Determinants of follow-up care associated with incident antidepressant use in older adults.

Objectives: To determine the proportion of older adults receiving guideline concordant antidepressant therapy and to determine patient, prescriber and organizational factors associated with adequate antidepressant therapy.

Methods: The study included secondary analyses of data collected in the Étude sur la Santé des Aînés (ESA) Services study on older adults recruited while consulting in primary care clinics in one of the largest health regions of the province of Québec. Antidepressant users (n = 349) were identified from information collected from the Régie de l'Assurance Maladie du Québec (RAMQ) pharmaceutical database which holds information on all drugs dispensed to all residents covered under the public drug plan.

Impact of depression and anxiety disorders on adherence to oral hypoglycemics in older adults with diabetes mellitus in Canada.

The prevalence of diabetes mellitus is increasing in Canada, and nonadherence to oral hypoglycemics is a common problem among older adults. This study aims to document the impact of depression and anxiety disorders on adherence to oral hypoglycemics in older adults with diabetes mellitus. Data used in this study came from the longitudinal Quebec survey on senior's health (Enquête sur la Santé des Ainés), using a representative sample of 2811 older adults aged 65 and over.

Healthcare costs in chronically ill community-living older adults are dependent on mental disorders.

Background: The economic impact on society associated with the healthcare of older adults depends on their health status. The aim was to estimate the excess costs associated with co-morbid mental and physical disorders.

Methods: Data were from a health survey of 2004 older adults.

Impact of Mental Disorders on the Association Between Adherence to Antihypertensive Agents and All-Cause Healthcare Costs.

Depression and anxiety are factors associated with poor adherence to medications that lead to increased healthcare costs. The authors hypothesize that these conditions will moderate the association between adherence and healthcare costs. The aim was to examine the healthcare costs associated with adherence to antihypertensive agents in the elderly with and without depression and anxiety.

Utilization of healthcare services among elderly with cognitive impairment no dementia and influence of depression and anxiety: a longitudinal study.

Objectives: Little objective and nationally representative data are available concerning the influence of cognitive impairment no dementia (CIND) on utilization of healthcare services. The main objective was to compare the use of healthcare services over three years, between elders with current or incident CIND and those without CIND. A second objective was to evaluate the effect of depression and anxiety.

Benzodiazepine use associated with co-morbid post-traumatic stress syndrome and depression in older adults seeking services in general medical settings.

Background: Benzodiazepines (BZD) should be limited in older adults. This study aimed to determine the association between BZD use and the presence of a probable post-traumatic stress syndrome (PTSS) and whether this association is dependent on gender and co-morbid physical and mental conditions.

Methods: Data were retained from the Étude sur la Santé des Aînés (ESA) - Services study (2011-2013) and included 1,453 older adults (≥65 years) who completed a face to face at-home interview, who were covered under Quebec's public drug insurance plan, and had given permission to access their Régie de l'Assurance Maladie du Québec (RAMQ) medical and pharmaceutical services data.

Adherence to Oral Antihyperglycemic Agents Among Older Adults With Mental Disorders and Its Effect on Health Care Costs, Quebec, Canada, 2005-2008.

Introduction: Nonadherence to oral antihyperglycemic agents (OHAs) leads to an increase in use of health care resources and overall expenditures due to type 2 diabetes and its complications. People with type 2 diabetes are almost twice as likely to have anxiety and depression as the general population. Our aim was to examine health care costs associated with adherence to OHAs and the effect of depression and anxiety disorders on these in older adults with type 2 diabetes.

Healthcare use and costs associated with post-traumatic stress syndrome in a community sample of older adults: results from the ESA-Services study.

Background: Studies have shown higher healthcare utilization and costs associated with post-traumatic stress syndrome (PTSS) in veterans and community adult populations. Given the aging population and the impact on health system resources, it is important to understand the economic consequences of PTSS.

Methods: The data retained came from 1,456 older adults aged 65 years and over recruited in primary medical clinics in the province of Quebec.

DNA methylation and single nucleotide variants in the brain-derived neurotrophic factor (BDNF) and oxytocin receptor (OXTR) genes are associated with anxiety/depression in older women.

Background: Environmental effects and personal experiences could be expressed in individuals through epigenetic non-structural changes such as DNA methylation. This methylation could up- regulate or down-regulate corresponding gene expressions and modify related phenotypes. DNA methylation increases with aging and could be related to the late expression of some forms of mental disease.

Screening instruments for a population of older adults: The 10-item Kessler Psychological Distress Scale (K10) and the 7-item Generalized Anxiety Disorder Scale (GAD-7).

Screening tools that appropriately detect older adults' mental disorders are of great public health importance. The present study aimed to establish cutoff scores for the 10-item Kessler Psychological Distress (K10) and the 7-item Generalized Anxiety Disorder (GAD-7) scales when screening for depression and anxiety. We used data from participants (n = 1811) in the Enquête sur la Santé des Aînés-Service study.

Post-traumatic stress syndrome in a large sample of older adults: determinants and quality of life.

Objectives: The aims of this study are to assess in a sample of older adults consulting in primary care practices the determinants and quality of life associated with post-traumatic stress syndrome (PTSS).

Method: Data used came from a large sample of 1765 community-dwelling older adults who were waiting to receive health services in primary care clinics in the province of Quebec. PTSS was measured with the PTSS scale.

The 6-month prevalence of posttraumatic stress syndrome (PTSS) among older adults: validity and reliability of the PTSS scale.

Objective: To document the 6-month prevalence of posttraumatic stress syndrome (PTSS) in the older adult population and the validity of a PTSS Scale in an epidemiologic setting.

Method: Data came from the Enquête sur la santé des aînés et l'utilisation des services de santé (ESA Services Study) conducted during 2012-2013 using a probability sample of older adults seeking medical services in primary health clinics.

