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Depression symptoms on the decline in older adults: birth cohort analyses from the rust belt

Sullivan, Kevin (2019) Depression symptoms on the decline in older adults: birth cohort analyses from the rust belt. Master Essay, University of Pittsburgh.

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Background/Objective. Depression symptoms in older adults are associated with poor health outcomes. Long-term population trends in depression are well established for younger adults and prevalence is reportedly on the rise, but there is a paucity of data on trends specific to older adults. The present population-based study aimed to investigate birth cohort effects in depression symptoms in older adults from small-town communities in Southwestern Pennsylvania.
Methods. In an analysis sample of 3227 older adults, we identified four decade-long birth cohorts: 1902-1911, 1912-1921, 1922-1931, and 1932-1941. The outcome was symptoms of depression assessed at baseline and follow-up study visits using a modified Center for Epidemiologic Studies Depression Scale (mCES-D). The depression outcome was operationalized as: 1. A binary outcome of having ≥5 depression symptoms on the total mCES-D at any study visit, and 2. A continuous outcome of four factor-analyzed component scores of the mCES-D including Depressed Mood, Anergia/Hopelessness, Withdrawal, and Poor Self-Esteem. All analyses were jointly modeled with attrition and adjusted for age, sex, education, Mini Mental State Examination score, antidepressant medications, and total prescription medications.
Results. Participants from more recently born cohorts were significantly less likely to have a study visit in which they reported ≥5 depression symptoms, controlling for attrition. Specifically, in comparison to the 1902-1911 referent cohort, the 1912-1921 birth cohort was 43% less likely (OR=0.566, 95% CI: 0.341-0.939), the 1922-1931 birth cohort was 63% less likely (OR=.0369, 95% CI: 0.215-0.632), and the 1932-1941 cohort was 79% less likely (OR=.205, 95% CI: 0.106-0.399). The cohort effect was primarily driven by symptoms included in the Depressed Mood and Anergia/Hopelessness composites.
Conclusions. Given the rapidly aging population, it is of great public health importance to investigate epidemiologic trends in older adult mental health. Reduced rates of depression symptoms observed in successive birth cohorts of older adults may reflect compression of morbidity or other secular trends.


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Item Type: Other Thesis, Dissertation, or Long Paper (Master Essay)
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Sullivan, Kevinkjs152@pitt.edukjs152
ContributionContributors NameEmailPitt UsernameORCID
Committee ChairStrotmeyer, Elsastrotmeyere@edc.pitt.eduUNSPECIFIEDUNSPECIFIED
Committee MemberGanguli, MaryGanguliM@upmc.eduUNSPECIFIEDUNSPECIFIED
Committee MemberTalbott, Evelyneot1@pitt.eduUNSPECIFIEDUNSPECIFIED
Date: 19 April 2019
Date Type: Submission
Submission Date: 1 April 2019
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Number of Pages: 38
Institution: University of Pittsburgh
Schools and Programs: School of Public Health > Epidemiology
Degree: MPH - Master of Public Health
Thesis Type: Master Essay
Refereed: Yes
Uncontrolled Keywords: Birth Cohort, Depression, Aging, Subsyndromal Depression
Date Deposited: 04 Oct 2019 23:46
Last Modified: 19 Apr 2022 05:15


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