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Cecchini V, Agahi N. Does losing family members in midlife matter for late-life mental and cognitive health? A longitudinal study of older Swedes spanning 30 years. Aging Ment Health 2024; 28:1401-1409. [PMID: 38644675 DOI: 10.1080/13607863.2024.2341877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 04/05/2024] [Indexed: 04/23/2024]
Abstract
OBJECTIVES Mental and cognitive health is crucial to ensure well-being in older age. However, prolonged periods of stress, grief, and bereavement might compromise mental health balance, leading to profound changes. This study investigated the sex-stratified associations between midlife bereavement experiences (e.g. sibling loss, spousal loss, and multiple losses) and late-life depression (LLD) and cognitive impairment. METHOD Linked data from the Swedish Level-of-Living Survey and the Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD) were used. Multiple logistic regressions were performed to examine the associations between midlife bereavement and LLD (n = 1078) and cognitive impairment (n = 995), separately. RESULTS Sibling loss and multiple losses in midlife were associated with lower odds of LLD, especially among women. Among men, sibling loss in midlife was associated with lower odds of cognitive impairment, while the experience of two losses among women suggested an increased (but non-significant) risk of cognitive impairment. Interaction analyses did not show significant effects between bereavement and gender on LLD and cognitive impairment. CONCLUSION Midlife bereavement might have gendered implications on LLD and cognitive impairment, but associations need to be confirmed by well-powered studies. Further research is warranted to elucidate the association between multiple midlife losses and reduced LLD risk.
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Affiliation(s)
- Valeria Cecchini
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Neda Agahi
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
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Sun W, Yang Y, Ding L, Wang L. Association between cognitive function and depressive symptoms in Chinese older adults: The mediating role of activities of daily living. Geriatr Nurs 2024; 60:258-264. [PMID: 39321735 DOI: 10.1016/j.gerinurse.2024.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 08/17/2024] [Accepted: 09/11/2024] [Indexed: 09/27/2024]
Abstract
OBJECTIVES Exploring the relationship between cognitive functioning and depressive symptoms in Chinese older adults and the mediating role of the ability to perform activities of daily living. METHODS This study included 5775 older adults, and correlation analysis and linear regression were used to analyze the relationship between the variables and mediated effects. RESULTS Cognitive functioning and the ability to perform daily living significantly influenced the depressive state (β = -0.163, p < 0.01; β = 0.288, p < 0.01), and the ability to perform daily living partially mediated the effect between the two, with an effect size of 27.95%. CONCLUSION Cognitive function can influence depressive status through the ability to perform activities of daily living, and individualized intervention strategies should be developed for older adults to maintain or delay cognitive decline, preserve the ability to perform activities of daily living, and reduce the risk of depression.
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Affiliation(s)
- Wenting Sun
- School of nursing, Shandong Second Medical University, Weifang, Shandong, 261053, PR China
| | - Yujia Yang
- School of nursing, Shandong Second Medical University, Weifang, Shandong, 261053, PR China
| | - Luying Ding
- School of nursing, Shandong Second Medical University, Weifang, Shandong, 261053, PR China
| | - Li Wang
- School of nursing, Shandong Second Medical University, Weifang, Shandong, 261053, PR China.
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Cao W, Cao C, Guo Y, Hong Z, Zheng X, Ren B, Hu Z, Chen R, Bai Z. Linear and non-linear associations of depressive symptoms with oral health knowledge, attitudes, and practices among rural older adults in China: a cross-sectional study. BMC Public Health 2024; 24:2528. [PMID: 39289689 PMCID: PMC11409690 DOI: 10.1186/s12889-024-19892-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 08/26/2024] [Indexed: 09/19/2024] Open
Abstract
BACKGROUND Depression affects the oral health of older adults; however, little is known about its impact on oral health among rural older adults in developing countries, which warrants further research. Taking China as an example, there is a large population base of rural older adults suffering from depression, and many rural older people also have long-term oral health problems, which have seriously affected their quality of life in later life. Therefore, this study aimed to explore linear and non-linear associations of depressive symptoms with oral health knowledge, attitudes, and practices among rural older adults in China. METHODS From November 2020 to December 2020, 1,902 rural community-dwelling older people aged 60 years and older were investigated, via a cross-sectional survey. The general information, depressive status, oral health knowledge, attitudes, and practices of the participants were obtained through face-to-face structured questionnaires. Among them, the Zung Depression Self-Rating Scale was used to investigate the depressive symptoms of the participants in this survey. The generalized linear model and classification and regression tree model were used, separately. RESULTS Based on linear analysis results, we found that minimal to mild depressive symptoms [regression coefficient (β) = -0.345; 95% confidence interval (CI): -0.582 to -0.109, P = 0.004] and depressive symptoms (β = -1.064; 95% CI: -1.982 to -0.146, P = 0.023) were significantly correlated with oral health knowledge. A negative correlation was observed between minimal to mild depressive symptoms (β = -0.385; 95% CI: -0.600 to -0.170, P < 0.001) and oral health attitudes. In addition, while both minimal to mild depressive symptoms (β = 0.018; 95% CI: -0.312 to 0.347, P = 0.916) and depressive symptoms (β = 0.604; 95% CI: -0.675 to 1.883, P = 0.355) were associated with oral health practices. Furthermore, the non-linear analysis showed a combined effect of depressive symptoms on oral health attitudes, indicating that older people of a younger age, not living alone, and not suffering from depressive symptoms are more likely to report better oral health attitudes. CONCLUSION Both the linear and non-linear analyses in our study showed that depressive symptoms are significantly correlated with the poor oral health attitudes of older adults in rural communities. Furthermore, depressive symptoms were associated with oral health knowledge in the linear analysis. However, no statistically significant difference was found between depressive symptoms and oral health practices in either analysis. This research deepens our knowledge and understanding of relevant evidence in the mental and oral health of people in later life. In addition, analyzing the factors that affect the oral health of older people from the perspective of their depressive status provides new thinking directions and scientific references for improving the oral health of older adults in practical life.
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Affiliation(s)
- Wenwen Cao
- Department of Health Services Management, School of Health Services Management, Anhui Medical University, Hefei, 230032, China
| | - Chenglin Cao
- Department of Health Services Management, School of Health Services Management, Anhui Medical University, Hefei, 230032, China
| | - Ying Guo
- Department of Health Services Management, School of Health Services Management, Anhui Medical University, Hefei, 230032, China
| | - Zixuan Hong
- Department of Health Services Management, School of Health Services Management, Anhui Medical University, Hefei, 230032, China
| | - Xin Zheng
- Department of Health Services Management, School of Health Services Management, Anhui Medical University, Hefei, 230032, China
| | - Bohua Ren
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Medical University, Dongguan, 523808, China
- Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton, WV1 1QU, UK
| | - Zhi Hu
- Department of Health Services Management, School of Health Services Management, Anhui Medical University, Hefei, 230032, China
| | - Ren Chen
- Department of Health Services Management, School of Health Services Management, Anhui Medical University, Hefei, 230032, China.
| | - Zhongliang Bai
- Department of Health Services Management, School of Health Services Management, Anhui Medical University, Hefei, 230032, China.
- Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton, WV1 1QU, UK.
- Key Laboratory of Public Health Social Governance, Philosophy and Social Sciences of Anhui Province, Hefei, 230032, China.
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Rong J, Cheng P, Li D, Wang X, Zhao D. Global, regional, and national temporal trends in prevalence for depressive disorders in older adults, 1990-2019: An age-period-cohort analysis based on the global burden of disease study 2019. Ageing Res Rev 2024; 100:102443. [PMID: 39097004 DOI: 10.1016/j.arr.2024.102443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 07/28/2024] [Indexed: 08/05/2024]
Abstract
As a severe public health issue, depressive disorders (DD) has caused an increasingly burden of disease, especially in the older adults. To provide an overview and in-depth analysis of temporal trends in prevalence of DD in older adults at global, regional, and national levels over the last 30 years. Here, an age-period-cohort model was adopted to analyze age, period, and cohort effects. We showed that the global prevalence of DD in older adults was increasing. The net drift of the global prevalence of DD was showing an increasing trend in 78 countries, while local drift showing a declining trend in all age groups in high sociodemographic index (SDI) region. Additionally, period and cohort effects exhibited different patterns across regions. Over time, the declining trend was most significant in high SDI regions, while this trend was most significant in middle SDI region. Interestingly, those aged 60-64 years to 70-74 years was increasing globally, while age group aged 75-79 years to 95-99 years was on declining. In high, high-middle, and low SDI regions, individuals born early face higher risks than those born late, while the opposite results were observed in low-middle SDI region. Overall, our findings offer a insight global perspective for studying the temporal trends of DD prevalence, supplementing our evidence and understanding of DD epidemiology, and identifying gaps in DD prevention, management, and intervention plans in different aspects.
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Affiliation(s)
- Jian Rong
- Department of Scientific Research, The Second Affiliated Hospital of Anhui Medical University, Hefei, PR China.
| | - Pan Cheng
- Department of Scientific Research, The Second Affiliated Hospital of Anhui Medical University, Hefei, PR China.
| | - Dan Li
- Department of Scientific Research, The Second Affiliated Hospital of Anhui Medical University, Hefei, PR China.
| | - Xueqin Wang
- Department of Materials and Equipment, The First Affiliated Hospital of Anhui Medical University, Hefei, PR China.
| | - Dahai Zhao
- Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, PR China.
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Monaghan C, Avila-Palencia I, Han SD, Power JM. Procrastination, depressive symptomatology, and loneliness in later life. Aging Ment Health 2024; 28:1270-1277. [PMID: 38695380 PMCID: PMC11324379 DOI: 10.1080/13607863.2024.2345781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 04/15/2024] [Indexed: 08/15/2024]
Abstract
OBJECTIVES Procrastination is an almost universal behaviour and yet little research to date has focused on procrastination among older adults. The purpose of this study was to explore the potential association between age and procrastination, and the potential mediating roles of depressive symptomatology and loneliness. METHOD Structural equation modelling was applied to data from 1309 participants (aged 29-92) from two waves United States Health and Retirement Study (2016-2020). Within the model, sex, education, marital status, and job status were added as covariates. RESULTS There was no statistically significant direct effect between age and procrastination (β = 0.06, p = 0.106). However, an indirect effect was present via depressive symptomatology (β = -0.40, p < 0.001). No mediating effect of loneliness was observed (β = - 0.01, p = 0.371). Subsequent analysis revealed that the symptoms, fatigue, loneliness, and lack of motivation significantly predicted procrastination. CONCLUSION While age was not directly associated with procrastination, increasing age was associated with a decreased likelihood of depressive symptomatology, which was in turn associated with an increased likelihood of procrastination. Such findings indicates that age demonstrates no association with procrastination because of the suppressing effect of depressive symptomatology.
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Affiliation(s)
| | | | - S. Duke Han
- Department of Psychology, University of Southern California
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Wang Y, Zhang H. Latent profile analysis of depression and its influencing factors in older adults raising grandchildren in China. Geriatr Nurs 2024; 59:67-76. [PMID: 38991297 DOI: 10.1016/j.gerinurse.2024.06.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 06/09/2024] [Accepted: 06/27/2024] [Indexed: 07/13/2024]
Abstract
OBJECTIVE To explore the latent profile of depression in older adults raising grandchildren in China, and to analyze the differences in the characteristics of the different profiles of the population and the factors influencing them. METHODS This study utilized the 2018 China Health and Retirement Longitudinal Study (CHARLS). Through a cross-sectional study, the latent profile analysis was used to analyze the potential classification of depression among older adults raising grandchildren, and using ordered multi-categorical logistic regression analyses to assess the effects of each factor on their different classifications. RESULTS The 1271 older adults raising grandchildren with depression symptoms were divided into three categories: low-level depression (55.4%), moderate-level depression (31.2%), and high-level depression (13.4%). Ordered multi-categorical Logistic results showed: Gender, marital status, pension insurance, physical health status, life satisfaction, and IADL were predictors of latent profile classification of depression symptoms in older adults raising grandchildren (P < 0.05). CONCLUSIONS In the future of primary care, it will be more meaningful to provide targeted interventions for different subgroups of depression in older adults raising grandchildren.
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Affiliation(s)
- Yanan Wang
- School of Nursing, Jinzhou Medical University, Jinzhou, Liaoning, PR China
| | - Huijun Zhang
- School of Nursing, Jinzhou Medical University, Jinzhou, Liaoning, PR China.
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Li X, He Y, Chen S, Zhang J. The impact of community services usage on geriatric depression: a ten-year follow-up study. BMC Geriatr 2024; 24:723. [PMID: 39215246 PMCID: PMC11363550 DOI: 10.1186/s12877-024-05290-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Accepted: 08/08/2024] [Indexed: 09/04/2024] Open
Abstract
BACKGROUND This study explores whether the impact of environmental factors (community services usage, CSU) on geriatric depression is mediated by psychological resilience and moderated by the COMT (catechol-O-methyltransferase) gene val158met polymorphism. METHODS The data consists of 13,512 entries from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) collected in the years 2008, 2011, 2014, and 2018. The study employed a Random Intercept Cross-Lagged Panel Model (RI-CLPM) to examine the relationship between CSU and geriatric depression, including the mediating effect of psychological resilience and the moderating role of the comt gene val158met gene polymorphism in this relationship. RESULTS Lower CSU at earlier assessments were significantly associated with more severe geriatric depression in subsequent evaluations.Psychological resilience was found to partially mediate the relationship between CSU and depression.Differential impacts were observed among various gene genotypes; specifically, the val genotype demonstrated a significantly greater influence of CSU on subsequent psychological resilience and on subsequent depression compared to the met genotype. CONCLUSION Enhancement in CSU can predict subsequent geriatric depression. The relationship between the CSU and depression can be mediated by psychological resilience, with genetics modulating the pathway from CSU through psychological resilience to depression. Multidisciplinary interventions focused on enhancing community service quality, boosting psychological resilience, and mitigating depression are likely to benefit the older adults's emotional and psychological well-being.
