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Li Y, Zhang C, Ding S, Li J, Li L, Kang Y, Dong X, Wan Z, Luo Y, Cheng AS, Xie J, Duan Y. Physical activity, smoking, alcohol consumption and depressive symptoms among young, early mature and late mature people: A cross-sectional study of 76,223 in China. J Affect Disord 2022; 299:60-66. [PMID: 34822919 DOI: 10.1016/j.jad.2021.11.054] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 10/30/2021] [Accepted: 11/18/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVES The purpose of this study was to screen for depressive symptoms in a large sample of Chinese population, and explore the effects of demographic and lifestyle factors on depressive symptoms based on the brain maturity. METHOD Adults from 8 health management centers in 6 provinces completed an online health self-report questionnaire. Finally, a total of 76,223 valid questionnaires were collected. RESULT A total of 76,223 participants were included in this study, including 44,167 (57.9%) males and 32,056 (42.1%) females. The percentage of clinically relevant depressive symptoms among young, early mature and late mature participants was 13.5%, 18.5% and 27.3%, respectively. Among young participants, being female was a risk factor for depressive symptoms, while having a bachelor's or graduate degree, being married, smoking, and moderate alcohol consumption were protective factors. And among early mature participants, female, married and other marital status, BMI of 24-27.9 were risk factors, post-graduate education or above, smoking, moderate alcohol consumption and meeting exercise standard were protective factors. Among late mature participants, Compared with junior high school, all other degrees were protective factors, as was meeting physical activity standards, excessive alcohol consumption was a risk factor. CONCLUSION This study analyzed the association among young, early mature and late mature participants respectively, and proposed strategies for improving healthy lifestyle of Chinese people. Our findings support the need for individualized recommendations to improve mental health based on brain maturity.
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Affiliation(s)
- Ying Li
- Institution: Health Management Center, The Third Xiangya Hospital of Central South University, China
| | - Chun Zhang
- Institution: Xiangya Nursing School, Central South University, Changsha, China
| | - Siqing Ding
- Institution: The Third Xiangya Hospital of Central South University, China
| | - Jie Li
- Institution: Xiangya Nursing School, Central South University, Changsha, China.
| | - Lijun Li
- Institution: Xiangya Nursing School, Central South University, Changsha, China
| | - Yue Kang
- Institution: Xiangya Nursing School, Central South University, Changsha, China
| | - Xiaoqian Dong
- Institution: Xiangya Nursing School, Central South University, Changsha, China
| | - Ziyu Wan
- Institution: Xiangya Nursing School, Central South University, Changsha, China
| | - Yating Luo
- Institution: Xiangya Nursing School, Central South University, Changsha, China
| | - Andy Sk Cheng
- Institution: The Hong Kong Polytechnic University, Department of Rehabilitation Sciences, Hong Kong, China
| | - Jianfei Xie
- Institution: Health Management Center, Nursing department, The Third Xiangya Hospital of Central South University, China.
| | - Yinglong Duan
- Institution: The Third Xiangya Hospital of Central South University, China.
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Cui L, Ding D, Chen J, Wang M, He F, Yu S. Factors affecting the evolution of Chinese elderly depression: a cross-sectional study. BMC Geriatr 2022; 22:109. [PMID: 35135473 PMCID: PMC8822727 DOI: 10.1186/s12877-021-02675-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Accepted: 11/25/2021] [Indexed: 11/28/2022] Open
Abstract
Background In the past decades, China’s rapid economic growth has been accompanied by rapid changes in lifestyle and an increasing prevalence of mental disorders. This study explored the changes and factors associated with depression among the elderly population of China from 2011 to 2018. Method Data were obtained from the China Health and Retirement Longitudinal Study. The total sample size consists of 21,484 individuals aged ≥60 years, and the sample sizes in 2011, 2013, 2015 and 2018 were 5081, 4853, 5207, 6343, respectively. Depressive symptoms were measured by the 10-item Short-Form developed by the Center for Epidemiological Studies Depression. Result We found that the tendency in depression rate of the Chinese elderly from 2011 (36.8%) to 2018 (44.5%). The results showed poor health (OR = 3.553), ADL damage (OR = 2.010), multiple chronic diseases (OR = 1.287), and western (OR = 1.777) are risk factors for depression. Conclusion The rate of depression of the elderly people in China has risen dramatically. Therefore, additional steps to prevent, treat and care for the affected population are needed, Mental health prevention and treatment strategies should be incorporated into China’s public health policies in a timely manner to mitigate the serious economic burden caused by the increase of depression.
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Affiliation(s)
- Longyan Cui
- College of Public Health, Dalian Medical University, Dalian, 116044, China
| | - Ding Ding
- College of Public Health, Dalian Medical University, Dalian, 116044, China.
| | - Junfeng Chen
- College of Public Health, Dalian Medical University, Dalian, 116044, China.
| | - Minghui Wang
- College of Public Health, Dalian Medical University, Dalian, 116044, China
| | - Fanrong He
- College of Public Health, Dalian Medical University, Dalian, 116044, China
| | - Shiyang Yu
- Dalian Municipal Center of Disease prevention and control, Dalian, 116044, China
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Gao J, Hu H, He H. Household indebtedness and depressive symptoms among older adults in China: The moderating role of social network and anticipated support. J Affect Disord 2022; 298:173-181. [PMID: 34737018 DOI: 10.1016/j.jad.2021.10.133] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 10/27/2021] [Accepted: 10/29/2021] [Indexed: 11/15/2022]
Abstract
BACKGROUND Examine the association of household financial indebtedness with depressive symptoms in old age, and investigate whether social network and support anticipation moderate the association. METHODS Data were obtained from Sample Survey on Vulnerable Populations from Poor Families in Urban/Rural China (2018), with a sample of 5 934 older adults included. Center for Epidemiologic Studies Depression Scales was applied to measure depressive symptoms. Household indebtedness was measured in several ways, including whether the household was indebted, the amount of debts, and types of debts. We used the 6-item Lubben Social Network Scale to measure individual's social network. Socio-demographic, socioeconomic status and physical health variables were included as covariates. RESULTS Household indebtedness, in form of being indebted and increased amount of debts, was associated with greater depressive symptoms in the Chinese elderly. The association of indebtedness and depressive symptoms may be driven by consumption and emergency debts. The moderating roles of social network and anticipation of support in the association of household indebtedness and depressive symptoms were found. Among those with household debts, older adults with larger size of social network and/or higher anticipation of being supported in the future reported with less symptoms of depressed. LIMITATIONS Due to a lack of information on the duration and debtor of household debt, we were not able to present a precise estimate for the exact impact of household indebtedness on mental health of elderly. CONCLUSION Familial financial strain was associated with aging mental well-being, increased social networks and social protections benefit aging health.
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Affiliation(s)
- Jiamin Gao
- School of Social Development and Public Policy, Beijing Normal University, No. 19 Xinjiekouwai St. Haidian District, Beijing 100875, PR China
| | - Hongwei Hu
- School of Public Administration and Policy, Renmin University of China, No. 59, Zhongguancun Street, Haidian District, Beijing 100872, PR China.
| | - Haotian He
- School of Public Administration and Policy, Renmin University of China, No. 59, Zhongguancun Street, Haidian District, Beijing 100872, PR China
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Effect of vortioxetine in subjects with major depressive and alcohol use disorders: a 6-month retrospective analysis. CNS Spectr 2022; 27:73-81. [PMID: 32772956 DOI: 10.1017/s109285292000173x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Major depressive disorder (MDD) and alcohol use disorder (AUD) are highly comorbid, with greater clinical complexity and psychosocial impairment. Several antidepressants have been used in this population, with mixed results. This preliminary study aims to investigate the effects of the multimodal antidepressant vortioxetine in MDD + AUD subjects. METHODS We retrospectively evaluated 57 MDD + AUD and 56 MDD outpatients, matched for baseline characteristics. Patients were assessed after 1, 3, and 6 months treatment with vortioxetine (10-20 mg/d, flexibly dosed) in combination with continuous psychosocial support. The primary outcome was improvement in depressive symptoms measured by the Montgomery-Åsberg Depression Rating Scale. We also investigated changes in anxiety, anhedonia, cognition, functioning, quality of life, and clinical global severity using the following instruments: Hamilton Anxiety Rating Scale, Snaith-Hamilton Pleasure Scale, Digit Symbol Substitution Test, Perceived Deficits Questionnaire-Depression, Functioning Assessment Short Test, Quality of Life Index, and Clinical Global Impression-Severity Scale. RESULTS Vortioxetine significantly improved mood in MDD + AUD patients (P < .001), with no differences when compared to MDD (P = .36). A substantial rate (45.6%) of comorbid subjects obtained clinical remission at endpoint (P = .36 vs MDD). We additionally observed baseline to endpoint improvements on all secondary outcomes (P < .001), with no significant difference between groups. Overall, vortioxetine was safe and well tolerated. CONCLUSIONS Given its effectiveness on mood, cognition, and functioning, its good safety and tolerability profile, and low potential for abuse, vortioxetine could represent a valid pharmacological intervention in MDD + AUD patients as part of an integrated therapeutic-rehabilitation program.
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Yang L, Wang H, Cheng J. Association between social capital and sleep duration among rural older adults in China. BMC Public Health 2022; 22:12. [PMID: 34986811 PMCID: PMC8734274 DOI: 10.1186/s12889-021-12441-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 12/17/2021] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE Sleep disturbances are great challenges to older adults' health promotion. The study tested gender differences in the association between different dimensions of social capital and self-reported sleep duration of Chinese rural older adults. DESIGN The data of rural older adults were extracted from a national cross-sectional survey of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) and analyzed in this study. SETTING CLHLS covered 23 provinces in China. PARTICIPANTS The 6552 rural respondents aged ≥65 years old were involved. MAIN OUTCOME MEASURES Generalized trust, informal social participation, formal social participation and social support were used to assess social capital. Self-reported sleep duration was measured as health outcome. RESULTS Low level of generalized trust had harmful effect on insufficient sleep (AOR 1.110, 95% CI 1.018-1.324), and having no formal or informal social participation was significantly positively associated with long sleep (AORformal 1.424, 95% CI 1.007-2.013; AORinformal 1.241, 95% CI 1.016-1.516). Rural older female adults with no emotional social support had higher odds of insufficient sleep (AOR 1.502, 95% CI 1.258-1.978). Meanwhile, both informal and formal social participation showed inverse association with long sleep for females. CONCLUSIONS This study found the relationship between social capital, sleep duration and the gender differences in Chinese rural older adults. More targeted sleep disturbance interventions could be taken in social capital of rural older adults, and gender differences should be considered when making social capital-embedded health promotion policies and interventions.
