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Depression in Older Adults
Open accessAbstract
Depression is less prevalent among older adults than among younger adults, but it can have serious consequences. More than half of cases represent a first onset in later life. Although suicide rates in the elderly are declining, they are still higher than in younger adults and are more closely associated with depression. Depressed older adults are less likely to endorse affective symptoms and more likely to display cognitive changes, somatic symptoms, and loss of interest than are depressed younger adults. Risk factors leading to the development of late-life depression likely comprise complex interactions among genetic vulnerabilities, cognitive diathesis, age-associated neurobiological changes, and stressful events. Insomnia is an often overlooked risk factor for late-life depression. We suggest that a common pathway to depression in older adults, regardless of which predisposing risks are most prominent, may be curtailment of daily activities. Accompanying self-critical thinking may exacerbate and maintain a depressed state. Offsetting the increasing prevalence of certain risk factors in late life are age-related increases in psychological resilience. Other protective factors include higher education and socioeconomic status, engagement in valued activities, and religious or spiritual involvement. Treatments including behavioral therapy, cognitive-behavioral therapy, cognitive bibliotherapy, problem-solving therapy, brief psychodynamic therapy, and life review/reminiscence therapy are effective but are too infrequently used with older adults. Preventive interventions including education for individuals with chronic illness, behavioral activation, cognitive restructuring, problem-solving skills training, group support, and life review have also received support.
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“Although aging itself is not associated with decline in affective functioning, aged individuals, compared with the young, are more vulnerable to depressive symptoms associated with physical illnesses, and life events (English and Carstensen, 2015;Fiske et al, 2009Fiske et al, , 2013)).”
From Microglia Priming with Aging and Stress (2017) · cites this paper as Fiske et al, 2009
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“Bibliotherapy has been found to be efficacious by several systematic reviews or meta-analyses in the treatment of emotional, physical, and mental health problems among adults.22,28–32”
From Comparative efficacy and acceptability of bibliotherapy for depression and anxiety disorders in children and adolescents: a meta-analysis of randomized clinical trials (2018) · cites this paper as [29]
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Metadata
- Authors
- Fiske, A., Wetherell, J. L., & Gatz, M.
- Affiliations
- West Virginia University (US)
- University of California San Diego (US)
- University of Southern California (US)
- Venue
- Annual Review of Clinical Psychology
- Publisher
- Annual Reviews
- Published
- 2009-04-01
- Volume
- 5
- Issue
- 1
- Pages
- 363-389
- ISSN
- 1548-5943 (ISSN-L)
- 1548-5951
- PMC
- PMC2852580
- OpenAlex
- W3026624461
- Cited by
- 2,353
- References
- 151
- Citations by year
- 2026: 123 · 2025: 159 · 2024: 171 · 2023: 190 · 2022: 203 · 2021: 266 · 2020: 219 · 2019: 157 · 2018: 152 · 2017: 132 · 2016: 137 · 2015: 106 · 2014: 97 · 2013: 84 · 2012: 65
- FWCI
- 6.94
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Annual Review of Clinical Psychology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Aging (R01 AG 10175, P50-AG05142, R01AG010175, P50AG005142)
- National Institute of Mental Health (R34MH080151, R15MH080399, R15 MH 80399)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Aging, Health, and Disability
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Developmental and Educational Psychology › Aging and Gerontology Research
- Keywords
- geriatric depression, older adults, suicide risk, somatic symptoms, risk factors, genetic susceptibility, life events, insomnia, self-criticism, psychological resilience, protective factors, depression treatment, cognitive behavioral therapy, bibliotherapy, problem-solving therapy, psychodynamic psychotherapy, life review, reminiscence therapy, behavioral activation, depression prevention, chronic disease
- MeSH terms
- Aged, Chronic Disease, Cognition Disorders, Depression, Humans, Risk Factors, Self Concept, Social Behavior, Social Environment, Social Support, Socioeconomic Factors, Prevalence, Age of Onset
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