Late Life Depression

There are certain thoughts - intimations - that will seem corny, or laughable, and therefore dismissed - and only seriously absorbed into the changing mind when felt, in the shelter of the quietly moving music of the soul.
It is the function of art, and of love, to make this music heard . . . 

  It is not the music of depression - it is the way through.

A key feature of depression is the internal monologue going on inside the depressed person´s head. When people are depressed, they spend a lot of time and energy on a daily basis telling themselves how crap their lives are, how much everything sucks and how much they hate it.

"We cannot tell that we are constantly splitting into duplicate selves because our consciousness rides smoothly along only one path in the endlessly forking chains."

This forthcoming paper will explore some highly speculative - even preposterous - but seductively appealing recent models of the physics of time-space and dimensionality.
It will be argued that although these models are seemingly impossible to test in the external world, they may have a profound truth and validity in the internal world of the human unconscious mind.

Psychoanalytic clinical material will be presented which convincingly suggests that we all live, emotionally, just as much in the worlds of possibility as we do in the world of " external reality ". For example, the loss of a baby may bring devastating grief or depression to a mother as much (if not more) for mourning the losses of imagined possible futures for that lost child, and for that potential mother, as for the loss of the  " actual baby. "

Whether or not parallel worlds and alternate realities and timelines exist in the physical world seems highly un-possible, and fraught with infinite contradiction. But in the unconscious world of the cognitive-emotional mind, we may be certain not only of their existence, but of their intense and profound psychological influence. To ignore the importance of a person's hopes and dreams of possibility in the formation of emotionally real losses and joys, even if deeply unconscious, is to forego the chance to truly understand their human self.

Of course, all this leaves wide open the issue of where, in the mind, theories of Physics - indeed of all scientific disciplines - are conceived.

  At the very least, this paper argues the importance of "mental" parallel universes and alternate realities in the formation and perseverance of depressive feelings.

The film "Mr. Nobody" (2009) and others are used to explicate these ideas.

Late-life depression (LLD) is a common emotional and mental disability in the elderly population characterized by the presence of depressed mood, the loss of interest or pleasure in daily activities, and other depression symptoms. It has a serious effect on the quality of life of elderly individuals and increases their risk of developing physical and mental diseases. It is an important area of research, given the growing elderly population. Brain functional connectivity modifications represent one of the neurobiological biomarker for LLD even if to date remains poorly understood. In our study, we enrolled 10 elderly patients with depressive symptoms compared to 11 age-matched healthy controls. All participants were evaluated by means of neuropsychological tests and underwent the same functional magnetic resonance imaging (fMRI) protocol to evaluate modifications of brain resting state functional connectivity. Between-group differences were observed for the Geriatric Depression Scale...

Learning to Preserve in Seniors Method: One-hundred and ninety-eight Dutch elderly participants reporting subjective cognitive decline are included and randomized to either a language intervention, a music intervention, or a social control intervention. During 3 to 6 months, the language group learns English, the music group learns to play the guitar and the social group participates in social meetings where art workshops are offered. At baseline, at a 3-month followup, and at 6 months after termination of the training program, clinical, cognitive and brain activity measurements (combined EEG and fNIRS methods) are taken to assess cognitive flexibility and mental health. Discussion: This is the first trial addressing combined effects of language learning in elderly on cognition, language proficiency, socio-affective measures, and brain activity in the context of a randomized controlled trial. If successful, this study can provide insights into how foreign language training can contribute to more cognitively and mentally healthy years in older adulthood.

The proportion of HIV-positive people over the age of 50 is rapidly increasing in the UK. This reflects the use of antiretroviral therapies and the transformation of HIV from life-threatening disease to chronic treatable illness. In this study a biographical narrative approach was used to explore the lived experience of ageing in 10 HIV-positive gay men aged between 50 and 78. While some participants regarded ageing as an opportunity to continue progressing towards valued life goals, others were more ambivalent about their future prospects. The findings suggest that these differences were particularly influenced by an individual's biographic relationship to the history of the HIV epidemic rather than chronological age. Those with long histories of involvement with HIV were more likely to be disadvantaged by careers interrupted by illness, to be dependent on state benefits and to have social networks damaged by multiple AIDS-related bereavements. The research identifies a cohort of older gay men likely to require additional support in adapting to the challenge of growing older with HIV. The article also explores the construction of moral identities in relation to discourses of ‘successful ageing’ and the possibility of building supportive communities that are sensitive to the needs of older gay men.

