Depression in old age.

The leading cause of disability among older adults is osteoarthritis (OA) (Centers
for Disease Control and Prevention [CDC], 2017). Chronic pain associated with arthritis
interferes with daily living among older adults and has been related to depression
(Zanocchi et al., 2008). Research suggests that ethnicity and psychosocial factors may
influence health outcomes of older adults with arthritis who are experiencing chronic pain
and depression (Im, Guevara, & Chee, 2007; Wilson et al., 2014). The influence of
ethnicity on depression among older adults with OA experiencing chronic pain is the
phenomenon of interest for this study. Chronic pain that interferes with activities of daily
living gives rise to disability, followed by potential episodes of depression. This currently
is impacting the quality of life for older adults with OA. The aim of this study was to gain new insight regarding the relationship and
predictive factors for depression between pain interference, gender, and ethnicity among
older adults with OA pain and depression. This study examined the research question, “Does ethnicity, gender, and pain interference predict depression among older adults with
osteoarthritis?”
This study was a secondary analysis of existing data from the National Institute of
Health National Center for Complementary and Integrative Health (Park, McCaffrey,
Newman, Cheung, & Hagen, 2014) study titled, The Effect of Sit ‘N’ Fit Chair Yoga on
Community-Dwelling Elders with Osteoarthritis. A descriptive retrospective correlational
design was utilized to investigate factors that predict depression. Statistical analysis
included multiple linear regression and analysis of variance. The study sample (n = 104)
consisted of community-dwelling older adults ages 65 years or older with osteoarthritis.
Findings indicated that (1) ethnicity, gender, and pain interference did predict
depression; (2) there were no significant difference in depression between Hispanics and
non-Hispanics while controlling for pain interference; and (3) there was statistically
significant differential interaction with depression when pain interference increased, with
Hispanics reporting higher levels of depressions as pain interference increased, as
compared to non-Hispanics.
The new knowledge gained from this study may help guide healthcare providers
in developing effective alternative approaches for improving health outcomes of
mismanaged ethnically diverse older adults with OA.

The purpose of this randomized control trial (RCT) was to investigate the effects
of a story-sharing intervention on older adults transitioning to long-term care (LTC). The
specific aims were (1) to determine the effects of story sharing on the health transition
outcomes of depression and well-being of adults transitioning to LTC; and (2) to
determine if the sociodemographic characteristics (age, gender, ethnicity, marital status,
level of education (LOE), months living at LTC facility, choice to move, and health
problem(s) that may have resulted in the move) predict depression and/or well-being.
Story sharing was defined as the respectful space where one tells and listens to stories of
others (Heliker, 2009) while being guided by another (the investigator). Meleis’ middlerange
theory of transitions (MMRTT) (Meleis et al., 2000) was used as a guide to
understand the transitioning process. A convenience sampling design was used to recruit
100 participants from 11 LTC facilities in Broward County, located in Southeast Florida. The sample included adults, age 65 years and older, who were transitioning to a
LTC facility within the past two years. Participants were randomly assigned to the control
group (n = 52), who received standard care, or to the intervention group (n = 41), who
received story-sharing and standard care.
The results indicated there was no significant greater improvement to suggest an
Intervention and Time effect for depression and/or well-being. Overall, predictive ability
of the sociodemographic variables for depression and well-being were not statistically
significant. However, LOE (junior college) did account for a significant portion of unique
variance for increased depression, and time, marital status, ethnicity, LOE, and choice to
move did account for a significant proportion of unique variance for well-being. Months
living in LTC (more months) and marital status (all but divorced) were significant for
improved well-being while ethnicity (Hispanic), LOE (high school and junior college),
and choice to move (no choice) were significant for reduced well-being. Similar studies
using a larger sample size, including non-English speaking participants; lengthier storysharing
sessions; and measuring for pain, health, and bereavement may offer additional
insights to healthy transition outcomes for this population.