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Affiliation(s)
- Le Yang
- School of Management, Shanxi Medical University, 56 Xinjian South Road, Taiyuan, Shanxi Province, China.
| | - Hongman Wang
- School of Health Humanities, Peking University, 38 Xueyuan Road, Haidian, Beijing, China
| | - Jingmin Cheng
- School of Management, Shanxi Medical University, 56 Xinjian South Road, Taiyuan, Shanxi Province, China
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Ye B, Xie R, Mishra SR, Dai X, Chen H, Chen X, Li D, Yuan C, Xu X. Bidirectional association between physical multimorbidity and subclinical depression in Chinese older adults: Findings from a prospective cohort study. J Affect Disord 2022; 296:169-174. [PMID: 34601304 DOI: 10.1016/j.jad.2021.09.067] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 09/08/2021] [Accepted: 09/21/2021] [Indexed: 01/28/2023]
Abstract
BACKGROUND Both physical multimorbidity and subclinical depression pose a significant threat to aging population worldwide. The association between these conditions appeared to be in a bidirectional way, however the joint causal relationship yet to be fully understood in elderly Chinese population. METHODS A total of 4605 Chinese elders from the China Health and Retirement Longitudinal Study (CHARLS, 2011-2015) were included for the present study. Physical multimorbidity was defined as having two or more self-reported chronic physical conditions. Subclinical depression was defined by ≥ 12 scores assessed using the 10-item Centre for Epidemiological Studies Depression Scale. The bidirectional association between physical multimorbidity and subclinical depression was examined using multivariable logistic regression models, adjusting for covariates. RESULTS During study period, 23.99% of participant reported incident episode of subclinical depression and 21.36% reported physical multimorbidity. In fully adjusted model, those with physical multimorbidity were two times more likely to have subclinical depression (OR = 2.05, 95% CI: 1.71-2.46). Besides that, subclinical depression was associated with physical multimorbidity (OR = 1.84, 95% CI: 1.50-2.46), but in slightly less magnitude. Furthermore, the bidirectional association remains statistically significant across different subgroups. LIMITATIONS Chronic conditions were all self-reported and we couldn't adjust for all confounders, which may be subject to measurement error. CONCLUSIONS Physical multimorbidity and subclinical depression was associated in a bidirectional way in elderly Chinese population, which highlights the necessary of covering a broad spectrum of aspects of clinical management among adults with physical multimorbidity or subclinical depression.
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Affiliation(s)
- Bingqi Ye
- The Second Affiliated Hospital and School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310058, China
| | - Renxiang Xie
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310058, China
| | - Shiva Raj Mishra
- Academy for Data Science and Global Health, Bharatpur, Chitwan, Nepal; School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Xiaochen Dai
- Department of Health Metrics Science, School of Medicine, University of Washington, Seattle, USA
| | - Hui Chen
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310058, China
| | - Xiao Chen
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310058, China
| | - Duanhui Li
- The Second Affiliated Hospital and School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310058, China
| | - Changzheng Yuan
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310058, China; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, USA.
| | - Xiaolin Xu
- The Second Affiliated Hospital and School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310058, China; School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Australia.
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Zhang W, Cao G, Sun Y, Wu F, Wang Q, Xu T, Hu H, Xu K. Depressive symptoms in individuals diagnosed with lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH) in middle-aged and older Chinese individuals: Results from the China Health and Retirement Longitudinal Study. J Affect Disord 2022; 296:660-666. [PMID: 34565588 DOI: 10.1016/j.jad.2021.09.045] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 09/11/2021] [Accepted: 09/14/2021] [Indexed: 12/31/2022]
Abstract
OBJECTIVES Male lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH) is common and may increase the risk of depressive symptoms. This study aimed to investigate the associated factors of LUTS/BPH and its association with depressive symptoms in middle-aged and older Chinese men. METHODS This study used data from the 2015 China Health and Retirement Longitudinal Study (CHARLS). A total number of 8,586 men aged ≥45 years were included in this study. Participants answered positively to whether they have ever been diagnosed with a prostate illness (excluding prostatic cancer) were defined as LUTS/BPH individuals. Depressive symptoms were assessed using the 10-item Center for Epidemiological Studies Depression Scale (CESD-10). Multivariate logistic analyses were applied to explore the associated factors of LUTS/BPH, association between LUTS/BPH and depressive symptoms, and risk factors of depressive symptoms according to LUTS/BPH status. RESULTS The weighted overall prevalence of LUTS/BPH was 13.1% in Chinese men aged ≥45 years. The prevalence of depressive symptoms was 29.1% in LUTS/BPH individuals and 22.9% in non-LUTS/BPH individuals. Depressive symptoms and LUTS/BPH shared some same risk factors, which were education, living regions, annual household consumption, sleep duration and multimorbidity. The results from logistic models showed that education, sleep duration and multimorbidity were significantly and independently associated with depression of LUTS/BPH individuals (P<0.001). CONCLUSIONS Prevalence of depressive symptoms in LUTS/BPH population was higher than in non-LUTS/BPH population. Education, sleep duration and multimorbidity were associated with the onset of depressive symptoms in LUTS/BPH individuals (P<0.001).
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Affiliation(s)
- Weiyu Zhang
- Department of Urology, Peking University People's Hospital, 100044 Beijing, China
| | - Guiying Cao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, 100191 Beijing, China; Medical Informatics Center, Peking University, 100191 Beijing, China
| | - Yiran Sun
- Department of Urology, Peking University People's Hospital, 100044 Beijing, China
| | - Feng Wu
- Institute for Disease Control and Prevention, Chinese PLA, 100071 Beijing, China
| | - Qi Wang
- Department of Urology, Peking University People's Hospital, 100044 Beijing, China
| | - Tao Xu
- Department of Urology, Peking University People's Hospital, 100044 Beijing, China
| | - Hao Hu
- Department of Urology, Peking University People's Hospital, 100044 Beijing, China.
| | - Kexin Xu
- Department of Urology, Peking University People's Hospital, 100044 Beijing, China.
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Liu Y, Li L, Miao G, Yang X, Wu Y, Xu Y, Gao Y, Zhan Y, Zhong Y, Yang S. Relationship between Children's Intergenerational Emotional Support and Subjective Well-Being among Middle-Aged and Elderly People in China: The Mediation Role of the Sense of Social Fairness. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:389. [PMID: 35010647 PMCID: PMC8751110 DOI: 10.3390/ijerph19010389] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 12/25/2021] [Accepted: 12/26/2021] [Indexed: 11/16/2022]
Abstract
This study explored the relations between children's intergenerational emotional support and subjective well-being (SWB) among Chinese middle-aged (45-60 years old) and elderly people (over 60 years old) and the mediation effect of the sense of social fairness between such associations. Using the 2017 Chinese General Social Survey dataset, a nationally representative survey, we selected 2413 middle-aged and elderly people who are 45 years and older, who suited the study requirements with 1097 males and 1316 females, which accounts for 45.5% and 54.5%, respectively. The average of age was 61.62 years old (SD = 10.45). The mediation analyses were conducted by multivariate regression and the SPSS macro PROCESS program. The results indicated that there was a significant association between children's intergenerational emotional support and subjective well-being of middle-aged and elderly people (β = 0.0819, p < 0.001). Children's intergenerational emotional support also had an indirect impact on subjective well-being through one path: the mediating role of the sense of social fairness (0.012). Direct effect (0.0699) and mediation effect (0.012) accounting for the total effect proportion was 85.35% and 14.65%, respectively. The findings may offer some meaningful implications for improving subjective well-being of middle-aged and elderly people. Future research should pay attention to the aforementioned factors with more detailed and comprehensive studies.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Shujuan Yang
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun 130021, China; (Y.L.); (L.L.); (G.M.); (X.Y.); (Y.W.); (Y.X.); (Y.G.); (Y.Z.); (Y.Z.)
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Han L, Shen S, Wu Y, Zhong C, Zheng X. Trajectories of depressive symptoms and risk of cardiovascular disease: Evidence from the China Health and Retirement Longitudinal Study. J Psychiatr Res 2021; 145:137-143. [PMID: 34922097 DOI: 10.1016/j.jpsychires.2021.12.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 11/23/2021] [Accepted: 12/10/2021] [Indexed: 12/27/2022]
Abstract
BACKGROUND Previous studies have reported that depression is associated with higher risk of cardiovascular disease (CVD). However, the association between long-term depressive symptom patterns and the risk of CVD was not well characterized. METHODS A total of 8621 participants with three Center for Epidemiological Studies Depression Scale (CES-D) measurements from the China Health and Retirement Longitudinal Study were included. Trajectories of depressive symptoms were identified by latent mixture modeling. Cox proportional hazards regression models were used to examine the association of depressive symptom trajectories with CVD (stroke or cardiac events), and accounting for mortality as a competing risk for CVD. RESULTS We identified four distinct depressive symptoms trajectories, characterized by maintaining low CES-D score throughout the follow-up (no depressive symptoms; 5642 participants [65.44%]); high starting CES-D scores but then decreasing scores (decreasing depressive symptoms; 1329 participants [14.91%]); low starting CES-D scores then increasing scores (increasing depressive symptoms; 1154 participants [13.39%]) and maintained high CES-D scores throughout the follow-up (persistent depressive symptoms; 496 participants [6.26%]). During the follow-up period, 853 CVD events (including 362 strokes and 535 cardiac events) were recorded. Compared to participants in the no depressive symptom trajectory, those in the increasing depressive symptoms and persistent depressive symptom trajectories had an increased risk of CVD, with multiple-adjusted hazard ratios (95% confidence intervals) of 1.53 (1.28-1.82) and 1.68 (1.34-2.12), respectively. Individuals with increasing and persistent depressive symptoms trajectories also had higher risks of stroke and cardiac events. CONCLUSIONS Individuals with increasing and persistent depressive symptom over time were associated with increased risk of incident CVD.
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Affiliation(s)
- Longyang Han
- Public Health Research Center and Department of Public Health and Preventive Medicine, Wuxi School of Medicine Jiangnan University, Wuxi, Jiangsu, 214122, China
| | - Suwen Shen
- Wuxi Municipal Center for Disease Control and Prevention, Wuxi, Jiangsu, 214023, China
| | - Yu Wu
- Public Health Research Center and Department of Public Health and Preventive Medicine, Wuxi School of Medicine Jiangnan University, Wuxi, Jiangsu, 214122, China
| | - Chongke Zhong
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, Jiangsu, 215000, China.
| | - Xiaowei Zheng
- Public Health Research Center and Department of Public Health and Preventive Medicine, Wuxi School of Medicine Jiangnan University, Wuxi, Jiangsu, 214122, China.
