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Objectives Growing evidence shows several possible relations between religiousness and late-life depression. Emotional aspects of religiousness such as facets of the perceived relationship with God can be crucial in this connection. The aim of the current study was to examine the association between the course of late-life depression and feelings about God and religious coping. Design Longitudinal survey study; naturalistic; 12-year follow-up. Setting Longitudinal Aging Study Amsterdam; population-based, in three regions in The Netherlands. Participants A subsample of 343 respondents (mean age: 77.2 years), including all respondents with high levels of depressive symptoms at any measurement cycle between 1992 and 2003 (assessed by using the Center for Epidemiologic Studies Depression Scale and the Diagnostic Interview Schedule) and a random sample of nondepressed respondents who completed a postal questionnaire in 2005. Measurements Scales on God Image and Religious Coping. Twelve-year depression course trajectories serve as predicting variables and are specified according to recency and seriousness. Results Persistent and emergent depression are significantly associated with fear of God, feeling wronged by God, and negative religious coping. In terms of negative religious coping, significant associations were observed after adjustment for concurrent depression with a history of repeated minor depression and previous major depression. Conclusions Late-life depression seems to maintain a pervasive relationship over time with affective aspects of religiousness. Religious feelings may parallel the symptoms of anhedonia or a dysphoric mood and could represent the experience of an existential void.

Objectives: To disentangle the reciprocal effects between depressive symptoms and cognitive functioning over time and to study the association between changes in their trajectories using 13 years of follow-up. Design and Participants: Data were used from five waves of the population-based Longitudinal Aging Study Amsterdam. Subjects were included if data was present on depressive symptoms and cognitive performance on at least two occasions, which resulted in a study sample of N = 2,299. Measurements: Depressive symptoms were assessed with the Center for Epidemiologic Studies Depression Scale. Cognitive functioning was assessed using the Mini- Mental State Examination (general cognitive functioning) and timed coding task (speed of information processing). Results: Cross-domain latent change analyses showed that depression at baseline predicted both decline of general cognitive functioning and information processing speed, independent of relevant covariates. Conversely, information processing speed at baseline, but not general cognitive functioning was related to the course of depressive symptoms. The course of cognitive functioning was not significantly associated with the course of depressive symptoms. Conclusion: Depressive symptoms in older patients flag an increased likelihood of cognitive decline. This effect is considerable and may be due to several underlying mechanisms. The likelihood of the relationship reflecting either a causal effect of depression on cognitive decline, or a common cause, or both, should be estimated. Likewise, older persons with more limitations in information processing speed specifically are more vulnerable to increases in depression. © 2013 American Association for Geriatric Psychiatry.

OBJECTIVES:: To investigate whether specific domains of cognitive functioning predict the natural course of depressive symptoms in older people. DESIGN AND Participants: Using the nationally representative, population-based cohort of the Longitudinal Aging Study Amsterdam, 281 participants with clinically relevant depressive symptoms (Center for Epidemiological Studies Depression Scale 16) aged 55 years and older were followed longitudinally during a period of 6 years. MEASUREMENTS:: Using a maximum of 14 successive Center for Epidemiological Studies Depression Scale observations, three clinical course types of depressive symptoms were defined. At baseline, general cognitive functioning was assessed using the Mini-Mental State Exam, memory performance (immediate recall and retention) by means of the auditory verbal learning test, and processing speed by means of a timed coding task. Results: Remission, fluctuating course, and chronic course were seen in 22%, 50%, and 28%, respectively. In univariate analyses, a slowed processing speed was associated with a chronic course of depressive symptoms, as compared with remission (mean: 21.5, SD: 6.6, versus mean: 24.6, SD: 6.8, t = 2.78, df = 139, p < 0.001). Using multivariate regression techniques, this association remained significant after correcting for potential confounders and a number of risk factors for vascular brain damage (odds ratio: 1.08, 95% confidence interval: 1.01-1.14). Neither global cognitive functioning nor memory performance was associated with any course type of depressive symptoms. Conclusion: We found an independent association of a slowed processing speed with a poor natural course of depressive symptoms in older people. In clinical practice, when dealing with an older depressed person with comorbid cognitive decline, processing speed might be a more useful tool than the Mini-Mental State Exam in predicting the prognosis. © 2011 American Association for Geriatric Psychiatry.

