Aging Research Article
Senior Blues
So you see your parents for the Thanksgiving Holiday after not seeing them for a while, and things seem…off. “Is my mom depressed?” you think to yourself, “And where did that come from? The last time I saw her, she was fine. She’s never been depressed before—what’s going on?”
It may come as a surprise that depression later in life is not at all uncommon. In fact, 65 percent of older adults suffer from some form of depression. Why?
Older adults experience so many losses that sometimes they slip into depression. Their lives have changed and their sense of independence may be wavering. Perhaps your parent has lost a network of good friends or relatives, has become the caregiver for a spouse with physical issues or loss of memory, or even is experiencing memory loss or physical problems him/herself. Getting together for the holidays may also trigger depression, because the holidays have changed, too; family members have passed away, or Mom can no longer handle cooking a meal for twenty people. The thought of the cold winter months and the shortened days of winter can also trigger or add to depression.
Everyone gets the blues sometimes. Feeling sad, upset or overwhelmed at times is normal, especially during the more difficult moments in life. Usually these feelings pass and we find the strength to go on with our lives. Clinical depression is different. Although it may feel similar to the blues, depression is a sense of sadness or hopelessness that just won’t go away, and in many cases interferes with day-to-day life. Depression is not a character flaw, but a medical condition that can affect anyone. In fact, more than 19 million Americans suffer from depression.
Depression is easily treatable, and a high percentage of those treated respond well to treatment. The problem is that many people suffering from depression do not seek help and thus do not receive it.
Older adults are one of the groups most prone to depression because of all of the losses they are going through. Many losses that are a part of aging, including dealing with the end of life itself, can cause depression. Other conditions such as Parkinson’s disease, stroke, Alzheimer’s disease and thyroid dysfunction can also hamper neurological function and may result in depression. Chronic illness is another frequent cause of depression in seniors. If depression is left untreated it can even exacerbate a chronic condition. Depression weakens the immune system, intensifies the perception of pain and other symptoms, and increases the likelihood of improper management of an illness.
What might you see if your parent or family member is depressed? Loss of interest or pleasure in family life, hobbies, or sex life; difficulty in concentrating or remembering things; a low energy level; sleeplessness or sleeping too much; loss of appetite or overeating; or unusual irritability. Additional signs include loss of self-esteem or an attitude of indifference, frequent or unexplainable crying spells, and recurrent thoughts of death or suicide.
If you suspect a parent or loved one might be depressed, initiate a discussion, acknowledge your loved one’s feelings, and encourage him or her to get professional help. If he or she has a family doctor, set up an appointment for an evaluation. If your loved one is able to participate in activities, suggest getting out to the senior program at the JCC or local senior center, or contact Jewish Family Services or a local counseling center. A short-term stay or move to Senior Housing or Assisted Living can help with feelings of loneliness and isolation, and add much-needed daily support. Adult day care can also be an option. If you feel that there is a risk of suicide, then take your loved one to a local hospital or emergency center immediately. Don’t wait—older adults, especially males, are at high risk for suicide.
Remember that depression is highly treatable. If you think a family member is suffering from depression, the most important step is to seek assistance from a health professional.
The information in this article is provided from the Senior Blues educational pamphlet, part of The Wilf Campus Senior Education Initiative and by Toby Ehrlich, ACSW, LCSW , The Martin and Edith Stein Assisted Living Residence at The Wilf Campus for Senior Living. For more information on The Wilf Campus, contact us at 732-568-1155.
How can counseling and support groups lead to better Alzheimer's caregivers?
As part of the long-running New York University Spouse-Caregiver Intervention Study, caregivers and family members are initially provided with individual and family counseling sessions (six sessions are formally provided). In addition, support groups and on-demand telephone counseling are provided on an ongoing basis. These services have been shown to significantly increase the time that patients with Alzheimer's remain at home and have also been shown to decrease depression and improve well-being among caregivers.
Counseling. Individual and family counseling sessions are specifically tailored to the needs of each caregiver and conducted in person at a location that is most convenient for the participants. The major aims of counseling are:
- Education so that caregivers and family member understand the nature of Alzheimer's and how it can affect each member of the family.
- Improving communication, so that family members can better convey and understand each other's needs.
- Problem solving. Because Alzheimer's disease can be so overwhelming, counselors aim to break the problem up into smaller, more manageable tasks. Counselors also make caregivers and family members aware to available options and formal services.
- Teaching caregivers and family members behavior management strategies. Remaining calm, not rushing the person with Alzheimer's disease, speaking softly and trying to understand the possible motivation for problem behaviors can reduce their severity and their impact on the caregiver.
- Concrete planning to enhance caregiver support. For example, family members other than the primary caregiver are encouraged to take over specific tasks. Caregivers are encouraged to use formal services such as legal and financial advice, and to obtain the best health care for themselves and for the person with Alzheimer's disease.
- Educating family members about specific drug treatments that are available for management of such symptoms as depression, agitation or nighttime wandering.