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Zhao D, Zhou Z, Shen C, Ibrahim S, Zhao Y, Cao D, Lai S. Gender differences in depressive symptoms of rural Chinese grandparents caring for grandchildren. BMC Public Health 2021; 21:1838. [PMID: 34635088 PMCID: PMC8507248 DOI: 10.1186/s12889-021-11886-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 09/29/2021] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Caring for grandchildren is regarded as one of the principle roles of middle- and old-aged adults, especially among rural Chinese grandparents. This study aims to examine the gender differences in depressive symptoms of rural Chinese grandparents caring for grandchildren, based on the gender differences in grandparental role engagement and the theories of role strain and role enhancement. METHODS A total of 4833 rural citizens with one or more grandchildren were selected from the China Health and Retirement Longitudinal Study (CHARLS) conducted in 2015. Grandchild care was measured by continuous variable (duration) and categorical variable (no care, low intensity, moderate intensity, high intensity). Depressive symptoms were assessed by the Center for Epidemiologic Studies Depression Scale (CES-D). We used coarsened exact matching (CEM) to balance the covariates of caregivers and non-caregivers. Following CEM, 1975 non-caregivers and 2212 caregivers were identified (N = 4187). Multilevel linear regression was employed to examine the gender differences in depressive symptoms. We also tested for the moderating role of gender on the association between grandchild care and depressive symptoms. RESULTS Grandmothers were more likely to provide grandchild care (54.42% vs 51.43%) at high intensity (61.46% vs 51.01%), with longer duration (39.24 h vs 33.15 h) than that given by grandfathers. Grandmothers suffered more from depressive symptoms than grandfathers, and such gap increased when grandparents were involved in high-intensity care. Grandmothers providing grandchild care, particularly at moderate intensity, were associated with fewer depressive symptoms (Coef. = - 0.087, 95%CI: - 0.163, - 0.010; Coef. = - 0.291, 95%CI: - 0.435, - 0.147), compared with non-caregivers. Grandmothers giving moderate intensity of grandchild care were also associated with fewer depressive symptoms (Coef. = - 0.171, 95% CI: - 0.313, - 0.029), compared with those with low-intensity care. However, such associations were not significant among grandfathers. CONCLUSIONS Our findings highlight the gender differences in depressive symptoms of rural Chinese grandparents caring for grandchildren. Grandparents should be encouraged to engage in grandchild care, but at moderate intensity. The health status of middle- and old-aged adults, particularly females, should be monitored closely. Humanistic care, preventive care and curative treatment strategies focusing on such populations should be developed and refined.
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Affiliation(s)
- Dantong Zhao
- School of Public Policy and Administration, Xi'an Jiaotong University, No. 28 Xianning West Road, Xi'an, 710049, Shaanxi, China
| | - Zhongliang Zhou
- School of Public Policy and Administration, Xi'an Jiaotong University, No. 28 Xianning West Road, Xi'an, 710049, Shaanxi, China.
| | - Chi Shen
- School of Public Policy and Administration, Xi'an Jiaotong University, No. 28 Xianning West Road, Xi'an, 710049, Shaanxi, China
| | - Sahardid Ibrahim
- School of Public Policy and Administration, Xi'an Jiaotong University, No. 28 Xianning West Road, Xi'an, 710049, Shaanxi, China
| | - Yaxin Zhao
- School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Dan Cao
- School of Public Policy and Administration, Xi'an Jiaotong University, No. 28 Xianning West Road, Xi'an, 710049, Shaanxi, China
| | - Sha Lai
- School of Public Policy and Administration, Xi'an Jiaotong University, No. 28 Xianning West Road, Xi'an, 710049, Shaanxi, China
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Li C, Zhou Y, Ding L. Effects of long-term household air pollution exposure from solid fuel use on depression: Evidence from national longitudinal surveys from 2011 to 2018. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2021; 283:117350. [PMID: 34034020 DOI: 10.1016/j.envpol.2021.117350] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 05/07/2021] [Accepted: 05/08/2021] [Indexed: 06/12/2023]
Abstract
Evidence of the effects of long-term household air pollution (HAP) on human mental health is limited. This study aimed to explore the longitudinal relationship between long-term household air pollution exposure from solid fuel use and depression based on nationally representative follow-up dataset. A total of 7005 middle- and old-age adults from the latest four waves (2011, 2013, 2015, and 2018) of China Health and Retirement Longitudinal Study (CHARLS) were involved. The Center for Epidemiologic Studies Depression scale (CES-D 10) was used to measure depressive symptoms and individuals who got more than 12 points were considered to have depression symptoms. We conducted Cox proportional hazards regression models to examine the association between household air pollution and depression in overall population, and subgroup stratified by socio-demographic factors, lifestyle behaviors, chronic diseases, and residential environments. We found long-term household air pollution exposure from solid fuel use was significantly associated with higher depression risk among Chinese older adults (HR 1.27, 95% CI 1.14-1.42 in heating; 1.26, 1.13-1.40 in cooking). Longer duration of household air pollution exposure (1.47, 1.28-1.68 in heating; 1.36, 1.19-1.56 in cooking) and household air pollution from crop residue/wood burning (1.66, 1.41-1.94 in heating; 1.37, 1.23-1.53 in cooking) was correlated with higher depression risk. For subgroups analysis, the effect of household air pollution from solid fuel on depression varied. Compared with those who using clean fuel, older adults living in small size houses or houses with small number rooms had increasing depression risks if they used solid fuel for heating or cooking. Our findings indicate long-term household air pollution exposure from solid fuel use is associated with higher depression risk. Reducing household air pollution by restricting solid fuel use can be effective ways to prevent depression for Chinese older adults and decrease related public health burden.
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Affiliation(s)
- Chenshuang Li
- Center for Smart and Healthy Buildings, Huazhong Univ. of Science and Technology, Wuhan, Hubei, 430074, China
| | - Ying Zhou
- Center for Smart and Healthy Buildings, Huazhong Univ. of Science and Technology, Wuhan, Hubei, 430074, China.
| | - Lieyun Ding
- Center for Smart and Healthy Buildings, Huazhong Univ. of Science and Technology, Wuhan, Hubei, 430074, China
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Feng Z, Li Q, Zhou L, Chen Z, Yin W. The relationship between depressive symptoms and activity of daily living disability among the elderly: results from the China Health and Retirement Longitudinal Study (CHARLS). Public Health 2021; 198:75-81. [PMID: 34365109 DOI: 10.1016/j.puhe.2021.06.023] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 02/25/2021] [Accepted: 06/22/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The acceleration of population aging has brought an unprecedented impact on China's health system. This study is designed to examine the association between depressive symptoms and activity of daily living disability among the elderly in China. STUDY DESIGN This is a cross-sectional study. METHODS Data were drawn from the China Health and Retirement Longitudinal Study (CHARLS). The 10-item Center for Epidemiologic Studies-Depression (CES-D) scale was used to access depressive symptoms, and physical function was assessed by the Activity of Daily Living (ADL) scale. Multivariate logistic regression was used to assess the association between depressive symptoms and ADL among the elderly. RESULTS Based on a sample of 5863 elderly people over 60 years old, our results showed that 1999 elderly people are with depressive symptoms, accounting for 34.1%. The mean score of ADL among the elderly with depressive symptoms (20.65 ± 7.14) was much higher than that in those without depressive symptoms (17.40 ± 4.87). After controlling potential confounders, multivariate logistic regression showed that ADL and its specific domains including personal care, transfer, medical care, household, and managing money were associated with depressive symptoms. CONCLUSION This cross-sectional study provides evidence of the association between depressive symptoms and ADL disability among the Chinese elderly. As a result, prevention or reduction of ADL disability may have a positive effect on the medical care of the elderly with depressive symptoms.
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Affiliation(s)
- Z Feng
- School of Public Health, Weifang Medical University, Shandong, China; "Health Shandong" Severe Social Risk Prevention and Management Synergy Innovation Center, China
| | - Q Li
- "Health Shandong" Severe Social Risk Prevention and Management Synergy Innovation Center, China; School of Management, Weifang Medical University, Shandong, China
| | - L Zhou
- "Health Shandong" Severe Social Risk Prevention and Management Synergy Innovation Center, China; School of Management, Weifang Medical University, Shandong, China
| | - Z Chen
- "Health Shandong" Severe Social Risk Prevention and Management Synergy Innovation Center, China; School of Management, Weifang Medical University, Shandong, China
| | - W Yin
- "Health Shandong" Severe Social Risk Prevention and Management Synergy Innovation Center, China; School of Management, Weifang Medical University, Shandong, China.
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Fan VS, Mahadevan R, Leung J. Effect of income inequality, community infrastructure and individual stressors on adult depression. Health Promot Int 2021; 36:46-57. [PMID: 32277828 DOI: 10.1093/heapro/daaa036] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
This paper considers the impact of variables at three different levels-city, community and individual-on the depression of adults aged 45 years and above in China. Evidence shows that community factors, such as infrastructure and elderly centres, are critical to reduce depression but the effect of city-level factors such as lowering income inequality and improving public health investment is different for the segments of poor and non-poor as well as the rural and urban residents. This highlights the need to consider targeted policy mix options to avoid resource misallocation. Lastly, Chinese females' depression has worsened over time with ageing, particularly those who drink alcohol or are less educated are prone to depression prompting the need for specialist women health centres.
