Prevention and early treatment of depression through the life course

This book presents current evidence of new perspectives for the prevention and appropriate management of depression in people across the life course. Special attention has been dedicated to facilitating factors for the development of health system capacity and the effectiveness of the different types of interventions. The first part of the book reviews the innovations in global prevention and non-pharmacological treatments for children, adolescents, and youths. The second part reviews interventions for adults across the lifespan, including older adults and caregivers. Despite the efforts to tackle depression, the COVID-19 pandemic directly or indirectly affected the mental health of the population, including an increase in the incidence of depressive disorders, which are underdiagnosed and undertreated in young and older people. Because of the characteristics of adolescence and older adulthood, people can consider depression signs and symptoms as natural, neglecting a proper diagnosis. To address these challenges in the clinical management of depression, Prevention and Early Treatment of Depression Through the Life Course presents a life course perspective on the analysis and treatment of depression to help clinical psychologists, psychiatrists and other mental health professionals understand the mechanisms associated with the onset of depression and identify/develop proper evidence-based treatments for different ages and in different circumstances. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Pandemic‐Related Stress, Coping, and Wellbeing in an International and Multi‐Ethnic Cohort of Older Adults

Background The COVID‐19 pandemic has impacted the wellbeing of older adults. Pandemic‐related stress has implications on cognitive status, including decline due to Alzheimer's disease and related dementias. Yet, evidence suggests that COVID‐19 has impacted culturally and linguistically diverse communities differently. We sought to examine the role of COVID‐19 on coping and wellbeing in an international, multi‐ethnic sample of older adults. Method Data from 955 older adults (age = 66.7±7.9 years;education = 15.2±5.9 years;71% female;41% Hispanic/Latino) were pulled from a larger, international sample examining the response of older adults to COVID‐19. All participants completed demographic questionnaires, measures of psychological distress, the Brief‐COPE – a 28‐item self‐report questionnaire used to measure respondent's efforts to minimize distress from a stressful life event – and the Epidemic‐Pandemic Impacts Inventory (EPII) – a 92‐item inventory of pandemic related experiences across several life domains. Using linear regression, we examined relationships between Brief‐COPE scores, ethnicity, and select EPII items controlling for several covariates (age, sex, education, marital status, number of children, employment status, household income, and history of COVID‐19 symptoms) in all analyses. Result Hispanic/Latino (H/L) ethnicity was associated with slightly higher scores on the approach‐focused coping subscale compared to the non‐Hispanic White (NHW) group (Approach: 27.3±6.6 vs 26.1±6.1;B = 1.205, p = 0.015, CI: 0.238, 2.172). There was no effect of ethnicity on Brief‐COPE Total or Avoidance subscale scores (both ps>0.050). Notably, review of covariates suggested increased age was associated with lower scores on Approach (B = ‐0.065, p = 0.041, CI: ‐0.128, ‐0.003), Avoidance (B = ‐0.054, p = 0.034, CI: ‐0.104, ‐0.004), and Total scores (B = ‐0.136, p = 0.028, CI: ‐0.257, ‐0.015). Higher Approach scores were associated with greater endorsement of Positive Life Changes in both ethnic groups (NHW: partial r = 0.298, p<0.001;H/L: partial r = 0.249, p<0.036), but with endorsement of Mental Health Problems in NHWs only (NHW: partial r = 0.144;p = 0.001;H/L: partial r = ‐0.019, p>0.050). Conclusion Findings suggest cross‐cultural differences in the stress coping response of older adults during the pandemic, even after controlling for symptomatic history and other relevant covariates. Moreover, coping may be differentially related to positive and negative outcomes across cultural groups. These results support the need to consider cultural background when considering coping and wellbeing in older adults.

Impact of social isolation on people with dementia and their family caregivers

Background: People with dementia and their family caregivers may face a great burden through social isolation due to the COVID-19 pandemic, which can be manifested as various behavioral and clinical symptoms. Objective: To investigate the impacts of social isolation due to the COVID-19 pandemic on individuals with dementia and their family caregivers. Methods: Two semi-structured questionnaires were applied via telephone to family caregivers of people diagnosed with dementia in three cities in Argentina, Brazil, and Chile, in order to assess clinical and behavioral changes in people with dementia and in their caregivers. Results: In general, 321 interviews were conducted. A significant decline in memory function has been reported among 53.0% of people with dementia. In addition, 31.2% of individuals with dementia felt sadder and 37.4% had increased anxiety symptoms. These symptoms of anxiety were greater in individuals with mild to moderate dementia, while symptoms of agitation were greater in individuals with severe dementia. Moreover, compulsive-obsessive behavior, hallucinations, increased forgetfulness, altered appetite, and increased difficulty in activities of daily living were reported more frequently among individuals with moderate to severe dementia. Caregivers reported feeling more tired and overwhelmed during this period and these symptoms were also influenced by the severity of dementia. Conclusion: Social isolation during the COVID-19 pandemic triggered a series of negative behavioral repercussions, both for people with dementia and for their family caregivers in these three South American countries. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

