OBM Geriatrics is an Open Access journal published quarterly online by LIDSEN Publishing Inc. The journal takes the premise that innovative approaches – including gene therapy, cell therapy, and epigenetic modulation – will result in clinical interventions that alter the fundamental pathology and the clinical course of age-related human diseases. We will give strong preference to papers that emphasize an alteration (or a potential alteration) in the fundamental disease course of Alzheimer’s disease, vascular aging diseases, osteoarthritis, osteoporosis, skin aging, immune senescence, and other age-related diseases.

Geriatric medicine is now entering a unique point in history, where the focus will no longer be on palliative, ameliorative, or social aspects of care for age-related disease, but will be capable of stopping, preventing, and reversing major disease constellations that have heretofore been entirely resistant to interventions based on “small molecular” pharmacological approaches. With the changing emphasis from genetic to epigenetic understandings of pathology (including telomere biology), with the use of gene delivery systems (including viral delivery systems), and with the use of cell-based therapies (including stem cell therapies), a fatalistic view of age-related disease is no longer a reasonable clinical default nor an appropriate clinical research paradigm.

Precedence will be given to papers describing fundamental interventions, including interventions that affect cell senescence, patterns of gene expression, telomere biology, stem cell biology, and other innovative, 21st century interventions, especially if the focus is on clinical applications, ongoing clinical trials, or animal trials preparatory to phase 1 human clinical trials.

Papers must be clear and concise, but detailed data is strongly encouraged. The journal publishes a variety of article types (Original Research, Review, Communication, Opinion, Comment, Conference Report, Technical Note, Book Review, etc.). There is no restriction on the length of the papers and we encourage scientists to publish their results in as much detail as possible.

Publication Speed (median values for papers published in 2023): Submission to First Decision: 5.7 weeks; Submission to Acceptance: 17.9 weeks; Acceptance to Publication: 7 days (1-2 days of FREE language polishing included)

Current Issue: 2024  Archive: 2023 2022 2021 2020 2019 2018 2017
Open Access Editorial

Depression and Aging: Role of Social Support

Ray Marks 1, 2, *

  1. Department of Health and Human Performance, School of Health Sciences and Professional Studies, City University of New York, York College, NY 11451, United States
  2. Department of Health and Behavior Studies, Teachers College, Columbia University, NY 10027, United States

Correspondence: Ray Marks

Special Issue: Depression and Aging: Role of Social Support

Received: March 25, 2019 | Accepted: March 26, 2019 | Published: March 28, 2019

OBM Geriatrics 2019, Volume 3, Issue 1 doi:10.21926/obm.geriatr.1901042

Recommended citation:  Marks R. Depression and Aging: Role of Social Support. OBM Geriatrics 2019; 3(1): 042; doi:10.21926/obm.geriatr.1901042

© 2019 by the authors. This is an open access article distributed under the conditions of the Creative Commons by Attribution License, which permits unrestricted use, distribution, and reproduction in any medium or format, provided the original work is correctly cited.

Keywords

Depression; aging; social support

Depression is a serious mood disorder associated with persistent feelings of sadness, loss of interest and pleasure in daily activities [1]. In addition to feelings of hopelessness, and low self-worth, individuals suffering from depression may experience poor sleep patterns, fatigue, excessive catastrophizing, interference with their daily activities, and appetite loss [1].

These symptoms, which may occur independently, or in reaction to the persistent presence of other illnesses, and/or adverse life events and losses, including mobility losses, can all influence the extent of suffering and disability as well as life quality associated with aging. Fortunately, depression can be reasonably well-diagnosed by taking a careful history, and by applying one or more validated scales to examine if indeed the individual is depressed, and if so, how severe the condition is.

However, even though research shows severe forms of depression affect 2-5% of the United States population, and up to 20% may suffer from milder forms of the illness, especially after 70 years of age [2], or if they suffer from medical problems, and/or chronic disabling pain, measures are not commonly put in place to identify depression, nor to treat the prevailing depression expected to prevail in older people in a holistic or integrated way. In particular, those suffering from severe depression [3], as well as those with more minor depression are not always evaluated for the important role of social support in moderating or mediating or offsetting the presence of depression.