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Affiliation(s)
- Vanessa Sha Fan
- China Institute of Innovation and Development, Beijing Normal University, Zhuhai Campus, Guangdong 519087, P.R. China
| | - Renuka Mahadevan
- School of Economics, The University of Queensland, Brisbane, Queensland 4072, Australia
| | - Janni Leung
- School of Psychology, The University of Queensland, Brisbane, Queensland 4072, Australia & National Drug and Alcohol Research Center, University of New South Wales, Sydney, New South Wales 2052, Australia
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Liu S, Qiao Y, Wu Y, Shen Y, Ke C. The longitudinal relation between depressive symptoms and change in self-rated health: A nationwide cohort study. J Psychiatr Res 2021; 136:217-223. [PMID: 33618063 DOI: 10.1016/j.jpsychires.2021.02.039] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 02/04/2021] [Accepted: 02/12/2021] [Indexed: 10/22/2022]
Abstract
OBJECTIVE This study aimed to prospectively assess the relationship between depressive symptoms and change in self-rated health (SRH) in middle-aged and elderly Chinese adults. METHODS We used data from the China Health and Retirement Longitudinal Study (CHARLS). The final analysis included 8169 participants (≥45 years old) and a multinomial logistic regression model was used to assess the association between baseline depression and follow-up change in SRH. RESULTS Taking no change in SRH as the reference, depressive symptoms at baseline were positively associated with a 2-year decline in SRH (OR: 1.38, 95% CI: 1.15-1.65) and negatively associated with a 2-year improvement in SRH (OR: 0.74, 95% CI: 0.63-0.85). Over a 4-year period, the OR (95% CI) values increased to 1.41 (1.19-1.67) and decreased to 0.69 (0.59-0.80) for decline and improvement in SRH, respectively. In stratified analyses, the association between depression and 2- or 4-year decline/improvement in SRH persisted in all sex and age subgroups. CONCLUSIONS Baseline depression is an independent predictor of change in SRH among Chinese people aged 45 and above. Early monitoring and management of depressive symptoms may be worthwhile to maintain and improve SRH in the middle-aged and elderly population.
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Affiliation(s)
- Siyuan Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou, 215123, China
| | - Yanan Qiao
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou, 215123, China
| | - Ying Wu
- Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, 510515, China
| | - Yueping Shen
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou, 215123, China.
| | - Chaofu Ke
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou, 215123, China.
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Okubo R, Tabuchi T. Smoking and drinking among patients with mental disorders: Evidence from a nationally representative Japanese survey. J Affect Disord 2021; 279:443-450. [PMID: 33120245 DOI: 10.1016/j.jad.2020.10.037] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 09/24/2020] [Accepted: 10/15/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND No studies to date have addressed the association of mental disorder with smoking and drinking behaviors independent of anxiety and depressive symptoms. We therefore examined this association, stratified by age and sex, to determine the target population for behavioral modification in Japan. METHODS We analyzed data from participants aged 20-79 years without hospitalized or institutionalized status who participated in the nationwide Comprehensive Survey of Living Conditions conducted in 2016. Prevalence ratios (PRs) for current smoking, heavy daily smoking (>20 cigarettes per day), at-risk drinking (>100 g alcohol per week), and heavy drinking (>350 g) were calculated with adjustment for potential confounders. After stratification by age (20-39, 40-64, and 65-79 years) and sex, prevalence and PRs were calculated using propensity scores. RESULTS From among 340,194 participants, 8275 (2.4%) had mental disorder. Presence of mental disorder was significantly associated with current smoking (PR=1.18, 95%CI=1.12-1.23) and heavy daily smoking (PR=1.35, 95%CI=1.21-1.50) and inversely associated with at-risk drinking (PR=0.70, 95%CI=0.66-0.75). PRs for smoking behavior were higher in women than in men and in younger adults than in the other age groups. They were particularly high in younger women (PR=1.67 for current smokers and PR=2.17 for heavy daily smokers). LIMITATIONS Our findings were obtained from a cross-sectional study. CONCLUSION This is the first evidence that the association of mental disorder with smoking behavior is independent of anxiety and depressive symptoms. Our results indicate the need for tailored behavioral modification interventions for young people with mental disorders in Japan, particularly young women.
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Affiliation(s)
- Ryo Okubo
- Department of Clinical Epidemiology, Translational Medical Center, National Center of Neurology and Psychiatry, Tokyo, Japan.
| | - Takahiro Tabuchi
- Cancer Control Center, Osaka International Cancer Institute, Osaka 541-8567, Japan
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Bedaso TS, Han B. Work after retirement affects elderly mental health and behaviors in Addis Ababa. Health Psychol Open 2021; 8:2055102921996189. [PMID: 33717495 PMCID: PMC7917865 DOI: 10.1177/2055102921996189] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
This study aimed to determine the impact of being without a job post-retirement on mental health (depression, life satisfaction) and behaviors (alcohol and cigarette). A cross-sectional study was conducted on 330 Ethiopians aged 60-69. Compared to workers, retirees without a job reported higher depression, lower life satisfaction, and hazardous drinking (d = .49, .39 and φ = .65, respectively). Hierarchical multiple regression analyses indicated that being without a job post-retirement was associated with depression and life dissatisfaction. Thus, greater emphasis has to be given to improve the mental health and behaviors of retired elderly.
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Affiliation(s)
- Teshome Sirak Bedaso
- Key Lab of Mental Health (Institute of Psychology),
Chinese Academy of Sciences, China
| | - Buxin Han
- Key Lab of Mental Health (Institute of Psychology),
Chinese Academy of Sciences, China
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Zhang Q, Cao GY, Yao SS, Wang C, Chen ZS, Hu YH, Xu B. Self-reported vision impairment, vision correction, and depressive symptoms among middle-aged and older Chinese: Findings from the China health and retirement longitudinal study. Int J Geriatr Psychiatry 2021; 36:86-95. [PMID: 32783270 DOI: 10.1002/gps.5398] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 05/17/2020] [Accepted: 07/30/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To investigate associations between vision impairment (VI), vision correction (VC) and depressive symptoms among middle-aged and older Chinese. METHODS 22 203 participants aged ≥45 years from China Health and Retirement Longitudinal Study 2011 to 2015 were divided into four self-reported VI categories: no VI, distance VI (DVI) only, near VI (NVI) only, and both distance and near VI (DNVI); and four self-reported VI/VC subgroups: VI(+)/VC(-), VI(+)/VC(+), VI(-)/VC(-) and VI(-)/VC(+). Depressive symptoms were evaluated by 10-item Center for Epidemiological Studies Depression Scale (CESD-10). RESULTS Compared with no VI, DVI only (OR = 2.12, 95% CI: 1.95, 2.31), NVI only (OR = 1.51, 95% CI: 1.39, 1.63) and DNVI (OR = 2.75, 95% CI: 2.47, 3.07) were associated with higher odds of depressive symptoms. Compared with VI(+)/VC(-), VI(+)/VC(+) (OR = 0.91, 95% CI: 0.83, 0.98), VI (-)/VC(-) (OR = 0.50, 95% CI: 0.48, 0.53) and VI(-)/VC(+) (OR = 0.49, 95% CI: 0.47, 0.54) were associated with lower odds of depressive symptoms. Compared with no VI at baseline, baseline DNVI was significantly associated with higher odds of depressive symptoms after two (OR = 1.48, 95% CI: 1.16, 1.88) and four (OR = 1.32, 95% CI: 1.04, 1.68) years. Baseline depressive symptoms were significantly associated with higher odds of VI after two (OR = 1.53, 95% CI: 1.34, 1.74) and four (OR = 1.54, 95% CI: 1.34, 1.76) years. CONCLUSION Adults with DNVI were more likely to report depressive symptoms in the future and those with depressive symptoms were more likely to report VI in the future. VC might be a protective factor for preventing depressive symptoms among adults with VI.
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Affiliation(s)
- Qin Zhang
- Department of Ophthalmology, Peking University People's Hospital, Beijing, China.,Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing, China.,Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China.,College of Optometry, Peking University Health science center, Beijing, China
| | - Gui-Ying Cao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.,Medical Informatics Center, Peking University, Beijing, China
| | - Shan-Shan Yao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.,Medical Informatics Center, Peking University, Beijing, China
| | - Chunxiu Wang
- Department of Evidence-based Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Zi-Shuo Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.,Medical Informatics Center, Peking University, Beijing, China
| | - Yong-Hua Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.,Medical Informatics Center, Peking University, Beijing, China
| | - Beibei Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.,Medical Informatics Center, Peking University, Beijing, China
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Garey L, Olofsson H, Garza T, Rogers AH, Kauffman BY, Zvolensky MJ. Directional Effects of Anxiety and Depressive Disorders with Substance Use: a Review of Recent Prospective Research. CURRENT ADDICTION REPORTS 2020. [DOI: 10.1007/s40429-020-00321-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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69
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Combined effect of high depressive symptom burden and hypertension on new-onset stroke: evidence from a nationwide prospective cohort study. J Hypertens 2020; 39:70-76. [PMID: 32740408 DOI: 10.1097/hjh.0000000000002599] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVE The aim of this study was to investigate whether the combination of high depressive symptom burden and hypertension increased the risk of stroke among the middle-aged and elderly Chinese using a nationwide prospective study. METHODS Data from the China Health and Retirement Longitudinal Study (CHARLS) during 2011-2015 were used. A total of 12 604 Chinese participants aged 45 years and older were included for final analysis. Multivariate Cox proportional hazards regression model was used to explore the associations between high depressive symptom burden, hypertension and new-onset stroke. RESULTS There were 244 stroke events occurred during a 4-year follow-up. Compared with those without high depressive symptom burden and hypertension, the adjusted hazard ratios (95% confidence intervals) were 1.96 (1.13-3.42) for individuals with high depressive symptom burden alone, 2.84 (1.77-4.57) for individuals with hypertension alone and 4.38 (2.66-7.20) for individuals with comorbid high depressive symptom burden and hypertension, respectively. In the subgroup analyses, people with the coexistence of high depressive symptom burden and hypertension had the highest risk of new-onset stroke in all subgroups. CONCLUSION Our results suggest a combined effect of high depressive symptom burden and hypertension on stroke risk among the middle-aged and elderly Chinese.
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Yang L, Weng X, Subramanian SV. Associations between older adults' parental bereavement and their health and well-being: Evidence from the China health and retirement longitudinal study. J Affect Disord 2020; 272:207-214. [PMID: 32553360 DOI: 10.1016/j.jad.2020.03.136] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 02/11/2020] [Accepted: 03/29/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVES Few studies have investigated the association between losing a child and parental health and wellbeing, especially among older Chinese bereaved parents. This study examined depressive symptoms, life satisfaction, and self-rated health of older Chinese bereaved parents to estimate the health and well-being of this group. METHODS This research used data from the 2015 China Health and Retirement Longitudinal Study (CHARLS). A total number of 11,507 participants age 45 and older were enrolled in the analysis, including 1,758 bereaved adults who had experienced a child's death and 9,749 non-bereaved counterparts. Multivariate linear and logistic regression models were used to examine the effect of bereavement and its interaction effect by sex and age. RESULTS Multivariate analyses revealed that the death of a child is associated with an increasing likelihood of experiencing depressive symptoms (adjusted OR = 1.425, p < 0.001), and a reduced probability of a high level of life satisfaction (adjusted OR = 0.725, p < 0.05), whereas experiencing a child's death is not significantly associated with self-reported health status. The effects of bereavement on health and well-being were found to have a much greater impact among participants who were males (compared to females) and who aged<60 years (compared to those ≥60 years). DISCUSSION Future longitudinal prospective research is expected to examine the causal relationship and explore the attributes of child death and its effects on parental health. Interventions to improve the health and well-being of the older bereaved population are warranted, particularly for those who are male and under 60 years of age.
