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Victoria Lane has made a successful career from writing; as an award-winning financial journalist for many years, editor and correspondent for many leading media publications, and of course, as a picture and chapter book writer for children. Today, we delve into Victoria’s writerly mind as she shares her inspirations behind her touching picture book, Celia […]

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By Siegfried Weyerer

Depression in old age occurs frequently, places a severe burden on patients and relatives, and increases the utilization of medical services and health care costs. Although the association between age and depression has received considerable attention, very little is known about the incidence of depression among those 75 years of age and older. Studies that treat the group 65+ as one entity are often heavily weighted towards the age group 65-75. Therefore, the prediction of depression in the very old is uncertain, since many community-based studies lack adequate samples over the age of 75.

With the demographic change in the forthcoming decades, more emphasis should be put on epidemiological studies of the older old, since in many countries the increase in this age group will be particularly high. To study the older old is also important, since some crucial risk factors such as bereavement, social isolation, somatic diseases, and functional impairment become more common with increasing age. These factors may exert different effects in the younger old compared to the older old. Knowledge of risk factors is a prerequisite to designing tailored interventions, either to tackle the factors themselves or to define high-risk groups, since depression is treatable in most cases.

In our recent study, over 3,000 patients recruited by GPs in Germany were assessed by means of structured clinical interviews conducted by trained physicians and psychologists during visits to the participants’ homes. Inclusion criteria for GP patients were an age of 75 years and over, the absence of dementia in the GP’s view, and at least one contact with the GP within the last 12 months. The two follow-up examinations were done, on average, one and a half and then three years after the initial interview.

Depressive symptoms were ascertained using the 15-item version of the Geriatric Depression Scale (GDS). We found that the risk for incident depression was significantly higher for subjects

• 85 years and older
• with mobility impairment and vision impairment
• with mild cognitive impairment and subjective memory impairment
• who were current smokers.

It revealed that the incidence of late-life depression in Germany and other industrialized countries is substantial, and neither educational level, marital status, living situation nor presence of chronic diseases contributed to the incidence of depression. Impairments of mobility and vision are much more likely to cause incidents of depression than individual somatic illnesses such as diabetes mellitus and coronary heart disease. As such, it is vital that more attention is paid to the oldest old, functional impairment, cognitive impairment, and smoking, when designing depression prevention programs.

GP practices offers ample opportunity to treat mental health problems such as depression occurring in relation to physical disability. If functional impairment causes greater likelihood of depression, GPs should focus on encouraging older patients to maintain physical health, whether by changing in personal health habits, advocating exercise, correcting or compensating functional deficits by means of medical and surgical treatments, or encouraging use of walking aids. Additionally, cognitive and memory training could prevent the onset of depressive symptoms, as could smoking cessation. If these steps are taken, the burden of old age depression could be significantly reduced.

Siegfried Weyerer is professor of epidemiology at the Central Institute of Mental Health in Mannheim, Germany. He has conducted several national and international studies on the epidemiology of dementia, depression and substance use disorders at different care levels. He is also an expert in health/nursing services research. He is one of the authors of the paper ‘Incidence and predictors of depression in non-demented primary care attenders aged 75 years and older: results from a 3-year follow-up study’, which appears in the journal Age and Ageing. You can read the paper in full here.

Age and Ageing is an international journal publishing refereed original articles and commissioned reviews on geriatric medicine and gerontology. Its range includes research on ageing and clinical, epidemiological, and psychological aspects of later life.

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Image credit: Grief. Photo by Anne de Haas, iStockPhoto.

The post Depression in old age appeared first on OUPblog.

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I don't want you to think I really swim a mile - or even half a mile - every day, as I did for a time when I was at school (well, every weekday, pretty much). I still enjoy swimming but my Olympic ambitions did not last long. I got as far as swimming for my (smallish) town, was beaten by the girl from Castleford, and that was pretty much it. Even if I'd had the talent, I don't think I'd ever have had the resolve and determination to do all that training day after day.

Like many others, I'm currently enjoying the Olympic Games and especially the swimming - marvelling at the performances, the dedication, the sportsmanship and the articulate interview responses of these inspirational youngsters.

My swimming ambitions fizzled out long ago but I do still have ambition of a kind, at least where my writing is concerned. In these last few weeks - a time of reflection following the sad and sudden death of my father - I've been trying to work out what ambition means, if anything, when you reach the age of 57. What exactly do I hope to achieve by all this writing I do every day? Is it really just a hobby, like going for an early morning swim or dabbling my feet (when I get the chance) in the sea? No, I think I'm fuelled by something more powerful than that - but what am I pointing myself towards?

