Objective
Older adults who live alone are more likely to report feelings of depression than those who live with a spouse or other family members. This study examines the effects of residential status and perceived neighborhood characteristics on depression in middle-aged and older adults.
Methods
This study is based on a probability sample of 1049 adults aged 55–98 years (M = 69 years) residing in Allegheny County, Pittsburgh, PA, USA in 2014. Thirty percent of participants reported living alone. We tested a multivariate model using living alone (vs. living with a family member or others) and perceived neighborhood physical and social quality as predictors of depressive symptomatology while controlling for age, sex, race, education, and disability.
Results
Living alone (compared to living with a family member) was associated with elevated levels of depressive symptomatology. However, perceptions of neighborhood social quality moderated this association. Living alone was more highly associated with depression when the perceived social quality of the neighborhood was low. Neighborhood social quality was not associated with depression among older adults who lived with a family member. Perceptions of neighborhood physical quality were not significantly associated with depression.
Conclusions
Perceptions of good neighborhood social quality is important for adults who live alone, in terms of fewer symptoms of depression.
This systematic review examines the relationship between late-life spousal bereavement and changes in routine health behaviors. We review six behavioral domains/modifiable risk factors that are important for maintaining health among elderly populations: physical activity, nutrition, sleep quality, alcohol consumption, tobacco use, and body weight status. Thirty-four articles were identified, derived from 32 studies. We found strong evidence for a relationship between bereavement and nutritional risk and involuntary weight loss, and moderate evidence for impaired sleep quality and increased alcohol consumption. There was mixed evidence for a relationship between bereavement and physical activity. We identify several methodological shortcomings, and describe the clinical implications of this review for the development of preventive intervention strategies.
Results indicate that FTP may play an important role in explaining engagement in health promoting behaviors across the life span. Researchers should consider additional constructs and perhaps adopt socioemotional selectivity theory when explaining adults' engagement in physical activity.
Prevention of major depressive disorder is important because current treatments are only partially adequate in reducing symptom burden and promoting health-related quality of life. Lifestyle interventions may be a desirable prevention strategy for reasons of patient preference, particularly among older patients from minority groups. Using evidence from a randomized depression prevention trial for older adults, the authors found that coaching in healthy dietary practices was potentially effective in protecting at-risk older adults from developing incident episodes of major depression. The authors describe the dietary coaching program (highlighted in a case example) as well as the feasibility and potential efficacy of the program within the context of evidence-based interventions for preventing episodes of major depression and mitigating symptoms of depression. Older adults receiving dietary coaching experienced a low incidence of major depressive episodes and exhibited a 40%–50% decrease in depressive symptoms, as well as enhanced well-being, during the initial 6-week intervention; these gains were sustained over 2 years. The authors also describe why lifestyle interventions like coaching in healthy dietary practices may hold promise as effective, practical, nonstigmatizing interventions for preventing episodes of major depressive disorder in older adults with sub-syndromal depressive symptoms.
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