Indeed, while the onset of depression may be genetic in origin, vulnerability towards depression may be increased by stress, loneliness, and isolation, among other factors, such as pain and chronic disability [4,5]. Since the treatments available for depression are not always efficacious, even if the condition is recognized, and unrelieved depression can be extremely injurious to the individual, efforts to prevent or ameliorate this condition among older adults are not only highly sought, but are of increasing importance in fostering successful aging. Alternately, in addition to a lower than desirable life quality, a failure to adequately attenuate depression among the elderly is strongly associated with a greater the risk of incurring a premature death, higher rates of inflammation, appetite changes, increased blood pressure, memory challenges, excess pain, a decreased desire for physical activities, weakness, trouble sleeping, anxiety, social withdrawal, and higher rates of osteoporosis, among other factors [2], including the overuse of existing health services.

Since depression is one of the most important predictors of health practitioner visits [5,6], and can lead to suicide, as well as considerable physical, and social disability, minimizing, preventing or treating depression is strongly indicated among the older population. As well, given the fact that many elderly people live in poverty, and social adversity complicates the management and treatment of depression, through its impact on social network factors, interventions that can address depression as well as related social problems that exacerbate this are strongly indicated [6].

Social support, which is a term referring in part to the availability of help from others, if help is desired, as well as feelings or beliefs one is cared for, loved, esteemed and valued, a strong health determinant [7] is found to impact depression negatively and adversely, if this is unavailable or of poor quality. Key forms of social support, which are emotional, appraisal, informational and instrumental support [7], if mobilized appropriately are independently and collectively linked to being a stress buffer, can arguably influence overall wellbeing, and health outcomes positively and significantly. Alternately, the lack of adequate social support is linked to higher levels of depression than not, and may reflect a lack of psychological and material resources, as well as direct assistance and feedback by others, limitations in access to needed social services, counselling, psychotherapy, medications, cognitive behavioural therapy, and exercise opportunities.

Conversely, research points to the positive value of the application of one or more forms of social support in the context of either direct assistance, indirect assistance, tangible and intangible aspects of support in efforts to impact physical as well as mental health, as well as health behaviors positively and significantly.

Unsurprisingly, Nam et al. [8] identified social support as an important variable not only for older adults with chronic illness who lived alone, but for those with symptoms of depression, who may also suffer from suicidal ideation, a finding supported by Koizumi et al. [9]. Olagunju al. [10] argued that considering the burden of depression in the elderly and the influential roles of social support especially from family and significant others on depression; strengthening of informal social support and formal social support for the elders is advocated. In addition, design of community based geriatric mental health with social services and articulation of public policy to address old age needs are implied both by this group and Nagoor et al. [11].

Geriatric depression is a mental and emotional disorder affecting many older adults, that results in trouble concentrating, hopelessness, feelings of worthlessness, reduced motivation, decreased drive and reward for pleasurable activities, too much or too little sleep, doom and suicidal thoughts. Depression in older adults can hence reduce quality and years of life, especially if social support and the provision or development of a supportive environment or atmosphere is unavailable or perceived to be negative. Conversely, although late life depression is associated with a significant burden of disease [6], including the perception of inadequate received social support [12], the careful design of formal and informal social supports may prove helpful in alleviating the depression burden [10].

In the belief that concerted efforts to examine the role of social support in the context of geriatric depression, functional disability [13,14,15], this special edition focuses on the role of social support in explaining the burden of depression and its relationship and its amelioration, a relatively underreported topic.

Articles of any genre concerning the importance of social support in preventing and treating geriatric depression and its correlates are specifically sought.

Author Contributions

The author did all the works.

Competing Interests

The author has declared that no competing interests exist.