While loss of socioeconomic status (SES) has been linked to suicidal behavior, it is unclear whether this experience is merely a downstream effect of psychopathology ("downward drift"), a sign of hardship, or an independent psychological contributor to suicide risk. We examined the association between the subjective experience of status loss and suicidal behavior and ideation in old age, while accounting for potential confounders. We were also interested in whether status loss was associated with mere thoughts of suicide vs. suicidal behavior. Fifty older (55+) depressed suicide attempters, 29 depressed suicide ideators with no history of attempted suicide, 38 nonsuicidal depressed participants, and 45 nonpsychiatric controls underwent detailed clinical characterization and reported their current and highest lifetime SES. Suicide attempters were more likely to report a decline in their SES compared to healthy controls and nonsuicidal depressed older adults, while not diffe...

Objections to life extension often focus on its effects for individual well-being. Prominent amongst these concerns is the possibility that life extending technologies will extend lifespan without preventing the ageing of the mind. Writers on the subject express the fear that life extending drugs will keep us physically youthful whilst our minds decay, succumbing to dementia, boredom, and loneliness.

Generally these fears remain speculative, in part due to the absence of genuine life extending technologies. In this paper, however, I examine the implications of an existing life extension technology. Caloric restriction (CR) and drugs that mimic its effects, such as rapamycin, metformin and resveratrol have been shown to increase average and maximum lifespan in a wide variety of organisms, and seem likely to do so in humans. Moreover, some CR mimetic drugs (CRMs) are already widely used. This means that they present a pressing test case for fears about mental ageing in an extended life.

Misgivings about mental ageing can be divided into biomedical factors such as the likelihood of brain ageing, and psychological factors such as loss of meaning and boredom. I argue that studies of CR suggest that brain ageing will be beneficially slowed. However, it is less clear that deleterious aspects of psychological ageing can be similarly retarded. I argue that this reduces the desirability of life extension unless major social changes can be made.

BACKGROUND: Depression in late life often follows a chronic course with residual depressive and anxiety symptoms. Levels of omega-3 polyunsaturated fatty acids (PUFAs) have been found to be depleted in people with major depression in the acute stage. Additionally, lower omega-3 PUFA levels have been suggested to be associated with anxiety. The aim of this study was to investigate whether PUFAs levels (omega-3 or omega-6) are correlated with residual depressive or anxiety symptoms in older people with previous depression.

METHODS: Participants aged 60years or over with previous major depression in remission were enrolled from outpatient psychiatric services of four hospitals. Participants with residual depressive symptoms were defined as the Hamilton Depression Rating Scale (HDRS) scores >5, and those with anxiety were defined as sum of scores for the two anxiety subscale of HDRS≧2. The levels of fatty acids in erythrocyte membranes and in plasma were measured separately by gas chromatography.

RESULTS: One hundred and thirty two older people with previous major depression (mean age of 68years, range 60-86years) were analyzed. Erythrocyte membrane linoleic acid levels had a curvilinear association with depressive symptoms and anxiety symptoms. Plasma linoleic acid levels were found to have a negative linear relationship with depressive symptoms. No significant associations were found between any omega-3 fatty acid level and depressive or anxiety symptoms.

CONCLUSION: Linoleic acid levels may be a possible biomarker for residual depression and anxiety in older people with previous depression. Possible clinical applications need further investigation.

