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Life Events and Senile Dementia Affective Symptoms

Published online by Cambridge University Press:  02 January 2018

Martin Orrell  and
Paul Bebbington
Martin Orrell*
Affiliation:
Department of Psychiatry, University College London Medical School, London W1N 8AA
Paul Bebbington
Affiliation:
MRC Social and Community Psychiatry Unit, Institute of Psychiatry, London SE5 8QU, UK
*
Dr M. W. Orrell, Department of Psychiatry, Princess Alexandra Hospital, Hamstel Road, Harlow, Essex, CM20 1QX, UK
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Abstract

Background

Previous research in the elderly has linked threatening life events with depression. Dementia sufferers are known to be sensitive to stressful changes in their daily life such as relocation. This study investigates whether threatening life events are associated with depressive symptoms in dementia sufferers.

Method

Using the Life Events and Difficulties Schedule, this study examined life events before admission in a group of 70 dementia patients compared with two control groups: dementia sufferers in the community and mentally fit elderly people matched for age and sex.

Results

Life events with severe threat were not significantly more frequent in the dementia patients than in two control groups. However, depressive symptoms in the dementia sufferers were significantly associated with independent severe life events. This strong association was maintained when a multivariate analysis was used to control for the effects of other social factors and severity of cognitive impairment. This association appears to be specific to the threat aspect of life events since there was no association between depressive symptoms and events relating to change in the social environment.

Conclusion

In dementia sufferers, threatening life events are associated with depressive symptoms. This means that dementia sufferers are responsive to stress in the same way as cognitively intact individuals, and clinicians need to be more aware of the social influences on them.

Type
Papers
Information
The British Journal of Psychiatry , Volume 166 , Issue 5 , May 1995 , pp. 613 - 620
Copyright
Copyright © Royal College of Psychiatrists, 1995 