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Affiliation(s)
- Xiaowen Li
- Institute of Mental Health Education, Anhui Normal University, Wuhu, 241000, China
| | - Yuanqing He
- School of Educational Science, Anhui Normal University, Wuhu, 241000, China.
| | - Shuhu Chen
- College of law, Anhui Normal University, Wuhu, 241000, China
| | - Jun Zhang
- Institute of Mental Health Education, Anhui Normal University, Wuhu, 241000, China
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Zeyen P, Sannemann L, Hu X, Kambeitz J, Rietz C, Wagner M, Woopen C, Zank S, Jessen F, Dafsari FS. Prediction of depressive symptoms at high age (80+) by psychological, biological and functional factors. J Affect Disord 2024; 359:342-349. [PMID: 38754595 DOI: 10.1016/j.jad.2024.05.059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 04/18/2024] [Accepted: 05/12/2024] [Indexed: 05/18/2024]
Abstract
BACKGROUND Late-life depression (LLD) is highly prevalent, especially in people aged 80 years and older. We aimed to investigate predictors and their influence on depressive symptoms in LLD. METHODS We analysed data from the NRW80+ study, a population-based cross-sectional study of individuals aged 80 years and older. Data from n = 926 cognitively unimpaired participants were included. We reduced 95 variables to 21 predictors of depressive symptoms by using a two-step cluster analysis (TSCA), which were assigned to one of four factors (function, values and lifestyle, autonomy and contentment, biological-somatic) according to a principal component analysis. A second TSCA with complete data sets (n = 879) was used to define clusters of participants. Using weighted mean composite scores (CS) for each factor group, binary logistic regression analyses were performed to predict depressive symptoms for each cluster and the total population. RESULTS The second TSCA yielded two clusters (cluster 1 (n = 688), cluster 2 (n = 191)). The proportion of participants with depressive symptoms was significantly higher in cluster 2 compared to cluster 1 (39 % vs. 15 %; OR = 3.6; 95 % CI 2.5-5.1; p < .001). Participants in cluster 2 were significantly older (mean age 88 vs. 85 years; p < .001), with a higher proportion of women (56 % vs. 46 %; OR = 1.5; 95 % CI 1.1-2.0; p = .016), had a higher BMI (p = .017), lower financial resources (OR = 2.3; 95 % CI 1.6-3.5; p < .001), lower educational level (OR = 1.8; 95 % CI 1.2-2.5; p = .002), higher proportion of single, separated or widowed participants (OR = 1.9; 95 % CI 1.3-2.6; p < .001) and a smaller mean social network (p = .044) compared to cluster 1. Binary logistic regression analyses showed that the weighted mean CS including the autonomy and contentment predictors explained the largest proportion of variance (22.8 %) for depressive symptoms in the total population (Nagelkerke's R2 = 0.228, p < .001) and in both clusters (cluster 1: Nagelkerke's R2 = 0.171, p < .001; cluster 2: Nagelkerke's R2 = 0.213, p < .001), respectively. LIMITATIONS The main limitations are the restriction to cognitively unimpaired individuals and the use of a self-rated questionnaire to assess depressive symptoms. CONCLUSIONS Psychological factors such as autonomy and contentment are critical for the occurrence of depressive symptoms at higher age, independent of the functional and somatic status and may serve as specific targets for psychotherapy.
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Affiliation(s)
- Philip Zeyen
- Department of Psychiatry and Psychotherapy, University of Cologne, Faculty of Medicine, University Hospital Cologne, Cologne, Germany.
| | - Lena Sannemann
- Department of Psychiatry and Psychotherapy, University of Cologne, Faculty of Medicine, University Hospital Cologne, Cologne, Germany
| | - Xiaochen Hu
- Department of Psychiatry and Psychotherapy, University of Cologne, Faculty of Medicine, University Hospital Cologne, Cologne, Germany
| | - Joseph Kambeitz
- Department of Psychiatry and Psychotherapy, University of Cologne, Faculty of Medicine, University Hospital Cologne, Cologne, Germany
| | - Christian Rietz
- CERES - Cologne Center for Ethics, Rights, Economics, and Social Sciences of Health, University of Cologne, Cologne, Germany; Institute for Educational Science, Heidelberg University of Education, Heidelberg, Germany
| | - Michael Wagner
- CERES - Cologne Center for Ethics, Rights, Economics, and Social Sciences of Health, University of Cologne, Cologne, Germany; Institute of Sociology and Social Psychology, University of Cologne, Cologne, Germany
| | - Christiane Woopen
- Heinrich-Hertz-Chair, Center for Life Ethics, University of Bonn, Bonn, Germany
| | - Susanne Zank
- CERES - Cologne Center for Ethics, Rights, Economics, and Social Sciences of Health, University of Cologne, Cologne, Germany; Department of Special Education and Rehabilitation Science, Faculty of Human Sciences, University of Cologne, Cologne, Germany
| | - Frank Jessen
- Department of Psychiatry and Psychotherapy, University of Cologne, Faculty of Medicine, University Hospital Cologne, Cologne, Germany; German Center for Neurodegenerative Disease (DZNE), Bonn, Cologne, Germany; Cellular Stress Response in Aging-Associated Diseases (CECAD) Cluster of Excellence, University of Cologne, Faculty of Medicine, University Hospital Cologne, Cologne, Germany
| | - Forugh S Dafsari
- Department of Psychiatry and Psychotherapy, University of Cologne, Faculty of Medicine, University Hospital Cologne, Cologne, Germany
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Min Y, Wei X, Yang C, Duan Z, Yang J, Ju K, Peng X. Associations and attributable burdens in late-life exposure to PM 2.5 and its major components and depressive symptoms in middle-aged and older adults: A nationwide cohort study. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2024; 280:116531. [PMID: 38852465 DOI: 10.1016/j.ecoenv.2024.116531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 04/21/2024] [Accepted: 05/29/2024] [Indexed: 06/11/2024]
Abstract
BACKGROUND Depression in late life has been associated with reduced quality of life and increased mortality. Whether the chronic fine particular matter (PM2.5) and its components exposure are contributed to the older depression symptoms remains unclear. METHOD Middle-aged and older adults (>45 years) were selected from the China Health and Retirement Longitudinal Study during the four waves of interviews. The concentrations of PM2.5 and its major constituents were calculated using near real-time data at a spatial resolution of 10 km during the study period. The depressive symptom was evaluated by the Depression Center for Epidemiologic Studies Depression (CES-D)-10 score. The fix-effect model was applied to evaluate the association between PM2.5 and its major constituents with depressive symptoms. Three three-step methods were used to explore the modification role of sleep duration against the depressive symptoms caused by PM2.5 exposure. RESULTS In our study, a total of 52,683 observations of 16,681 middle-aged and older adults were assessed. Each interquartile range (IQR) level of PM2.5 concentration exposure was longitudinally associated with a 2.6 % (95 % confidence interval [CI]: 1.3 %, 4.0 %) increase in the depression CES-D-10 score. Regarding the major components of PM2.5, OM, NO3-, and NH4+ showed the leading toxicity effects, which could increase the depression CES-D-10 score by 2.2 % (95 %CI: 1.0 %, 3.4 %), 2.2 % (0.6 %, 3.9 %), and 2.0 % (95 %CI: 0.6 %, 3.4 %) correspondingly. Besides, males were more susceptible to the worse depressive symptoms caused by PM2.5 and its major components exposure than female subpopulations. Shortened sleep duration might be the mediator of PM2.5-associated depressive symptoms. CONCLUSION Our results suggest that long-term exposure to PM2.5 and its major components were associated with an increased risk for depressive symptoms in middle-aged and older adults. Reducing the leading components of PM2.5 may cost-effectively alleviate the disease burden of depression and promote healthy longevity in heavy pollutant countries.
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Affiliation(s)
- Yu Min
- Department of Biotherapy and National Clinical Research Center for Geriatrics, Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Xiaoyuan Wei
- Department of Head and Neck Oncology, Department of Radiation Oncology, Cancer Center, and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Chenyu Yang
- Department of Big Data in Health Science, School of Public Health, and Center of Clinical Big Data and Analytics of The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Zhongxin Duan
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Jingguo Yang
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Ke Ju
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
| | - Xingchen Peng
- Department of Biotherapy and National Clinical Research Center for Geriatrics, Cancer Center, West China Hospital, Sichuan University, Chengdu, China.
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Rivier C, Szejko N, Renedo D, Clocchiatti-Tuozzo S, Huo S, de Havenon A, Zhao H, Gill T, Sheth K, Falcone G. Bidirectional relationship between epigenetic age and brain health events. RESEARCH SQUARE 2024:rs.3.rs-4378855. [PMID: 38978587 PMCID: PMC11230493 DOI: 10.21203/rs.3.rs-4378855/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/10/2024]
Abstract
Chronological age offers an imperfect estimate of the molecular changes that occur with aging. Epigenetic age, which is derived from DNA methylation data, provides a more nuanced representation of aging-related biological processes. This study examines the bidirectional relationship between epigenetic age and the occurrence of brain health events (stroke, dementia, and late-life depression). Using data from the Health and Retirement Study, we analyzed blood samples from over 4,000 participants to determine how epigenetic age relates to past and future brain health events. Study participants with a prior brain health event prior to blood collection were 4% epigenetically older (beta 0.04, SE 0.01), suggesting that these conditions are associated with faster aging than that captured by chronological age. Furthermore, a one standard deviation increase in epigenetic age was associated with 70% higher odds of experiencing a brain health event in the next four years after blood collection (OR 1.70, 95%CI 1.16-2.50), indicating that epigenetic age is not just a consequence but also a predictor of poor brain health. Both results were replicated through Mendelian Randomization analyses, supporting their causal nature. Our findings support the utilization of epigenetic age as a useful biomarker to evaluate the role of interventions aimed at preventing and promoting recovery after a brain health event.
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Lee YT, Chang YH, Tsai HJ, Chao SP, Chen DYT, Chen JT, Cherng YG, Wang CA. Altered pupil light and darkness reflex and eye-blink responses in late-life depression. BMC Geriatr 2024; 24:545. [PMID: 38914987 PMCID: PMC11194921 DOI: 10.1186/s12877-024-05034-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 05/02/2024] [Indexed: 06/26/2024] Open
Abstract
BACKGROUND Late-life depression (LLD) is a prevalent neuropsychiatric disorder in the older population. While LLD exhibits high mortality rates, depressive symptoms in older adults are often masked by physical health conditions. In younger adults, depression is associated with deficits in pupil light reflex and eye blink rate, suggesting the potential use of these responses as biomarkers for LLD. METHODS We conducted a study using video-based eye-tracking to investigate pupil and blink responses in LLD patients (n = 25), older (OLD) healthy controls (n = 29), and younger (YOUNG) healthy controls (n = 25). The aim was to determine whether there were alterations in pupil and blink responses in LLD compared to both OLD and YOUNG groups. RESULTS LLD patients displayed significantly higher blink rates and dampened pupil constriction responses compared to OLD and YOUNG controls. While tonic pupil size in YOUNG differed from that of OLD, LLD patients did not exhibit a significant difference compared to OLD and YOUNG controls. GDS-15 scores in older adults correlated with light and darkness reflex response variability and blink rates. PHQ-15 scores showed a correlation with blink rates, while MoCA scores correlated with tonic pupil sizes. CONCLUSIONS The findings demonstrate that LLD patients display altered pupil and blink behavior compared to OLD and YOUNG controls. These altered responses correlated differently with the severity of depressive, somatic, and cognitive symptoms, indicating their potential as objective biomarkers for LLD.
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Affiliation(s)
- Yao-Tung Lee
- Department of Psychiatry, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- Department of Psychiatry, Far Eastern Memorial Hospital, New Taipei City, Taiwan
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yi-Hsuan Chang
- Eye-Tracking Laboratory, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- Institute of Cognitive Neuroscience, College of Health Science and Technology, National Central University, Taoyuan City, Taiwan
| | - Hsu-Jung Tsai
- Eye-Tracking Laboratory, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Shu-Ping Chao
- Taipei Neuroscience Institute, Taipei Medical University, New Taipei City, Taiwan
- Dementia Center, Department of Neurology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - David Yen-Ting Chen
- Department of Medical Image, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- Department of Radiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan
| | - Jui-Tai Chen
- Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Anesthesiology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Yih-Giun Cherng
- Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Anesthesiology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Chin-An Wang
- Eye-Tracking Laboratory, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
- Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
- Department of Anesthesiology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
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Luppa M, Pabst A, Löbner M, Mallon T, Brettschneider C, Hajek A, Heser K, Kleineidam L, Weyerer S, Werle J, Pentzek M, Weeg D, Mösch E, Wiese B, Oey A, Wagner M, Maier W, Scherer M, König HH, Riedel-Heller SG. Age-specific risk factors of depression among the oldest-old - evidence from the multicenter AgeCoDe-AgeQualiDe study. Front Psychiatry 2024; 15:1367225. [PMID: 38919640 PMCID: PMC11196990 DOI: 10.3389/fpsyt.2024.1367225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 05/13/2024] [Indexed: 06/27/2024] Open
Abstract
Purpose The present study aimed to investigate age-group-specific incidence rates and risk factors for depressive symptoms in the highest age groups. Methods Data were derived from a prospective multicenter cohort study conducted in primary care - the AgeCoDe/AgeQualiDe study. In total, 2,436 patients 75 years and older were followed from baseline to ninth follow-up. To assess depressive symptoms, the short version of the Geriatric Depression Scale (GDS-15, cutoff score 6) was used. Age-specific competing risk regressions were performed to analyze risk factors for incident depressive symptoms in different age groups (75 to 79, 80 to 84, 85+ years), taking into account the accumulated mortality. Results The age-specific incidence rate of depression was 33 (95% CI 29-38), 46 (95% CI 40-52) and 63 (95% CI 45-87) per 1,000 person years for the initial age groups 75 to 79, 80 to 84 and 85+ years, respectively. In competing risk regression models, female sex, mobility as well as vision impairment, and subjective cognitive decline (SCD) were found to be risk factors for incident depression for age group 75 to 79, female sex, single/separated marital status, mobility as well as hearing impairment, and SCD for age group 80 to 84, and mobility impairment for age group 85+. Conclusion Depressive symptoms in latest life are common and the incidence increases with increasing age. Modifiable and differing risk factors across the highest age groups open up the possibility of specifically tailored prevention concepts.