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Affiliation(s)
- Lei Yang
- Department of Social Work, The Chinese University of Hong Kong, Hong Kong
| | - Xue Weng
- School of Nursing, University of Hong Kong, Hong Kong
| | - S V Subramanian
- Harvard Center for Population and Development Studies, Cambridge, MA 02138, USA; Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
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Li J, Wang H, Li M, Shen Q, Li X, Zhang Y, Peng J, Rong X, Peng Y. Effect of alcohol use disorders and alcohol intake on the risk of subsequent depressive symptoms: a systematic review and meta-analysis of cohort studies. Addiction 2020; 115:1224-1243. [PMID: 31837230 DOI: 10.1111/add.14935] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 09/23/2019] [Accepted: 12/10/2019] [Indexed: 01/01/2023]
Abstract
BACKGROUND AND AIMS Alcohol use disorders (AUD) are often comorbid with depressive symptoms. Cohort studies on the association between AUD and subsequent depressive symptoms have produced inconsistent results. Moreover, regarding alcohol intake, the risk of developing depressive symptoms might vary with alcohol intake level. We aimed to investigate the association between AUD, alcohol intake and subsequent depressive symptoms. DESIGN AND SETTING We conducted a systematic search in PubMed, Embase and PsycINFO for cohort studies on the association between AUD or alcohol intake and subsequent depressive symptoms. PARTICIPANTS We included 338 426 participants from 42 studies. Six and four studies analyzed only females and males, respectively. MEASUREMENTS We combined risk estimates for developing depressive symptoms using a random-effects model. We divided alcohol intake into abstinence, light (0-84 g/week), moderate (85-168 g/week) and heavy drinking (> 168 g/week or > 48 g/day at least weekly). We conducted a categorical analysis to compare the risk of depressive symptoms between abstinence and different intake categories. Further, we conducted a dose-response analysis to investigate the alcohol-depression association. FINDINGS We analyzed 42 studies (follow-up time: 1-40 years). AUD was associated with significantly increased risk of subsequent depressive symptoms [relative risk (RR) = 1.57, 95% confidence interval (CI) = 1.41-1.76]. Regarding alcohol intake, heavy drinking had an increased risk of depressive symptoms; however, the association was only significant when controls were limited to non-heavy drinkers (RR = 1.13, 95% CI = 1.05-1.22). Taking into consideration the possibility of publication bias and confounding factors made the association non-significant. We observed J-shaped associations in both categorical and dose-response analyses where light-moderate drinking had a significantly decreased risk of depression, while heavy drinking did not show a significant association with depressive symptoms compared with non-drinkers. CONCLUSION Alcohol use disorders are associated with increased the risk of subsequent depressive symptoms. Heavy drinking does not significantly predict occurrence of depressive symptoms after adjusting for potential confounders.
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Affiliation(s)
- Jiande Li
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, China
| | - Hongxuan Wang
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, China
| | - Mei Li
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, China
| | - Qingyu Shen
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, China
| | - Xiangpen Li
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, China
| | - Yuanpei Zhang
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, China
| | - Jialing Peng
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, China
| | - Xiaoming Rong
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, China
| | - Ying Peng
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, China.,Guangdong Provincial Key Laboratory of Malignant Tumour Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, China
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Determinants of smoking behavior of older women (Ethnic Kaili) in Palu city. ENFERMERIA CLINICA 2020. [DOI: 10.1016/j.enfcli.2019.10.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Jang BN, Lee HJ, Joo JH, Park EC, Jang SI. Association between health behaviours and depression: findings from a national cross-sectional study in South Korea. BMC Psychiatry 2020; 20:238. [PMID: 32408865 PMCID: PMC7227033 DOI: 10.1186/s12888-020-02628-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 04/27/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Depression is a leading cause of disability, and it has been reported that more than 264 million people worldwide have depression. The causes of depression may be numerous, and physical health has also been linked to depression. Therefore, the aim of this study was to determine the effect of health behaviours on depression. METHODS This study used the data of 224,868 participants from the Community Health Survey, conducted in 2017. We defined health behaviours by combining three variables: no smoking, not belonging to high-risk drinking group, and walking frequently. Depression was measured using the Patient Health Questionnaire-9. Logistic regression was used to examine the association between health behaviours and depression. RESULTS Both men and women who did not practise health behaviours were more likely to experience depressive symptoms than those who did (men, odds ratio (OR): 1.48, 95% confidence interval (CI): 1.31-1.68; women, OR: 1.42, 95% CI: 1.32-1.53). Not walking frequently had the strongest association with depression in men and the risk of depression was the highest in women who smoked. Participants who did not practise any health behaviours were the most likely to have depressive symptoms (men, OR: 1.69, 95% CI: 1.38-2.07; women, OR: 3.08, 95% CI: 2.27-4.19). CONCLUSION Our study found that lack of health behaviours is significantly associated with depression. Furthermore, the most influential factor of health behaviours in depression was different for men and women. It is necessary to manage depression through interventional methods customised to gender characteristics. Additionally, national-level policies are needed to encourage steps to improve personal lifestyles, including practising health behaviours.
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Affiliation(s)
- Bich Na Jang
- grid.15444.300000 0004 0470 5454Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea ,grid.15444.300000 0004 0470 5454Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Hyeon Ji Lee
- grid.15444.300000 0004 0470 5454Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea ,grid.15444.300000 0004 0470 5454Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Jae Hong Joo
- grid.15444.300000 0004 0470 5454Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea ,grid.15444.300000 0004 0470 5454Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Eun-Cheol Park
- grid.15444.300000 0004 0470 5454Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea ,grid.15444.300000 0004 0470 5454Department of Preventive Medicine and Institute of Health Services Research, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722 South Korea
| | - Sung-In Jang
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea. .,Department of Preventive Medicine and Institute of Health Services Research, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea.
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Im PK, Millwood IY, Chen Y, Guo Y, Du H, Kartsonaki C, Bian Z, Tan Y, Su J, Li Y, Yu C, Lv J, Li L, Yang L, Chen Z. Problem drinking, wellbeing and mortality risk in Chinese men: findings from the China Kadoorie Biobank. Addiction 2020; 115:850-862. [PMID: 31692116 PMCID: PMC7156287 DOI: 10.1111/add.14873] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 09/10/2019] [Accepted: 10/23/2019] [Indexed: 11/30/2022]
Abstract
AIMS To assess the associations of problem drinking with wellbeing and mortality in Chinese men. DESIGN Population-based prospective cohort study. SETTING Ten diverse areas across China. PARTICIPANTS A total of 210 259 men aged 30-79 years enrolled into China Kadoorie Biobank between 2004 and 2008. MEASUREMENTS Self-reported alcohol intake and indicators of problem drinking (i.e. drinking in the morning, unable to stop drinking, unable to work due to drinking, negative emotions after drinking, having shakes after stopping drinking) were assessed by questionnaire at baseline, along with stressful life events (e.g. divorce, income loss, violence) and wellbeing-related measures (e.g. life satisfaction, sleep problems, depression, anxiety). Problem drinking was defined as reporting at least one of the drinking problem indicators. Follow-up for mortality and hospitalized events was through linkage to death registries and national health insurance systems. Multivariate logistic regression models assessed cross-sectional relationships between problem drinking and stressful life events/wellbeing. Cox proportional hazards regression models estimated prospective associations of problem drinking with mortality/hospitalized events. FINDINGS A third of men were current regular drinkers (i.e. drank alcohol at least weekly), 24% of whom reported problem drinking: 8% of all men. Experience of stressful life events in the past 2 years, especially income loss [odds ratio (OR) = 1.86, 95% confidence interval (CI) = 1.45-2.39], was associated with increased problem drinking. Compared with low-risk drinkers (i.e. intake < 200 g/week, no reported problem drinking or habitual heavy drinking episodes), men with problem drinking had poorer self-reported health, poorer life satisfaction and sleep problems, and were more likely to have symptoms of depression and anxiety. Men with two or more problem drinking indicators had an approximately twofold higher risk for all-cause mortality as well as mortality and morbidity from external causes (i.e. injuries), respectively, and 15% higher risk for any hospitalization, compared with low-risk drinkers (all P < 0.01). CONCLUSION Eight per cent of men in China are problem drinkers, and this is associated with significantly increased risk of physical and mental health problems and premature death.
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Affiliation(s)
- Pek Kei Im
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population HealthUniversity of OxfordOxfordUK
| | - Iona Y. Millwood
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population HealthUniversity of OxfordOxfordUK
- Medical Research Council Population Health Research Unit (MRC PHRU), Nuffield Department of Population HealthUniversity of OxfordOxfordUK
| | - Yiping Chen
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population HealthUniversity of OxfordOxfordUK
- Medical Research Council Population Health Research Unit (MRC PHRU), Nuffield Department of Population HealthUniversity of OxfordOxfordUK
| | - Yu Guo
- Chinese Academy of Medical SciencesBeijingChina
| | - Huaidong Du
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population HealthUniversity of OxfordOxfordUK
- Medical Research Council Population Health Research Unit (MRC PHRU), Nuffield Department of Population HealthUniversity of OxfordOxfordUK
| | - Christiana Kartsonaki
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population HealthUniversity of OxfordOxfordUK
- Medical Research Council Population Health Research Unit (MRC PHRU), Nuffield Department of Population HealthUniversity of OxfordOxfordUK
| | - Zheng Bian
- Chinese Academy of Medical SciencesBeijingChina
| | - Yunlong Tan
- Chinese Academy of Medical SciencesBeijingChina
| | | | | | - Canqing Yu
- Department of Epidemiology and Biostatistics, School of Public HealthPeking UniversityBeijingChina
| | - Jun Lv
- Department of Epidemiology and Biostatistics, School of Public HealthPeking UniversityBeijingChina
| | - Liming Li
- Department of Epidemiology and Biostatistics, School of Public HealthPeking UniversityBeijingChina
| | - Ling Yang
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population HealthUniversity of OxfordOxfordUK
- Medical Research Council Population Health Research Unit (MRC PHRU), Nuffield Department of Population HealthUniversity of OxfordOxfordUK
| | - Zhengming Chen
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population HealthUniversity of OxfordOxfordUK
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Decomposing Inequality in Long-Term Care Need Among Older Adults with Chronic Diseases in China: A Life Course Perspective. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17072559. [PMID: 32276486 PMCID: PMC7177914 DOI: 10.3390/ijerph17072559] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 04/03/2020] [Accepted: 04/04/2020] [Indexed: 12/29/2022]
Abstract
Background: China has the largest number of aging people in need of long-term care, among whom 70% have chronic diseases. For policy planners, it is necessary to understand the different levels of needs of long-term care and provide long-term care insurance to ensure the long-term care needs of all people can be met. Methods: This study combines the 2013 wave of CHARLS survey and the Life Course Survey of 2014. The combination allows us to factor in both childhood and adulthood data to provide life-course analysis. We identified 7,734 older adults with chronic diseases for analysis. The need for long-term care is defined by the presence of functional limitations based on the performance of basic activities of daily living (ADLs) and of instrumental activities of daily living (IADLs). Two dummy variables, ADLs disability and IADLs disability, and two count variables, ADLs score and IADLs score, were defined to measure incidence and severity of long-term care need, respectively. The concentration index was used to capture the inequality in long-term care need, and a decomposition method based on Probit Regression and Negative Binomial Regression was exploited to identify the contribution of each determination. Results: At least a little difficulty was reported in ADLs and IADLs in 20.44% and 19.25% of respondents, respectively. The concentration index of ADLs disability, ADLs score, IADLs disability, IADLs score were −0.085, −0.109, −0.095 and −0.120, respectively, all of which were statistically significant, indicating the pro-poor inequality in the incidence and severity of long-term care need. Decomposition analyses revealed that family income, education attainment, aging, and childhood experience played a significant role in explaining the inequalities. Conclusions: The long-term care need among older adults with chronic disease is high in China and low socioeconomic groups had a higher probability of needing long-term care or need more long-term care. It is urgent to implement long-term care insurance, especially for the individuals from lower socioeconomic groups.