An important part of the program is getting family members involved early on in the process. Family counseling sessions provide problem solving and communication techniques for the family. In addition, the primary caregiver learns to ask for and accept help, and family members learn how to offer help so that it is likely to be accepted. These aspects improve family relations and may lead to increased intimacy.
Support Groups. Immediately after the individual and family counseling sessions, caregivers are required to join support groups affiliated with the Alzheimer's Association. These support groups are widely available in New York and many other metropolitan areas. These groups, which meet weekly, are led by an individual who is experienced in working with caregivers of those with Alzheimer's.
Support group leaders teach about Alzheimer's disease and suggest appropriate resources for information and referral. Group members learn techniques from each other on home-care skills and how to cope with special problem situations and discuss the emotional aspects of the caregivers experience with each other. During support group sessions, members are encouraged to consider their own needs as well as the needs of the person with Alzheimer's disease. The group is available as long as the caregiver needs support.
Ongoing "On-Demand" Counseling. In the third component of treatment, ad hoc counseling, family counselors provide informal consultations on the telephone or in person to caregivers or family members whenever they request it. This ongoing support allows counselors to respond to the effects of the changing nature of the disease and to provide continuing care and crisis intervention.
Adapted from research and reviewed by Mary S. Mittelman, Dr.P.H., New York University School of Medicine
Vitamin D May Be Good for the Brain
Mon, 13 April 2009 11:53:00 AM EST
Vitamin D, sometimes called the sunshine vitamin because the body makes it upon exposure to sunlight, may help protect the brain against the ravages of dementia, British researchers report. Although more research is needed, the scientists found that older people who had low blood levels of the vitamin were at increased risk for developing memory loss and other symptoms of Alzheimer’s disease late in life.
The study, which appeared in the Journal of Geriatric Psychology and Neurology, was based on data from 1,766 seniors. All were 65 or older and part of the Health Survey for England in 2000 study.
The study found that as levels of vitamin D went down, levels of cognitive impairment went up. Compared to those with optimum levels of Vitamin D, those with the lowest levels were more than twice as likely to be cognitively impaired.
About 12 percent of the participants had memory problems, and the lower their vitamin D level, the more likely they were to be in that group. Compared with those in the highest one-quarter for serum vitamin D, those in the lowest were 2.3 times as likely to be impaired, even after statistically adjusting for age, sex, education and ethnicity. Men showed the effect more strongly than women.
"This is the first large-scale study to identify a relationship between Vitamin D and cognitive impairment in later life," said study co-author Dr. Iain Lang from the Peninsula Medical School in the U.K. "Dementia is a growing problem for health services everywhere, and people who have cognitive impairment are at higher risk of going on to develop dementia. That means identifying ways in which we can reduce levels of dementia is a key challenge for health services."
Dr. Lang added: "For those of us who live in countries where there are dark winters without much sunlight, like the U.K., getting enough vitamin D can be a real problem, particularly for older people, who absorb less vitamin D from sunlight."
One way to address this deficit, Dr. Lang suggested, might be to provide older adults with vitamin D supplements, though further research is needed to explore the possible link between the nutrient and its possible role in Alzheimer’s disease. “We need to investigate whether vitamin D supplementation is a cost-effective and low-risk way of reducing older people's risks of developing cognitive impairment and dementia."
“The cause of dementia is not vitamin D deficiency,” added lead author David Llewellyn, a research associate at Cambridge University. “It’s a very complicated disease. But while further research is needed, vitamin D supplementation is cheap, safe and convenient, and may therefore play an important role in prevention.”
Vitamin D has long been known for its bone-strengthening properties. That’s one reason it is added to milk. But a growing number of studies point to additional benefits, like lowering the risk of diabetes and certain cancers.
In addition to fortified drinks like milk, soy milk and some juices, the vitamin is also found in oily fish like salmon, mackerel, bluefish, catfish, sardines and tuna, as well as cod liver oil and fish oils. Fish oils have also been linked to a lower risk of Alzheimer’s disease.
By ALZinfo.org, The Alzheimer's Information Site. Reviewed by William J. Netzer, Ph.D., Fisher Center for Alzheimer's Research Foundation at The Rockefeller University.
David J. Llewellyn, Ph.D., Kenneth Langa, M.D., Ph.D., and Iain Lang, Ph.D.: “Serum 25-Hydroxyvitamin D Concentration and Cognitive Impairment.” Journal of Geriatric Psychiatry and Neurology. February 4, 2009. The Peninsula College of Medicine and Dentristry.
Reading, Crafts Help Keep the Brain Young
Mon, 13 April 2009 12:38:00 PM EST
More good news on the neurobics front: Reading books, playing games or engaging in computer activities or crafts like pottery or quilting helps keep the brain young into old age, according to a new report. And while reading was good for the brain, watching too much TV seemed to be bad for it.
The findings, to be presented at the American Academy of Neurology’s 61st Annual Meeting in Seattle in late April, add to a growing body of evidence that mental challenges, or “neurobics,” like crossword puzzles and word games help keep memory and thinking sharp.