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Affiliation(s)
- Melanie Luppa
- Institute of Social Medicine, Occupational Health and Public Health, Leipzig University, Leipzig, Germany
| | - Alexander Pabst
- Institute of Social Medicine, Occupational Health and Public Health, Leipzig University, Leipzig, Germany
| | - Margrit Löbner
- Institute of Social Medicine, Occupational Health and Public Health, Leipzig University, Leipzig, Germany
| | - Tina Mallon
- Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg, Eppendorf, Germany
| | - Christian Brettschneider
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg, Eppendorf, Germany
| | - André Hajek
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg, Eppendorf, Germany
| | - Kathrin Heser
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital, Bonn, Germany
| | - Luca Kleineidam
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital, Bonn, Germany
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Siegfried Weyerer
- Central Institute of Mental Health, Medical Faculty, Mannheim, Germany
| | - Jochen Werle
- Central Institute of Mental Health, Medical Faculty, Mannheim, Germany
| | - Michael Pentzek
- Institute of Family Practice (ifam), Medical Faculty, University of Duisburg, Essen, Germany
| | - Dagmar Weeg
- Department of Psychiatry, Technical University of Munich, Munich, Germany
| | - Edelgard Mösch
- Department of Psychiatry, Technical University of Munich, Munich, Germany
| | - Birgitt Wiese
- Institute of General Practice, Hannover Medical School, Hannover, Germany
| | - Anke Oey
- Institute of General Practice, Hannover Medical School, Hannover, Germany
| | - Michael Wagner
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital, Bonn, Germany
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Wolfgang Maier
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital, Bonn, Germany
| | - Martin Scherer
- Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg, Eppendorf, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg, Eppendorf, Germany
| | - Steffi G. Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health, Leipzig University, Leipzig, Germany
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13
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Chen Y, Guo H, Li Z, Huang L, Hong T, Wang H. Association of self-reported arthritis with depression, anxiety, and comorbid depression/anxiety among the older Chinese adults: A cross-sectional study. J Affect Disord 2024; 354:323-330. [PMID: 38494138 DOI: 10.1016/j.jad.2024.03.086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 02/19/2024] [Accepted: 03/14/2024] [Indexed: 03/19/2024]
Abstract
BACKGROUND Arthritis is relatively common among middle-aged and older people and is a significant public health problem. However, research on the relationship between arthritis and mental health in older populations is currently limited. METHODS Data were obtained from the Chinese Longitudinal Healthy Longevity Survey. The 10-item Center for Epidemiologic Studies Depression Scale and 7-item Generalized Anxiety Disorder Scale were used to evaluate depressive and anxiety symptoms. Arthritis status was self-reported. Linear and logistic regression analyses were conducted to assess the impact of arthritis on depression, anxiety, and comorbid depression/anxiety symptoms. RESULTS A total of 11,104 participants aged ≥65 years (mean age, 83.1 ± 11.1 years) were included in the analysis. We detected positive associations of arthritis with depression symptoms (adjusted odds ratio [OR]: 1.57, 95 % confidence interval [CI] 1.33 to 1.86), anxiety symptoms (adjusted OR: 1.48, 95 % CI: 1.15 to 1.90), and comorbid depression/anxiety symptoms (adjusted OR: 1.88, 95 % CI: 1.41 to 2.5) in the older adult population. Participants with arthritis had higher anxiety (adjusted linear regression coefficient: 0.43, 95 % CI: 0.24 to 0.63) and depression (adjusted linear regression coefficient: 0.87, 95 % CI: 0.57 to 1.14) scores compared with those without arthritis. In addition, there were no significant interaction effects between arthritis and participant characteristics on depression symptoms, anxiety symptoms, or comorbid depression/anxiety symptoms. CONCLUSIONS Arthritis was positively associated with depression symptoms, anxiety symptoms, and comorbid depression/anxiety symptoms among older adults. Further cohort studies are needed to validate these associations.
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Affiliation(s)
- Yu Chen
- Research Center for Universal Health, School of Public Health, China Medical University, Shenyang 110122, China.
| | - Huifang Guo
- Department of Nursing, The First Affiliated Hospital of Dalian Medical University, Dalian 116011, China
| | - Zheng Li
- Research Center for Universal Health, School of Public Health, China Medical University, Shenyang 110122, China
| | - Lina Huang
- Department of Child and Adolescent Health, School of Public Health, China Medical University, Shenyang 110122, China
| | - Tao Hong
- Research Center for Universal Health, School of Public Health, China Medical University, Shenyang 110122, China
| | - Haiyuan Wang
- Department of Critical Care Medicine, Shengjing Hospital of China Medical University, Shenyang 110004, China.
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Nazari T, Moodi M, Fakhrzadeh H, Khodabakhshi H, Khorashadizadeh M, Arzaghi SM, Shoaee S, Varmaghani M, Ejtahed HS, Sharifi F. The association of depressive symptoms with handgrip strength and gait speed in community-dwelling older adults: data from the baseline phase of Birjand Longitudinal Aging Study. BMC Geriatr 2024; 24:393. [PMID: 38702602 PMCID: PMC11069203 DOI: 10.1186/s12877-024-04944-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 04/03/2024] [Indexed: 05/06/2024] Open
Abstract
BACKGROUND Depression is a multifaceted condition with a high prevalence and burden to society. Handgrip strength (HGS) and gait speed (GS) are indices of physical health, which is linked to mental health. Previous studies have shown heterogeneity among countries in the association of physical parameters and depression. In this study, we aimed to investigate the association of HGS and GS with depressive symptoms in older adults. METHODS This is a cross-sectional study analyzing data from the Birjand Longitudinal Aging Study, a cohort of community-dwelling older adults (≥ 60 years old). Depressive symptoms were assessed by the nine-item Patient Health Questionnaire. HGS was measured with a hand dynamometer in a sitting position, and GS was estimated by a 15-foot walk test at usual pace. RESULTS Compared to participants in the first quartile, those in the second quartile of HGS had significantly lower odds of suffering from depressive symptoms, while GS was not significantly associated with depressive symptoms. A higher HGS was associated with a lower risk of moderate depressive symptoms, while a higher GS was related to a lower risk of moderately severe and severe symptoms. CONCLUSIONS Our findings suggest that older people residing in Birjand, Iran with a moderate HGS are less likely to suffer from depressive symptoms than those with lower HGS.
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Affiliation(s)
- Tina Nazari
- Department of Medical Geriatrics, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mitra Moodi
- Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran
- School of Health, Birjand University of Medical Sciences, Birjand, Iran
| | - Hossein Fakhrzadeh
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Huriye Khodabakhshi
- Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Masoumeh Khorashadizadeh
- Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Seyed Masoud Arzaghi
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Shervan Shoaee
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Varmaghani
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hanieh-Sadat Ejtahed
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Farshad Sharifi
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
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Wang W, Liu Y, Ji D, Xie K, Yang Y, Zhu X, Feng Z, Guo H, Wang B. The association between functional disability and depressive symptoms among older adults: Findings from the China Health and Retirement Longitudinal Study (CHARLS). J Affect Disord 2024; 351:518-526. [PMID: 38307133 DOI: 10.1016/j.jad.2024.01.256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 01/14/2024] [Accepted: 01/27/2024] [Indexed: 02/04/2024]
Abstract
BACKGROUND Previous research has shown that depressive symptoms in older adults was associated with functional disability, including basic activities of daily living (BADLs) and instrumental activities of daily living (IADLs). However, little is known about the impact of different patterns of functional disability and new-onset functional disability on subsequent depressive symptoms. OBJECTIVE To determine the effect of various patterns of functional disability and new-onset functional disability on depressive symptoms among Chinese older adults aged 60 years and above. METHOD The study included 3242 older adults from the China Health and Retirement Longitudinal Study (CHARLS), which was conducted from 2011 to 2018. Cox proportional hazards models were used to investigate the associations between patterns of functional disability and depressive symptoms. The associations were also examined in the population with new-onset functional disability. RESULT During 15,321 person-years of follow-up, 946 depressive symptoms occurred. The hazard ratios (HRs) of depressive symptoms were 1.29 (95 % confidence intervals [CI]: 1.05-1.58) for IADLs disability, 1.22 (95 % CI: 0.75-1.55) for BADLs disability, and 1.78 (95 % CI: 1.41-2.22) for both IADLs and BADLs disabilities. In the analysis of new-onset functional disability, the HRs were 1.50 (95 % CI: 1.06-2.13) for onset IADLs disability, 1.28 (95 % CI: 0.85-1.91) for onset BADLs disability, and 1.69 (95 % CI: 1.03-2.76) for both onset BADLs and IADLs disabilities. LIMITATIONS Depressive symptoms were assessed using the Centre for Epidemiological Studies Depression Scale, which has limitations in diagnosing clinical depression. CONCLUSION Functional disability increases the risk of depressive symptoms, particularly impaired IADLs function. Psychological care for older adults with functional disability should be strengthened.
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Affiliation(s)
- Weihao Wang
- School of Public Health, Southeast University, Nanjing, Jiangsu, China
| | - Yuxiang Liu
- School of Public Health, Southeast University, Nanjing, Jiangsu, China
| | - Dakang Ji
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu, China
| | - Kaihong Xie
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Ying Yang
- School of Public Health, Southeast University, Nanjing, Jiangsu, China
| | - Xiaoyue Zhu
- School of Public Health, Southeast University, Nanjing, Jiangsu, China
| | - Zhuoyue Feng
- School of Public Health, Southeast University, Nanjing, Jiangsu, China
| | - Haijian Guo
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu, China.
| | - Bei Wang
- School of Public Health, Southeast University, Nanjing, Jiangsu, China.
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Wang Y, Yen PS, Ajilore OA, Bhaumik DK. A novel biomarker selection method using multimodal neuroimaging data. PLoS One 2024; 19:e0289401. [PMID: 38573979 PMCID: PMC10994318 DOI: 10.1371/journal.pone.0289401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 07/18/2023] [Indexed: 04/06/2024] Open
Abstract
Identifying biomarkers is essential to obtain the optimal therapeutic benefit while treating patients with late-life depression (LLD). We compare LLD patients with healthy controls (HC) using resting-state functional magnetic resonance and diffusion tensor imaging data to identify neuroimaging biomarkers that may be potentially associated with the underlying pathophysiology of LLD. We implement a Bayesian multimodal local false discovery rate approach for functional connectivity, borrowing strength from structural connectivity to identify disrupted functional connectivity of LLD compared to HC. In the Bayesian framework, we develop an algorithm to control the overall false discovery rate of our findings. We compare our findings with the literature and show that our approach can better detect some regions never discovered before for LLD patients. The Hub of our discovery related to various neurobehavioral disorders can be used to develop behavioral interventions to treat LLD patients who do not respond to antidepressants.
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Affiliation(s)
- Yue Wang
- Division of Epidemiology and Biostatistics, University of Illinois at Chicago, Chicago, IL, United States of America
| | - Pei-Shan Yen
- Division of Epidemiology and Biostatistics, University of Illinois at Chicago, Chicago, IL, United States of America
| | - Olusola A. Ajilore
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, United States of America
| | - Dulal K. Bhaumik
- Division of Epidemiology and Biostatistics, University of Illinois at Chicago, Chicago, IL, United States of America
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, United States of America
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Choi NG, Marti CN, Choi BY, Kunik MM. Healthcare Cost Burden and Self-Reported Frequency of Depressive/Anxious Feelings in Older Adults. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2024; 67:349-368. [PMID: 38451780 PMCID: PMC10978223 DOI: 10.1080/01634372.2024.2326683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 01/11/2024] [Indexed: 03/09/2024]
Abstract
Using the 2018-2021 National Health Interview Survey data, we examined the associations between healthcare cost burden and depressive/anxious feelings in older adults. Nearly12% reported healthcare cost burden and 18% daily/weekly depressive/anxious feelings. Healthcare cost burden was higher among women, racial/ethnic minorities, those with chronic illnesses, mobility impairment, and those with Medicare Part D, but lower among individuals with Medicare-Medicaid dual eligibility, Medicare Advantage, VA/military insurance, and private insurance. Daily/weekly depressive/anxious feelings was higher among healthcare cost burden reporters. The COVID-19 pandemic-related medical care access problems were also associated with a higher risk of reporting healthcare cost burden and depression/anxiety.
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Affiliation(s)
- Namkee G. Choi
- Steve Hicks School of Social Work, University of Texas at Austin
| | - C. Nathan Marti
- Steve Hicks School of Social Work, University of Texas at Austin
| | - Bryan Y. Choi
- Department of Emergency Medicine, Philadelphia College of Osteopathic Medicine and BayHealth
| | - Mark M. Kunik
- Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety; Michael E. DeBakey VA Medical Center; Director, VA South Central Mental Illness Research, Education and Clinical Center; and Baylor College of Medicine
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18
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Judson MA. Health-Related Quality of Life Assessment in Sarcoidosis. Clin Chest Med 2024; 45:159-173. [PMID: 38245364 DOI: 10.1016/j.ccm.2023.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2024]
Abstract
Health-related quality of life (HRQoL) is of major concern to patients with sarcoidosis. HRQoL impairment is the most common reason to treat the disease. Advances in patient-reported outcome (PRO) methodology offer the promise to use these instruments to follow quality of life in individual patients with sarcoidosis over time. Several HRQoL issues will be highlighted including their clinical importance, common causes in patients with sarcoidosis, the construction and use of PROs in clinical sarcoidosis trials, methods to adapt PROs to monitor HRQoL in individual patients with sarcoidosis, and the approach to improving HRQoL in this disease.
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Affiliation(s)
- Marc A Judson
- Division of Pulmonary and Critical Care Medicine, Albany Medical Center, 16 New Scotland Avenue, MC-91 Division Pulm-CCM, Albany, NY 12208, USA.
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Gao J, Fan H, Wang X, Cheng Y, Hao J, Han S, Wu S. Association between serum omega-3 PUFAs levels and cognitive impairment in never medically treated first-episode patients with geriatric depression: A cross-sectional study. J Affect Disord 2024; 346:1-6. [PMID: 37923225 DOI: 10.1016/j.jad.2023.10.153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 10/16/2023] [Accepted: 10/29/2023] [Indexed: 11/07/2023]
Abstract
BACKGROUND Geriatric depression increases the public health burden and health care costs, reduces quality of life. Studies have shown the association between ω-3 PUFAs levels and inflammatory markers levels and depression, but few have explored the relationship between omega-3 PUFAs, inflammatory markers, and cognitive function in geriatric depression. This study aimed to compare the differences in ω-3 PUFAs levels and inflammatory markers between geriatric depression with cognitive impairment (CI) and those without CI. METHODS A total of three hundred and five elderly patients were recruited. In addition to collecting basic information, their blood specimens were collected to detect serum EPA, DHA, AA, TC, LDL-C, IL-6, TNF-α, and hs-CRP levels. The Hamilton depression scale (HAMD), Hamilton anxiety scale (HAMA), and The Montreal cognitive assessment (MoCA) were used to assess their depression, anxiety, and cognitive function, respectively. RESULTS Compared to those without CI, geriatric depression patients with CI had higher serum TC, LDL-C levels, lower EPA, DHA, and AA levels, and more elevated IL-6, TNF-α, and hs-CRP levels (all P < 0.05). Further linear regression analysis showed that EPA, DHA, and TNF-α, hs-CRP levels were significantly associated with the occurrence and the severity of CI. LIMITATIONS No causal relationship could be drawn due to the cross-sectional design. CONCLUSIONS Omega-3 PUFAs and inflammatory factors levels may predict CI in elderly patients with MDD in the future. Our findings suggest that ω-3 PUFAs (EPA and DHA) and inflammatory factors (TNF-α and CRP) may predict the occurrence and the severity of CI among elderly MDD patients.