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76
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Suchy-Dicey A, Verney SP, Nelson LA, Barbosa-Leiker C, Howard BA, Crane PK, Buchwald DS. Depression Symptoms and Cognitive Test Performance in Older American Indians: The Strong Heart Study. J Am Geriatr Soc 2020; 68:1739-1747. [PMID: 32250446 DOI: 10.1111/jgs.16434] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 02/25/2020] [Accepted: 03/04/2020] [Indexed: 01/24/2023]
Abstract
BACKGROUND American Indians have excess risk of depression, which can contribute to cerebrovascular and cognitive disability, with effects on memory, processing speed, executive function, and visuospatial ability. However, studies examining depression and cognition in American Indians are limited; this study aims to report associations of depression with general cognition, verbal fluency and memory, and processing speed. DESIGN Cohort study. SETTING The Cerebrovascular Disease and its Consequences in American Indians study was an ancillary examination of Strong Heart Study participants from 3 U.S. regions. PARTICIPANTS All eligible were included in this analysis (N=818). MEASUREMENTS Participants completed evaluations for depressive symptomology, cognition, and physical function-including Center for Epidemiologic Studies Depression (CESD), Modified Mini-Mental State Examination (3MSE), Wechsler Adult Intelligence Scale-Fourth Edition coding (WAIS), Controlled Oral Word Association (COWA), California Verbal and Learning Test, Halstead finger tapping, grip strength, and Short Physical Performance Battery (SPPB) tests. Linear mixed models were adjusted for site, age, sex, education, income, marital status, alcohol, smoking, diabetes, hypertension, obesity, cholesterol, stroke, infarct, and hemorrhage. RESULTS Symptoms of depression were common, with 20% (N=138) endorsing CES-D scores of 16+. More depressive symptoms were associated with older age, female sex, lower education, lower income, non-married status, not using alcohol, not smoking, hypertension, diabetes, and stroke. In adjusted analyses, processing speed (WAIS: β -0.13, 95%CI -0.25, -0.03), general cognition (3MSE: β -0.10, 95%CI -0.17, -0.03), verbal fluency (COWA: β -0.10, 95%CI -0.19, -0.01), and motor function (SPPB: β -0.05, 95%CI -0.07, -0.03) were significantly associated with more symptoms of depression. CONCLUSION These findings maybe informative for health disparities populations, especially those with depressive risk. Clinicians may require particular training in cultural humility. Future studies should validate use of the CES-D scale in this population; longitudinal studies may focus on causal mechanisms and potential secondary prevention, such as social support. J Am Geriatr Soc 68:1739-1747, 2020.
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Affiliation(s)
- Astrid Suchy-Dicey
- Elson S Floyd College of Medicine, Washington State University, Seattle, Washington, USA.,Institute for Education and Research to Advance Community Health, Washington State University, Seattle, Washington, USA
| | - Steven P Verney
- Psychology Clinical Neuroscience Center, University of New Mexico, Albuquerque, New Mexico, USA
| | - Lonnie A Nelson
- Institute for Education and Research to Advance Community Health, Washington State University, Seattle, Washington, USA.,College of Nursing, Washington State University, Seattle, Washington, USA
| | | | | | - Paul K Crane
- School of Medicine, University of Washington, Seattle, Washington, USA
| | - Dedra S Buchwald
- Elson S Floyd College of Medicine, Washington State University, Seattle, Washington, USA.,Institute for Education and Research to Advance Community Health, Washington State University, Seattle, Washington, USA
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77
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Luo X, Ke X, Li H, Dai Q, Zhang C, Zheng W, Fang Z, Wu F, Ning Y. Prevalence and risk factors for depression in outpatient departments of three general hospitals in China: a cross-sectional study. Int J Psychiatry Clin Pract 2020; 24:88-95. [PMID: 31718347 DOI: 10.1080/13651501.2019.1687723] [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: 10/25/2022]
Abstract
Objectives: To determine the prevalence and risk factors associated with depression of outpatients in three general hospitals in southern China.Methods: This hospital-based, cross-sectional descriptive study was conducted in outpatient departments of Neurology, Gastroenterology, Cardiology and Gynaecology of three general hospitals between March and June 2016. A total of 5294 adult respondents (≥18 years) in clinic waiting rooms were recruited, and 4976 were eligible to participate in the study. The nine-item Patient Health Questionnare-9 (PHQ-9) Scale was used to assess the presence of depressive symptoms. Binary logistic regression analysis was performed to identify the risk factors associated with depressive symptoms.Results: The prevalence of depressive symptoms among outpatients was 26.0% (95% CI: 24.8-27.3%). Risk factors associated with depressive symptoms included younger age (OR = 0.960; 95% CI: 0.95-0.971), social alcohol drinking (OR = 1.339; 95% CI: 1.074-1.668) and sleep disturbance (OR = 3.678; 95% CI: 3.025-4.471).Conclusions: This study provides evidence that depressive symptoms are prevalent among outpatients of general hospitals. Moreover, younger age, alcohol consumption and sleep disturbance may potentially be useful for targeted screening and prevention for outpatients with depression seen in general hospitals.KeypointsThe prevalence of self-reported depressive symptoms is common in outpatients in clinical settings.Younger age, current alcohol drinking and sleep disturbance are the associated risk factors for depression in outpatient population.Alcohol prevention and sleep quality improvement need to be incorporated into strategies aimed at the prevention and management of depression.
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Affiliation(s)
- Xinni Luo
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, China.,Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - Xiaoyin Ke
- Shenzhen Mental Health Center, Shenzhen, China
| | - Haiyan Li
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Qing Dai
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Chanjuan Zhang
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Wei Zheng
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Ziyan Fang
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Fengchun Wu
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Yuping Ning
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, China.,Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
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78
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Prospective associations between depressive symptoms and cognitive functions in middle-aged and elderly Chinese adults. J Affect Disord 2020; 263:692-697. [PMID: 31744738 DOI: 10.1016/j.jad.2019.11.048] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 10/14/2019] [Accepted: 11/10/2019] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To examine prospective associations of clinically relevant depressive symptoms with cognitive functions and rates of cognitive decline among Chinese adults aged 45 years and older. METHODS Data was from the China Health and Retirement Longitudinal Study (CHARLS) with a follow-up of 4 years. Based on the Chinese version of 10-item Center for Epidemiologic Studies Depression Scale (CESD-10), clinically relevant depressive symptoms were defined with a CESD-10 score≥10 points. Cognitive functions were measured in three domains: episodic memory, mental status and global cognition. Linear mixed models were used to assess the associations between clinically relevant depressive symptoms and cognitive functions. RESULTS A total of 7335 participants (50.10% men; mean age: 57.47) were included in analyses. Participants with clinically relevant depressive symptoms showed poorer episodic memory (β=-0.35; 95% CI:-0.41, -0.29), mental status (β=-0.48; 95% CI: -0.57, -0.39), and global cognition (β=-0.82; 95% CI: -0.94, -0.70) during the follow-up. Compared with counterparts, rates of decline in episodic memory, mental status, and global cognition increased by 0.04 (β=0.04; 95% CI: 0.02, 0.06), 0.06 (β=0.06; 95% CI: 0.02, 0.09) and 0.11 (β=0.11; 95% CI: 0.06, 0.15) units per year in participants with clinically relevant depressive symptoms. LIMITATIONS A major limitation is that clinically relevant depressive symptoms were assessed by a screening tool and the follow-up was short. CONCLUSION More severe clinically relevant depressive symptoms were associated with poorer cognitive functions and moderately faster cognitive decline in episodic memory, mental status and global cognition in middle-aged and elderly Chinese adults.
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79
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Liu Y, Chen X, Yan Z. Depression in the house: The effects of household air pollution from solid fuel use among the middle-aged and older population in China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 703:134706. [PMID: 31731156 PMCID: PMC9420076 DOI: 10.1016/j.scitotenv.2019.134706] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 08/22/2019] [Accepted: 09/27/2019] [Indexed: 05/23/2023]
Abstract
BACKGROUND Although the adverse health effects of ambient air pollution are well documented, evidence on the depression effects of household air pollution (HAP) are scarce. OBJECTIVES We investigated the effects of HAP exposure from the use of solid fuel on depression using a nationally representative dataset of middle-aged and older population in China. METHODS By employing the propensity score matching method, we first matched the type of household fuel based on background information, including demographic characteristics, lifestyles, health status, and household economic levels. Based on the matched data, we conducted OLS and logistic regressions with cluster standard error at community level to examine the effects of household solid fuel use on depression and adjusted for potential confounders. Heterogeneous effects for vulnerable population were also considered. RESULTS We found a significantly higher Center for Epidemiologic Studies Depression Scale (CES-D) score and depression risk among current household solid fuel users. After matching and adjusting for potential confounders, current solid fuel users had a higher CES-D score of 0.59 (95% confidence interval [CI]: 0.31, 0.89) than clean fuel users. The OR of depression risk were 1.26 (95% CI: 1.14, 1.41). Solid fuel users had the highest CES-D scores (β = 0.99, 95% CI: 0.62, 1.36) and depression risk (OR = 1.49, 95% CI: 1.30, 1.73) for over five years. These associations were generally higher in females, participants aged 65 years and older, with a BMI ≥ 25, with low education, with low household economic levels, and those suffer from chronic diseases, including diabetes, chronic lung diseases, and cardiovascular diseases. CONCLUSIONS Exposure to HAP from solid fuel combustion was linked with strong depression outcomes. Findings suggested a need to strengthen public health efforts, such as controlling the social, health, and economic costs of depression by taking the physical environment, including HAP exposure, into account.
