Soziale Verlusterlebnisse und deren Zusammenhang mit Depressionen im hohen Alter – Ergebnisse der Leipziger Langzeitstudie in der Altenbevölkerung (LEILA 75+)

Zusammenfassung

Ziel der Studie Verlusterlebnisse im Alter können mit einer Vielzahl negativer gesundheitlicher Folgen für Betroffene wie Depressionen einhergehen.

Methodik 706 Personen (75+ Jahre) wurden mit einem strukturierten klinischen Interview befragt.

Ergebnisse Es zeigte sich, dass soziale Verlusterlebnisse signifikant mit Depressionen assoziiert waren.

Schlussfolgerung Die vorliegende Arbeit legt erstmalig für Deutschland umfängliche Ergebnisse zu sozialen Verlusterlebnissen im hohen Alter vor und stellt einen wertvollen Ausgangspunkt für zukünftige Forschungsarbeiten dar.

Abstract

Objective Loss experiences in old age are common and can be accompanied by serious consequences such as depression. This study aimed at investigating the distribution of loss experiences and their association with depression in old age.

Methods Based on the Leipzig Longitudinal Study of the Aged 75+ (LEILA 75+), a sample of 706 individuals was assessed via structured clinical interviews. Data on social loss experiences were collected via the Leipziger Lebensereignis-Liste. Descriptive and interferential statistical analyses were conducted in order to examine the association between loss experiences and depression.

Results Overall, 16.4 % of the oldest old reported at least one social loss experience in the last 6 months while the death of a loved one (46.6 %) and severe illness (43.1 %) were the most frequent types of social loss experiences. Analyses revealed that social loss experiences were significantly associated with depression.

Conclusion This study provides, for the first time in Germany, data on loss experiences in the oldest old. These findings may contribute to the development of interventions and effective treatment for the bereaved elderly with depression.