I thought I was aiming to earn enough from my books (some hope?) to buy myself a little seaside retreat. But, as it turns out, my wonderful father, who never earned a high salary in his life but never spent much either and invested wisely, has left me enough to make this dream come true. So, all being well, I will have my seaside hideaway, which I hope to share with family and friends. But where does that leave my writing ambitions? Intact, I'm sure of that, but the question remains - why I am working so hard?

It's not for fame, I know that much. I'm old enough to know that fame is not what Rosalies like best (not this one, anyway). Not that I've ever experienced it, but you know what I mean. I hate attention, being stared at, having my photo taken, being expected to behave in certain ways and having things to live up to. Nor is it for money, since I'm also old enough to know that fortunes bring troubles of their own.

I suppose it all boils down to wanting to write the best books I can - and wanting people to read them. I think my deepest ambition is to go on being active, both mentally and physically, for as long as I possibly can. And never to stop trying something new, especially where my writing is concerned.

Alongside that is a wish to be part of something wonderful - something that involves inspiring young people both to read and write. When I hear youngsters enthusing over books - and when I see them having a go at writing for themselves - it makes me happier than just about anything else. Yes, of course it's extra special if they like my books and engage with my characters, but, leaving ego aside, to be part of the tradition (beautifully enacted in that Olympic opening ceremony) of writing for children and YA - is a wonderful privilege. So I guess my ambition has to be to try to find better ways to connect with my readers through my books, and maybe to get some children reading who might not otherwise have thought of it. And to try to support, as well as be supported by, other writers, teachers, librarians, publishers, etc, who are doing the same. Not very original, perhaps, but enough to keep me going for as many years as I have left!

So I will continue to write my daily mile, and try to keep up the swimming too.

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I’m a big fan of Allen Say so I was happy to see him featured recently in our illustrator’s gallery. I’ve read a number of his books but one I enjoyed recently was Music for Alice.  Alice is a Japanese American woman who loves to dance, but circumstances in her life prevent her from enjoying this dream to the full.  Born in California, Alice grows up, goes to college and marries a man named Mark who “wasn’t much of a dancer” and moves to Seattle, Washington.  Not long afterwards, the war comes, and Alice and Mark are sent to Portland, Oregon and are then removed inland to work farm fields on the eastern edge of the state.  Such hardship was difficult and as Alice puts it “Even the thought of dancing didn’t cheer me very much.”  The couple survive, however, and go on to buy a farm of their own on which they grow various crops until they hit upon the idea of growing flowers — gladioli — to be specific, and become the largest gladiola bulb growers in the U.S.

All throughout the book as Alice recounts her life, she reflects occasionally on her love of dancing.  It is not until the end of the book and the end of her life, does she suddenly come to an epiphany.  Looking on the ruins of her old farm house, she is overcome by a “wonderful feeling” that makes her suddenly ask, “Now I can dance?”  And as the book concludes, “And dance I do — all that I can.”

Music for Alice is an old woman’s meditation on the past.  Old age is its own frontier, and there are still things to learn and discover there.  Allen Say’s superb, nuanced illustrations evoke Alice’s life with clarity and depth.  I highly recommend his picture books which make wonderful reading for children and adults.

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Good Afternoon:

It's been ever so long since I've had a few spare moments to pamper my blog.

You see, one of our dear family members is not doing so well. Although she's only 13 years old, if the wives tale of "dog years" is true, then really, she's 91 years old.

Dear old Homerella. Our loyal, sweet and silly Labrador Retriever is giving out. As so many large breed dog owners know, those old hips and back legs can become weak and painful in the later years.

Homer joined our family when she was 2-1/2 years young. She was so very playful. Her favorite pastime was chasing bees ~



and rolling and lolling about the patio ~





She loved modeling for my art work ~





She was obedient and always ready to sit for a treat ~



Today, she is still all those things in her heart. The difference is, her body won't allow her to chase bees, sit for a treat or roll about the patio. She is quite thin and her hips and back legs are atrophied ~





She has the look of oldness in her eyes ~



I don't know how much longer she'll be with us, so we are lavishing her with even more attention than usual, and smuggling bits of cheese in her food bowl! Her mind and soul are still strong, as is her appetite. But her body is not so strong. I, on the other hand, am becoming quite strong considering I have been lifting her up to move her about.

So, as we enter the weekend, we are stepping easy and hopeful that she'll still be with us this time next week.

We love you girl.

Until Next Time:
Kim
Garden Painter Art

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Thomas Hine's beloved Populuxe is now available in paperback, just as Hine's fabulous new book on the 70's, The Great Funk, hits bookshelves. Populuxe is an entertaining look at America at midcentury, from 1954 to 1964, and covers everything from tailfins and tv dinners to Barbie dolls and fallout shelters. Michiko Kakutani of The New York Times wrote "Mr. Hine's text is so lively and informative that Populuxe must surely stand as one of most sprightly cultural histories to come along in a long time."

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