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Affiliation(s)
- Yan Liu
- School of Management and Economics, Beijing Institute of Technology, Beijing, China; Department of Health Policy and Management, Yale School of Public Health, New Haven, CT, United States
| | - Xi Chen
- Department of Health Policy and Management, Yale School of Public Health, New Haven, CT, United States; Department of Economics, Yale University, New Haven, CT, United States
| | - Zhijun Yan
- School of Management and Economics, Beijing Institute of Technology, Beijing, China; Sustainable Development Research Institute for Economy and Society of Beijing, Beijing, China.
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80
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Jing R, Xu T, Rong H, Lai X, Fang H. Longitudinal Association Between Sleep Duration and Depressive Symptoms in Chinese Elderly. Nat Sci Sleep 2020; 12:737-747. [PMID: 33117009 PMCID: PMC7569072 DOI: 10.2147/nss.s269992] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 09/14/2020] [Indexed: 11/24/2022] Open
Abstract
AIM This study aimed to evaluate the longitudinal association between sleep duration and depressive symptoms among the elderly in China. METHODS A data set from China Health and Retirement Longitudinal Study (CHARLS) in 2011, 2013 and 2015 was adopted with a total of 22,847 respondents aged ≥60-years-old. A linear regression analysis with generalized estimating equations was employed to examine the longitudinal associations between duration of total sleep, nighttime sleep and daytime nap, and depressive symptoms. RESULTS An extra hour of total sleep including nighttime sleep and daytime nap was associated with lower incidence of depressive symptoms among the elderly after adjusting all confounders (OR=0.83, 95% CI: 0.82-0.84). In addition, an extra hour of nighttime sleep (OR=0.82, 95% CI: 0.80-0.83) or daytime nap (OR=0.93, 95% CI: 0.89-0.97) was also negatively associated with depressive symptoms among the elderly. After controlling the total sleep time, an extra hour of nighttime sleep was negatively associated with depressive symptoms (OR=0.88, 95% CI: 0.84 to 0.92), while an extra hour of daytime nap displayed a positive association with depressive symptoms (OR=0.88, 95% CI: 0.84 to 0.92). Compared with the moderate nappers, only extended nappers had significantly higher incidence of depressive symptoms (OR=1.32, 95% CI: 1.19 to 1.45). CONCLUSION For the elderly in China, increasing their total sleep, nighttime sleep, and/or daytime nap duration would reduce the incidence of depressive symptoms. Moreover, after fixing the total sleep time, increasing nighttime sleep was more beneficial to the decrease of the incidence of depressive symptoms than daytime nap.
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Affiliation(s)
- Rize Jing
- School of Public Health, Peking University, Beijing 100083, People's Republic of China.,China Center for Health Development Studies, Peking University, Beijing 100083, People's Republic of China
| | - Tingting Xu
- School of Public Health, Peking University, Beijing 100083, People's Republic of China.,Department of Social and Behavioral Science, Harvard TH Chan School of Public Health, Harvard University, Boston, Massachusetts 02115, USA
| | - Hongguo Rong
- China Center for Health Development Studies, Peking University, Beijing 100083, People's Republic of China
| | - Xiaozhen Lai
- School of Public Health, Peking University, Beijing 100083, People's Republic of China
| | - Hai Fang
- China Center for Health Development Studies, Peking University, Beijing 100083, People's Republic of China.,Peking University Health Science Center- Chinese Center for Disease Control and Prevention Joint Center for Vaccine Economics, Peking University, Beijing 100083, People's Republic of China.,Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Peking University, Beijing 10083, People's Republic of China
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81
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Feng Z, Cramm JM, Nieboer AP. A healthy diet and physical activity are important to promote healthy ageing among older Chinese people. J Int Med Res 2019; 47:6061-6081. [PMID: 31709866 PMCID: PMC7045665 DOI: 10.1177/0300060519882590] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 09/24/2019] [Indexed: 11/17/2022] Open
Abstract
Objective To examine the associations between multiple health behaviours and health outcomes among older Chinese adults. Methods Data from the World Health Organization’s Study on global AGEing and adult health Wave 1 (2007–2010), collected among the older Chinese population, were included in this study. Smoking, diet, and physical activity were analysed by linear regression for any associations with depressive symptoms, quality of life (QoL), cognitive function, and physical function. Results A total of 13 367 participants aged >49 years were included in the analyses. After controlling for key socioeconomic factors, healthy diet was significantly associated with higher QoL (β = 0.099) and better cognitive function (β = 0.023). Physical activity was significantly associated with fewer depressive symptoms (β = –0.020), higher QoL (β = 0.086), better cognitive function (β = 0.072), and better physical function (β = –0.155 [higher scores = poorer physical function]). No relationship was found between smoking and any health-related outcome included in this study. Conclusion This study demonstrates the importance of healthy diet and physical activity for health outcomes in the older Chinese population.
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Affiliation(s)
- Zeyun Feng
- Department of Socio-Medical Sciences, Erasmus School of Health
Policy & Management, Erasmus University Rotterdam, Rotterdam, The
Netherlands
- Department of Health Technology Assessment, Shanghai Health
Development Research Centre (Shanghai Medical Information Centre), Shanghai,
China
| | - Jane Murray Cramm
- Department of Socio-Medical Sciences, Erasmus School of Health
Policy & Management, Erasmus University Rotterdam, Rotterdam, The
Netherlands
| | - Anna Petra Nieboer
- Department of Socio-Medical Sciences, Erasmus School of Health
Policy & Management, Erasmus University Rotterdam, Rotterdam, The
Netherlands
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82
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Chen W. Does More Sleep Time Improve Memory? Evidence for the Middle-Aged and Elderly. AMERICAN JOURNAL OF HEALTH EDUCATION 2019. [DOI: 10.1080/19325037.2019.1662859] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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83
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Zhao F, Pan A, Yang X, Meng R, Ye Y, Wang Y, Xie Y, Pan XF, Yang CX. Bidirectional association between depressive symptoms and type 2 diabetes mellitus: The China Health and Retirement Longitudinal Study. J Diabetes Complications 2019; 33:107387. [PMID: 31331733 DOI: 10.1016/j.jdiacomp.2019.05.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 05/22/2019] [Accepted: 05/23/2019] [Indexed: 02/08/2023]
Abstract
OBJECTIVE To prospectively examine the bidirectional relationship between depressive symptoms and type 2 diabetes mellitus (T2DM) among middle-aged and elderly Chinese. METHODS Participants were enrolled in 2011-2012 (Wave 1) and followed up in 2013-2014 (Wave 2) and 2015-2016 (Wave 3) in the China Health and Retirement Longitudinal Study. Depressive symptoms were evaluated by the Chinese language version of 10-item Center for Epidemiological Studies Depression Scale (CESD-10) at three waves. T2DM was assessed by biochemical biomarkers at Wave 1 and reported physician-diagnosis at Wave 2 and 3. Cox proportional hazards regression was applied to calculate hazard ratio (HR) and 95% confidence intervals (CIs) for the bidirectional association. RESULTS Participants with baseline depressive symptoms were 1.33 times as likely to develop T2DM (HR, 1.33; 95% CI: 1.06, 1.66), compared to their counterparts after adjusting for demographic characteristics and T2DM risk factors. The risk of T2DM increased linearly with higher severity of depression as determined by a higher CESD-10 score (P for trend ≪ 0.001). In addition, baseline T2DM was associated with increased risk of incident depressive symptoms (1.15; 1.00, 1.31) and persistent depressive symptoms (1.35; 1.03, 1.77). CONCLUSION There is a positive bidirectional association between depressive symptoms and T2DM in middle-aged and elderly Chinese.
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Affiliation(s)
- Fei Zhao
- West China School of Public Health and West China Fourth Hospital, Sichuan University, China
| | - An Pan
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health and State Key Laboratory of Environmental Health (incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xue Yang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, China
| | - Ruiwei Meng
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health and State Key Laboratory of Environmental Health (incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yi Ye
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health and State Key Laboratory of Environmental Health (incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yi Wang
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health and State Key Laboratory of Environmental Health (incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yue Xie
- West China School of Public Health and West China Fourth Hospital, Sichuan University, China
| | - Xiong-Fei Pan
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health and State Key Laboratory of Environmental Health (incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China; The George Institute for Global Health, University of New South Wales, Sydney, Australia.
| | - Chun-Xia Yang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, China.
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84
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Wen Y, Liu C, Liao J, Yin Y, Wu D. Incidence and risk factors of depressive symptoms in 4 years of follow-up among mid-aged and elderly community-dwelling Chinese adults: findings from the China Health and Retirement Longitudinal Study. BMJ Open 2019; 9:e029529. [PMID: 31501114 PMCID: PMC6738713 DOI: 10.1136/bmjopen-2019-029529] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVES The purpose of this study was to examine the incidence of depressive symptoms, and determine if baseline risk factors conferred a risk for incident depressive symptoms in nationally representative sample of mid-aged and elderly Chinese adults. DESIGN This study was a secondary analysis of a prospective cohort from a nationally representative sample. SETTING Community samples were recruited from the baseline survey of the China Health and Retirement Longitudinal Study. A four-stage, stratified, cluster probability sampling strategy was used, which included 10 257 households with members aged 45 years or older and their spouse. PARTICIPANTS A total of 11 533 participants free of depressive symptoms at baseline were identified, and 10 288 were re-examined in either the first and/or the second follow-up surveys. The current analysis was conducted among the 10 288 participants. PRIMARY AND SECONDARY OUTCOME MEASURES Depressive symptoms were measured by the Center for Epidemiological Studies Depression Scale short form. RESULTS The findings showed that the incidence of depressive symptoms in a 4-year follow-up was as high as 22.3%. The incidence was much higher in rural areas (25.7%) and in women (27.9%). Furthermore, participants with 1 hour longer of night-time sleep had a 10% lower risk of developing depressive symptoms. Compared with individuals who perceived their health status as poor, those who perceived their health status as excellent had a 62% lower risk of developing depressive symptoms. In addition, having diabetes (OR=1.19), chronic kidney disease (OR=1.32), chronic digestive disorders (OR=1.15) and arthritis (OR=1.43) at baseline increased the risk of depressive symptoms. However, baseline body mass index was not associated with the subsequent depressive symptoms in this population. CONCLUSIONS This study highlights the importance of developing an appropriate screening test to identify depressive symptoms for those who are vulnerable and ensure these individuals can receive early interventions for depressive symptoms.