Introduction: This study had two goals. First, we investigated how World War II (WW II) military service impacted marital stability during men's young and middle adulthood in a large community sample of American men of Japanese descent. Second, within a subgroup of WW II veterans, we assessed how the level of combat exposure affected marital stability. Material and Methods: The Honolulu Heart Program and later Honolulu-Asia Aging Project were longitudinal, community-based studies of Japanese-American men living in Hawai'i. This study is a secondary data analysis of 1,249 male WW II veterans and 3,489 men of Japanese descent who were civilians during WW II, born 1910-1919, who completed interviews at the first (1965-1968) and third (1971-1975) exams. Data from a subsample of veterans who completed a military service interview during the sixth exam (1997-1999) also were used. In the first set of analyses, we compared veterans to civilians on three marital outcomes for ages 15-59: (1) likelihood of never marrying, (2) age at first marriage, and (3) likelihood of divorce. Next, we investigated the negative consequences of increasing combat exposure on the same marital outcomes. All analyses controlled for age in 1941 and occupation. Results: Overall, 88% of the sample remained in their first marriage with no differences between veterans and civilians. We found no effects of military service on the timing of first marriages on the likelihood of divorce during young and middle adulthood. However, among those who had not married before WW II, veterans were significantly more likely to remain unmarried compared with civilians; odds ratio = 1.52 (1.10, 2.09). The level of combat exposure did not predict any of the three marital outcomes among WW II veterans. In fact, none of the other military service characteristics assessed (i.e., age of military induction, years of service, and service-connected disability) predicted marital outcomes. We found that age at the beginning of WW II impacted the timing and stability of marriage in both veterans and civilians. Finally, we identified cultural effects on the likelihood of marriage between Nisei and Kibei groups with Nisei men being less likely to marry. Conclusion: Similar to other groups in this era, long-term marriage with one partner was the norm for both veterans and civilians. For a small portion of American men of Japanese descent, military service seemed to impact the transition into marriage. However, we found no differences in the timing of marriage or the likelihood of divorce based on military service or level of combat exposure. While our findings are inconsistent with previous research on the impact of military service and combat exposure, much of that research was conducted with mainland veterans, usually of European descent. There appears to be little long-term disruption of life course events. Results highlight the importance of studying diverse groups of veterans to understand how experiences in the military interact with pre-military factors in defining long-term responses to military service.

This report brings together findings from qualitative research undertaken by the Policy Studies Institute (PSI) during 2003/04 on behalf of the Department for Work and Pensions (DWP). This
explored factors influencing perceptions and experiences of independent living in later life and analysed pensioners’ service needs and accessing behaviour, in turn considering the relationship between independence and service use. These issues are timely given the projected rise in the proportion of the UK’s population which is over State Pension age in the near future. The research was also designed to provide refinement of the DWP’s Customer Segmentation Model for Today’s Pensioners, a tool depicting a sliding scale of support needs, differentiating pensioners into seven subsegments on the basis of key demographic criteria.

Depression in late life often follows a chronic course with residual depressive and anxiety symptoms. Levels of omega-3 polyunsaturated fatty acids (PUFAs) have been found to be depleted in people with major depression in the acute stage. Additionally, lower omega-3 PUFA levels have been suggested to be associated with anxiety. The aim of this study was to investigate whether PUFAs levels (omega-3 or omega-6) are correlated with residual depressive or anxiety symptoms in older people with previous depression.Participants aged 60 years or over with previous major depression in remission were enrolled from outpatient psychiatric services of four hospitals. Participants with residual depressive symptoms were defined as the Hamilton Depression Rating Scale (HDRS) scores > 5, and those with anxiety were defined as sum of scores for the two anxiety subscale of HDRS≧2. The levels of fatty acids in erythrocyte membranes and in plasma were measured separately by gas chromatography.One hundred and thirty two older people with previous major depression (mean age of 68 years, range 60–86 years) were analyzed. Erythrocyte membrane linoleic acid levels had a curvilinear association with depressive symptoms and anxiety symptoms. Plasma linoleic acid levels were found to have a negative linear relationship with depressive symptoms. No significant associations were found between any omega-3 fatty acid level and depressive or anxiety symptoms.Linoleic acid levels may be a possible biomarker for residual depression and anxiety in older people with previous depression. Possible clinical applications need further investigation.