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Affiliation(s)
- Jing Gao
- Department of Psychiatry, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang Province, China
| | - Huiyu Fan
- Key Laboratory of Forensic Medicine, Key Laboratory of Forensic Science, Ministry of Justice, Shanghai Forensic Service Platform, Academy of Forensic Science, Shanghai, China
| | - Xiaohong Wang
- Department of Psychiatry, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang Province, China
| | | | - Jingjing Hao
- Department of Psychiatry, The Mental Health Center of Tsingtao, Tsingtao, Shandong Province, China
| | - Siqi Han
- Department of Psychiatry, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang Province, China
| | - Suping Wu
- Department of Psychiatry, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang Province, China.
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Yang HJ, Cheng Y, Yu TS, Cheng WJ. Association Between Retirement Age and Incidence of Depressive Disorders: A 19-Year Population-Based Study. Am J Geriatr Psychiatry 2024; 32:166-177. [PMID: 37838542 DOI: 10.1016/j.jagp.2023.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 09/08/2023] [Accepted: 09/08/2023] [Indexed: 10/16/2023]
Abstract
OBJECTIVE To investigate the occurrence of depressive disorders spanning the transition to retirement, and explore the relationship between retirement age and depressive disorders. METHODS We utilized a national population-based health insurance database encompassing 2 million Taiwanese individuals from 2000 to 2019. The study focused on individuals aged 50 years and older who were employed at the baseline, and 84,224 individuals had records of retirement during the follow-up period. Depressive disorders were identified using codes from the International Classification of Diseases. To assess the trend in the incidence of depressive disorders 7-year period before and after retirement, an interrupted time series analysis was performed. Cox-proportional hazard models were employed to investigate the association between retirement age and the occurrence of depressive disorders following retirement. RESULTS The incidence of depression peaks at the time of retirement and shows a significant decrease after retirement. Incidence of depressive disorders was 6.4 and 7.6 per 1000 person-years among individuals who retired between the ages of 60-64 and 65-69. Comparing the two groups, those who retired between 65 and 69 exhibits a higher risk of developing depressive disorders (hazard ratio = 1.10, 95% confidence interval = 1.02-1.18). This association is particularly pronounced among women and individuals residing in areas with low urbanization levels. CONCLUSION Retirement marks a crucial life milestone accompanied by a peak in depressive disorders. It is important to address the higher risk of depression associated with late retirement among socially disadvantaged groups.
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Affiliation(s)
- Hang-Ju Yang
- Department of Emergency Medicine (H-JY), Jen Ai Dali Branch, Dali, Taichung, Taiwan
| | - Yawen Cheng
- Institute of Health Policy and Management (YC), College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Teng-Shun Yu
- Management Office for Health Data (T-SY), China Medical University Hospital, Taichung, Taiwan; College of Medicine (T-SY), China Medical University, Taichung, Taiwan
| | - Wan-Ju Cheng
- National Center for Geriatrics and Welfare Research (W-JC), National Health Research Institutes, Miaoli, Taiwan; Department of Psychiatry (W-JC), China Medical University Hospital, Taichung, Taiwan; Department of Public Health (W-JC), China Medical University, Taichung, Taiwan.
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Sato M, Tsuji T, Ueno T, Watanabe R, Ide K, Kondo K. Socioeconomic status and incident depressive symptoms among older adults: A 3-year longitudinal study from the Japan Gerontological Evaluation Study. Int J Geriatr Psychiatry 2024; 39:e6069. [PMID: 38357974 DOI: 10.1002/gps.6069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 02/06/2024] [Indexed: 02/16/2024]
Abstract
OBJECTIVES The association between socioeconomic status (SES) and the onset of depressive symptoms has attracted considerable attention. However, few studies have simultaneously examined the association of multiple SES indicators, including "assets," with the onset of depressive symptoms. Therefore, this study examined the association of four SES indicators in old age ('years of education' 'equivalent income,' 'equivalent assets,' and 'the longest-held job') with new-onset depressive symptoms in a large Japanese dataset. METHODS This longitudinal study used panel data of cognitively and physically independent older adults from the Japan Gerontological Evaluation Study (JAGES) conducted in 2013 and 2016. Multivariate logistic regression analysis was conducted to examine the association of each SES indicator with new-onset depressive symptoms, and odds ratios and 95% confidence intervals (CIs) were calculated. RESULTS We analyzed the data of 40,257 older adults, with a mean age (± standard deviation) of 72.9 (±5.5) years. In the follow-up survey, 4292 older adults had new-onset depression symptoms (10.7%). 39.3% had 10-12 years of education. 36.9% had an equivalent income of up to JPY 1.99 million. 24.4% had equivalent assets of JPY 4-17.99 million. Most had a clerical job for the long time. Furthermore, fewer years of education (males: OR = 1.42, 95% CI = 1.22-1.64, p-value <0.001/females: 1.26, [1.09-1.47], p = 0.002), lower income (males: 1.64, [1.34-2.01], p < 0.001/females: 1.82, [1.49-2.22], p < 0.001), and fewer assets (males: 1.40, [1.16-1.68], p < 0.001/females: 1.21, [1.02-1.42], p = 0.025) resulted in higher odds of having new-onset depressive symptoms, even when other SES indicators were entered simultaneously. CONCLUSIONS All four SES indicators have an independent association with the development of new-onset depressive symptoms among older adults, reflecting different aspects of SES. The association between the "longest-held job" and new-onset depressive symptoms can be largely explained by other SES indicators. A multifaceted and lifetime approach is required to prevent the onset of depressive symptoms in old age.
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Affiliation(s)
- Masashi Sato
- Graduate School of Medical and Pharmaceutical Sciences, Chiba University, Chiba, Japan
- Faculty of Health Care and Medical Sports, Teikyo Heisei University, Chiba, Japan
| | - Taishi Tsuji
- Institute of Health and Sport Sciences, Tsukuba University, Ibaraki, Japan
- Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Takayuki Ueno
- Graduate School of Medical and Pharmaceutical Sciences, Chiba University, Chiba, Japan
- Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Ryota Watanabe
- Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
- Center for Well-being and Society, Nihon Fukushi University, Aichi, Japan
- Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Kazushige Ide
- Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Katsunori Kondo
- Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
- Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Aichi, Japan
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Hannon K, Bijsterbosch J. Challenges in Identifying Individualized Brain Biomarkers of Late Life Depression. ADVANCES IN GERIATRIC MEDICINE AND RESEARCH 2024; 5:e230010. [PMID: 38348374 PMCID: PMC10861244 DOI: 10.20900/agmr20230010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]
Abstract
Research into neuroimaging biomarkers for Late Life Depression (LLD) has identified neural correlates of LLD including increased white matter hyperintensities and reduced hippocampal volume. However, studies into neuroimaging biomarkers for LLD largely fail to converge. This lack of replicability is potentially due to challenges linked to construct variability, etiological heterogeneity, and experimental rigor. We discuss suggestions to help address these challenges, including improved construct standardization, increased sample sizes, multimodal approaches to parse heterogeneity, and the use of individualized analytical models.
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Affiliation(s)
- Kayla Hannon
- Department of Radiology, Washington University in St Louis, St Louis MO, 63110, USA
| | - Janine Bijsterbosch
- Department of Radiology, Washington University in St Louis, St Louis MO, 63110, USA
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AlQashqri H, Hariri N, Jadkarim RJ, Falemban AH, Alfalogy E. Screening of Geriatric Depression in Makkah, Saudi Arabia: A Pilot Study. Cureus 2024; 16:e53313. [PMID: 38435946 PMCID: PMC10906780 DOI: 10.7759/cureus.53313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2024] [Indexed: 03/05/2024] Open
Abstract
OBJECTIVE There is currently limited evidence about the prevalence of depression among elderly people residing in Makkah, Saudi Arabia. This study aims to report the magnitude of depression among the older population in Makkah, Saudi Arabia, and the related risk factors. METHODS An online cross-sectional pilot survey was carried out in Makkah City, Saudi Arabia. Data were collected using an online self-administered questionnaire. RESULTS The study questionnaire was completed by 191 older people. The participants' ages varied from 60 to 88 years. 55.5% were women, 47.9% were married, and 21.5% were divorced/widowed. 46.6% had hypertension, 42.4% had diabetes, 17.3% had hypothyroidism, 7.9% had cardiovascular diseases (CVDs), and 6.3% reported psychiatric problems. 44.5% of the subjects had no depression, 23.5% had mild, 15.2% had moderate, and 16.8% had severe depression. The sample included 32% who had been classified as having major depression. Elderly participants with insomnia, cognitive diseases, and chronic diseases showed a high risk for experiencing severe depression (OR=2.74; 95% CI: 1.42-5.28),(OR=2.63; 95% CI: 1.29-5.40), and (OR=2.62; 95% CI: 1.11-6.14) respectively. CONCLUSION Depression was common among the elderly population in Makkah, particularly among those with a documented history of insomnia, cognitive diseases, and chronic diseases. Depression screening and treatment for old people in medical settings is recommended.
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Affiliation(s)
- Hamsa AlQashqri
- Community and Family Medicine, Umm Al-Qura University, Makkah, SAU
| | - Nahla Hariri
- Community Medicine, Umm Al-Qura University, Makkah, SAU
| | - Renad J Jadkarim
- Epidemiology and Public Health, Umm Al-Qura University, Makkah, SAU
| | - Alaa H Falemban
- Pharmacology and Toxicology, Umm Al-Qura University, Makkah, SAU
| | - Enas Alfalogy
- Family Medicine, Suez Canal University, Ismailia, EGY
- Family Medicine, Umm Al-Qura University, Makkah, SAU
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Zhao L, Xu F, Zheng X, Xu Z, Osten B, Ji K, Ding S, Liu G, Yang S, Chen R. Mediation role of anxiety on social support and depression among diabetic patients in elderly caring social organizations in China during COVID-19 pandemic: a cross-sectional study. BMC Geriatr 2023; 23:790. [PMID: 38041007 PMCID: PMC10691130 DOI: 10.1186/s12877-023-04502-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 11/21/2023] [Indexed: 12/03/2023] Open
Abstract
BACKGROUND Diabetes has become a prominent global public health problem, which is an important cause of death, disease burden, and medical and health economic burden. Previous studies have reported that majority of persons diagnosed with diabetes later presented with psychological and mental health diseases. The study aimed to explore the mediation role of anxiety on social support and depression among diabetic patents in elderly caring social organizations (SOs). METHODS A multi-stage stratified cluster random sampling method was used in this cross-sectional study, and a questionnaire consisting of demographic questionnaire, MSPSS, GAD-7, and CES-D-10 was utilized to gather data. SPSS 22.0 and MPLUS 7.4 were used for statistical analysis. Spearman correlation analysis was employed to investigate correlations of key variables. A generalized linear model was used to exam factors associated with depression. Finally, the mediation effect among study variables was investigated by structural equation modeling (SEM). RESULTS The average scores of social support, anxiety, and depression were 58.41 ± 14.67, 2.95 ± 3.95, and 7.24 ± 5.53, respectively. The factors of gender, social support, and anxiety were identified as significantly influential factors related to depression among diabetic patients in elderly caring SOs. The effect of social support on depression was significantly mediated by anxiety (β = -0.467, 95%CI: -0.813 to -0.251). Furthermore, anxiety partially mediated the relationship between family support and depression (β = -0.112, 95%CI: -0.229 to -0.012), and anxiety functioned as a complete mediator in the effect of significant others' support and depression (β = -0.135, 95%CI: -0.282 to -0.024). CONCLUSIONS The indirect effect of social support on depression through anxiety among diabetic patients in elderly caring SOs was elucidated. Social support played a key role in maintaining and regulating their mental health, particularly from family and significant others. Social support provided by both family and significant others exerted an important influence on maintaining and regulating their mental health. In light of this pathway, the elderly caring SOs should enhance the magnitude of social support from these two sources, thereby diminishing the likelihood of experiencing anxiety and depression.
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Affiliation(s)
- Lanlan Zhao
- School of Health Services Management, Anhui Medical University, Hefei, 230032, China
| | - Fuqin Xu
- School of Health Services Management, Anhui Medical University, Hefei, 230032, China
| | - Xin Zheng
- School of Health Services Management, Anhui Medical University, Hefei, 230032, China
| | - Ziwen Xu
- School of Health Services Management, Anhui Medical University, Hefei, 230032, China
| | - Benjamin Osten
- School of Health Services Management, Anhui Medical University, Hefei, 230032, China
- Registrars' Department, University of Cape Coast, Cape Coast, Ghana
| | - Kai Ji
- School of Health Services Management, Anhui Medical University, Hefei, 230032, China
| | - Shuo Ding
- School of Health Services Management, Anhui Medical University, Hefei, 230032, China
| | - Guoqing Liu
- School of Health Services Management, Anhui Medical University, Hefei, 230032, China
| | - Shufan Yang
- School of Computing, Engineering and Built Environment, Edinburgh Napier University, Edinburgh, UK
- Research Department of Orthopaedics and Musculoskeletal Science, University College London, UCL, London, UK
| | - Ren Chen
- School of Health Services Management, Anhui Medical University, Hefei, 230032, China.
- Key Laboratory of Public Health Social Governance, Philosophy and Social Sciences of Anhui Province, Hefei, China.
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Basu T, Sehar U, Malhotra K, Culberson J, Khan H, Morton H, Orlov E, Brownell M, Reddy PH. Healthy brain aging and delayed dementia in Texas rural elderly. Ageing Res Rev 2023; 91:102047. [PMID: 37652312 PMCID: PMC10843417 DOI: 10.1016/j.arr.2023.102047] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 08/24/2023] [Accepted: 08/27/2023] [Indexed: 09/02/2023]
Abstract
Healthy aging is the process of preserving and enhancing one's independence, physical and mental well-being, and overall quality of life. It involves the mental, emotional, and cognitive wellness. Although biological and genetic factors have a significant influence on the process of aging gracefully, other adjustable factors also play a crucial role. Adopting positive behaviors such as maintaining a nutritious and balanced diet, engaging in regular physical activity, effectively managing stress and anxiety, ensuring sufficient sleep, nurturing spiritual coping mechanisms, and prioritizing overall well-being from an early stage can collectively influence both lifespan and the quality of health during advanced years. We aim to explore the potential impacts of biological, psychosocial, and environmental factors on the process of healthy cognitive aging in individuals who exhibit healthy aging. Additionally, we plan to present initial findings that demonstrate how maintaining good cognitive health during aging could potentially postpone the emergence of neurodegenerative disorders. We hypothesize that there will be strong associations between biological, environmental, and social factors that cause some elderly to be superior in cognitive health than others. For preliminary data collection, we recruited 25 cognitively healthy individuals and 5 individuals with MCI/AD between the ages of 60-90 years. We conducted anthropometric measurements, and blood biomarker testing, administered surveys, and obtained structural brain magnetic resonance imaging (MRI) scans. The Montreal Cognitive Assessment (MoCA) scores and sub-scores for the healthy group were also reported. We found that at baseline, individuals exhibiting healthy cognitive aging, and those with MCI/AD had comparable measures of anthropometrics and blood biomarkers. The healthy group exhibited lower signs of brain volume loss and the ones observed were age-related. Moreover, within the healthy group, there was a significant correlation (p = 0.003) between age and MoCA scores. Conversely, within the individuals with MCI/AD, the MRI scans showed disease signs of grey and white matter and loss of cerebral volume. Healthy brain aging is a scientific area that remains under-explored. Our current study findings support our hypothesis. Future studies are required in diverse populations to determine the various biological, psychological, environmental, lifestyle, and social factors that contribute to it.