Results: Results showed that a first-order PTSS measurement model consisting of 3 indicators-the number of lifetime traumatic events, the frequency of reactions and symptoms of distress associated with the traumatic events, and the presence of consequences on the social functioning-was plausible.

Dyadic Adjustment Scale: a validation study among older French-Canadians living in relationships.

The principal objective of this study, the first of its kind to use this population, is to describe the factor analysis and validity of the Dyadic Adjustment Scale (EAD) among 895 French Canadian seniors living as couples. A confirmatory factor analysis was carried out using structural equation modeling. Results support Spanier's hierarchical model questionnaire (1976).

Family violence among older adult patients consulting in primary care clinics: results from the ESA (Enquête sur la santé des aînés) services study on mental health and aging.

Objective: To document the reliability and construct validity of the Family Violence Scale (FVS) in the older adult population aged 65 years and older.

Method: Data came from a cross-sectional survey, the Enquête sur la santé des aînés et l'utilisation des services de santé (ESA Services Study), conducted in 2011-2013 using a probabilistic sample of older adults waiting for medical services in primary care clinics (n = 1765). Family violence was defined as a latent variable, coming from a spouse and from children.

Association between perceived social stigma against mental disorders and use of health services for psychological distress symptoms in the older adult population: validity of the STIG scale.

Objectives: To document the reliability, construct and nomological validity of the perceived Social Stigmatisation (STIG) scale in the older adult population.

Design: Cross-sectional survey.

Setting: Primary medical health services clinics.

[The effect of age, gender and socioeconomic status on the use of services for psychological distress symptoms in the general medical sector: Results from the ESA research program on mental health and aging].

Objectives: The objective of this study was, first, to document the psychometric characteristics of a measure of the older adults' socioeconomic status and, secondly, to test the effect of the socioeconomic status on the association between the older adults perceived need to improve their mental health and their use of services in the general medical sector for psychological distress symptoms taking into account the effect of age and gender.

Method: Data used in this study come from the ESA study (Enquête sur la santé des ainés) on mental health and aging, conducted in 2005-2008 using a probabilistic sample (n=2811) of the older adult population aged 65 years and over living at home in Quebec.

Results: Our results showed that a measurement model of the older adults' socioeconomic status including an individual-level (SES_I) and an area/contextual-level dimension of socioeconomic deprivation (SES_C) was plausible.

[Association between anxiety and cognitive decline in community-dwelling elderly].

The present study was conducted to determine whether anxiety among community-dwelling elders is associated with cognitive decline over a period of one year as well as to verify whether there are sex differences in the association between anxiety and cognitive decline. Participants (n=1942) were community-dwelling adults aged 65-96 years assessed at study entry (T0) and one year later (T1). Anxiety was identified with a semi-structured interview and cognitive functioning was assessed using the Mini-Mental State Examination.

Association between skin conditions and depressive disorders in community-dwelling older adults.

Background: Depression is frequently observed in dermatologic patients. However, the association between depressive disorders and skin conditions has rarely been explored through population-based studies, especially within older-adult populations.

Objective: To test this association in a representative sample of an older-adult population.

Gender differences in general and specialty outpatient mental health service use for depression.

Background: This study ascertained gender-specific determinants of outpatient mental health (MH) service use for depression to highlight any gender disparities in barriers to care and explain how depressed men and women in need of care might differ in their help-seeking behaviour.

Methods: Data used in this study came from the Canadian Community Health Survey on Mental Health and Well Being, cycle 1.2 (CCHS 1.

Skin conditions in community-living older adults: prevalence and characteristics of medical care service use.

Background: There are considerable gaps in the knowledge of the global epidemiology of skin conditions in the geriatric population.

Objective: This study attempted to (1) determine the frequency of skin conditions, (2) evaluate the agreement between two different data sources of information (self-report versus administrative), and (3) document medical care service use for skin conditions in a representative sample of community-dwelling older adults.

Methods: A secondary analysis using data from a longitudinal population-based health survey conducted in Quebec (2005-2008) within a sample of 2,811 community-dwelling older adults.

Subjective sleep characteristics associated with anxiety and depression in older adults: a population-based study.

Objective: Sleep complaints are often associated with anxiety and depression, but the specific complaints related to each syndrome are poorly characterized, especially in older adults. The objective was to identify subjective sleep characteristics specific to anxiety and depression in this population.

Methods: A random sample of 2393 individuals aged 65 years or older was used.

Subjective sleep quality in non-demented older adults with and without cognitive impairment.

Objective: Sleep problems are prevalent among older adults who are at risk of developing dementia. Until now, there have been relatively few studies investigating subjective sleep quality in these individuals. The first objective of this study was to compare seniors with cognitive impairment no dementia (CIND) and older adults without cognitive impairment (non-CIND) on several subjective sleep measures.

Bereavement-related depression in the older adult population: a distinct disorder?

Background: Bereavement is a phenomenon that shares many symptoms with depression, and that a great number of older adults experience following the loss of a close relative. The objectives of the present study were to (1) determine whether the symptoms of depression reported by bereaved individuals differ from those with non-bereavement minor/major depression (NBRD), (2) assess whether BRD is as persistent during a one year follow-up as compared to NBRD, and (3) identify factors and consequences associated with BRD.

Methods: The data used for this study came from the Longitudinal Study ESA (Study Health of Elders), conducted between 2005 and 2008, using a representative sample (n=2811) of community-dwelling older adults, aged 65 and over.

[Impact benzodiazepine dependence on the use of health services: senior' health study].

Context: Prolonged use of benzodiazepines increases the risk of addiction. The impact of this disease on the use of health services by older adults is not known.

Objective: Examine the association between benzodiazepine dependence and use of health services by older adults in Quebec.