older adult module 8

Donovan, N. J., Wu, Q., Rentz, D. M., Sperling, R. A., Marshall, G. A., & Glymour, M. M. (2017). Loneliness, depression and cognitive function in older US adults. International journal of geriatric psychiatry, 32(5), 564-573.

Loneliness is the experience of social deprivation which has been associated with increased functional decline and high mortality in older adults. The purpose of the study was to examine the reciprocal relationship of loneliness and cognitive function in older adults, depression, coping with the social network, and other health-related and demographic factors. The researchers hypothesized that the relationship between loneliness and poor cognition is bi-directional and loneliness causes poor cognition.

Data were obtained from the Health and Retirement Study (HRS). Adults between 50 and 65 years were included in the study. A sample size of 10,817 was used but 954 participants were excluded because they didn’t meet the inclusion criteria. The study revealed that loneliness and depressive symptoms worsen cognition, however, the low cognitive function doesn't increase loneliness over time.

Older adults are at high risk for loneliness because of the increased probability of factors like living alone, chronic illnesses, loss of family members, and hearing loss. The study findings show that maintaining satisfactory cognitive functioning is critical for healthy aging. Loneliness and depression increase the risk of cognitive impairment and fast cognitive decline. However, a strong cognitive reserve or resilience can help older adults to reduce the effects of loneliness on health and wellbeing. Loneliness in older adults is also associated with mental health disorders like depression and anxiety.

Sobieraj, D. M., Martinez, B. K., Hernandez, A. V., Coleman, C. I., Ross, J. S., Berg, K. M., ... & Baker, W. L. (2019). Adverse effects of pharmacologic treatments of major depression in older adults. Journal of the American Geriatrics Society, 67(8), 1571-1581.

The purpose of the study was to determine the adverse effects of pharmacologic antidepressants for major depressive disorder (MDD) treatment in adults 65 years of age or older. The researchers conducted a systematic review through a contract with US Agency for Healthcare Research and Quality (AHRQ). The search was conducted through Embase, Medline, PsycINFO, and Cochrane Central. Older adults aged 65 years and above with MDD were involved in the study.

Based on the study results, treatment of MDD patients aged 65 years or above with serotonin norepinephrine reuptake inhibitors (SNRIs) increases the risk of adverse events. SNRIs and Selective serotonin reuptake inhibitors (SSRIs) increase the risk of withdrawal due to adverse events. Other treatments like Duloxetine increase the risk of falls. The limitation of this study is the interpretations of study findings based on statistical significance which may miss small differences due to inadequate power.

Depression is a common condition in older adults and it affects them differently than younger people. This is because it goes along with other diseases and disabilities related to old age. Prescription antidepressants cause adverse events because of slower clearance of medication and the possibility of interactions because the older population generally takes more medications. Tricyclic antidepressants (TCA) and SSRIs are the recommended prescription for adults.

References.

Donovan, N. J., Wu, Q., Rentz, D. M., Sperling, R. A., Marshall, G. A., & Glymour, M. M. (2017). Loneliness, depression and cognitive function in older US adults. International journal of geriatric psychiatry, 32(5), 564-573.

Sobieraj, D. M., Martinez, B. K., Hernandez, A. V., Coleman, C. I., Ross, J. S., Berg, K. M., ... & Baker, W. L. (2019). Adverse effects of pharmacologic treatments of major depression in older adults. Journal of the American Geriatrics Society, 67(8), 1571-1581.