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Affiliation(s)
- Tanisha Basu
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
| | - Ujala Sehar
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
| | - Keya Malhotra
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA; Grace Clinic, Covenant Health System, Lubbock, TX, USA
| | - John Culberson
- Department of Family Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
| | - Hafiz Khan
- Public Health Department, School of Population and Public Health, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
| | - Hallie Morton
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
| | - Erika Orlov
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
| | - Malcolm Brownell
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
| | - P Hemachandra Reddy
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA; Public Health Department, School of Population and Public Health, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA; Neurology, Departments of School of Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA; Department of Speech, Language and Hearing Sciences, School Health Professions, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA; Department of Pharmacology and Neuroscience, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA; Nutritional Sciences Department, College of Human Sciences, Texas Tech University, 1301 Akron Ave, Lubbock, TX 79409, USA.
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Bergua V, Blanchard C, Amieva H. Depression in Older Adults: Do Current DSM Diagnostic Criteria Really Fit? Clin Gerontol 2023:1-38. [PMID: 37902598 DOI: 10.1080/07317115.2023.2274053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/31/2023]
Abstract
OBJECTIVES The great heterogeneity in symptoms and clinical signs of depression in older adults makes the current diagnostic criteria difficult to apply. This scoping review aims to provide an update on the relevance of each of the diagnostic criteria as defined in the DSM-5. METHODS In order to limit the risk of bias inherent in the study selection process, a priori inclusion and exclusion criteria were defined. Articles meeting these criteria were identified using a combination of search terms entered into PubMed, PsycINFO, PsycARTICLES and SocINDEX. RESULTS Of the 894 articles identified, 33 articles were selected. This review highlights a different presentation of depression in older adults. Beyond the first two DSM core criteria, some symptoms are more common in older adults: appetite change, sleep disturbance, psychomotor slowing, difficulty concentrating, indecisiveness, and fatigue. CONCLUSIONS This review provides an updated description of the clinical expression of depressive symptoms in the older population while highlighting current pending issues. CLINICAL IMPLICATIONS Somatic symptoms should be systematically considered in order to improve the diagnosis of depression in older adults, even if, in some cases, they may reflect symptoms of age-related illnesses.
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Affiliation(s)
- Valérie Bergua
- Public health - Psychology, University of Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219, Bordeaux, France
| | - Cécile Blanchard
- Public health - Psychology, University of Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219, Bordeaux, France
- Psychiatry, Centre Hospitalier Cadillac, Bordeaux, France
| | - Hélène Amieva
- Public health - Psychology, University of Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219, Bordeaux, France
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27
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Wan Z, Qin X, Tian Y, Ouyang F, Wang G, Wan Q. Long-Term Consumption of Green Tea Can Reduce the Degree of Depression in Postmenopausal Women by Increasing Estradiol. Nutrients 2023; 15:4514. [PMID: 37960167 PMCID: PMC10650806 DOI: 10.3390/nu15214514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 10/23/2023] [Accepted: 10/24/2023] [Indexed: 11/15/2023] Open
Abstract
Postmenopausal women face a higher risk of depression due to a combination of social and physiological factors. As a beverage rich in a variety of bioactive substances, green tea has significant effects on metabolism, inflammation and endocrine, and may reduce the risk of depression, but few studies have looked at the effects of green tea on postmenopausal women. Therefore, we designed this study to investigate the effects of long-term green tea consumption on inflammation, endocrine and depression levels in postmenopausal women. We investigated a tea-producing village and eventually included 386 postmenopausal women, both in the tea drinking and control groups. The results showed that there were significant differences in the degree of insomnia, degree of depression, BMI, SII and estradiol between the two groups. And, green tea consumption may reduce the risk of depression through the mediating pathway of sleep, SII and estradiol. In summary, long-term green tea consumption can reduce the risk of depression in postmenopausal women by reducing inflammation and increasing estradiol. This kind of living habit deserves further promotion.
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Affiliation(s)
- Zhenyu Wan
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan 430000, China; (Z.W.); (X.Q.)
| | - Xucong Qin
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan 430000, China; (Z.W.); (X.Q.)
| | - Yuling Tian
- Yichang City Clinical Research Center for Mental Disorders, Yichang 443000, China;
| | | | - Gaohua Wang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan 430000, China; (Z.W.); (X.Q.)
| | - Qirong Wan
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan 430000, China; (Z.W.); (X.Q.)
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28
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Gide DN, El-Den S, Lee YLE, Gisev N, Ou K, O'Reilly CL. Community pharmacists' acceptability of pharmacist-delivered depression screening for older adults: a qualitative study. Int J Clin Pharm 2023; 45:1144-1152. [PMID: 37081167 PMCID: PMC10600303 DOI: 10.1007/s11096-023-01581-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Accepted: 03/22/2023] [Indexed: 04/22/2023]
Abstract
BACKGROUND Late-life depression often goes underdiagnosed and undertreated, affecting the quality of life of older adults. Pharmacists are well-placed to identify older adults who may be at risk of depression by using appropriate screening tools. AIM To explore community pharmacists' acceptability of performing late-life depression screening in Australian community pharmacies. METHOD Semi-structured interviews with community pharmacists were conducted to gauge their perceptions regarding delivering depression screening services for older adults. Data analysis was conducted using an iterative, inductive approach. Key themes were identified, which were further explored and divided into subthemes. Subthemes were categorised as either barriers or facilitators. Each subtheme was mapped to the Capability, Opportunity, Motivation-Behaviour model by classifying whether they impacted pharmacists' capability, opportunity, or motivation regarding depression screening. RESULTS Fifteen pharmacists were interviewed, 12 of whom were female and 11 of whom practised in a metropolitan area. Four key themes were identified including: training needs, environmental factors, pharmacists' roles, and organisational support, which were further divided into 13 subthemes. Three subthemes were mapped to Capability, seven to Opportunity and three to Motivation. Barriers included lack of resources and lack of remuneration, while facilitators included training, pharmacists' accessibility, and rapport with consumers. CONCLUSION The findings of this study demonstrate that while community pharmacists found depression screening for older adults in community pharmacies to be an acceptable service, there remains a need for the development of funding schemes and standardised guidelines for pharmacist-delivered depression screening for older adults.
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Affiliation(s)
- Duha N Gide
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Building Number A15, Science Rd Camperdown, Sydney, NSW, 2006, Australia.
| | - Sarira El-Den
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Building Number A15, Science Rd Camperdown, Sydney, NSW, 2006, Australia
| | - Yee Lam Elim Lee
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Building Number A15, Science Rd Camperdown, Sydney, NSW, 2006, Australia
| | - Natasa Gisev
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW, Australia
| | - Kevin Ou
- Pharmaceutical Society of Australia, Sydney, NSW, Australia
| | - Claire L O'Reilly
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Building Number A15, Science Rd Camperdown, Sydney, NSW, 2006, Australia
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29
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Alam MM, Das R, Clara AA, Mohsin FM, Rumi MAH, Wahab A, Hasan MA, Hawlader MDH. The assessment of geriatric malnutrition, geriatric depression and associated co-morbidities among forcibly displaced Myanmar nationals in Bangladesh. Public Health Nutr 2023; 26:2048-2055. [PMID: 37529859 PMCID: PMC10564601 DOI: 10.1017/s1368980023001556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 07/01/2023] [Accepted: 07/29/2023] [Indexed: 08/03/2023]
Abstract
OBJECTIVE To assess the nutritional status and depression of the elderly forcibly displaced Myanmar nationals (FDMN) in Bangladesh and determine the associated factors of geriatric depression (GD). DESIGN This was a community-based, cross-sectional study among elderly FDMN. The Mini Nutritional Assessment Short-Form (MNA@-SF) and Geriatric Depression Scale Short-Form (GDS-15 SF) were used to determine malnutrition and GD, respectively. SETTING The study was conducted between November 2021 and March 2022 in Kutupalong Refugee Camp, Cox's Bazar, Bangladesh. PARTICIPANTS The study participants were elderly FDMN aged ≥ 60 years (n 430). RESULTS The mean age and BMI were 71·7(±7·8) years and 21·94(±2·6) kg/m2, respectively. There was a high prevalence of self-reported diabetes mellitus (32·1 %), hypertension (26·7 %), hypotension (20 %), skin diseases (28·4 %) and chronic obstructive pulmonary disease (16·5 %). The prevalence of malnutrition was 25·3 %, and another 29·1 % were at risk. The prevalence of GD was 57·9 %, and co-occurrences of GD and malnutrition were seen in 17·5 % of participants. GD was significantly higher among elderly people with malnutrition (adjusted OR, AOR = 1·71, 95 % CI: 1·01, 2·89). FDMN aged ≥ 80 years were at higher risk of GD (AOR = 1·84, 95 % CI: 1·01, 3·37), and having fewer than five members in the household was an independent predictor of GD. Diabetes mellitus (AOR = 1·95, 95 % CI: 1·24, 3·08) and hypotension (AOR = 2·17, 95 % CI: 1·25, 2·78) were also significantly associated with an increased risk of GD. CONCLUSION A high prevalence of GD and malnutrition was observed among elderly FDMN in Bangladesh. The agencies working in Cox's Bazar should focus on geriatric malnutrition and GD for the improvement of the health situation of FDMN in Bangladesh.
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Affiliation(s)
- Mohammad Morshad Alam
- Department of Public Health, North South University, Dhaka1213, Bangladesh
- Health Nutrition and Population Global Practice, The World Bank, Dhaka, Bangladesh
| | - Rajib Das
- International Organization for Migration, Dhaka, Bangladesh
| | - Afrin Ahmed Clara
- Department of Public Health, North South University, Dhaka1213, Bangladesh
| | - Faroque Md Mohsin
- Directorate General of Health Services, Ministry of Health and Family Welfare, Dhaka, Bangladesh
| | | | - Abrar Wahab
- Department of Public Health, North South University, Dhaka1213, Bangladesh
| | - Md Abeed Hasan
- International Organization for Migration, Dhaka, Bangladesh
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30
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Kim JH, Yang HM. Moderating Effect of Self-Esteem on the Relationship between Depression and Family Conflict Coping Strategies in the Elderly with Chronic Diseases in Korea. Healthcare (Basel) 2023; 11:2569. [PMID: 37761766 PMCID: PMC10531067 DOI: 10.3390/healthcare11182569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 09/09/2023] [Accepted: 09/16/2023] [Indexed: 09/29/2023] Open
Abstract
(1) Background: The elderly with chronic diseases often experience high levels of depression, which can negatively affect their family conflict coping strategies. Additionally, as the level of depression increases, self-esteem tends to decrease. This study aims to investigate whether self-esteem plays a moderating role in the relationship between depression and family conflict coping strategies among the elderly with chronic diseases. (2) Method: The subjects were 2501 older adults with chronic diseases included in the 16th Korean Welfare Panel Study. The CES-D scale, Rosenberg Self-Esteem Scale, and the tool of Family Conflict Coping Strategies were used. (3) Results: Depression was negatively correlated with self-esteem and coping strategies for family conflict, while self-esteem was positively correlated with coping strategies for family conflict. In the multiple regression model, self-esteem had a moderating effect (F = 43.20, p < 0.001). This result indicated that as self-esteem increases, the negative influence of depression on family conflict coping strategies becomes weaker (β = -0.08, t = -3.04, p = 0.002). (4) Conclusions: When addressing family conflict coping strategies in the elderly with chronic diseases, it is crucial to focus on enhancing self-esteem. Additionally, it may be beneficial to classify the elderly into groups based on their level of self-esteem.
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Affiliation(s)
| | - Hwa-Mi Yang
- Department of Nursing, Daejin University, Pocheon-si 11159, Republic of Korea;
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31
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Missell-Gray R, Van Orden K, Simning A. Hospitalization's association with depression in adults over 50 years old: does living arrangement matter? Findings from the Health and Retirement Study. Aging Ment Health 2023; 27:1684-1691. [PMID: 36591606 PMCID: PMC10314961 DOI: 10.1080/13607863.2022.2163978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Accepted: 12/24/2022] [Indexed: 01/03/2023]
Abstract
OBJECTIVES To examine how living arrangements are associated with depressive symptoms in late middle-life and older adults following hospitalization within the last two years. DESIGN We used the 2016 wave of the Health and Retirement Study (HRS), a nationally representative survey of adults over 50 years old living in the United States. METHODS The dependent variable was whether HRS participants screened positive for having depressive symptoms. The primary independent variable was self-reported hospitalization in the prior two years. We stratified bivariate analyses and multivariate logistic regressions by living arrangement to examine hospitalizations' association with depressive symptoms. RESULTS Depressive symptoms were less prevalent among participants who were married or partnered and living with a partner (14.0%) compared to those who were not married or partnered and were living with others (31.7%) and were not married or partnered and were living alone (27.8%). In multivariate analyses stratified by living arrangement, however, hospitalization was associated with depressive symptoms for those married or partnered and living with a partner (OR = 1.39, 95% CI: 1.14-1.69) but not for those who were not married and living with other(s) (OR = 0.88, 95% CI: 0.65-1.18) and not married or partnered and living alone (OR = 1.06, 95% CI: 0.82-1.36). CONCLUSIONS Late middle-life and older adults residing with spouses or cohabitating appear at risk for having depressive symptoms following a hospitalization. A better understanding of how relationships and living arrangements may affect depression risk in the context of an acute medical illness is needed to identify points of intervention.
