UNASSIGNED: The aim was to systematically review the association between depression and frailty in the elderly.
UNASSIGNED: Databases such as PubMed, Web of Science, Embase, and Scopus were searched for articles on the link between the risk of depression and frailty since the creation of the databases to September 1, 2023. A pair of investigators collaboratively conducted the screening, collected data, and evaluated the potential for bias in the included studies. R software was utilized for meta-synthesis.
UNASSIGNED: Eight cohort studies comprising 13 043 participants and 14 854 senior individuals with depression were included. The meta-analysis showed that there was a significant connection regarding frailty and the incidence of depression among the elderly (Risk Ratio [RR] = 3.26, 95% Confidence Interval [CI]: 1.68-6.32). Subgroup evaluations showed that there was no association between frailty and depression in the community-dwelling elderly (RR = 2.28, 95% CI: 0.644-8.102) and in the elderly patients with depression assessed by Center for Epidemiological Studies Depression Scale (CES-D) (RR = 5.82, 95% CI: 0.481-70.526).
UNASSIGNED: Frailty is correlated with the risk of depression in the elderly. Frailty is a contributing factor to depression in the elderly.

BACKGROUND: Given the rising prevalence of depression among older adults and the associated increase in caregiving responsibilities, understanding factors influencing caregiver burden is crucial. Previous research has not extensively explored the impact of caregivers\' attributional styles, that is, how individuals interpret the causes of life events, on their care burden.
OBJECTIVE: This study examined the relationship between caregivers\' attributional styles and their care burden for older patients with depression.
METHODS: This cross-sectional study enrolled older adults aged ≥ 65 years diagnosed with depression and their caregivers. Depression was diagnosed according to the DSM-V criteria for Major Depressive Disorder or Persistent Depressive Disorder. Caregivers completed the Chinese Depression Caregiver Burden Scale (CDCBS) to assess care burden, the Hamilton Depression Rating Scale (HAM-D) to evaluate patient symptom severity, the Center for Epidemiological Studies Depression Scale (CES-D) for measuring caregivers\' depression, and the Chinese Depression Patient Caregiver Attribution Style Scale (CDPCAS) to assess attributional styles. Hierarchical regression analysis was used to identify the factors independently associated with the caregiver\'s subjectively assessed care burden.
RESULTS: The sample included 146 caregivers of geriatric patients with depression. Most depression patients were women (74.7%) with a mean age of 74.3 years, whereas the mean age of caregivers was 57.7 years. Hierarchical regression analysis identified that caregivers\' gender (β = - 0.14, p = .044), educational level (β = 0.19, p = .008), caregivers\' own depression assessed by the Center for Epidemiological Studies Depression Scale (β = 0.41, p < .001), and attributional styles, particularly manipulation (β = 0.29, p < .001) and illness/stress attributional style (β = 0.23, p = .002) as independent factors associated with care burden. Patient symptom severity assessed using the Hamilton Depression Scale was not significantly correlated with care burden after controlling for attributional styles.
CONCLUSIONS: Certain attributional styles, particularly the manipulation and illness/stress attributional styles, significantly increased self-reported care burden. These findings highlight the need for educational resources to change the attribution style, along with support systems and accessible mental health services for caregivers to potentially ease the care burden.

OBJECTIVE: The impact of the government-initiated senior employment program (GSEP) on geriatric depressive symptoms is underexplored. Unearthing this connection could facilitate the planning of future senior employment programs and geriatric depression interventions. In the present study, we aimed to elucidate the possible association between geriatric depressive symptoms and GSEP in older adults.
METHODS: This study employed data from 9,287 participants aged 65 or older, obtained from the 2020 Living Profiles of Older People Survey. We measured depressive symptoms using the Korean version of the 15-item Geriatric Depression Scale. The principal exposure of interest was employment status and GSEP involvement. Data analysis involved multiple linear regression.
RESULTS: Employment, independent of income level, showed association with decreased depressive symptoms compared to unemployment (p<0.001). After adjustments for confounding variables, participation in GSEP jobs showed more significant reduction in depressive symptoms than non-GSEP jobs (β=-0.968, 95% confidence interval [CI]=-1.197 to -0.739, p<0.001 for GSEP jobs, β=-0.541, 95% CI=-0.681 to -0.401, p<0.001 for non-GSEP jobs). Notably, the lower income tertile in GSEP jobs showed a substantial reduction in depressive symptoms compared to all income tertiles in non-GSEP jobs.
CONCLUSIONS: The lower-income GSEP group experienced lower depressive symptoms and life dissatisfaction compared to non-GSEP groups regardless of income. These findings may provide essential insights for the implementation of government policies and community-based interventions.