References

  1. Edwards RR, Cahalan C, Mensing G, Smith M, Haythornthwaite JA. Pain, catastrophizing, and depression in the rheumatic diseases. Nat Rev Rheumatol. 2011; 7: 216-224. [CrossRef]
  2. Alexopoulos GS. Depression in the elderly. Lancet. 2005; 365: 1961-1970. [CrossRef]
  3. López-López A, Montorio I, Izal M, Velasco L. The role of psychological variables in explaining depression in older people with chronic pain. Aging Ment Health. 2008; 12: 735-745. [CrossRef]
  4. Alpass FM, Neville S. Loneliness, health and depression in older males. Aging Ment Health. 2003; 7: 212-216. [CrossRef]
  5. Areán PA, Mackin S, Vargas-Dwyer E, Raue P, Sirey JA, Kanellopolos D, et al. Treating depression in disabled, low-income elderly: A conceptual model and recommendations for care. Int J Geriatr Psychr. 2010; 25: 765-769. [CrossRef]
  6. Gonçalves-Pereira M, Prina AM, Cardoso AM, da Silva JA, Prince M, Xavier M, et al. The prevalence of late-life depression in a Portuguese community sample: A 10/66 Dementia Research Group study. J Affect Disord. 2019; 246: 674-681. [CrossRef]
  7. Cobb S. Social support as a moderator of lifestress. Psychosom Med. 1976; 38: 300-314. [CrossRef]
  8. Nam EJ, Lee JE. Mediating effects of social support on depression and suicidal ideation in older korean adults with hypertension who live alone. J Nurs Res. 2018. doi: 10.1097/jnr.0000000000000292. [CrossRef]
  9. Koizumi Y, Awata S, Kuriyama S, Ohmori K, Hozawa A, Seki T, et al. Association between social support and depression status in the elderly: Results of a 1-year community-based prospective cohort study in Japan. Psychiatry Clin Neurosci. 2005; 59: 563-569. [CrossRef]
  10. Olagunju AT, Olutoki MO, Ogunnubi OP, Adeyemi JD. Late-life depression: Burden, severity and relationship with social support dimensions in a West African community. Arch Gerontol Geriatr. 2015; 61: 240-246. [CrossRef]
  11. Nagoor K, Darivemula SB, Reddy NB, Patan SK, Deepthi CS, Chittooru CS. Prevalence of mental illness and their association with sociodemographic factors in the rural geriatric population in Chittoor, Andhra Pradesh, India: A community-based study. J Educ Health Promot. 2018; 7: 165.
  12. Rajapakshe OBW, Sivayogan S, Kulatunga PM. Prevalence and correlates of depression among older urban community-dwelling adults in Sri Lanka. Psychogeriatrics. 2018. doi: 10.1111/psyg.12389. [CrossRef]
  13. Travis LA, Lyness JM, Shields CG, King DA, Cox C. Social support, depression, and functional disability in older adult primary-care patients. Am J Geriatr Psychiatry. 2004; 12: 265-271. [CrossRef]
  14. Patra P, Alikari V, Fradelos EC, Sachlas A, Kourakos M, Rojas Gil AP, et al. Assessment of depression in elderly. Is perceived social support related? a nursing home study: depression and social support in elderly. Adv Exp Med Biol. 2017; 987: 139-150. [CrossRef]
  15. Steffens DC, Hays JC, Krishnan KR. Disability in geriatric depression. Am J Geriatr Psychiatry. 1999; 7: 34-40. [CrossRef]
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OBM Geriatrics | Depression and Aging: Role of Social Support

OBM Geriatrics is an Open Access journal published quarterly online by LIDSEN Publishing Inc. The journal takes the premise that innovative approaches – including gene therapy, cell therapy, and epigenetic modulation – will result in clinical interventions that alter the fundamental pathology and the clinical course of age-related human diseases. We will give strong preference to papers that emphasize an alteration (or a potential alteration) in the fundamental disease course of Alzheimer’s disease, vascular aging diseases, osteoarthritis, osteoporosis, skin aging, immune senescence, and other age-related diseases.

Geriatric medicine is now entering a unique point in history, where the focus will no longer be on palliative, ameliorative, or social aspects of care for age-related disease, but will be capable of stopping, preventing, and reversing major disease constellations that have heretofore been entirely resistant to interventions based on “small molecular” pharmacological approaches. With the changing emphasis from genetic to epigenetic understandings of pathology (including telomere biology), with the use of gene delivery systems (including viral delivery systems), and with the use of cell-based therapies (including stem cell therapies), a fatalistic view of age-related disease is no longer a reasonable clinical default nor an appropriate clinical research paradigm.

Precedence will be given to papers describing fundamental interventions, including interventions that affect cell senescence, patterns of gene expression, telomere biology, stem cell biology, and other innovative, 21st century interventions, especially if the focus is on clinical applications, ongoing clinical trials, or animal trials preparatory to phase 1 human clinical trials.

Papers must be clear and concise, but detailed data is strongly encouraged. The journal publishes a variety of article types (Original Research, Review, Communication, Opinion, Comment, Conference Report, Technical Note, Book Review, etc.). There is no restriction on the length of the papers and we encourage scientists to publish their results in as much detail as possible.

