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Background Somatic and other non-affective symptomatology characterizes late life depression and contributes to its under-diagnosis, especially in some ethnic groups. Objectives We examined variations in non-affective presentation and its health and functional significance across different ethnic groups of Chinese, Malays and Indians. Method We analyzed data from the National Mental Health Survey for Elderly, a population-based cross-sectional study of older adults aged 60 and above (N = 1092). Results Compared to the depressed Chinese as the reference group, depressed Malays were more likely to endorse symptoms of appetite decrease (OR = 5.19), sleep disturbances (OR = 2.93), disabling pain (OR = 3.12), psychomotor slowing (OR = 2.73) and anergia (OR = 3.70), while concurrently reporting poorer general health status and greater role limitations resulting from their mental and emotional problems (OR from 2.13 to 3.31). These differences were not influenced by anxiety, dementia or physical comorbidity. Conclusion We revealed striking differences in the somatic and non-affective symptomatology of geriatric depression among different Asian ethnic groups. Non-affective symptoms in depression have large health and functional significance and important implications for the diagnosis and management of depression among elderly in primary care. Copyright © 2008 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Background Studies that investigated the relationship between obesity and depressive symptoms in the elderly have generated conflicting findings, partly because of the use of body mass index (BMI) alone to measure obesity in the elderly. The use of BMI fails to account for varying proportions of muscle, fat and bone, and few studies have used other measures of central obesity, such as waist–hip ratio (WHR) and waist circumference (WC). Objectives We examined whether individually BMI, WHR and WC were consistently associated with depressive symptoms in the elderly. Methods Analysis of cross-sectional data of 2604 community dwelling Chinese elderly aged 55 and above, including socio-emotional characteristics, self-rated health and functional status, anthropometric measurements and Geriatric Depression Scale (15 items, GDS-15). Results There was a negative trend in the prevalence of depressive symptoms (GDS ≥5) across increasing BMI categories: 16.9% in low BMI, 14.2% in normal weight, 12.1% in moderate to high BMI. The associations for moderate to high BMI (OR, 0.77; p = 0.04) relative to normal BMI, were statistically significant after controlling for confounding variables. However, no consistent trends in the prevalence of depressive symptoms and OR's were observed for increasing WHR and WC categories. Conclusion Our results suggest that waist–hip and circumference measures of central obesity did not support an inverse relationship of obesity and depressive symptoms. An inverse relationship of BMI with depressive symptoms may indicate greater physiologic and functional reserve from greater muscle mass that protects against depressive symptoms. Copyright © 2007 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Objective Depression in elderly is reportedly associated with a number of specific chronic illnesses. Whether each of these co-morbid associations results uniquely from disease-specific psychobiological responses or is mediated by non-specific factors like subjective health and functional status is unclear. Method Analysis of data of 2,611 community-dwelling Chinese aged 55 and older, including depressive symptoms defined by Geriatric Depression Scale score ≥ 5 and self-reports of specific chronic illnesses. Results The prevalence of depressive symptoms was 13.3%, lower in those without chronic illness (7.5%), and higher in those with illnesses (13.2–24.2%). Crude Odds Ratios (OR) were significantly elevated for hypertension, eye disorders, diabetes, arthritis, ischemic heart disease, asthma/COPD, stroke, osteoporosis, heart failure, thyroid problem, and gastric problem. In multivariable analyses, only asthma/COPD [OR:2.85, 95% Confidence Intervals (CI): 1.36, 5.98], gastric problem (OR:2.64, 95% CI: 1.11, 6.29), arthritis (OR:1.87, 95% CI: 1.02, 3.42) and heart failure (OR:2.11, 95% CI: 0.98, 4.58) remained independently associated with depressive symptoms, after adjusting for comorbidities, subjective health and functional status, cognitive functioning, smoking, alcohol, psychosocial and demographic variables. Conclusion Most comorbid associations of depressive symptoms with specific chronic illnesses are explained by accompanying poor self-reported health and functional status, but some illnesses probably have a direct psychobiological basis. Copyright © 2007 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Background Clinical studies have mostly linked anxiety disorders with asthma in young patients, but the data are inconsistent for depression. Few population-based studies have investigated the co-morbid diagnoses of mental disorders with asthma in older adults. Method Cross-sectional study of a population sample of older adults aged 60 and above (n = 1092). The diagnoses of recent depression and anxiety were made using the Geriatric Mental State (GMS) Schedule. The presence of asthma was ascertained by self-reports of physician-diagnosed asthma. Results Asthma was associated with a higher prevalence of depressive disorders, with odds ratio of 2.45 (95% CI, 1.06–5.69) when compared against non-asthmatic controls; and 2.42 (95% CI, 1.04–5.64) when compared against controls with other chronic illnesses, after adjusting for psychosocial factors, physical co-morbidity and use of depression-causing drugs. Odds ratios were elevated but statistically insignificant for anxiety disorders and dementia. Conclusion We observed that asthma in the elderly was more evidently associated co-morbidly with depression, rather than anxiety disorder. However, possible associations with anxiety and dementia are not excluded, and should be further investigated. Copyright © 2006 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

There are a few reports on the trends of elderly suicide rates in western countries but none from Asian countries. To describe the trends of elderly suicide rates of Chinese, Malays and Indians in Singapore from 1991 to 2000. Data obtained from the National Department of Statistics were used in the analysis of sex- and age-standardized suicide rates and relative risks. Overall, the suicide rates for the elderly showed a decline from 40.1 per 100,000 in 1990 to 17.8 per 100,000 in 2000, with the most pronounced decline occurring from 1995 to 2000. The suicide rate for elderly Chinese was at a peak of 52 per 100,000 in 1995 and declined to 20 per 100,000 in 2000. The rates for elderly Malays were consistently low at 2.2 per 100,000 for the 10 years; for elderly Indians the rates were between the other two ethnic groups. In the 10-year period, the elderly suicide rates in Singapore declined markedly, especially for elderly Chinese. Copyright © 2003 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]