OBJECTIVES: To study the onset and compare risk factors for pure depression (DEP), pure anxiety (ANX), and comorbid anxiety-depression (ANXDEP) in the aging population. DESIGN: Prospective study with 3-year intervals over a 9-year period. SETTING: Data of the Longitudinal Aging Study Amsterdam were used, which is a population-based study among older adults (55-85 years at baseline). PARTICIPANTS: Older adults free of depression and anxiety at baseline (N = 1,712). MEASUREMENTS: Clinically relevant levels of depression and anxiety were measured with the Center for Epidemiologic Studies Depression scale ≥16 and Hospital Anxiety and Depression Scale ≥7, respectively. A broad range of potential sociodemographic, health, and psychosocial risk factors for anxiety and/or depression were examined by using polytomous logistic regression analyses. RESULTS: Within 9 years, 184 subjects (10.8%) developed DEP, 93 (5.4%) ANX, and 103 (6.0%) ANXDEP. Concerning sociodemographics, higher age and lower educational level were predictors for DEP. Health indicators were predictive for DEP and ANXDEP but not for ANX. Depressive symptoms at baseline were predictive for DEP, whereas initial anxiety symptoms were predictive for ANX and ANXDEP. Neuroticism increased the risk of DEP and ANXDEP. Mixed effects of psychosocial variables were found: DEP was associated with recent widowhood, whereas ANX and ANXDEP were associated with other life events such as having an ill partner. CONCLUSION: Although onset of ANXDEP demonstrated communality in risk factors, comparing risk factors associateds with DEP and ANX revealed more differences than similarities. This underlines the need to distinguish anxiety from depression in preventive strategies. © 2009 American Association for Geriatric Psychiatry.

Objective: To identify target groups for prevention of chronic or recurrent depressionin old age such that prevention is likely to become cost-effective. Methods: Data wereused from a population-based cohort study (N = 2,200). Chronic or recurrentdepression was defined when people presented with clinically high levels of depressionat two time points separated by 3 years. Risk profiles of these conditions wereidentified using classification and regression trees analysis. The combinations of riskfactors were then evaluated in multivariate models to ascertain their utility forpreventing depression in high-risk groups. Results: People are placed at a high riskof depression when having symptoms of anxiety, functional impairments, two ormore chronic illnesses, and either a low attained educational level or belowaverage levels of mastery, while living without a partner. These risk profilescorrespond with groups no larger than 8.3% of the older population. Containingthe adverse effects of the risk factors would help to reduce the incidence ofdepression by possibly as much as 48.7%, indicating that large health gains canbe generated, which can also be done efficiently with numbers-needed-to-betreated,perhaps as small as three. Conclusion: Targeting prevention on theselected high-risk groups is likely to become a cost-effective endeavor, becauseoptimal health gains can be generated efficiently in groups small enough to belogistically manageable. The burden of illness associated with depression, particularlydepression, in aging populations underscores the public health significanceof such an approach.

Objective: Prayer is generally recognized as an important aspect of religiousness. Relatively few empiric studies examined the relation between prayer and depressive symptoms in later life, and findings so far are mixed. Method: Respondents, aged 60ĝ€"91 years, participated in the third (N ≤ 1,702) and fourths (N ≤ 1,346) assessment cycles, with three-year intervals, of the Longitudinal Aging Study Amsterdam. Data were collected on frequency of prayer, perceived meaningfulness of prayer, religious affiliation, church attendance, salience of religion, demographics, and health variables. Depressive symptoms were assessed with the Center for Epidemiologic Studiesĝ€"Depression Scale. Results: In the total sample, there was no significant association between frequency of prayer and depressive symptoms. Among those who were not religiously affiliated, prayer was associated with higher levels of depressive symptoms. The results were particularly pronounced among nonaffiliated widowed respondents; odds ratio for praying daily associated with having Center for Epidemiologic Studiesĝ€" Depression Scale scores of 16 and higher amounted to 3.59 (99% confidence interval: 1.01ĝ€"11.79). At three-year follow up, prayer did not predict change of depressive symptoms. Conclusions: As secularization in Western Europe progresses, the current results suggest that clinical exploration of private religiousness among older patients remains relevant, also among people who seem to be less religious.