M. Morri

Prevalence and Gender Differences in Late-Life Depression: A Population-Based Study

OBJECTIVE The worldwide phenomenon of an aging population combined with the increasing prevalence of depression in late life are issues that need to be addressed. This study aims to estimate the frequency of depression and subthreshold depression occurring in a sample of cognitively well-functioning, community-dwelling, older Italian adults and to investigate sociodemographic and clinical correlates of depression, exploring gender differences. METHODS We used a cross-sectional analyses of survivors in a population-based study (the Faenza Project) that included 359 subjects aged 74 years and older (49.3% women). A modified version of Cambridge Examination for Mental Disorders of Elderly Persons-Revised was administered to all participants. Prevalence rates of depression and 95% confidence intervals (CIs) were estimated according to International Classification of Diseases, Tenth Revision criteria. Statistical analyses were implemented to describe sociodemographic and clinical features associated with depression. Odds ratios were estimated by multivariate logistic regression, and the dependant variable was any type of depression. RESULTS Overall prevalence of depression was 25.1% (95% CI: 20.6-29.6), with no evidence of gender difference. Prevalence of mild, moderate, and severe depression was 16.4% (95% CI: 12.6-20.2), 7.5% (95% CI: 4.8-10.2), and 1.1 (95% CI: -0.4-2.6), respectively. A rate of 5.6% of the population complained of subthreshold depressive symptoms. After age 81, depression occurrence decreased as age increased. The association between depression and functional measures, such as primary activity, mobility, and disability in performing household chores, were stronger in men than in women. Similarly, severely disabling conditions like stroke were more strongly associated with depression in men than in women. CONCLUSION Our data suggest a disparity between men and women regarding the impact of depression on everyday life. Specific gender differences need to be taken into account for the evaluation of the depression-related burden in late life.

Anxiety Symptoms in 74+ Community-Dwelling Elderly: Associations with Physical Morbidity, Depression and Alcohol Consumption

Objective Anxiety among community-dwelling older adults has not been studied sufficiently. The aims of this cross-sectional population-based study were to estimate the point prevalence of clinically relevant anxiety symptoms and to describe their socio-demographic and clinical features, with particular focus on the association with somatic illnesses. Methods Three-hundred-sixty-six non-demented older adults (mean age 83.7±6.2, range 74–99 years) from the Faenza Project (Northern Italy) were assessed using the Cambridge Mental Disorders of the Elderly Examination-Revised (CAMDEX-R) and the Geriatric Anxiety Inventory short form (GAI-sf). Multi-adjusted regression analyses were used to estimate Odds Ratio (OR) and 95% Confidence Intervals (95% CI). Results Clinically relevant anxiety symptoms occurred in one out of five participants (point prevalence 21.0%) and were significantly associated with depression (OR 5.6 per rank; 95% CI: 3.1–10.1), physical morbidity (OR 3.5 per illness; 95% CI: 1.0–11.9) and female gender (OR 2.8; 95% CI: 1.4–5.5). Further, there were significant associations with a consumption of alcohol exceeding 1 alcoholic unit/day. Conclusions Anxiety symptoms are very common in older subjects, especially when medically ill. Depression and alcohol consumption often co-occur with late-life anxiety symptoms, thus requiring special attention in daily clinical practice.

PW01-77 - Cognitive status in 75 years and older subjects. A population-based study

Objectives To evaluate the cognitive status in an elderly population including both community-dwellers and institutionalised subjects. Methods 462 subjects (mean age 85.1±6.9 years, 53.2% females) living in the Faenza district (Ravenna, Northern Italy) were interviewed and clinically evaluated. The Cambridge Mental Disorders of the Elderly Examination (CAMDEX) was administered to all participants to collect socio-demographic and clinical information. The cognitive status was evaluated using the cognitive assessment included in the CAMDEX (CAMCOG) and the Mini-Mental State Examination (MMSE) (adjusted by sex and age). Cut-offs were as follow: CAMCOG scores Results The CAMCOG identified 245 subjects (53.0%) as cognitively impaired; 132 persons (28.6%) had a MMSE score Cognitive domains: mean score and standard deviation (p Non-demented vs Demented All subjects: 78.4(±15.9) vs 28.7(±21.7) Males: 81.1(±13.0) vs 35.0(±19.9) ≤85: 83.3(±12.3) vs 38.0(±20.5) >85: 75.7(±13.2) vs 34.0(±20.2) Females all: 75.7(±18.0) vs 24.3(±21.9) ≤85: 82.5(±12.4) vs 58.5(±10.8) >85: 67.0(±20.2) vs 18.4(±17.5) Among demented subjects, only 4.5% were treated with acetylcholinesterase inhibitors (p=0.046); 10.2% used other anti-dementia medications (p=0.067). Conclusions Despite of the high prevalence of dementia, only few subjects affected by dementia were properly treated.