The impact of COVID-19 on the well-being and cognition of older adults living in the United States and Latin America

Background In the COVID-19 pandemic, older adults from vulnerable ethnoracial groups are at high risk of infection, hospitalization, and death. We aimed to explore the pandemic?s impact on the well-being and cognition of older adults within and outside of the United States (US). Method 1,747 (646 White, 991 Latino, 77 Black, 33 Asian;72% female) individuals from the US and 14 Latin American countries completed an online survey regarding well-being and cognition during the pandemic. Outcome variables (pandemic impact, discrimination, loneliness, purpose of life, subjective cognitive concerns) were compared across four US ethnoracial groups, and Latinos living in the US and Latin America. Result Mean age was 66·5 (SD = 7·70) years and mean education was 15·4 (SD = 2·76) years. We found no differences in the pandemic?s overall impact across US ethnoracial groups. Compared to Whites, Latinos reported greater economic impact (p < ·001, ?p2 = .031);while Blacks reported experiencing discrimination more often (p < ·001, ?p2 = .050). Blacks and Latinos reported more positive coping (p < ·001, ?p2 = 040). Latin American Latinos reported greater pandemic impact (p < ·001, ?p2 =.013 ), more positive coping (p =·006, ?p2 =.008 ), and less discrimination than US Latinos (p < ·001, ?p2 = .013 ). Conclusion The COVID-19 pandemic has differentially impacted the well-being of older ethnically diverse individuals in the US and Latin America. Future studies should examine how mediators like income and coping skills modify the pandemic?s impact.

Dementia and COVID-19 in Chile, New Zealand and Germany: A Research Agenda for Cross-Country Learning for Resilience in Health Care Systems

The COVID-19 pandemic has revealed existing gaps in policies, systems and services, stressing the need for concerted global action on healthy aging. Similar to the COVID-19 pandemic, dementia is a challenge for health systems on a global scale. Our hypothesis is that translational potential lies in cross-country learning by involving three high-income countries with distinct geo-political-cultural-social systems in Latin America (Chile), the South Pacific (New Zealand) and Europe (Germany). Our vision is that such cross-country learning will lead to providing adequate, equitable and sustainable care and support for families living with dementia during a pandemic and beyond. We are proposing a vision for research that takes a multi-disciplinary, strength-based approach at the intersection of health care research, disaster research, global health research and dementia research. We present some insights in support of our hypothesis and proposed research agenda. We anticipate that this research has the potential to contribute towards strengthening and transforming health care systems in times of crises and beyond.

Impact of social isolation and coping strategies in older adults with mild cognitive impairment during the covid-19 pandemic: A qualitative study.

OBJECTIVES: The objective of this study was to explore the experiences and feelings of older adults with MCI during the COVID-19 outbreak in Chile and to know what strategies they used to overcome social isolation. METHOD: A qualitative design was used. Ten participants with a diagnosis of MCI took part in this study. All interviews were recorded and coded using thematic analysis. RESULTS: The thematic analysis identified three themes related to the quarantine experience of older adults with MCI diagnosis: (1) Effects of social isolation during the COVID-19 pandemic (2) Believes, feelings and behaviors about the SARS-CoV-2 virus (3) Coping with social isolation/response to difficulties during the pandemic. It was found that older adults with MCI have been mainly psychologically and socially affected by social distancing and isolation, particularly individuals who were alone during COVID-19 outbreak. The only physical dimension negatively affected was the level of activity. Social isolation led to a significant number of negative emotions such as anger, fear of contracting the virus or possibility of contagion for their families, worries and sadness as well as emotional loneliness. It is noteworthy that the majority of participants have used several coping strategies during this challenging time. CONCLUSION: Since social isolation and a sedentary life have been associated with poorer cognition and functionality in people with MCI, a rational plan to both prevent the progression of cognitive decline and to increase social contact, is essential. Special attention must be drawn to maintaining people physically active at home and keeping their daily routine (within the possibilities) and also to ensure social connectedness through technology. Implementation of these measures could potentially reduce negative emotions during the pandemic.