UNASSIGNED: The prevalence of depression among the elderly is a growing concern, and this study examines the differences between urban and rural areas in terms of geriatric depression.
UNASSIGNED: Using a two-stage random sampling approach in urban areas and a multistage random sampling approach in rural areas, the study surveyed 944 elderly individuals of both sexes.
UNASSIGNED: The results indicate that the prevalence of depression was high, with 52.5% of the elderly population experiencing mild to severe depression. The study found that increasing age, female gender, nuclear family structure, and involvement of housewives or others were significant factors affecting depression in urban areas, while increasing age and elderly people without spouses were significant factors in rural areas. Additionally, the study identified hearing impairment, asthma, and arthritis as risk factors for depression in rural areas, and bronchitis, heart disease, and thyroid illness as significant factors in urban areas.
UNASSIGNED: These findings highlight the need for policymakers to focus on addressing the mental health needs of older people, particularly women and those without spouses.

UNASSIGNED: Depression is one of the most common psychological disorders in later life. Although psychological interventions are recommended by treatment guidelines, most older adults with depression remain untreated. The aim of this study is to evaluate the efficacy of the Portuguese version of Metacognitive Training for Depression in later life (MCT-Silver).
UNASSIGNED: This is a study protocol of an observer-blind, parallel-group, randomized controlled trial to compare the efficacy of MCT-Silver with a treatment as usual (TAU) control group among older adults (age 65 years and older) with depressive symptoms according to the Montgomery-Asberg Depression Scale. Participants will be tested at three assessment time points (baseline, immediately following the intervention [8 weeks], and 3 months after the intervention). The primary outcome is change in self-rated depression symptoms assessed by the Beck Depression Inventory (BDI-II). Secondary outcomes include clinician-rated depression, self-esteem, dysfunctional beliefs, metacognitive beliefs, ruminations, attitudes toward aging and quality of life. A self-designed subjective appraisal rating scale consisting of 21-items will be used to assess participant acceptance of MCT-Silver.
UNASSIGNED: MCT-Silver is an innovative intervention, which aims to reduce dysfunctional thoughts as well as depression-related behaviors and coping strategies through the metacognitive perspective. Until now, the training has only been tested in Germany. It is expected that after 8 weeks of treatment and 3 months later, the experimental group will demonstrate significant reductions in depressive symptoms, metacognitive beliefs, dysfunctional attitudes and ruminative responses compared to the TAU group. Moreover, quality of life, self-esteem, and attitudes towards aging will be significantly improved in MCT-Silver compared to the TAU group.
UNASSIGNED: ClinicalTrials.gov, NCT05640492.

UNASSIGNED: Elderly individuals are among the age groups with the highest risk of suicide. The coronavirus (COVID-19) pandemic forced isolation and resulted in an increased risk of depression, hopelessness, and perceived burdensomeness among the elderly, thereby increasing the risk of suicide.
UNASSIGNED: This is a case report of an elderly single retired school principal with obsessive-compulsive personality traits who developed depression with psychotic symptoms after being isolated following the movement control order (MCO) during the COVID-19 pandemic. The social isolation led to feelings of loneliness and hopelessness. The patient\'s depressive symptoms worsened after he developed physical illnesses, such as eye floaters, that affected his daily activities. This caused him to have suicidal ideation to the extent that he attempted suicide by ingesting 90 mL of pesticide. Two weeks prior to the attempt, he updated his will and asked his friend to keep it. After the suicide attempt, he vomited and had diarrhea and epigastric pain. He called his friend, who brought him to the hospital emergency room (ER). He was resuscitated and subsequently admitted to the intensive care unit (ICU). After being medically stabilized, he was transferred to the psychiatric ward, where further treatment was administered for his depression. His depressive symptoms and suicidal ideation improved after he was administered antidepressants and psychotherapy.
UNASSIGNED: The impact of the COVID pandemic has led to a surge in mental health issues such as anxiety and depression. The elderly are among the highest-risk groups of individuals to contract or die of COVID-19 infection, and they are also the most likely to develop mental health issues related to the pandemic. Furthermore, the risk of death by suicide is highest in this age group due to physical illness, social isolation, and the lack of a support system. This case also highlights the need for awareness of suicidal ideation screening among non-medical healthcare professionals and religious organizations to avoid the treatment gap.
UNASSIGNED: It is essential to enhance suicide risk assessment and management among the elderly after the COVID-19 pandemic.

The prevalence of depression is increasing, and geriatric depression, in particular, is difficult to recognize and treat. Depression in older adults is often accompanied by neuroinflammation in the central nervous system (CNS). Neuroinflammation affects the brain\'s physiological and immune functions through several pathways and induces depressive symptoms. This study investigated the relationship among depression, neuroinflammation, and fish oil supplementation. Thirty-six male Sprague-Dawley rats were used in an aging-related depression animal model to simulate geriatric depression. Cognitive function, depressive-like symptoms, peripheral nervous system and CNS inflammation status, and the tryptophan-related metabolic pathway were analyzed. The geriatric depression animal model was associated with depressive-like behaviors and cognitive impairment. The integrity of the blood-brain barrier was compromised, resulting in increased expression of ionized calcium-binding adapter molecule 1 and the glial fibrillary acidic protein in the brain, indicating increased neuroinflammation. Tryptophan metabolism was also negatively affected. The geriatric-depressive-like rats had high levels of neurotoxic 5-hydroxyindoleacetic acid and kynurenine in their hippocampus. Fish oil intake improved depressive-like symptoms and cognitive impairment, reduced proinflammatory cytokine expression, activated the brain\'s glial cells, and increased the interleukin-10 level in the prefrontal cortex. Thus, fish oil intervention could ameliorate abnormal neurobehaviors and neuroinflammation and elevate the serotonin level in the hippocampus.