Late-Life Mental Health Disorders. Data from a Population-Based Study

Although highly prevalent, so far mental disorder in late life has deserved little research interest, especially at the population level. Our study provides a reliable picture of the distribution of mental health disorders in a sample of 462 Italian older people aged 75+, women are 53.2%, from a population-based study, the Faenza Project. In our sample, one mental disorder is diagnosable in one out of 3 elderly. The most prevalent diagnosis was General Anxiety Disorder (20.7%) and Dementia (19.0%), with female significantly more affected than male. Also Cognitive Impairment No Dementia was highly prevalent with 13.9% of the sample showing these symptoms. The most frequent overlap was between GAD and Major Depressive Episode. The risk of suicide is very high among older, in our sample 7.3% had suicidal thoughts. In spite of that approximately 70% of older adults with mood and anxiety disorders did not use services. There is a need to improve awareness about mental disorders in late- life, both in the community and among health care professionals to find innovative strategies to promote a successful aging with the integration of geriatric psychiatry and primary care.

1111 – Assertiveness and eating disorders: the efficacy of a CBT group training. Preliminary findings

Introduction Low assertiveness and difficulties in emotions regulation can perpetuate symptoms and worsen the outcome in patients with eating disorders (ED). Objectives Cognitive-behavioral-therapy (CBT) is the most effective treatment for bulimia nervosa (BN) and binge eating disorders (BED). Group training helps patients to cope with interpersonal difficulties. Aims To examine the effects of a CBT-group-training on assertiveness, emotions regulation and binge behaviors in patients with ED. Methods Scale for Interpersonal Behavior (Arrindell et al, 1984; Sanavio, 2002), Difficulties in Emotion Regulation Scale (Gratz et al, 2004; Sighinolfi et al, 2010), Bulimic Investigatory Test of Edinburgh (BITE) were administered at baseline and one and three months after a CBT-training to 20 patients with ED (BED, NES, BN, EDNOS) (90% women, age 25-69 years). Results Patients who took part in the training improves assertiveness and emotions regulation. Download : Download full-size image [SIB] Download : Download full-size image [DERS] Conclusions CBT-group-training increases assertiveness, improves emotions regulation, has little effects on binge behaviors severity.

P-1019 - Mental health in late-life. Data from an Italian population-based study

Background Technological and medical progresses stimulated a worldwide demographic transition with a high socio-economic impact. The Mental Health in Older People Consensus suggests that elderly mental health deserve attention from a research and a public health perspective. Aims To investigate mental disorders in a population-based sample of persons aged 75+ living in Faenza (Northern Italy). Methods The Cambridge Mental Disorders of the Elderly Examination (CAMDEX) (Roth, 1986) was administered to 462 elderly (or/and their proxies/informants). Cognitive functions were tested using CAMDEX-Cognitive section (CAMCOG) and dementia diagnoses were achieved according to DSM-IV criteria. Among cognitively intact individuals, depression was diagnosed based on DSM-IV and ICD-10 criteria. Presence of general anxiety disorder was evaluated using the Geriatric Anxiety Inventory Short Form (GAI-sf) (Byrne, 2011). Results Dementia prevalence was 19.1% (95% Confidence Intervals: 16–23%). Even if only eight (2.2%) participants were affected by a major depressive episode (DSM-IV criteria), one out of four participants was clinically diagnosed as being depressed when ICD-10 criteria were applied: mildmoderate- and severe-depression prevalence was 16.4% (95%CI: 12.6–20.2%); 7.5% (95%CI: 4.8–10.2%); 1.1 (95%CI: 0.04–2.2%) respectively. Furthermore 20 (5.4%) participants complained sub-threshold depressive symptoms. Three persons had psychotics’ symptoms (two were depressed). Fifty-one participants (11.0%) felt that living was not worthy (95%CI: 8.0–14.0%) and 29 (7.0%) had suicidal thoughts (95%CI: 4.0–8.0%). Anxiety affected the 18.6% of the sample (95%CI: 14.0–22.0%). Depression and anxiety co-occurred in 36 persons (10.2% of the total population). Conclusions At least one mental disorder is diagnosable in one out of two community-dwelling elderly.