Publication Speed (median values for papers published in 2023): Submission to First Decision: 5.7 weeks; Submission to Acceptance: 17.9 weeks; Acceptance to Publication: 7 days (1-2 days of FREE language polishing included)

Current Issue: 2024  Archive: 2023 2022 2021 2020 2019 2018 2017
Open Access Editorial

Depression and Aging: Role of Social Support

Ray Marks 1, 2, *

  1. Department of Health and Human Performance, School of Health Sciences and Professional Studies, City University of New York, York College, NY 11451, United States
  2. Department of Health and Behavior Studies, Teachers College, Columbia University, NY 10027, United States

Correspondence: Ray Marks

Special Issue: Depression and Aging: Role of Social Support

Received: March 25, 2019 | Accepted: March 26, 2019 | Published: March 28, 2019

OBM Geriatrics 2019, Volume 3, Issue 1 doi:10.21926/obm.geriatr.1901042

Recommended citation:  Marks R. Depression and Aging: Role of Social Support. OBM Geriatrics 2019; 3(1): 042; doi:10.21926/obm.geriatr.1901042

© 2019 by the authors. This is an open access article distributed under the conditions of the Creative Commons by Attribution License, which permits unrestricted use, distribution, and reproduction in any medium or format, provided the original work is correctly cited.

Keywords

Depression; aging; social support

Depression is a serious mood disorder associated with persistent feelings of sadness, loss of interest and pleasure in daily activities [1]. In addition to feelings of hopelessness, and low self-worth, individuals suffering from depression may experience poor sleep patterns, fatigue, excessive catastrophizing, interference with their daily activities, and appetite loss [1].

These symptoms, which may occur independently, or in reaction to the persistent presence of other illnesses, and/or adverse life events and losses, including mobility losses, can all influence the extent of suffering and disability as well as life quality associated with aging. Fortunately, depression can be reasonably well-diagnosed by taking a careful history, and by applying one or more validated scales to examine if indeed the individual is depressed, and if so, how severe the condition is.

However, even though research shows severe forms of depression affect 2-5% of the United States population, and up to 20% may suffer from milder forms of the illness, especially after 70 years of age [2], or if they suffer from medical problems, and/or chronic disabling pain, measures are not commonly put in place to identify depression, nor to treat the prevailing depression expected to prevail in older people in a holistic or integrated way. In particular, those suffering from severe depression [3], as well as those with more minor depression are not always evaluated for the important role of social support in moderating or mediating or offsetting the presence of depression.

Indeed, while the onset of depression may be genetic in origin, vulnerability towards depression may be increased by stress, loneliness, and isolation, among other factors, such as pain and chronic disability [4,5]. Since the treatments available for depression are not always efficacious, even if the condition is recognized, and unrelieved depression can be extremely injurious to the individual, efforts to prevent or ameliorate this condition among older adults are not only highly sought, but are of increasing importance in fostering successful aging. Alternately, in addition to a lower than desirable life quality, a failure to adequately attenuate depression among the elderly is strongly associated with a greater the risk of incurring a premature death, higher rates of inflammation, appetite changes, increased blood pressure, memory challenges, excess pain, a decreased desire for physical activities, weakness, trouble sleeping, anxiety, social withdrawal, and higher rates of osteoporosis, among other factors [2], including the overuse of existing health services.

Since depression is one of the most important predictors of health practitioner visits [5,6], and can lead to suicide, as well as considerable physical, and social disability, minimizing, preventing or treating depression is strongly indicated among the older population. As well, given the fact that many elderly people live in poverty, and social adversity complicates the management and treatment of depression, through its impact on social network factors, interventions that can address depression as well as related social problems that exacerbate this are strongly indicated [6].

Social support, which is a term referring in part to the availability of help from others, if help is desired, as well as feelings or beliefs one is cared for, loved, esteemed and valued, a strong health determinant [7] is found to impact depression negatively and adversely, if this is unavailable or of poor quality. Key forms of social support, which are emotional, appraisal, informational and instrumental support [7], if mobilized appropriately are independently and collectively linked to being a stress buffer, can arguably influence overall wellbeing, and health outcomes positively and significantly. Alternately, the lack of adequate social support is linked to higher levels of depression than not, and may reflect a lack of psychological and material resources, as well as direct assistance and feedback by others, limitations in access to needed social services, counselling, psychotherapy, medications, cognitive behavioural therapy, and exercise opportunities.

Conversely, research points to the positive value of the application of one or more forms of social support in the context of either direct assistance, indirect assistance, tangible and intangible aspects of support in efforts to impact physical as well as mental health, as well as health behaviors positively and significantly.

Unsurprisingly, Nam et al. [8] identified social support as an important variable not only for older adults with chronic illness who lived alone, but for those with symptoms of depression, who may also suffer from suicidal ideation, a finding supported by Koizumi et al. [9]. Olagunju al. [10] argued that considering the burden of depression in the elderly and the influential roles of social support especially from family and significant others on depression; strengthening of informal social support and formal social support for the elders is advocated. In addition, design of community based geriatric mental health with social services and articulation of public policy to address old age needs are implied both by this group and Nagoor et al. [11].