The research, from the Mayo Clinic in Rochester, Minn., involved a random sampling of 1,321 men and women in their 70s and 80s. Among the participants, 197 had mild cognitive impairment, a form of memory loss that sometimes precedes Alzheimer’s disease. The remainder had no memory problems.
Both groups filled out questionnaires about their everyday activities during the previous year. They also answered questions about what they engaged in during middle age, when they were in their 50s and 60s.
The researchers found that during the later years, those who regularly engaged in mentally-stimulating tasks like reading, crafts and computer activities were 30 to 50 percent less likely to suffer from serious memory loss compared to people who did not do those activities. People who watched television for less than seven hours a day as seniors were 50 percent less likely to develop memory loss than people who watched TV for more than seven hours a day.
People who participated in social activities and read magazines during middle age were about 40 percent less likely to develop memory loss than their less social peers or those who read less frequently.
“This study is exciting because it demonstrates that aging does not need to be a passive process,” said study author Yonas Geda, M.D., M.Sc., a neuropsychiatrist at the Mayo Clinic. “By simply engaging in cognitive exercise, you can protect against future memory loss.”
The researchers warned that these kinds of studies, which depend on participants’ recall of long past events, can be unreliable. But a growing body of evidence points to the benefits of mental stimulation in helping to ward off memory loss. Such activities may help to preserve and strengthen connections between brain cells in areas of the brain critical for memory.
Visit ALZinfo.org, the Alzheimer’s Information Site, to learn more about keeping the brain sharp and prevention of Alzheimer’s disease. And for thought-provoking games and word puzzles, subscribe free to the Fisher Center’s “Preserving Your Memory” magazine.
By ALZinfo.org, The Alzheimer's Information Site. Reviewed by William J. Netzer, Ph.D., Fisher Center for Alzheimer's Research Foundation at The Rockefeller University.
Source:
Yonas E. Geda, Rosebud Roberts, David Knopman, et al: “Cognitive Activities Are Associated With Decreased Risk of Mild Cognitive Impairment: The Mayo Clinic Population-Based Study of Aging.” The American Academy of Neurology.
Vitamin D, sometimes called the sunshine vitamin because the body makes it upon exposure to sunlight, may help protect the brain against the ravages of dementia, British researchers report. Although more research is needed, the scientists found that older people who had low blood levels of the vitamin were at increased risk for developing memory loss and other symptoms of Alzheimer’s disease late in life.
The study, which appeared in the Journal of Geriatric Psychology and Neurology, was based on data from 1,766 seniors. All were 65 or older and part of the Health Survey for England in 2000 study.
The study found that as levels of vitamin D went down, levels of cognitive impairment went up. Compared to those with optimum levels of Vitamin D, those with the lowest levels were more than twice as likely to be cognitively impaired.
About 12 percent of the participants had memory problems, and the lower their vitamin D level, the more likely they were to be in that group. Compared with those in the highest one-quarter for serum vitamin D, those in the lowest were 2.3 times as likely to be impaired, even after statistically adjusting for age, sex, education and ethnicity. Men showed the effect more strongly than women.
"This is the first large-scale study to identify a relationship between Vitamin D and cognitive impairment in later life," said study co-author Dr. Iain Lang from the Peninsula Medical School in the U.K. "Dementia is a growing problem for health services everywhere, and people who have cognitive impairment are at higher risk of going on to develop dementia. That means identifying ways in which we can reduce levels of dementia is a key challenge for health services."
Dr. Lang added: "For those of us who live in countries where there are dark winters without much sunlight, like the U.K., getting enough vitamin D can be a real problem, particularly for older people, who absorb less vitamin D from sunlight."
One way to address this deficit, Dr. Lang suggested, might be to provide older adults with vitamin D supplements, though further research is needed to explore the possible link between the nutrient and its possible role in Alzheimer’s disease. “We need to investigate whether vitamin D supplementation is a cost-effective and low-risk way of reducing older people's risks of developing cognitive impairment and dementia."
“The cause of dementia is not vitamin D deficiency,” added lead author David Llewellyn, a research associate at Cambridge University. “It’s a very complicated disease. But while further research is needed, vitamin D supplementation is cheap, safe and convenient, and may therefore play an important role in prevention.”
Vitamin D has long been known for its bone-strengthening properties. That’s one reason it is added to milk. But a growing number of studies point to additional benefits, like lowering the risk of diabetes and certain cancers.
In addition to fortified drinks like milk, soy milk and some juices, the vitamin is also found in oily fish like salmon, mackerel, bluefish, catfish, sardines and tuna, as well as cod liver oil and fish oils. Fish oils have also been linked to a lower risk of Alzheimer’s disease.
By ALZinfo.org, The Alzheimer's Information Site. Reviewed by William J. Netzer, Ph.D., Fisher Center for Alzheimer's Research Foundation at The Rockefeller University.
David J. Llewellyn, Ph.D., Kenneth Langa, M.D., Ph.D., and Iain Lang, Ph.D.: “Serum 25-Hydroxyvitamin D Concentration and Cognitive Impairment.” Journal of Geriatric Psychiatry and Neurology. February 4, 2009. The Peninsula College of Medicine and Dentristry.