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Affiliation(s)
- Rachel Missell-Gray
- Department of Psychiatry, University of Rochester (U.R.), Rochester, NY, United States of America (USA)
- University of Rochester, Margaret Warner School of Education and Human Development, Rochester, NY, USA
| | - Kimberly Van Orden
- Department of Psychiatry, University of Rochester (U.R.), Rochester, NY, United States of America (USA)
| | - Adam Simning
- Department of Psychiatry, University of Rochester (U.R.), Rochester, NY, United States of America (USA)
- Department of Public Health Sciences, U.R., Rochester, NY, USA
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Bhaumik DK, Wang Y, Yen PS, Ajilore OA. Development of a Bayesian multimodal model to detect biomarkers in neuroimaging studies. FRONTIERS IN NEUROIMAGING 2023; 2:1147508. [PMID: 37554638 PMCID: PMC10406277 DOI: 10.3389/fnimg.2023.1147508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 04/20/2023] [Indexed: 08/10/2023]
Abstract
In this article, we developed a Bayesian multimodal model to detect biomarkers (or neuromarkers) using resting-state functional and structural data while comparing a late-life depression group with a healthy control group. Biomarker detection helps determine a target for treatment intervention to get the optimal therapeutic benefit for treatment-resistant patients. The borrowing strength of the structural connectivity has been quantified for functional activity while detecting the biomarker. In the biomarker searching process, thousands of hypotheses are generated and tested simultaneously using our novel method to control the false discovery rate for small samples. Several existing statistical approaches, frequently used in analyzing neuroimaging data have been investigated and compared via simulation with the proposed approach to show its excellent performance. Results are illustrated with a live data set generated in a late-life depression study. The role of detected biomarkers in terms of cognitive function has been explored.
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Affiliation(s)
- Dulal K. Bhaumik
- Division of Epidemiology and Biostatistics, University of Illinois at Chicago, Chicago, IL, United States
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, United States
| | - Yue Wang
- Division of Epidemiology and Biostatistics, University of Illinois at Chicago, Chicago, IL, United States
| | - Pei-Shan Yen
- Division of Epidemiology and Biostatistics, University of Illinois at Chicago, Chicago, IL, United States
| | - Olusola A. Ajilore
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, United States
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Bugallo-Carrera C, Dosil-Díaz C, Pereiro AX, Anido-Rifón L, Pacheco-Lorenzo M, Fernández-Iglesias MJ, Gandoy-Crego M. Assessment of validity and comparison of two Spanish versions of the Geriatric Depression Scale. Front Psychol 2023; 14:1101886. [PMID: 37265959 PMCID: PMC10231636 DOI: 10.3389/fpsyg.2023.1101886] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 04/21/2023] [Indexed: 06/03/2023] Open
Abstract
Introduction The Geriatric Depression Scale is an instrument used to identify depression in people of an older age. The original English version of this scale has been translated into Spanish (GDS-VE); two shorter versions of 5- (GDS-5) and 15-items (GDS-15) have been developed. Aim of the study To assess the validity and compare the 5- and 15-item Spanish versions of the GDS among the Spanish population. Materials and methods 573 Galicia residents aged >50 years participated in this study. The following instruments were applied: the 19-item Control, Autonomy, Self-Realization and Pleasure scale, the Subjective Memory Complaints Questionnaire, the Mini-Mental State Examination test, the GDS-5, and the GDS-15. Results We found differences in total score between GDS-5 and GDS-15 regarding the variable sex. Internal reliability for GDS-5 and GDS-15 was 0.495 and 0.715, respectively. Sensitivity and specificity for GDS-5 - with a cut-off value of 1 - was 0.517 and 0.650, respectively; for GDS-15 - with a cut-off value of 3 points - sensitivity was 0.755 and specificity 0.668. GDS-5 has a ROC curve of 0.617 and GDS-15 of 0.764. Conclusion GDS-15, and to a greater extent GDS-5, should be revised or even reformulated to improve their diagnostic usefulness by choosing higher discriminative ability items or even include new items with greater sensitivity that consider currently prevailing psychosocial factors.
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Affiliation(s)
- Cesar Bugallo-Carrera
- Department of Developmental Psychology, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Carlos Dosil-Díaz
- Department of Developmental Psychology, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Arturo X. Pereiro
- Department of Developmental Psychology, University of Santiago de Compostela, Santiago de Compostela, Spain
| | | | | | | | - Manuel Gandoy-Crego
- Department of Psychiatry, Radiology, Public Health, Nursing and Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain
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Jellinger KA. The heterogeneity of late-life depression and its pathobiology: a brain network dysfunction disorder. J Neural Transm (Vienna) 2023:10.1007/s00702-023-02648-z. [PMID: 37145167 PMCID: PMC10162005 DOI: 10.1007/s00702-023-02648-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 04/28/2023] [Indexed: 05/06/2023]
Abstract
Depression is frequent in older individuals and is often associated with cognitive impairment and increasing risk of subsequent dementia. Late-life depression (LLD) has a negative impact on quality of life, yet the underlying pathobiology is still poorly understood. It is characterized by considerable heterogeneity in clinical manifestation, genetics, brain morphology, and function. Although its diagnosis is based on standard criteria, due to overlap with other age-related pathologies, the relationship between depression and dementia and the relevant structural and functional cerebral lesions are still controversial. LLD has been related to a variety of pathogenic mechanisms associated with the underlying age-related neurodegenerative and cerebrovascular processes. In addition to biochemical abnormalities, involving serotonergic and GABAergic systems, widespread disturbances of cortico-limbic, cortico-subcortical, and other essential brain networks, with disruption in the topological organization of mood- and cognition-related or other global connections are involved. Most recent lesion mapping has identified an altered network architecture with "depressive circuits" and "resilience tracts", thus confirming that depression is a brain network dysfunction disorder. Further pathogenic mechanisms including neuroinflammation, neuroimmune dysregulation, oxidative stress, neurotrophic and other pathogenic factors, such as β-amyloid (and tau) deposition are in discussion. Antidepressant therapies induce various changes in brain structure and function. Better insights into the complex pathobiology of LLD and new biomarkers will allow earlier and better diagnosis of this frequent and disabling psychopathological disorder, and further elucidation of its complex pathobiological basis is warranted in order to provide better prevention and treatment of depression in older individuals.
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Affiliation(s)
- Kurt A Jellinger
- Institute of Clinical Neurobiology, Alberichgasse 5/13, 1150, Vienna, Austria.
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Cai W, Wei XF, Zhang JR, Hu C, Shen WD. Does acupuncture treatment have satisfactory clinical efficacy for late-life depression? A systematic review and meta-analysis. Geriatr Nurs 2023; 51:215-221. [PMID: 37015141 DOI: 10.1016/j.gerinurse.2023.03.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 03/08/2023] [Accepted: 03/10/2023] [Indexed: 04/03/2023]
Abstract
OBJECTIVE This systematic review and meta-analysis aimed to assess the clinical efficacy of acupuncture in late-life depression (LLD). METHODS A comprehensive search of seven electronic databases was conducted from inception to November 2022, including the Cochrane Library, PubMed, Embase, CNKI, VIP, CBM and the Wan Fang database. All data analysis were conducted by Revman 5.3. RESULTS A total of nine RCTs involving 603 participants were included. The meta-analysis results showed that acupuncture combined with antidepressants significantly reduced HAMD scores (MD, -3.69 [95% CI, -5.11 to -2.27], I2 =74%) and a significantly higher cure rate (RR, 1.11 [95% CI, 1.01 to 1.22], I2 = 0%) compared with antidepressants alone. However, no significant difference was found between acupuncture and antidepressants in reducing HAMD scores and improving clinical outcomes. CONCLUSIONS Acupuncture combined or not combined with antidepressants is an effective and safe treatment for LLD.
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Affiliation(s)
- Wa Cai
- Department of acupuncture, Shanghai Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xi-Fang Wei
- Department of acupuncture, Shanghai Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jing-Ruo Zhang
- Department of acupuncture, Shanghai Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Chen Hu
- Department of acupuncture, Shanghai Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Wei-Dong Shen
- Department of acupuncture, Shanghai Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China.
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Olofsson E, Gustafson Y, Mukka S, Tengman E, Lindgren L, Olofsson B. Association of depressive disorders and dementia with mortality among older people with hip fracture. BMC Geriatr 2023; 23:135. [PMID: 36890449 PMCID: PMC9996856 DOI: 10.1186/s12877-023-03862-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 03/01/2023] [Indexed: 03/10/2023] Open
Abstract
BACKGROUND Hip fracture (HF) is a significant cause of mortality among older people. Almost half of the patients with HF have dementia, which increases the mortality risk further. Cognitive impairment is associated with depressive disorders (DDs) and both dementia and DDs are independent risk factors for poor outcome after HF. However, most studies that evaluate mortality risk after HF separate these conditions. AIMS To investigate whether dementia with depressive disorders (DDwD) affects the mortality risk at 12, 24, and 36 months after HF among older people. METHODS Patients with acute HF (n = 404) were included in this retrospective analysis of two randomized controlled trials performed in orthopedic and geriatric departments. Depressive symptoms were assessed using the Geriatric Depression Scale and cognitive function was assessed using the Mini-Mental State Examination. A consultant geriatrician made final depressive disorder and dementia diagnoses using the Diagnostic and Statistical Manual of Mental Disorders criteria, with support from assessments and medical records. The 12-, 24- and 36-month mortality after HF was analyzed using logistic regression models adjusted for covariates. RESULTS In analyses adjusted for age, sex, comorbidity, pre-fracture walking ability, and fracture type, patients with DDwD had increased mortality risks at 12 [odds ratio (OR) 4.67, 95% confidence interval (CI) 1.75-12.51], 24 (OR 3.61, 95% CI 1.71-7.60), and 36 (OR 4.53, 95% CI 2.24-9.14) months. Similar results were obtained for patients with dementia, but not depressive disorders, alone. CONCLUSION DDwD is an important risk factor for increased mortality at 12, 24, and 36 months after HF among older people. Routinely assessments after HF for cognitive- and depressive disorders could identify patients at risk for increased mortality, and enable early interventions. TRIAL REGISTRATION RCT2: International Standard Randomized Controlled Trial Number Register, trial registration number: ISRCTN15738119.
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Affiliation(s)
| | - Yngve Gustafson
- Department of Community Medicine and Rehabilitation, Geriatric Medicine Division, Umeå University, Umeå, Sweden
| | - Sebastian Mukka
- Department of Surgical and Perioperative Sciences, Umeå University, Umeå, Sweden
| | - Eva Tengman
- Department of Community Medicine and Rehabilitation, Physiotherapy Division, Umeå University, Umeå, Sweden
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Nowakowska-Domagała K, Podlecka M, Stecz P, Lewandowska A, Sipowicz K, Kosmalski M, Pietras T, Mokros Ł. The Relationship between Selected Factors (Temperament, Bipolar Traits, Sleep Quality, Severity of Addiction) and Depressive Symptoms in Alcohol-Dependent Men. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4072. [PMID: 36901082 PMCID: PMC10001749 DOI: 10.3390/ijerph20054072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 02/11/2023] [Accepted: 02/22/2023] [Indexed: 06/18/2023]
Abstract
Clinical and epidemiological studies have demonstrated a relationship between alcohol addiction and mood disorders. Alcohol-dependent patients with depression tend to demonstrate clinically more severe manic symptoms, which complicates the process of diagnosis and therapy. However, the predictors indicating the risk of mood disorders in addicted patients remain unclear. The aim of the study was to examine the relationship between personal dispositions, bipolar traits, depth of addiction, quality of sleep, and depressive symptoms in alcohol-dependent men. The study group comprised 70 men (age M = 46.06, SD = 11.29) diagnosed with alcohol addiction. The participants completed a battery of questionnaires: BDI, HCL-32, PSQI, EPQ-R and MAST. The results were tested using Pearson's correlation quotient and general linear model. The findings indicate that some of the studied patients are likely to have mood disorders of clinically significant severity. High neuroticism and poor sleep quality are independent predictors of depressive symptoms in alcohol-dependent patients. Among the components of sleep quality, problems with falling asleep and waking up at night appear to be most strongly associated with depressive symptoms. The intensity of depressive symptoms may relate to the intensity of certain bipolar features, such as risk-taking activity and irritability. High neuroticism and poor sleep quality are independent predictors of depressive symptoms in the studied group.
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Affiliation(s)
- Katarzyna Nowakowska-Domagała
- Institute of Psychology, Faculty of Educational Sciences, University of Lodz, Al. Rodzeństwa Scheiblerów 2, 90-128 Lodz, Poland
| | - Marlena Podlecka
- Institute of Psychiatry and Neurology, Department of Neurosis, Personality and Eating Disorders, Sobieskiego Street 9, 02-957 Warsaw, Poland
| | - Patryk Stecz
- Institute of Psychology, Faculty of Educational Sciences, University of Lodz, Al. Rodzeństwa Scheiblerów 2, 90-128 Lodz, Poland
| | - Aleksandra Lewandowska
- J. Babiński Specialist Psychiatric Health Care Team, Psychiatric Ward for Children, Aleksandrowska 159, 02-229 Lodz, Poland
| | - Kasper Sipowicz
- Department of Interdisciplinary Disability Studies, The Maria Grzegorzewska University in Warsaw, Szczęśliwicka 40, 02-353 Warsaw, Poland
| | - Marcin Kosmalski
- Department of Clinical Pharmacology, Medical University of Lodz, Kopcinskiego Street 22, 90-153 Lodz, Poland
| | - Tadeusz Pietras
- Institute of Psychiatry and Neurology, Second Department of Psychiatry, Sobieskiego Street 9, 02-957 Warsaw, Poland
| | - Łukasz Mokros
- Department of Clinical Pharmacology, Medical University of Lodz, Kopcinskiego Street 22, 90-153 Lodz, Poland
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Steinman LE, Parrish AT, Kohn MJ, Wu S, Hara-Hubbard KK, Brown L, Imam S, Baquero B, Hannon PA, Snowden MB. Partnering with community-based organizations to improve equitable access to depression care for underserved older adults in the U.S.: Qualitative formative research. Front Public Health 2023; 10:1079082. [PMID: 36793362 PMCID: PMC9922751 DOI: 10.3389/fpubh.2022.1079082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 12/29/2022] [Indexed: 02/03/2023] Open
Abstract
Background Embedding evidenced-based programs (EBPs) like PEARLS outside clinical settings can help reduce inequities in access to depression care. Trusted community-based organizations (CBOs) reach older adults who are underserved; however, PEARLS adoption has been limited. Implementation science has tried to close this know-do gap, however a more intentional focus on equity is needed to engage CBOs. We partnered with CBOs to better understand their resources and needs in order to design more equitable dissemination and implementation (D&I) strategies to support PEARLS adoption. Methods We conducted 39 interviews with 24 current and potential adopter organizations and other partners (February-September 2020). CBOs were purposively sampled for region, type, and priority older populations experiencing poverty (communities of color, linguistically diverse, rural). Using a social marketing framework, our guide explored barriers, benefits and process for PEARLS adoption; CBO capacities and needs; PEARLS acceptability and adaptations; and preferred communication channels. During COVID-19, interviews also addressed remote PEARLS delivery and changes in priorities. We conducted thematic analysis of transcripts using the rapid framework method to describe the needs and priorities of older adults who are underserved and the CBOs that engage them, and strategies, collaborations, and adaptations to integrate depression care in these contexts. Results During COVID-19, older adults relied on CBO support for basic needs such as food and housing. Isolation and depression were also urgent issues within communities, yet stigma remained for both late-life depression and depression care. CBOs wanted EBPs with cultural flexibility, stable funding, accessible training, staff investment, and fit with staff and community needs and priorities. Findings guided new dissemination strategies to better communicate how PEARLS is appropriate for organizations that engage older adults who are underserved, and what program components are core and what are adaptable to better align with organizations and communities. New implementation strategies will support organizational capacity-building through training and technical assistance, and matchmaking for funding and clinical support. Discussion Findings support CBOs as appropriate depression care providers for older adults who are underserved, and suggest changes to communications and resources to better fit EBPs with the resources and needs of organizations and older adults. We are currently partnering with organizations in California and Washington to evaluate whether and how these D&I strategies increase equitable access to PEARLS for older adults who are underserved.