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References

Alexopoulos, G. S. & Abrams, R. C. (1991) Depression in Alzheimer's disease. Psychiatric Clinics of North America, 14, 327–340.CrossRefGoogle ScholarPubMed
Amster, L. E. & Krauss, H. H. (1974) The relationship between life crises and mental deterioration in old age. International Journal of Aging and Human Development, 5, 51–55.CrossRefGoogle ScholarPubMed
Anthony, K., Proctor, A. W., Silverman, A. M., et al (1987) Mood and behaviour problems following the relocation of elderly patients with mental illness. Age & Ageing, 16, 355–365.CrossRefGoogle ScholarPubMed
Bebbington, P. E., Der, G., MacCarthy, B. (1993) Stress incubation and the onset of affective disorders. British Journal of Psychiatry, 162, 358–362.CrossRefGoogle ScholarPubMed
Brown, G. W. & Harris, T. O. (1978) Social Origins of Depression. London: Tavistock.Google ScholarPubMed
Burns, A., Jacoby, R. & Levy, R. (1990) Psychiatric phenomena in Alzheimer's disease. British Journal of Psychiatry, 157, 72–94.CrossRefGoogle ScholarPubMed
Copeland, J. R. M. (1990) Suitable instruments for detecting dementia in community samples. Age & Ageing, 19, 81–83.CrossRefGoogle ScholarPubMed
Copeland, J. R. M., Kelleher, M. J., Kellett, J. M., et al (1976) A semistructured clinical interview for the assessment of diagnosis and mental state in the elderly: the Geriatric Mental State Schedule. 1. Development and reliability. Psychological Medicine, 6, 439–449.CrossRefGoogle Scholar
Copeland, J. R. M., Dewey, M. E. & Griffiths-Jones, H. M. (1986) Psychiatric case nomenclature and a computerised diagnostic system for elderly subjects: GMS and AGECAT. Psychological Medicine, 16, 89–99.CrossRefGoogle Scholar
Copeland, J. R. M., Gurland, B. J., Dewey, M. E., et al (1987) Is there more dementia, depression and neurosis in New York? A comparative study of the elderly in New York and London using the computer diagnosis AGECAT. British Journal of Psychiatry, 151, 466–473.CrossRefGoogle ScholarPubMed
Copeland, J. R. M., Davidson, I. A., Dewey, M. E., et al (1992) Alzheimer's disease, other dementias, depression and pseudodementia: Prevalence, incidence and three-year outcome in Liverpool. British Journal of Psychiatry, 161, 230–239.CrossRefGoogle ScholarPubMed
Crank, J. Z. & Zweig, J. P. (1980) Relative mortality of chronically ill geriatric patients with organic brain damage before and after relocation. Journal of the American Geriatric Society, 28, 76–83.Google Scholar
Cummings, J. Miller, B., Hill, M. A., et al (1987) Neuropsychiatric aspects of multi-infarct dementia and dementia of the Alzheimer type. Archives of Neurology, 44, 389–393.CrossRefGoogle ScholarPubMed
Davies, A. D. M. (1993) Life events in the normal elderly. In The Psychiatry of Old Age (eds J. R. M. Copeland, M. T. Abou-Saleh & D. G. Blazer). Chichester: Wiley.Google Scholar
Davies, A. D. M., Saunders, C. & Newton, T. J. (1987) Age differences in the rating of life stress events: Does contextual detail make a difference? British Journal of Clinical Psychology, 26, 299–303.CrossRefGoogle Scholar
Dohrenwend, B. P., Levav, I., Shrout, P. E., et al (1987) Life stress and psychopathology: process on research done with Barbara Snell Dohrenwend. American Journal of Community Psychology, 15, 677–715.CrossRefGoogle Scholar
Emmerson, J. P., Burvill, P. W., Finlay-Jones, R., et al (1989) Life events, life difficulties and confiding relationships in the depressed elderly. British Journal of Psychiatry, 155, 787–792.CrossRefGoogle ScholarPubMed
Evans, S. & Katona, C. (1993) The epidemiology of depressive symptoms in elderly primary care attenders. Dementia, 4, 327–333.Google ScholarPubMed
Förstl, H., Satel, H. & Bahro, M. (1993) Clinical features of Alzheimer's Disease. International Review of Psychiatry, 5, 327–349.CrossRefGoogle Scholar
Jorm, A. F., van Duijn, C. M., Chandra, V., et al (1991) Psychiatric history and related exposures as risk factors for Alzheimer's disease: a collaborative re-analysis of case control studies. International Journal of Epidemiology, 20 (Suppl. 2), 43–47.CrossRefGoogle ScholarPubMed
Katona, C. L. E. (1991) Depression of old age. Reviews in Clinical Gerontology, 1, 371–384.CrossRefGoogle Scholar
Kitwood, T. (1993) Person and process in dementia. International Journal of Geriatric Psychiatry, 8, 541–545.CrossRefGoogle Scholar
Lam, D., Brewin, C. R., Woods, R. T. & Bebbington, P. E. (1987) Cognition and social adversity in the depressed elderly. Journal of Abnormal Psychology, 96, 23–26.CrossRefGoogle ScholarPubMed
Linn, M. W., Hunter, K. & Harris, R. (1980) Symptoms of depression and recent life events in the community. Journal of Clinical Psychology, 36, 675–82.3.0.CO;2-N>CrossRefGoogle ScholarPubMed
Minde, R., Haynes, E. & Rodenburg, M. (1990) The ward milieu and its effect on the behaviour of psychogeriatric patients. Canadian Journal of Psychiatry, 35, 133–138.CrossRefGoogle ScholarPubMed
Murphy, E. (1982) Social origins of depression in old age. British Journal of Psychiatry, 141, 135–42.CrossRefGoogle ScholarPubMed
Oatley, K. & Bolton, W. (1985) A social-cognitive theory of depression in reaction to life events. Psychological Review, 92, 372–388.CrossRefGoogle ScholarPubMed
O'Dwyer, A. M. & Orrell, M. W. (1994) Stress, ageing and dementia. International Review of Psychiatry, 6, 73–83.CrossRefGoogle Scholar
Orrell, M. W. (1994) Life Events and Senile Dementia. PhD thesis, University of London.Google Scholar
Orrell, M. W., Howard, R., Payne, A., et al (1992) Differentiation between organic and functional psychiatric illness in the elderly: An evaluation of four cognitive tests. International Journal of Geriatric Psychiatry, 7, 263–275.CrossRefGoogle Scholar
Orrell, M. W. & Bebbington, P. E. (1994) Life events and senile dementia 1. Admission, deterioration and social environment change. Psychological Medicine (in press).Google Scholar
Orrell, M. W. & Davies, A. D. M. (1994) Life events in the elderly. International Review of Psychiatry, 6, 59–71.CrossRefGoogle Scholar
Patrick, L. F. & Moore, J. S. (1986) Life-event types and attributional styles as predictors of depression in elderly women. Journal of Geriatric Psychiatry, 19, 241–262.Google ScholarPubMed
Pattie, A. H. & Gilleard, C. J. (1979) Manual for the Clifton Assessment Procedures for the Elderly (CAPE). Sevenoaks: Hodder & Stoughton Educational.Google Scholar
Pruchno, R. A. & Resch, N. L. (1988) Intra-institutional relocation: mortality effects. Gerontologist, 28, 311–317.CrossRefGoogle Scholar
Wilkinson, S. J., Downes, J., Owen, J., et al (1986) Rating reliability for life events and difficulties in the elderly. Psychological Medicine, 16, 101–105.CrossRefGoogle ScholarPubMed
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