute of Gerontology, Wayne State University, Detroit, MI 48202-3801, USA.
Journal of aging research 07/2011; 2011:912680. DOI: 10.4061/2011/912680
Source: PubMed


Based in successful aging theory and terminal cognitive drop research, this paper investigates cerebrovascular burden (CVB), depressive symptoms, and cognitive decline as threats to longevity. A subsample of stroke-free women over the age of 80 was identified in the Health and Retirement Survey (years 2000-2008). Mortality at 2, 6, and 8 year intervals was predicted using CVB (diabetes, heart disease, hypertension), depressive symptoms (Center for Epidemiological Studies Depression Scale), and cognitive decline (decline of 1 standard deviation or more on the 35-point Telephone Interview for Cognitive Status over 2 years). At most waves (2002, 2004, and 2006) mortality was predicted by CVB, depressive symptoms, and cognitive drop measured 2 years prior. CVB and depressive symptoms at the 2000 wave predicted mortality at 6 and 8 years. Older women with the greatest longevity had low CVB, robust cognitive functioning, and few depression symptoms, supporting successful aging theory and terminal cognitive drop.

Download full-text


Available from: Mary Elizabeth Bowen
  • Source
    • "A lower cerebrovascular burden in the oldest-old is associated with longevity, fewer depressive symptoms, and stable cognitive function.27 Table 2 shows that the effect of certain cognitive tests (digit cancellation, comparing figures, mental rotations, and verbal fluency) remains in the healthy groups (ie, those not affected by hypertension, stroke, or dementia), meaning that the results are not based on a lower LS score due to effects of stroke or dementia per se. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Studies on the associations between cognitive abilities and life satisfaction (LS) in the oldest-old are few. The aim of this study was to explore whether abilities in six different cognitive domains could predict LS in the oldest-old 3 years later. The study population consisted of 681 individuals aged 78-98 years, drawn from the longitudinal population study "Good Aging in Skåne," which is part of a national survey (The Swedish National Study on Aging and Care). Scores on 13 cognitive tests were related to scores on Neugartens' LS index A (LSI-A) 3 years later. The cognitive tests were added into six different cognitive domains. A multiple regression analysis was constructed for each cognitive domain separately, with scores on the LSI-A as the dependent variable. The model was adjusted stepwise for sex, age, education, functional capacity, and depressive mood. Significant correlations were found between digit cancellation, word recall, verbal fluency (VF) A, VF animals, VF occupations, and mental rotations at baseline, as well as LSI-A at follow-up. The domains of spatial abilities (B = 0.453, P = 0.014) and processing speed (B = 0.118, P = 0.020) remained significantly associated with LSI-A 3 years later after adjustment. The cognitive domains of spatial abilities and processing speed predicted LS 3 years later in the oldest-old. Clinical implications are discussed.
    Preview · Article · Jul 2013 · Clinical Interventions in Aging
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background and aim: Depressive symptoms are common symptoms impairing the quality of life of older people. This population-based birth year cohort study investigated the prevalence of depressive symptoms and factors associated with them among home-dwelling older people. Study Design: A prospective, population-based 15-year follow-up study of the age cohort of 70-yearolds living in the city of Turku, Finland. Methods: The data were collected in 1991 by a postal questionnaire that was sent to all residents of Turku, Finland, born in 1920 (N = 1530). Follow-ups using the same procedure were conducted in 2001 and 2006. All examinations included an identical study protocol; the participants´ self-reported health status/habits and depressive symptoms were investigated via a questionnaire. Afterwards, thorough clinical examinations including the Zung depression scale were conducted by a nurse and physician/geriatrician. Results: The mean of the Zung depression scale total score was 34 (SD 7.7) at the age of 70 and a significant increase was found in both re-examinations. At the age of 80 the mean of the Zung score was 35.8 (SD 7.5) while it was 37.6 (SD 8.9) at the age of 85 years. A similar increasing trend was found in the proportion of persons classified into the high Zung score group (􀀁 45 points) indicating more depressive symptoms over the 15 year follow-up. Univariate and multivariate analyses showed that mostly functional and social factors were associated with subjectively reported depressive symptoms, while few associations were evidenced between depressive symptoms and medical conditions or poor health. Conclusions: Our findings revealed an increase in prevalence of depressive symptoms throughout the course of the investigation. Our findings suggest that even in the absence of a diagnosis of major depression, depressive symptoms assume importance in the evaluation of the health status and need for health care services among older people.
    No preview · Article · Apr 2012 · Aging - Clinical and Experimental Research
  • [Show abstract] [Hide abstract]
    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.
    No preview · Article · Jun 2012 · Aging and Mental Health
Show more