Schlüsselwörter

Verlusterfahrungen - Epidemiologie - hohes Alter - Depressionen

Keywords

loss experiences - epidemiology - old age - depression

^* geteilte Erstautorenschaft

• Literatur

• 1 Statistisches Bundesamt. Ältere Menschen in Deutschland und der EU. Wiesbaden: Statistisches Bundesamt; 2016
• 2 Robert Koch-Institut. Gesundheit in Deutschland. Gesundheitsberichterstattung des Bundes: Gemeinsam getragen von RKI und DESTATIS. Beiträge zur Gesundheitsberichterstattung des Bundes. Berlin: Robert Koch-Institut; 2015
• 3 Luppa M, Sikorski C, Luck T. et al. Age- and gender-specific prevalence of depression in latest-life – Systematic review and meta-analysis. J Affect Disord 2012; 136: 212-221
• 4 Katon WJ, Lin E, Russo J. et al. Increased medical costs of a population-based sample of depressed elderly patients. Arch Gen Psychiatry 2003; 60: 897-903
• 5 Luber MP, Meyers BS, Williams-Russo PG. et al. Depression and Service Utilization in Elderly Primary Care Patients. Am J Geriatr Psychiatry 2001; 9: 169-176
• 6 Luppa M, Heinrich S, Matschinger H. et al. Direct costs associated with depression in old age in Germany. J Affect Disord 2008; 105: 195-204
• 7 Unützer J, Patrick DL, Simon G. et al. Depressive Symptoms and the Cost of Health Services in HMO Patients Aged 65 Years and Older. A 4-year prospective study. JAMA 1997; 277: 1618-1623
• 8 Williams BR, Sawyer Baker P, Allman RM. et al. Bereavement Among African American and White Older Adults. J Aging Health 2007; 19: 313-333
• 9 Holmes TH, Rahe RH. The Social Readjustment Rating Scale. J Psychosom Res 1967; 11: 213-218
• 10 Moon JR, Kondo N, Glymour MM. et al. Widowhood and Mortality: A Meta-Analysis. PLoS One 2011; 6: e23456
• 11 Stroebe M, Schut H, Stroebe W. Health outcomes of bereavement. Lancet 2007; 370: 1960-1973
• 12 Victor CR, Scambler SJ, Bowling A. et al. The prevalence of, and risk factors for, loneliness in later life: a survey of older people in Great Britain. Ageing Soc 2005; 25: 357-375
• 13 Stahl ST, Schulz R. Changes in routine health behaviors following late-life bereavement: A systematic review. J Behav Med 2014; 37: 736-755
• 14 Christakis NA, Allison PD. Mortality after the Hospitalization of a Spouse. N Engl J Med 2006; 354: 719-730
• 15 Kraaij V, Arensman E, Spinhoven P. Negative Life Events and Depression in Elderly Persons: A Meta-Analysis. J Gerontol B Psychol Sci 2002; 57B: 87-94
• 16 Turvey CL, Carney C, Arndt S. et al. Conjugal loss and syndromal depression in a sample of elders aged 70 years or older. Am J Psychiatry 1999; 156: 1596-1601
• 17 Lalive d’Epinay CJ, Cavalli S, Guillet LA. Bereavement in Very Old Age: Impact on Health and Relationships of the Loss of a Spouse, a Child, a Sibling, or a Close Friend. OMEGA 2010; 60: 301-325
• 18 Prince MJ, Harwood RH, Blizard RA. et al. Social support deficits, loneliness and life events as risk factors for depression in old age. The Gospel Oak Project VI. Psychol Med 2007; 27: 323-332
• 19 Sikorski C, Luppa M, Heser K. et al. The role of spousal loss in the development of depressive symptoms in the elderly – Implications for diagnostic systems. J Affect Disord 2014; 161: 97-103
• 20 de Beurs E, Beekman A, Geerlings S. et al. On becoming depressed or anxious in late life: Similar vulnerability factors but different effects of stressful life events. Br J Psychiatry 2001; 179: 426-431
• 21 Glass TA, Kasl SV, Berkman LF. Stressful Life Events and Depressive Symptoms Among the Elderly. J Aging Health 1997; 9: 70-89
• 22 Röhr S, Luck T, Villringer A. et al. Subjektiver kognitiver Abbau und Demenzentwicklung – Ergebnisse der Leipziger Langzeitstudie in der Altenbevölkerung (LEILA75+). Psychiat Prax 2017; 44: 47-49
• 23 Riedel-Heller SG, Schork A, Matschinger H. et al. Recruitment Procedures and Their Impact on the Prevalence of Dementia. Neuroepidemiology 2000; 19: 130-140
• 24 Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975; 12: 189-198
• 25 Rahe RH. Epidemiological studies of life change and illness. Int J Psychiatry Med 1975; 6: 133-146
• 26 Brown GW, Harris T. Social Origins of Depression: A Study of Psychiatric Disorders in Women. New York: Free Press; 1978
• 27 Radloff LS. The CES-D Scale: A Self-Report Depression Scale for Research in the General Population. Appl Psychol Meas 1977; 1: 385-401
• 28 Hautzinger M, Bailer M. ADS, Allgemeine Depressions-Skala. Manual. Göttingen: Beltz-Test-GmbH; 1993
• 29 Hautzinger M, Bailer M, Hofmeister D, Keller F. Allgemeine Depressionsskala (ADS). Manual. 2. Aufl. Göttingen: Hogrefe; 2012
• 30 Kessler J, Folstein SE, Denzler P. MMST. Mini-Mental-Status-Test. Weinheim: Beltz; 1990
• 31 Mitchell AJ. A meta-analysis of the accuracy of the mini-mental state examination in the detection of dementia and mild cognitive impairment. J Psychiatr Res 2009; 43: 411-431
• 32 Brauns H, Steinmann S. Educational reform in France, West-Germany and the United Kingdom: Updating the CASMIN educational classification. ZUMA Nachrichten 1999; 1999: 7-44
• 33 Williams BR, Sawyer Baker P, Allman RM. Nonspousal Family Loss among Community-Dwelling Older Adults. OMEGA 2005; 51: 125-142
• 34 Brown SL, Lin I-F. The Gray Divorce Revolution: Rising Divorce Among Middle-Aged and Older Adults, 1990–2010. J Gerontol B Psychol Sci Soc Sci 2012; 67: 731-741
• 35 Djernes JK. Prevalence and predictors of depression in populations of elderly: A review. Acta Psychiatr Scand 2006; 113: 372-387
• 36 Vink D, Aartsen MJ, Schoevers RA. Risk factors for anxiety and depression in the elderly: A review. J Affect Disord 2008; 106: 29-44
• 37 Glaesmer H, Riedel-Heller SG, Braehler E. et al. Age- and gender-specific prevalence and risk factors for depressive symptoms in the elderly: a population-based study. Int Psychogeriatr 2011; 23: 1294-1300
• 38 Arbuckle NW, de Vries B. The long-term effects of later life spousal and parental bereavement on personal functioning. Gerontologist 1995; 45: 637-647
• 39 Stein J, Pabst A, Weyerer S. et al. The assessment of met and unmet care needs in the oldest old with and without depression using the Camberwell Assessment of Need for the Elderly (CANE): Results of the AgeMooDe study. J Affect Disord 2016; 193: 309-317
• 40 Holtgraves T. Social Desirability and Self-Reports: Testing Models of Socially Desirable Responding. Pers Soc Psychol Rev 2004; 30: 161-172