BACKGROUND: Homebound older adults are a high-risk group for depression. However, many of them face barriers to accessing evidence-supported mental health treatments. Digital mental health interventions can potentially improve treatment access, but few web-based interventions are explicitly tailored for depression in older adults.
OBJECTIVE: This paper describes the development process of Empower@Home, a web-delivered intervention for depression in homebound older adults that is based on cognitive behavioral therapy, and reports on the outcomes of usability studies.
METHODS: Empower@Home was developed in collaboration with community agencies, stakeholders, and older adults, guided by user-centered design principles. User needs were assessed through secondary data analysis, demographic and health profiles from administrative data, and interviews and surveys of community partners. A comparative usability evaluation was conducted with 10 older adults to assess the usability of Empower@Home compared to 2 similar programs. Field testing was conducted with 4 end users to detect additional usability issues.
RESULTS: Feedback and recommendations from community partners heavily influenced the content and design of Empower@Home. The intervention consists of 9 sessions, including psychoeducation and an introduction to cognitive behavioral therapy skills and tools through short video clips, in-session exercises, an animated storyline, and weekly out-of-session home practice. A printed workbook accompanies the web-based lessons. In comparative usability testing (N=10), Empower@Home received a System Usability Scale score of 78 (SD 7.4), which was significantly higher than the 2 comparator programs (t9=3.28; P=.005 and t9=2.78; P=.011). Most participants, 80% (n=8), preferred Empower@Home over the comparators. In the longitudinal field test (n=4), all participants reported liking the program procedures and feeling confident in performing program-related tasks. The single-subject line graph showed an overall downward trend in their depression scores over time, offering an encouraging indication of the intervention\'s potential effects.
CONCLUSIONS: Collaboration with community stakeholders and careful consideration of potential implementation issues during the design process can result in more usable, engaging, and effective digital mental health interventions.

BACKGROUND: Depression in the elderly is an understudied condition. Psychopharmacological and psychotherapeutic approaches suffer from specific difficulties with this patient group. Brain stimulation techniques such as repetitive transcranial magnetic stimulation (rTMS) offer a therapeutic alternative. rTMS remains understudied in this age group when compared with younger patients.
METHODS: A cohort of 505 patients with depression was analyzed in retrospect concerning their response to rTMS treatment. A total of 15.5% were 60 years old or older, defined as the elderly group of depressed patients. The majority of these were treated with high-frequency protocols over the left dorsolateral prefrontal cortex (DLPFC). For group comparisons, we used Student t-tests or chi-square-tests, depending on the scales of measurement. As measures for effect size, we used Cohen\'s d for the relative and absolute change in the HDRS total score.
RESULTS: Groups did not differ significantly with respect to baseline depression severity or treatment parameters. In the group of elderly patients, a higher number of females were present. Groups did not differ significantly with respect to treatment efficacy, as indicated by the absolute and relative changes in the HDRS-21 sum score. Elderly patients tended to take higher numbers of mood stabilizers. Elderly patients showed a significantly superior reduction for the item \"appetite\" and a superior reduction tending towards significance for the item \"work and interests\".
CONCLUSIONS: Antidepressant rTMS treatment showed comparable efficacy for patients above 60 years to that in younger patients. Differences between the age groups concerning amelioration of distinct HDRS single items deserve further investigation.

The definition of geriatrics is very complex to explain though it can be written as the treatment and care provided by healthcare and medical systems primarily to more venerable and senior citizens group of the population. The age group considered to be entering the old group is believed to be those who have reached their sixth decade of life. However, most of the global geriatric population doesn\'t need treatment until their seventh decade. Bodily impairment, both physical and mental, due to various reasons, for example, financial or personal reasons or feeling ignored, is reasonable for clinicians to anticipate caring for a growing proportion of older patients with complicated medical and psychosocial concerns. Complex ethical quandaries could develop as a result of these difficulties and problems. Who should anticipate ethical challenges faced by doctors early during management? We offer practical recommendations for improving communication because ineffective patient-clinician communication might result in moral dilemmas. Physical impairment, hopelessness, and cognitive decline are all more prevalent as people age. Politicians and healthcare providers of nations should step in to search for a measure to reduce the uprising of the condition; otherwise, it will lead to an uprising of the cases in an exponential manner. It is necessary to increase the financial challenges faced by the elderly. In addition, awareness should be increased, as well as programs aimed at enhancing their standard of living.