Developmental Crisis in Aging: Depression

Developmental Crisis in Aging: Depression

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  Developmental Crisis inAging: Depression KarenWhiteman,PhD June30,2014 1
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  Population65 Years andOlder by Size and Percentof Total Population:1900to 2010 2 (U.S. Census Bureau, 2010)
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  Prevalenceof DepressionAmong OlderAdults in the U.S. Depression is one of the most common mental illnesses suffered by older adults (Kessler, 2003). • Major depressive disorder affects between 1 and 4% of adult aged 65 years, and subsyndromal depression affects between 10 and 15% of adults aged 65 years and older (Blazer, 2009; Thomas & O’Brien, 2006). • Burt and Stein (2002) found that “females have a lifetime rate of major depressive disorder 1.7 to 2.7 times greater than men” (p. 258). 3
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  Depression Video http://youtu.be/h-lsyKBzuZo 4
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  Small Group Discussion •What does depression look like in older adults (men vs women)? • What are the social risk factors for depression in older adults (men vs women)? • What tools do you use to screen and assess for depression in older adults (men vs women)? 5
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  What does depressionlook like in older adults? 6 Common Symptoms: Memory complaints, anhedonia, somatic complaints, anxiety, lack of interest in personal care, sleep disturbance, tiredness, loss of interest in life, hopelessness, slowed movement, and agitation Gender-specific (women): Appetite problems, vegetative symptoms, and cognitive dysfunction
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  Common Biological RiskFactors for Depression in Older Adults • Biological: Genetics and heredity; Vascular depression; Alzheimer’s disease; Medical issues including myocardial infarction and other heart conditions, diabetes, hip fracture, stroke, functional impairment, and Parkinson's disease • Gender-specific (women): Biological effects of substance use, including prescription drug use and alcohol use; Neurotransmitter dysfunction; Endocrine changes; Insomnia; multiple chronic physical conditions including diabetes, cardiovascular disease, and obesity. 7
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  Common Psychological RiskFactors for Depression in Older Adults • Psychological: Neuroticism; Cognitive distortions; Emotional control; Avoidant coping style • Gender-specific (women): None found specific for older women 8
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  What are thesocial risk factors for depression in older adults? • Social: Death of a close family member, friend, or spouse; Personal illness; Change in sleeping habits; Social isolation; Relationship problems • Gender-specific (women): Bereavement; Change in financial situation; Change in the health of a family member (caregiving); Change in living condition/residence; Personal injury (older adult mistreatment/abuse) *Death of a close family member or friend spouse *Personal illness *Personal injury *Change in sleeping habits 9
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  What tools doyou use to screen and assess for depression in older adults? • The Geriatric Depression Scale • The Mini International Neuropsychiatric Interview-Depression • Center for Epidemiologic Studies Depression Scale 10
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  Theoretical Model: AnIntegrated Life Span Risk and Resilience Perspective 11 • The life span perspective suggests that development occurs throughout a lifetime. • Risk and resilience perspective suggests that problems can be prevented or at least reduced by identifying the factors that increase the risk of having these problems and then eliminating them or reducing their effects.
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  Significance for HealthProfessionals • Research • Research has focused primarily on reducing the symptoms of depression for the general aging population, not the root causes of depression. • Researchers need to develop gender-specific interventions, and screening and assessment tools. • Apps • Social media (facebook, twitter, google +) • Skype (Reminiscence therapy) 12
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  Significance for Health Professionals •Practice and Teaching • Health care providers must be knowledgeable about depression in older adults and men’s and women’s experience of life stress related to depression. • Change Agents! • Workbooks (HHS, SAMHSA, and AHRQ) • Curricula (National university accreditation) 13
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  Significance for Health Professionals •Policy • Policies need to support looking at the individual more holistically. • Promote health through considering contextual factors associated with the development of depression. • Engage policy stakeholders and partners to support research to design gender-based screening and early and preventative interventions and advance educational curriculum. • Policymakers need to consider this study’s findings as they develop and support existing health policy. • Integrated care and enhanced specialty referral 14
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  Thank you Contact Information: [email protected] www.karenwhiteman.com @karenwhiteman15