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Affiliation(s)
- Lesley E. Steinman
- Health Promotion Research Center, Department of Health Systems and Population Health, University of Washington, Seattle, WA, United States
| | - Amanda T. Parrish
- Health Promotion Research Center, Department of Health Systems and Population Health, University of Washington, Seattle, WA, United States
| | - Marlana J. Kohn
- Health Promotion Research Center, Department of Health Systems and Population Health, University of Washington, Seattle, WA, United States
| | - Sherry Wu
- Health Promotion Research Center, Department of Health Systems and Population Health, University of Washington, Seattle, WA, United States
| | - KeliAnne K. Hara-Hubbard
- Health Promotion Research Center, Department of Health Systems and Population Health, University of Washington, Seattle, WA, United States
| | - Lori Brown
- Southeast Washington Aging and Long-Term Care, Yakima, WA, United States
| | - Syed Imam
- Union for Pan Asian Communities (UPAC) Positive Solutions Program, San Diego, CA, United States
| | - Barbara Baquero
- Health Promotion Research Center, Department of Health Systems and Population Health, University of Washington, Seattle, WA, United States
| | - Peggy A. Hannon
- Health Promotion Research Center, Department of Health Systems and Population Health, University of Washington, Seattle, WA, United States
| | - Mark B. Snowden
- Health Promotion Research Center, Department of Health Systems and Population Health, University of Washington, Seattle, WA, United States
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States
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Lin S, Wu Y, He L, Fang Y. Prediction of depressive symptoms onset and long-term trajectories in home-based older adults using machine learning techniques. Aging Ment Health 2023; 27:8-17. [PMID: 35118924 DOI: 10.1080/13607863.2022.2031868] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVES Our aim was to explore the possibility of using machine learning (ML) in predicting the onset and trajectories of depressive symptom in home-based older adults over a 7-year period. METHODS Depressive symptom data (collected in the year 2011, 2013, 2015 and 2018) of home-based older Chinese (n = 2650) recruited in the China Health and Retirement Longitudinal Study (CHARLS) were included in the current analysis. The latent class growth modeling (LCGM) and growth mixture modeling (GMM) were used to classify different trajectory classes. Based on the identified trajectory patterns, three ML classification algorithms (i.e. gradient boosting decision tree, support vector machine and random forest) were evaluated with a 10-fold cross-validation procedure and a metric of the area under the receiver operating characteristic curve (AUC). RESULTS Four trajectories were identified for the depressive symptoms: no symptoms (63.9%), depressive symptoms onset {incident increasing symptoms [new-onset increasing (16.8%)], chronic symptoms [slowly decreasing (12.5%), persistent high (6.8%)]}. Among the analyzed baseline variables, the 10-item Center for Epidemiologic Studies Depression Scale (CESD-10) score, cognition, sleep time, self-reported memory were the top five important predictors across all trajectories. The mean AUCs of the three predictive models had a range from 0.661 to 0.892. CONCLUSIONS ML techniques can be robust in predicting depressive symptom onset and trajectories over a 7-year period with easily accessible sociodemographic and health information. UNLABELLED Supplemental data for this article is available online at http://dx.doi.org/10.1080/13607863.2022.2031868.
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Affiliation(s)
- Shaowu Lin
- The State Key Laboratory of Molecular Vaccine and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China.,National Institute for Data Science in Health and Medicine, Xiamen University, Xiamen, China.,Key Laboratory of Health Technology Assessment of Fujian Province, School of Public Health, Xiamen University, Xiamen, China
| | - Yafei Wu
- The State Key Laboratory of Molecular Vaccine and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China.,National Institute for Data Science in Health and Medicine, Xiamen University, Xiamen, China.,Key Laboratory of Health Technology Assessment of Fujian Province, School of Public Health, Xiamen University, Xiamen, China
| | - Lingxiao He
- The State Key Laboratory of Molecular Vaccine and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China.,Key Laboratory of Health Technology Assessment of Fujian Province, School of Public Health, Xiamen University, Xiamen, China
| | - Ya Fang
- The State Key Laboratory of Molecular Vaccine and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China.,National Institute for Data Science in Health and Medicine, Xiamen University, Xiamen, China.,Key Laboratory of Health Technology Assessment of Fujian Province, School of Public Health, Xiamen University, Xiamen, China
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40
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Cui L, Wang Y, Cao L, Wu Z, Peng D, Chen J, Yang H, Rong H, Liu T, Fang Y. Age of onset for major depressive disorder and its association with symptomatology. J Affect Disord 2023; 320:682-690. [PMID: 36183820 DOI: 10.1016/j.jad.2022.09.096] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 05/31/2022] [Accepted: 09/20/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND The age of onset (AOO) is a key factor for heterogeneity in major depressive disorder (MDD). Looking at the effect of AOO on symptomatology may improve clinical outcomes. This study aims to examine whether and how AOO affects symptomatology using a machine learning approach and latent profile analysis (LPA). METHODS The study enrolled 915 participants diagnosed with MDD from eight hospitals across China. Depressive symptoms were assessed using the 17-item Hamilton Depression Rating Scale. The relationship between symptom profiles and AOO was explored using Random Forest. The effect of AOO on symptom clusters and subtypes was investigated using multiple linear regression and LPA. A continuous AOO indicator was used to conduct the analyses. RESULTS Based on the Random Forest, symptom profiles were closely associated with AOO. The regression model showed that the severity of neurovegetative symptoms was positively associated with AOO (β = 0.18, p < 0.001), and the severity of cognitive-behavioral symptoms was negatively associated with AOO (β = -0.12, p < 0.001). LPA demonstrated that the subgroups characterized by suicide and guilt had earlier onset of depression. The subgroup with the lowest global severity of depression had the latest onset. LIMITATIONS AOO was recalled retrospectively. The relative scarcity of participants with childhood and adolescence onset depression. CONCLUSIONS AOO has an important impact on symptomatology. The findings may enhance clinical evaluations for MDD and assist clinicians in promoting earlier detection and individualized care in vulnerable individuals.
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Affiliation(s)
- Lvchun Cui
- Clinical Research Center & Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Yun Wang
- Clinical Research Center & Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Lan Cao
- Clinical Research Center & Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Zhiguo Wu
- Department of Psychiatry and Psychology, Shanghai Deji Hospital affiliated to Qingdao University, Shanghai 200331, China
| | - Daihui Peng
- Clinical Research Center & Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Jun Chen
- Clinical Research Center & Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Haichen Yang
- Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen 518020, China
| | - Han Rong
- Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen 518020, China
| | - Tiebang Liu
- Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen 518020, China
| | - Yiru Fang
- Clinical Research Center & Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China; CAS Center for Excellence in Brain Science and Intelligence Technology, Shanghai 200031, China; Shanghai Key Laboratory of Psychotic Disorders, Shanghai 201108, China.
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Lin S, Wu Y, Fang Y. A hybrid machine learning model of depression estimation in home-based older adults: a 7-year follow-up study. BMC Psychiatry 2022; 22:816. [PMID: 36544119 PMCID: PMC9768728 DOI: 10.1186/s12888-022-04439-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 11/30/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Our aim was to explore whether a two-step hybrid machine learning model has the potential to discover the onset of depression in home-based older adults. METHODS Depression data (collected in the year 2011, 2013, 2015 and 2018) of home-based older Chinese (n = 2,548) recruited in the China Health and Retirement Longitudinal Study were included in the current analysis. The long short-term memory network (LSTM) was applied to identify the risk factors of participants in 2015 utilizing the first 2 waves of data. Based on the identified predictors, three ML classification algorithms (i.e., gradient boosting decision tree, support vector machine and random forest) were evaluated with a 10-fold cross-validation procedure and a metric of the area under the receiver operating characteristic curve (AUROC) to estimate the depressive outcome. RESULTS Time-varying predictors of the depression were successfully identified by LSTM (mean squared error =0.8). The mean AUCs of the three predictive models had a range from 0.703 to 0.749. Among the prediction variables, self-reported health status, cognition, sleep time, self-reported memory and ADL (activities of daily living) disorder were the top five important variables. CONCLUSIONS A two-step hybrid model based on "LSTM+ML" framework can be robust in predicting depression over a 5-year period with easily accessible sociodemographic and health information.
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Affiliation(s)
- Shaowu Lin
- grid.12955.3a0000 0001 2264 7233The State Key Laboratory of Molecular Vaccine and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, 361102 China ,grid.12955.3a0000 0001 2264 7233National Institute for Data Science in Health and Medicine, Xiamen University, Xiamen, 361102 China ,grid.12955.3a0000 0001 2264 7233Key Laboratory of Health Technology Assessment of Fujian Province, School of Public Health, Xiamen University, Xiamen, 361102 China
| | - Yafei Wu
- grid.12955.3a0000 0001 2264 7233The State Key Laboratory of Molecular Vaccine and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, 361102 China ,grid.12955.3a0000 0001 2264 7233National Institute for Data Science in Health and Medicine, Xiamen University, Xiamen, 361102 China ,grid.12955.3a0000 0001 2264 7233Key Laboratory of Health Technology Assessment of Fujian Province, School of Public Health, Xiamen University, Xiamen, 361102 China
| | - Ya Fang
- The State Key Laboratory of Molecular Vaccine and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, 361102, China. .,National Institute for Data Science in Health and Medicine, Xiamen University, Xiamen, 361102, China. .,Key Laboratory of Health Technology Assessment of Fujian Province, School of Public Health, Xiamen University, Xiamen, 361102, China.
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Yang G, D'Arcy C. Age, period and cohort effects in depression prevalence among Canadians 65+, 1994 to 2018: A multi-level analysis. Int J Soc Psychiatry 2022:207640221141785. [PMID: 36475530 DOI: 10.1177/00207640221141785] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND The nature of the Canadian population 65+ has changed considerably over the past several decades. They comprise a larger proportion of the population, are better educated, and are wealthier than previous generations. We estimate the contributions of chronological aging, temporal periods, and birth cohort effects on the trends in the major depressive episode (MDE) prevalence among Canadian seniors from 1994/1995 to 2017/2018. METHODS Using data from two sets of national health surveys, the National Population Health Survey (NPHS) and the Canadian Community Health Survey (CCHS). Pooled data on 150,246 survey respondents aged 65+ from 16 repeated cross-sectional surveys are included. Hierarchical regression age-period-cohort models were used to visualize the linear and non-linear effects of age, period, and cohort trends in late-life depression. RESULTS We found that: the prevalence of MDE in later life fluctuated non-significantly during the study time period; the probability of developing MDE declined with increasing age from 65 to 80+ (β = -.32, p = .027). The significant quadratic birth cohort predictor showed a non-linear increasing association with the prevalence of MDE from the earlier to later-born cohorts (β = .01, p = .049). We also found that females 65+ were consistently more likely to be depressed than males 65+ (β = .47, p = .007). The significantly negative "age × female" interaction shows that age exerts a greater effect on females' probability of developing MDE than males (β = -.09, p = .011). There were no consistent significant period effects but there were peaks in prevalence around 2001, 2008, and 2012 which corresponded to some recent historical events. Our moderation analysis documents that lower levels of education significantly contributed to the higher rates of depression among cohorts born earlier in the 20th century. CONCLUSIONS Our findings show the presence of strong chronological age and cohort effects and weaker period effects on the prevalence of late-life depression in Canadian seniors.
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Affiliation(s)
- Guang Yang
- School of Public Health, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Carl D'Arcy
- School of Public Health, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.,Department of Psychiatry, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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Azizabadi Z, Aminisani N, Emamian MH. Socioeconomic inequality in depression and anxiety and its determinants in Iranian older adults. BMC Psychiatry 2022; 22:761. [PMID: 36471352 PMCID: PMC9721087 DOI: 10.1186/s12888-022-04433-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 11/28/2022] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Older adults with lower socioeconomic status are more vulnerable to stressful life events and at increased risk of common mental health disorders like anxiety and depression. This study investigates the socioeconomic inequality in depressive symptoms and anxiety. METHODS The data were from 7462 participants of the Neyshabur longitudinal study of ageing registered during 2016-2018. The outcome variables were anxiety and depressive symptoms. Anxiety was defined by the "Hospital Anxiety and Depression scale Questionnaire", and depressive symptoms was defined and measured by the "short-term form of the Epidemiological Center Questionnaire." The socioeconomic status was defined using principal component analysis of home assets. The Concentration Index (C) was used to measure socioeconomic inequality in anxiety and depressive symptoms. Concentration index was decomposed to its determinants to determine the role of the independent variables on inequality. RESULTS The prevalence of depressive symptoms and anxiety was 12.2% (95% CI: 11.4, 12.9) and 7.0% (95% CI: 6.4, 7.5), respectively. Moreover, the C for anxiety was -0.195 (95% CI: -0.254, -0.136) and for depressive symptoms was -0.206 (95% CI: -0.252, -0.159), which indicate a considerable inequality in favor of high socioeconomic group for anxiety and depressive symptoms. Decomposition of the concentration Index showed that education, unemployment and male sex were the most important positive contributors to the observed inequality in anxiety and depressive symptoms, while age and number of grandchildren were main negative contributors of this inequality. CONCLUSION Low socioeconomic groups were more affected by anxiety and depressive symptoms. Any intervention for alleviation of inequality in anxiety and depression should be focus on education and employment of people, especially in younger elderly.
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Affiliation(s)
- Zahra Azizabadi
- grid.444858.10000 0004 0384 8816Student Research Committee, School of Public Health, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Nayyereh Aminisani
- grid.502998.f0000 0004 0550 3395Healthy Ageing Research Centre, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | - Mohammad Hassan Emamian
- Ophthalmic Epidemiology Research Center, Shahroud University of Medical Sciences, Shahroud, Iran.
