title: Higher morale is associated with lower risk of depressive disorders five years later among very old people.
abstract: The aim of this study was to investigate whether higher morale, i.e. future-oriented optimism, at baseline was associated with lower risk of depressive disorders five years later among very old people.Methods The Umeå85+/GErontological Regional Database, a population-based study with a longitudinal design, recruited participants in Sweden and Finland aged 85, 90 and ≥95 years. The sample in the present study included 647 individuals (89.1±4.4 years (Mean±SD), range 85-103). After five years, 216 were alive and agreed to a follow-up (92.6±3.4 years, range 90-104). The Philadelphia Geriatric Center Morale Scale (PGCMS) was used to assess morale. The depressive disorder diagnosis was determined according to DSM-IV based on medical records and interview data including assessment scales for depressive disorders. A number of sociodemographic, functional and health-related variables were analysed as possible confounders.Results For those with no depressive disorders at baseline, the only baseline variable significantly associated with depressive disorders five years later was the PGCMS score. A logistic regression model showed lower risk of depressive disorders five years later with higher baseline PGCMS scores (odds ratio 0.779 for one point increase in PGCMS, p<0.001). The association remained after adjusting for social isolation (p<0.1 association with depressive disorders five years later).Conclusion Our results indicate that the higher the morale, the lower the risk of depressive disorders five years later among very old people. The PGCMS seems to identify those very old individuals at increased risk of depressive disorders five years later. Preventive measures could befocused on this group.
authors.affiliation: Department of Community Medicine and Rehabilitation, Geriatric Medicine, Sunderby Research Unit, Umeå University, Umeå, Sweden. Electronic address: Johan.Niklasson@umu.se.
authors.forename: Johan
authors.initials: J
authors.lastname: Niklasson
authors.affiliation: Faculty of Education and Welfare Studies, Social Sciences Study Programme, Social Policy Unit, Åbo Akademi University, Vaasa, Finland; Society of Swedish Literature in Finland, Helsinki, Finland.
authors.forename: Marina
authors.initials: M
authors.lastname: Näsman
authors.affiliation: Faculty of Education and Welfare Studies, Social Sciences Study Programme, Social Policy Unit, Åbo Akademi University, Vaasa, Finland.
authors.forename: Fredrica
authors.initials: F
authors.lastname: Nyqvist
authors.affiliation: Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden.
authors.forename: Mia
authors.initials: M
authors.lastname: Conradsson
authors.affiliation: Department of Nursing, Umeå University, Umeå, Sweden.
authors.forename: Birgitta
authors.initials: B
authors.lastname: Olofsson
authors.affiliation: Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden.
authors.forename: Hugo
authors.initials: H
authors.lastname: Lövheim
authors.affiliation: Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden.
authors.forename: Yngve
authors.initials: Y
authors.lastname: Gustafson
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology; D000369:Aged, 80 and over; D003866:Depressive Disorder / Q000453:epidemiology / Q000517:prevention & control* / Q000523:psychology; D005260:Female; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D015577:Geriatric Assessment / Q000379:methods*; D006304:Health Status; D006801:Humans; D015994:Incidence; D008297:Male; D009013:Morale; D000067656:Optimism / Q000523:psychology*; D011581:Psychological Tests; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology
keywords: Aged, 80 and over; Depressive disorders; Future-oriented optimism; Geriatric psychiatry; Morale; Salutogenic factor