[Effects of the COVID-19 confinement on mental health among higher education students in Chile]. / Efectos del confinamiento por COVID-19 en la salud mental de estudiantes de educación superior en Chile.

BACKGROUND: Chilean higher education students have faced highly stressful events in 2020, including confinement and remote education. This population is particularly susceptible to mental health problems, such as high levels of stress, anxiety, and depression. AIM: To evaluate possible negative impacts of confinement by COVID-19 on Chilean higher education students' mental health. MATERIAL AND METHODS: The Center for Epidemiologic Studies Depression Scale (CES-D) Scale and the Profile of Mood States (POMS) were applied to 315 students during 2016 and to 301 students during 2020. RESULTS: In 2020, depression mean scores for men (24.1) and women (29.7) exceeded the cutoff point, therefore suggesting the presence of depressive disorder. Women had higher depressive and anxious symptoms in both years, however, in 2020 a significant increase was observed for depression, indicating interaction between the year of assessment andgender (0 = 6.74; p <.001). In both samples, first-year students hadsignificantly higherdepressionscores (fl = -1,909;p = 0.05). CONCLUSIONS: An increase in depression was observed in 2020. Confinement by COVID-19 had a high impact on mental health in female students. Women and first-year students appear to be high risk groups for developing depressive symptoms.

The impact of COVID-19 on the well-being and cognition of older adults living in the United States and Latin America.

BACKGROUND: In the COVID-19 pandemic, older adults from vulnerable ethnoracial groups are at high risk of infection, hospitalization, and death. We aimed to explore the pandemic's impact on the well-being and cognition of older adults living in the United States (US), Argentina, Chile, Mexico, and Peru. METHODS: 1,608 (646 White, 852 Latino, 77 Black, 33 Asian; 72% female) individuals from the US and four Latin American countries aged ≥ 55 years completed an online survey regarding well-being and cognition during the pandemic between May and September 2020. Outcome variables (pandemic impact, discrimination, loneliness, purpose of life, subjective cognitive concerns) were compared across four US ethnoracial groups and older adults living in Argentina, Chile, Mexico, and Peru. FINDINGS: Mean age for all participants was 66.7 (SD = 7.7) years and mean education was 15.4 (SD = 2.7) years. Compared to Whites, Latinos living in the US reported greater economic impact (p < .001, ηp 2  = 0.031); while Blacks reported experiencing discrimination more often (p < .001, ηp 2  = 0.050). Blacks and Latinos reported more positive coping (p < .001, ηp 2  = 0.040). Compared to Latinos living in the US, Latinos in Chile, Mexico, and Peru reported greater pandemic impact, Latinos in Mexico and Peru reported more positive coping, Latinos in Argentina, Mexico, and Peru had greater economic impact, and Latinos in Argentina, Chile, and Peru reported less discrimination. INTERPRETATION: The COVID-19 pandemic has differentially impacted the well-being of older ethnically diverse individuals in the US and Latin America. Future studies should examine how mediators like income and coping skills modify the pandemic's impact. FUNDING: Massachusetts General Hospital Department of Psychiatry.

Impact of Social Isolation on People with Dementia and Their Family Caregivers.

BACKGROUND: People with dementia and their family caregivers may face a great burden through social isolation due to the COVID-19 pandemic, which can be manifested as various behavioral and clinical symptoms. OBJECTIVE: To investigate the impacts of social isolation due to the COVID-19 pandemic on individuals with dementia and their family caregivers. METHODS: Two semi-structured questionnaires were applied via telephone to family caregivers of people diagnosed with dementia in three cities in Argentina, Brazil, and Chile, in order to assess clinical and behavioral changes in people with dementia and in their caregivers. RESULTS: In general, 321 interviews were conducted. A significant decline in memory function has been reported among 53.0%of people with dementia. In addition, 31.2%of individuals with dementia felt sadder and 37.4%had increased anxiety symptoms. These symptoms of anxiety were greater in individuals with mild to moderate dementia, while symptoms of agitation were greater in individuals with severe dementia. Moreover, compulsive-obsessive behavior, hallucinations, increased forgetfulness, altered appetite, and increased difficulty in activities of daily living were reported more frequently among individuals with moderate to severe dementia. Caregivers reported feeling more tired and overwhelmed during this period and these symptoms were also influenced by the severity of dementia. CONCLUSION: Social isolation during the COVID-19 pandemic triggered a series of negative behavioral repercussions, both for people with dementia and for their family caregivers in these three South American countries.