While loss of socioeconomic status (SES) has been linked to suicidal behavior, it is unclear whether this experience is merely a downstream effect of psychopathology ("downward drift"), a sign of hardship, or an independent psychological contributor to suicide risk. We examined the association between the subjective experience of status loss and suicidal behavior and ideation in old age, while accounting for potential confounders. We were also interested in whether status loss was associated with mere thoughts of suicide vs. suicidal behavior. Fifty older (55+) depressed suicide attempters, 29 depressed suicide ideators with no history of attempted suicide, 38 nonsuicidal depressed participants, and 45 nonpsychiatric controls underwent detailed clinical characterization and reported their current and highest lifetime SES. Suicide attempters were more likely to report a decline in their SES compared to healthy controls and nonsuicidal depressed older adults, while not diffe...

Methods and compositions relating to Alzheimer's disease are done by analyzing the proteins that are differentially expressed in the brain in the Alzheimer's disease state. These are very much different from the proteins in normal brain.

Dementia is one of the major public health problems of the geriatric population. But off late it seems to affecting even those in their thirties. Increasing numbers of patients with dementia are imposing a major financial burden on health systems around the world. More than half of the patients with dementia have Alzheimer's disease (AD). The prevalence and incidence of AD have been shown to increase exponentially. The prevalence for AD in Europe is 0.5% for ages 60-69 years, 4.2% for ages 70-79 years, and 13.8% for ages 80-89 years. The survival time after the onset of AD is approximately from 3 to 10 years. Death occurs as the brain cells are starved of the energy and nutrients.

Alzheimer's disease (AD), the most common cause of dementia in older individuals, is a debilitating neurodegenerative disease for which there is no definitive cure as of now. It destroys the neurons in parts of the brain, chiefly the hippocampus, which is a region involved in coding memories. Alzheimer's disease gives rise to an irreversible progressive loss of cognitive functions and of functional autonomy. The earliest signs of AD may be mistaken for simple forgetfulness, but in those who are eventually diagnosed with the disease, these initial signs inexorably progress to more severe symptoms of mental deterioration. While the time it takes for AD to develop will vary from person to person, advanced signs include severe memory impairment, confusion, language disturbances, personality and behavior changes, and impaired judgement. Persons with AD may become non-communicative and hostile. As the disease ends its course in profound dementia, patients are unable to care for themselves and often require institutionalization or professional care in the home setting. While some patients may live for years after being diagnosed with AD, the average life expectancy after diagnosis is eight years.

In the past, AD could only be definitively diagnosed by brain biopsy or upon autopsy after a patient died. These methods, which demonstrate the presence of the characteristic plaque and tangle lesions in the brain, are still considered the gold standard for the pathological diagnoses of AD. However, in the clinical setting brain biopsy is rarely performed and diagnosis depends on a battery of neurological, psychometric and biochemical tests, including the measurement of biochemical markers such as the ApoE and tau proteins or the beta-amyloid peptide in cerebrospinal fluid and blood.

Biomarkers may possibly possess the key in the next step for diagnosing AD and other dementia. A biological marker that fulfils the requirements for the diagnostic test for AD would have several advantages. An ideal biological marker would be one that identifies AD cases at a very early stage of the disease, before there is degeneration observed in the brain imaging and neuropathological tests. A biomarker could be the first indicator for starting treatment as early as possible, and also very valuable in screening the effectiveness of new therapies, particularly those that are focused on preventing the development of neuropathological changes. A biological marker would also be useful in the follow-up of the development of the disease.

The University of California, Los Angeles, Loneliness Scale-Version 3 (UCLA LS3) is the most frequently used loneliness assessment tool. This study aimed to examine the psychometric properties of the UCLA LS3 by utilizing two separate and independent samples: Turkish university students (n = 481) and elderly (n = 284). The results demonstrate that the 3-factor model reveals significant results in both samples in terms of goodness of fit indices in confirmatory factor analysis. In addition to satisfactory reliability, the concurrent and discriminant validity of the scale were supported in both samples by revealing the association of the UCLA LS3 with conceptually related measures (i.e., social support, social provision, depression, positive affect, negative affect, and self esteem in the sample of university students; geriatric depression, self esteem and life satisfaction in the sample of elderly) and the unrelated measure (i.e., social desirability). In addition to examining the psychometric properties of the UCLA LS3, the present study adds to the present literature about loneliness, shedding light on a non-western culture.