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Imai A, Matsuoka T, Narumoto J. Older people with severe loneliness have an atrophied thalamus, hippocampus, and entorhinal cortex. Int J Geriatr Psychiatry 2022; 37. [PMID: 36394171 DOI: 10.1002/gps.5845] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 11/04/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Loneliness has been shown to increase the risk of dementia. However, it is unclear why greater loneliness is associated with greater susceptibility to dementia. Herein, we aimed to examine the morphological characteristics of the brain associated with loneliness in older people concerned about cognitive dysfunction. METHODS In this retrospective study, 110 participants (80 with amnestic mild cognitive impairment, and 30 cognitively healthy individuals) were included. Participants were assessed using the revised University of California at Los Angeles (UCLA) loneliness scale and had undergone magnetic resonance imaging. Spearman correlation analysis and Mann-Whitney U tests were used to examine the clinical factors associated with loneliness. Multiple regression was performed to examine the relationship between the revised UCLA loneliness scale score and regional gray matter (GM) volume on voxel-based morphometry. RESULTS The revised UCLA loneliness scale scores were not significantly correlated with age, sex, or mini-mental state examination (MMSE) scores. Multiple regression using age, sex, MMSE score, and total brain volume as covariates showed negative correlations of the revised UCLA loneliness scale scores with the grey matter volume in regions centered on the bilateral thalamus, left hippocampus and left parahippocampal gyrus, and left entorhinal area. CONCLUSIONS Subjective loneliness was associated with decreased GM volume in the bilateral thalamus, left hippocampus, and left entorhinal cortex of the brain in the older people, thereby providing a morphological basis for the increased risk of dementia associated with greater loneliness.
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Affiliation(s)
- Ayu Imai
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Teruyuki Matsuoka
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Jin Narumoto
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
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Rusowicz J, Serweta A, Juszko K, Idzikowski W, Gajda R, Szczepańska-Gieracha J. Factors Associated with Undertaking Health-Promoting Activities by Older Women at High Risk of Metabolic Syndrome. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15957. [PMID: 36498030 PMCID: PMC9736211 DOI: 10.3390/ijerph192315957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/26/2022] [Accepted: 11/28/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND The complexity of health problems concerning women aged ≥60 years makes it necessary to develop effective, low-cost strategies involving biopsychosocial interventions. The aim of this study is to identify the factors associated with undertaking health-promoting activities by older women at high risk of metabolic syndrome (MetS) with or without depressive symptoms. METHODS The study group consisted of 70 older women (62-84 years old) undertaking regular physical activity. A self-developed questionnaire (used to determine the living situation, selected lifestyle components and health problems), the Perceived Stress Questionnaire (PSQ) and the Geriatric Depression Scale (GDS) were used. RESULTS In the study group undertaking regular physical activity, 40% had increased symptoms of depression (D group), and 60% were classified as non-depressed (ND group). The D group had a higher general stress level (t = -6.18, p = 0.001). Improving and/or maintaining physical fitness was identified as the greatest motivation in both groups. Willingness to spend time with other people significantly differed between the two groups (χ2 = 4.148, p = 0.042). The sole factor significantly differentiating between both groups was lack of time (χ2 = 8.777, p = 0.003). CONCLUSIONS Motivations and barriers to undertaking health-promoting activities and levels of perceived stress were significantly different between the depressed and non-depressed groups. It is important to encourage primary care physicians to perform screening tests for late-life depression and to provide information on where therapeutic interventions are available for patients with symptoms of MetS and coexisting depressive symptoms.
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Affiliation(s)
- Jagoda Rusowicz
- Department of Physiotherapy, Wroclaw University of Health and Sport Sciences, 51-612 Wroclaw, Poland
| | - Anna Serweta
- Department of Physiotherapy, Wroclaw University of Health and Sport Sciences, 51-612 Wroclaw, Poland
| | - Karolina Juszko
- Department of Physiotherapy, Wroclaw University of Health and Sport Sciences, 51-612 Wroclaw, Poland
| | - Wojciech Idzikowski
- Department of Physical Education and Sport Sciences, Wroclaw University of Health and Sport Sciences, 51-612 Wroclaw, Poland
| | - Robert Gajda
- Gajda-Med District Hospital, 06-100 Pultusk, Poland
- Department of Kinesiology and Health Prevention, Jan Dlugosz University, 42-200 Czestochowa, Poland
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Sun J, Luo Y, Ma Y, Guo C, Du Z, Gao S, Chen L, Wang Z, Li X, Xu K, Hong Y, Yu X, Xiao X, Fang J. Sex Differences of the Functional Brain Activity in Treatment-Resistant Depression: A Resting-State Functional Magnetic Resonance Study. Brain Sci 2022; 12:brainsci12121604. [PMID: 36552064 PMCID: PMC9775169 DOI: 10.3390/brainsci12121604] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 11/16/2022] [Accepted: 11/19/2022] [Indexed: 11/24/2022] Open
Abstract
The presence of different clinical symptoms in patients with treatment-resistant depression (TRD) of different sexes may be related to different neuropathological mechanisms. A total of 16 male patients with TRD, 18 female patients with TRD, 18 male healthy controls (HCs) and 19 female HCs completed this study. We used the amplitude of low frequency fluctuations (ALFF) method to analyze the results. Moreover, the correlation between abnormal brain areas and clinical symptoms in different sexes of the TRD groups was also analyzed. The effects of the sex-by-group interaction difference in ALFF among the four groups was located in the left middle frontal gyrus, left precentral gyrus and left precuneus. Post hoc comparisons revealed that the male TRD group had lower ALFF in the left middle frontal gyrus and left precentral gyrus compared with the female TRD group. There was a positive correlation between the left middle frontal gyrus, the left precuneus and the 17-item Hamilton Rating Scale for Depression scale (HAMD-17) scores, and a negative correlation between the left precentral gyrus and the HAMD-17 scores in the female TRD group. This study will provide some clinical reference value for the sex differences in neuropathological mechanisms of TRD.
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Affiliation(s)
- Jifei Sun
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China
| | - Yi Luo
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China
| | - Yue Ma
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China
| | - Chunlei Guo
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China
| | - Zhongming Du
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, China
| | - Shanshan Gao
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China
| | - Limei Chen
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China
| | - Zhi Wang
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China
| | - Xiaojiao Li
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China
| | - Ke Xu
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China
| | - Yang Hong
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China
| | - Xue Yu
- Beijing First Hospital of Integrated Chinese and Western Medicine, Beijing 100026, China
| | - Xue Xiao
- Beijing First Hospital of Integrated Chinese and Western Medicine, Beijing 100026, China
| | - Jiliang Fang
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China
- Correspondence: ; Tel.: +010-88001493
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Zheng W, Zhang XY, Xu R, Huang X, Zheng YJ, Huang XB, Li ZZ, Chen HD. Adjunctive accelerated repetitive transcranial magnetic stimulation for older patients with depression: A systematic review. Front Aging Neurosci 2022; 14:1036676. [PMID: 36353689 PMCID: PMC9637870 DOI: 10.3389/fnagi.2022.1036676] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 10/10/2022] [Indexed: 07/23/2023] Open
Abstract
OBJECTIVE We performed this systemic review to investigate the therapeutic potential and safety of adjunctive accelerated repetitive transcranial magnetic stimulation (aTMS) for older patients with depression. METHODS We included published randomized clinical trials (RCTs) and observational studies targeting adjunctive aTMS for older patients with depression. RESULTS Two open-label self-controlled studies (n = 29) fulfilled the criteria for inclusion. The included studies reported significant improvements in depressive symptoms from baseline to post-aTMS (all Ps < 0.05). One study reported a dropout rate of 10.5% (2/19). Mild headache was the most common adverse reaction. CONCLUSION The currently available evidence from two open-label self-controlled studies indicates that adjunctive aTMS is a safe and effective therapy for older patients with depression.
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Affiliation(s)
- Wei Zheng
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xin-Yang Zhang
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Rui Xu
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xiong Huang
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Ying-Jun Zheng
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xing-Bing Huang
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Ze-Zhi Li
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Huo-Di Chen
- Laboratory of Laser Sports Medicine, School of Sports Science, South China Normal University, Guangzhou, China
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McClain AC, Xiao RS, Tucker KL, Falcón LM, Mattei J. Depressive symptoms and allostatic load have a bidirectional association among Puerto Rican older adults. Psychol Med 2022; 52:3073-3085. [PMID: 33443008 PMCID: PMC8277900 DOI: 10.1017/s0033291720005139] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND Depression is strongly associated with chronic disease; yet, the direction of this relationship is poorly understood. Allostatic load (AL) provides a framework for elucidating depression-disease pathways. We aimed to investigate bidirectional, longitudinal associations of baseline depressive symptoms or AL with 5-year AL or depressive symptoms, respectively. METHODS Data were from baseline, 2-year, and 5-year visits of 620 adults (45-75 years) enrolled in the Boston Puerto Rican Health Study. The Center for Epidemiology Studies Depression (CES-D) scale (0-60) captured depressive symptoms, which were categorized at baseline as low (<8), subthreshold (8-15), or depression-likely (⩾16) symptoms. AL was calculated from 11 parameters of biological functioning, representing five physiological systems. Baseline AL scores were categorized by the number of dysregulated parameters: low (0-2), moderate (3-5), or high (⩾6) AL. Multivariable, multilevel random intercept and slope linear regression models were used to examine associations between 3-category baseline CES-D score and 5-year continuous AL score, and between baseline 3-category AL and 5-year continuous CES-D score. RESULTS Baseline subthreshold depressive symptoms [(mean (95% CI)): 4.8 (4.5-5.2)], but not depression-likely symptoms [4.5 (4.2-4.9)], was significantly associated with higher 5-year AL scores, compared to low depressive symptoms [4.3 (3.9-4.7)]. Baseline high AL [19.4 (17.6-21.2)], but not low AL [18.5 (16.5-20.6)], was significantly associated with higher 5-year CES-D score, compared to baseline moderate AL [16.9 (15.3-18.5)]. CONCLUSIONS Depressive symptoms and AL had a bi-directional relationship over time, indicating a nuanced pathway linking depression with chronic diseases among a minority population.
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Affiliation(s)
- Amanda C. McClain
- School of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA, USA
| | - Rui S. Xiao
- IQVIA, Real-World Evidence, Cambridge, MA, USA
| | - Katherine L. Tucker
- Department of Biomedical and Nutritional Sciences, University of Massachusetts, Lowell, MA, USA
| | - Luis M. Falcón
- College of Fine Arts, Humanities and Social Sciences, University of Massachusetts, Lowell, MA, USA
| | - Josiemer Mattei
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Depression/anxiety symptoms and self-reported difficulty managing medication regimen among community-dwelling older adults. Gen Hosp Psychiatry 2022; 78:50-57. [PMID: 35853418 DOI: 10.1016/j.genhosppsych.2022.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 06/17/2022] [Accepted: 07/07/2022] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To examine the associations between depression/anxiety severity and changes in severity and self-reported difficulty managing medications among a representative sample of community-residing US Medicare beneficiaries without a reported dementia diagnosis. METHOD We used the 2018 and 2019 National Health and Aging Trend Study (analysis sample N = 3198, 98% age 70+). Depression/anxiety was measured with the PHQ-4, and difficulty managing medication was self-reported. Following descriptive statistics, we fit a multinomial logistic regression model to examine the associations between depression/anxiety symptoms in 2018 and changes in severity between 2018 and 2019 and self-reported level of difficulty managing medication in 2019. RESULTS Of past-month prescription medication users in 2019, 85.2%, 10.7%, and 4.1% reported no difficulty, a little/some difficulty, and a lot of difficulty or partial/full reliance on other's help for health/functioning reasons, respectively. Both mild and moderate/severe levels of depression/anxiety in 2018 were associated with significantly higher risks of a little/some difficulty and a lot of difficulty/other's help in 2019. Compared to no change in depression/anxiety symptoms between 2018 and 2019, decreased symptoms were associated with lower risk (RRR = 0.47, 95% CI = 0.28-0.78) and increased symptoms were associated with higher risk (RRR = 1.73, 95% CI = 1.12-2.67) of a little/some difficulty managing one's medication. CONCLUSIONS Decrease and increase in depression/anxiety are associated with decreased and increased risk, respectively, of medication self-management difficulty among community-residing older adults. Healthcare providers should more carefully assess for medication management problems in their older adults with depression and anxiety symptoms and provide individually tailored interventions for those with great difficulty self-managing medication.
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Wang H, Hou Y, Zhang L, Yang M, Deng R, Yao J. Chinese elderly migrants' loneliness, anxiety and depressive symptoms: The mediation effect of perceived stress and resilience. Front Public Health 2022; 10:998532. [PMID: 36091520 PMCID: PMC9452831 DOI: 10.3389/fpubh.2022.998532] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 08/10/2022] [Indexed: 01/26/2023] Open
Abstract
Elderly migrants who face the dual challenges of aging and migration are more likely to suffer psychological disorders. Existing research has demonstrated a link between loneliness and psychological disorders in the general elderly population. However, we know little about the relationships among elderly migrants, and the psychological mechanisms linking them. This study aims to examine the effects of loneliness on anxiety and depressive symptoms among Chinese elderly migrants, and explore the mediating roles of perceived stress and resilience. All 654 participants were recruited in Nanjing, Jiangsu Province, China. Results showed that loneliness was significantly correlated with anxiety and depressive symptoms (p < 0.001). Perceived stress and resilience mediated the relationship between loneliness and anxiety symptoms. The mediating effect of perceived stress was 0.128 (Bootstrap 95% CI: 0.092-0.168, Ratio = 37.4%). Resilience was 0.026 (Bootstrap 95% CI: 0.005-0.049, Ratio = 7.6%). Furthermore, perceived stress and resilience also mediated the relationship between loneliness and depressive symptoms. The mediating effects were 0.111 and 0.043, respectively (Bootstrap 95% CI: 0.073-0.151, Ratio = 27.9%; Bootstrap 95% CI: 0.020-0.069, Ratio = 10.8%). All the mediating effects were significant because the bootstrap 95% CIs did not contain zero. Overall, our findings suggested that loneliness not only can directly influence elderly migrants' anxiety and depressive symptoms but also by increasing perceived stress or decreasing resilience.
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Affiliation(s)
- Hao Wang
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - Yanjie Hou
- School of Health Policy and Management, Nanjing Medical University, Nanjing, China
| | - Lin Zhang
- School of Health Policy and Management, Nanjing Medical University, Nanjing, China
| | - Man Yang
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - Ruyue Deng
- School of Health Policy and Management, Nanjing Medical University, Nanjing, China
| | - Jun Yao
- School of Nursing, Nanjing Medical University, Nanjing, China,School of Health Policy and Management, Nanjing Medical University, Nanjing, China,Institute of Healthy Jiangsu Development, Nanjing Medical University, Nanjing, China,*Correspondence: Jun Yao
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