Inner strength – associated with reduced prevalence of depression among older women

Objectives: The aim of this study was to explore if inner strength is independently associated with a reduced prevalence of depression after controlling for other known risk factors associated with depression. Methods: A population-based cross-sectional study was performed, where all women living in Åland, a Finnish self-govern island community in the Baltic Sea, aged 65 years or older were sent a questionnaire including the Geriatric Depression Scale and the Inner Strength Scale along with several other questions related to depression. Factors associated with depression were analyzed by means of multivariate logistic regression. Results: The results showed that 11.2% of the studied women (n = 1452) were depressed and that the prevalence increased with age and was as high as 20% in the oldest age group. Non-depressed women were more likely to never or seldom feel lonely, have a strong inner strength, take fewer prescription drugs, feeling needed, being able to engage in meaningful leisure activities, as well as cohabit. Conclusion: Our results showed an association between stronger inner strength and being non-depressed. This can be interpreted to mean that inner strength might have a protective effect against depression. These findings are interesting from a health-promotion perspective, yet to verify these results, further longitudinal studies are required.

[1]  L. Kurlowicz.  Geriatric Depression Scale , 2017 .

[2]  Y. Gustafson,et al.  Risk factors for depressive disorders in very old age: a population-based cohort study with a 5-year follow-up , 2014, Social Psychiatry and Psychiatric Epidemiology.

[3]  Catherine Dingley,et al.  The role of inner strength in quality of life and self-management in women survivors of cancer. , 2014, Research in nursing & health.

[4]  B. Lundman,et al.  Inner strength in relation to age, gender and culture among old people – a cross-sectional population study in two Nordic countries , 2013, Aging & mental health.

[5]  K. Luyckx,et al.  Sense of coherence, depressive feelings and life satisfaction in older persons: a closer look at the role of integrity and despair , 2013, Aging & mental health.

[6]  Tracy Chippendale.  Factors Associated With Depressive Symptoms Among Elders in Senior Residences: The Importance of Feeling Valued by Others , 2013 .

[7]  Y. Gustafson,et al.  Usefulness of the Geriatric Depression Scale 15-item version among very old people with and without cognitive impairment , 2013, Aging & mental health.

[8]  F. Nyqvist,et al.  Structural and cognitive social capital and depression among older adults in two Nordic regions , 2012, Aging & mental health.

[9]  A. Norberg,et al.  Inner strength in relation to functional status, disease, living arrangements, and social relationships among people aged 85 years and older. , 2012, Geriatric nursing.

[10]  Ming-Hong Hsieh,et al.  Leisure activity, mobility limitation and stress as modifiable risk factors for depressive symptoms in the elderly: results of a national longitudinal study. , 2012, Archives of gerontology and geriatrics.

[11]  A. Norberg,et al.  Development and psychometric properties of the Inner Strength Scale. , 2011, International journal of nursing studies.

[12]  Gayle Roux,et al.  Psychometric testing of the Inner Strength Questionnaire: women living with chronic health conditions. , 2011, Applied nursing research : ANR.

[13]  E. Stordal,et al.  Increased prevalence of depression in cohorts of the elderly: an 11-year follow-up in the general population – the HUNT study , 2011, International Psychogeriatrics.

[14]  H. Brenner,et al.  Association between the prevalence of depression and age in a large representative German sample of people aged 53 to 80 years , 2011, International journal of geriatric psychiatry.

[15]  Amy Restorick Roberts,et al.  Changes in activity and interest in the third and fourth age: associations with health, functioning and depressive symptoms. , 2011, Occupational therapy international.

[16]  Y. Gustafson,et al.  Sense of coherence (SOC) related to health and mortality among the very old: the Umeå 85+ study. , 2010, Archives of gerontology and geriatrics.

[17]  Y. Gustafson,et al.  Depression in relation to purpose in life among a very old population: A five-year follow-up study , 2010, Aging & mental health.

[18]  L. Hawkley,et al.  Loneliness Matters: A Theoretical and Empirical Review of Consequences and Mechanisms , 2010, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.

[19]  R. Kravitz,et al.  Depression , 2010, Annals of Internal Medicine.

[20]  A. Norberg,et al.  Inner strength--a theoretical analysis of salutogenic concepts. , 2010, International journal of nursing studies.

[21]  T. Ng,et al.  Criterion-based validity and reliability of the Geriatric Depression Screening Scale (GDS-15) in a large validation sample of community-living Asian older adults , 2009, Aging & mental health.

[22]  Y. Gustafson,et al.  Gender differences in depression among the very old , 2007, International Psychogeriatrics.

[23]  J. K. Djernes,et al.  Prevalence and predictors of depression in populations of elderly: a review , 2006, Acta psychiatrica Scandinavica.

[24]  L. Hawkley,et al.  Loneliness as a specific risk factor for depressive symptoms: cross-sectional and longitudinal analyses. , 2006, Psychology and aging.

[25]  H. Adèr,et al.  Test-Characteristics of the GDS-15 in Screening for Major Depression in Elderly Patients in General Practice , 2006 .

[26]  C. Stinson,et al.  Structured reminiscence: an intervention to decrease depression and increase self-transcendence in older women. , 2006, Journal of clinical nursing.

[27]  Y. Gustafson,et al.  Resilience, sense of coherence, purpose in life and self-transcendence in relation to perceived physical and mental health among the oldest old , 2005, Aging & mental health.

[28]  Y. Gustafson,et al.  Morale in the oldest old: the Umeå 85+ study. , 2005, Age and ageing.

[29]  C. Lyketsos,et al.  Prevalence and correlates of depression in late life: a population based study from a rural Greek town , 2005, International journal of geriatric psychiatry.

[30]  Susan E. Hardy,et al.  Resilience of Community‐Dwelling Older Persons , 2004, Journal of the American Geriatrics Society.

[31]  Timothy B. Smith,et al.  Religiousness and depression: evidence for a main effect and the moderating influence of stressful life events. , 2003, Psychological bulletin.

[32]  O. Almeida,et al.  Short versions of the geriatric depression scale: a study of their validity for the diagnosis of a major depressive episode according to ICD‐10 and DSM‐IV , 1999, International journal of geriatric psychiatry.

[33]  J. Cataldo,et al.  Hardiness and death attitudes: predictors of depression in the institutionalized elderly. , 1994, Archives of psychiatric nursing.

[34]  J. Yesavage,et al.  Geriatric Depression Scale (GDS): Recent evidence and development of a shorter version. , 1986 .

[35]  F J Durgin,et al.  Depression in the elderly. , 1978, Comprehensive therapy.

[36]  B. Lundman,et al.  Inner strength as a mediator of the relationship between disease and self-rated health among old people. , 2014, Journal of advanced nursing.

[37]  K. Sattler.  Principles and methods , 2011 .

[38]  J. Yesavage.  Geriatric Depression Scale. , 1988, Psychopharmacology bulletin.

[39]  V. Leirer,et al.  Development and validation of a geriatric depression screening scale: a preliminary report. , 1982, Journal of psychiatric research.

[40]  Burns Bh.  Psychiatric disorders in the elderly. , 1981, The Practitioner.