Geriatric depression is a mental and emotional disorder affecting many older adults, that results in trouble concentrating, hopelessness, feelings of worthlessness, reduced motivation, decreased drive and reward for pleasurable activities, too much or too little sleep, doom and suicidal thoughts. Depression in older adults can hence reduce quality and years of life, especially if social support and the provision or development of a supportive environment or atmosphere is unavailable or perceived to be negative. Conversely, although late life depression is associated with a significant burden of disease [6], including the perception of inadequate received social support [12], the careful design of formal and informal social supports may prove helpful in alleviating the depression burden [10].

In the belief that concerted efforts to examine the role of social support in the context of geriatric depression, functional disability [13,14,15], this special edition focuses on the role of social support in explaining the burden of depression and its relationship and its amelioration, a relatively underreported topic.

Articles of any genre concerning the importance of social support in preventing and treating geriatric depression and its correlates are specifically sought.

Author Contributions

The author did all the works.

Competing Interests

The author has declared that no competing interests exist.

References

  1. Edwards RR, Cahalan C, Mensing G, Smith M, Haythornthwaite JA. Pain, catastrophizing, and depression in the rheumatic diseases. Nat Rev Rheumatol. 2011; 7: 216-224. [CrossRef]
  2. Alexopoulos GS. Depression in the elderly. Lancet. 2005; 365: 1961-1970. [CrossRef]
  3. López-López A, Montorio I, Izal M, Velasco L. The role of psychological variables in explaining depression in older people with chronic pain. Aging Ment Health. 2008; 12: 735-745. [CrossRef]
  4. Alpass FM, Neville S. Loneliness, health and depression in older males. Aging Ment Health. 2003; 7: 212-216. [CrossRef]
  5. Areán PA, Mackin S, Vargas-Dwyer E, Raue P, Sirey JA, Kanellopolos D, et al. Treating depression in disabled, low-income elderly: A conceptual model and recommendations for care. Int J Geriatr Psychr. 2010; 25: 765-769. [CrossRef]
  6. Gonçalves-Pereira M, Prina AM, Cardoso AM, da Silva JA, Prince M, Xavier M, et al. The prevalence of late-life depression in a Portuguese community sample: A 10/66 Dementia Research Group study. J Affect Disord. 2019; 246: 674-681. [CrossRef]
  7. Cobb S. Social support as a moderator of lifestress. Psychosom Med. 1976; 38: 300-314. [CrossRef]
  8. Nam EJ, Lee JE. Mediating effects of social support on depression and suicidal ideation in older korean adults with hypertension who live alone. J Nurs Res. 2018. doi: 10.1097/jnr.0000000000000292. [CrossRef]
  9. Koizumi Y, Awata S, Kuriyama S, Ohmori K, Hozawa A, Seki T, et al. Association between social support and depression status in the elderly: Results of a 1-year community-based prospective cohort study in Japan. Psychiatry Clin Neurosci. 2005; 59: 563-569. [CrossRef]
  10. Olagunju AT, Olutoki MO, Ogunnubi OP, Adeyemi JD. Late-life depression: Burden, severity and relationship with social support dimensions in a West African community. Arch Gerontol Geriatr. 2015; 61: 240-246. [CrossRef]
  11. Nagoor K, Darivemula SB, Reddy NB, Patan SK, Deepthi CS, Chittooru CS. Prevalence of mental illness and their association with sociodemographic factors in the rural geriatric population in Chittoor, Andhra Pradesh, India: A community-based study. J Educ Health Promot. 2018; 7: 165.
  12. Rajapakshe OBW, Sivayogan S, Kulatunga PM. Prevalence and correlates of depression among older urban community-dwelling adults in Sri Lanka. Psychogeriatrics. 2018. doi: 10.1111/psyg.12389. [CrossRef]
  13. Travis LA, Lyness JM, Shields CG, King DA, Cox C. Social support, depression, and functional disability in older adult primary-care patients. Am J Geriatr Psychiatry. 2004; 12: 265-271. [CrossRef]
  14. Patra P, Alikari V, Fradelos EC, Sachlas A, Kourakos M, Rojas Gil AP, et al. Assessment of depression in elderly. Is perceived social support related? a nursing home study: depression and social support in elderly. Adv Exp Med Biol. 2017; 987: 139-150. [CrossRef]
  15. Steffens DC, Hays JC, Krishnan KR. Disability in geriatric depression. Am J Geriatr Psychiatry. 1999; 7: 34-40. [CrossRef]
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