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Affiliation(s)
- Yue Wen
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Chunjuan Liu
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Jing Liao
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Yiqiong Yin
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Dongmei Wu
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
- Psychiatric Research Laboratory, The Fourth People's Hospital of Chengdu and Chengdu Mental Health Center, Chengdu, China
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85
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Wang R, Chen Z, Zhou Y, Shen L, Zhang Z, Wu X. Melancholy or mahjong? Diversity, frequency, type, and rural-urban divide of social participation and depression in middle- and old-aged Chinese: A fixed-effects analysis. Soc Sci Med 2019; 238:112518. [PMID: 31473574 DOI: 10.1016/j.socscimed.2019.112518] [Citation(s) in RCA: 84] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 08/17/2019] [Accepted: 08/22/2019] [Indexed: 12/20/2022]
Abstract
The potential benefit of social participation (SP) to one's mental health has been widely acknowledged. Nevertheless, the specific type and amount of SP that is associated with improved depressive symptoms in middle- and old-aged Chinese awaits further investigation. This study aimed to understand the patterns of depression and SP by comparing urban vs rural China, and according to which, measure the associations between changes in SP and that in depressive symptoms. A total of 10,988 community residents aged 45 years and above were selected from wave 1 (2011), wave 2 (2013), and wave 4 (2015) of the China Health and Retirement Longitudinal Study (CHARLS), a nationally representative survey. The fixed-effects analysis was used to explore the association between the changes in diversity, frequency, and type of SP and the changes in depressive symptoms. The results indicated that rural respondents suffered from a significantly higher risk of depression and took less SP than their urban counterparts. Transitioning from no SP to 1 or more types of SP or to a once a week or higher frequency was associated with a decline in depressive symptoms. For urban respondents, playing mah-jong or cards and joining sports or social clubs predicted a decline in depressive symptoms. For rural residents, interacting with friends regularly was associated with fewer depressive symptoms. In conclusion, more diverse and higher frequency of SP was associated with better mental health, while the social significance of SP varied across different types of SP and between rural and urban areas.
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Affiliation(s)
- Ruoxi Wang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China.
| | - Zhuo Chen
- College of Public Health, University of Georgia, Athens, GA 30606, USA; School of Economics, University of Nottingham Ningbo China, Ningbo, 315100, China.
| | - Yongjie Zhou
- Affiliated Mental Health Center of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430012, China; Research Center for Psychological and Health Sciences, China University of Geosciences, Wuhan, Hubei, 430074, China.
| | - Lining Shen
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China; Hubei Provincial Research Center for Health Technology Assessment, Wuhan, Hubei, 430030, China.
| | - Zhiguo Zhang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China; Hubei Provincial Research Center for Health Technology Assessment, Wuhan, Hubei, 430030, China.
| | - Xiang Wu
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China.
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86
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Wang R, Bishwajit G, Zhou Y, Wu X, Feng D, Tang S, Chen Z, Shaw I, Wu T, Song H, Fu Q, Feng Z. Intensity, frequency, duration, and volume of physical activity and its association with risk of depression in middle- and older-aged Chinese: Evidence from the China Health and Retirement Longitudinal Study, 2015. PLoS One 2019; 14:e0221430. [PMID: 31425559 PMCID: PMC6699736 DOI: 10.1371/journal.pone.0221430] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Accepted: 08/06/2019] [Indexed: 12/13/2022] Open
Abstract
Background The general benefit of physical activity (PA) to one’s mental health has been widely acknowledged. Nevertheless, the specific type and amount of PA that associates with lower risk of depression in China awaits further investigation. The present study was conducted on middle- and older-aged Chinese population with two objectives: 1) to understand the patterns of PA; 2) to measure the associations between depression and PA at different levels from various aspects. Methods Using data from the China Health and Retirement Longitudinal Study (CHARLS, 2015), we selected 9118 community residents aged 45 years and older. Depressive symptoms were measured by 10-item Center for Epidemiologic Studies (CES-D 10). Multivariate logistic regression model was performed to examine the association between risk of depression and PA from four aspects including intensity, frequency, duration, and volume. Results Spending 1–2 days/week (OR = 0.58, 95% CI: 0.36, 0.91), less than 30 minutes each time (OR = 0.66, 95% CI: 0.42, 1.03) or 150–299 min/week (OR = 0.49, 95% CI: 0.28, 0.87) on Moderate Physical Activity (MPA) was associated with lower odds of depression in women. Spending 3–5 days/week (OR = 1.98, 95% CI: 1.29, 3.05) or 6–7 days/week (OR = 1.50, 95% CI: 1.07, 2.11), 4 hours and longer each time (OR = 1.65, 95% CI: 1.18, 2.32), 300 min/week or longer (OR = 1.65, 95% CI: 1.22, 2.24) on Vigorous Physical Activity (VPA) in total, or 2250 Metabolic Equivalent of Task (OR = 1.73, 95% CI: 1.26, 2.38) on Moderate-to-Vigorous PA was associated with higher risk of depression in men. Conclusions The association between depression and PA depended largely on intensity and gender. Lower frequency, shorter duration, and moderate amount of MPA was associated with lower risk of depression in women. Risk of depression was higher in men who spent higher frequency, longer duration, and overlong time on VPA.
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Affiliation(s)
- Ruoxi Wang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Ghose Bishwajit
- School of International Development and Global Studies, University of Ottawa, Ottawa, Canada
| | - Yongjie Zhou
- Research Center for Psychological and Health Sciences, China University of Geosciences, Wuhan, China
- Affiliated Mental Health Center of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xiang Wu
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Da Feng
- School of Pharmacy, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Shangfeng Tang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Zhuo Chen
- College of Public Health, University of Georgia, Athens, GA, United States of America
| | - Ian Shaw
- School of Sociology and Social Policy, University of Nottingham, Nottingham, United Kingdom
| | - Tailai Wu
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Hongxun Song
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Qian Fu
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Zhanchun Feng
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- * E-mail:
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Fang M, Mirutse G, Guo L, Ma X. Role of socioeconomic status and housing conditions in geriatric depression in rural China: a cross-sectional study. BMJ Open 2019; 9:e024046. [PMID: 31110082 PMCID: PMC6530296 DOI: 10.1136/bmjopen-2018-024046] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVES The primary aim of this study was to describe the socioeconomic status (SES), housing conditions and depression of the elderly in rural China, as well as to examine the associations between depression and SES and housing conditions using the China Health and Retirement Longitudinal Study (CHARLS). DESIGN This is a cross-sectional study. SETTING A nationally representative sample of elderly in rural China. PARTICIPANTS A total of 4585 elderly adults in 2015 in rural China. OUTCOME MEASURES Prevalence and risk factors of depression among rural elderly. RESULTS Among the participants in this study, approximately 46.15% (2116/4585) reported depressive symptoms (10-item Center for Epidemiologic Studies Depression Scale [CESD-10] score >10) in rural China. The results revealed significant associations between higher scores on CESD-10 (indicating more symptoms of depression) and lowest personal annual income (OR=1.63, 95% CI 1.290 to 2.060), polluting cooking fuel (OR=1.16, 95% CI 1.018 to 1.321), toilet without seat (OR=1.273, 95% CI 1.056 to 1.535), as well as having no bath facility (OR=1.172, 95% CI 1.025 to 1.341) after adjustment for confounders. CONCLUSION Elderly in rural China experienced severe depressive symptoms. Lowest personal annual income, polluting cooking fuel, toilet without seat and having no bath facility were significantly associated with more depressive symptoms. Caution needs to be taken in generalising the findings of this study to the rest of the population in China since its highly selected sample.
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Affiliation(s)
- Mingwang Fang
- West China School of Public Health, Sichuan University, Chengdu, China
| | | | - Ling Guo
- Department of Health Management, Chongqing Nursing Vocational College, Chongqing, China
| | - Xiao Ma
- West China School of Public Health, Sichuan University, Chengdu, China
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Association between Diabetes and Cognitive Function among People over 45 Years Old in China: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16071294. [PMID: 30978913 PMCID: PMC6479487 DOI: 10.3390/ijerph16071294] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 04/03/2019] [Accepted: 04/09/2019] [Indexed: 12/12/2022]
Abstract
Objectives: The aim of this study is to identify the relationship between diabetes status including characteristics of diabetes and cognition among the middle-aged and elderly population (≥45 years) in China. Methods: A sample of 8535 people who participated in the China Health and Retirement Longitudinal Study (CHARLS) from June 2011 to March 2012 was analyzed. Two cognitive domains including episodic memory and executive function were measured through questionnaires. People were classified into four groups: no diabetes, controlled diabetes, untreated diabetes, treated but uncontrolled diabetes. Weighted multiple regression model was conducted to explore the association between diabetes and cognition in full sample as well as three different age groups (45–59, 60–74, ≥75). Adjustments were made for demographics and cardiovascular risk factors. Results: After adjusting several covariates, untreated diabetes (β = −0.192, p < 0.05) was significantly associated with episodic memory. In the age group of 45–69 years, untreated diabetes (β = −0.471, p < 0.05) and HbA1c level (β = −0.074, p < 0.05) were significantly associated with episodic memory. When adjusting for cardiovascular risk factors, all correlations were non-significant. Conclusion: The cross-sectional study suggests that untreated diabetes and HbA1c are the potential risk factor for cognitive impairment, and these associations are more significant in the age group of 45–59 years old. Cardiovascular factors are important mediating factors in the pathway between diabetes and cognitive impairment. More longitudinal studies are needed to confirm these associations.
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Fang M, Chen J, Guo L, Ma X. Gender Differences in Geriatric Depressive Symptoms in Rural China: The Role of Physical Housing Environments and Living Arrangements. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16050774. [PMID: 30836602 PMCID: PMC6427662 DOI: 10.3390/ijerph16050774] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/15/2018] [Revised: 02/14/2019] [Accepted: 02/20/2019] [Indexed: 11/25/2022]
Abstract
Physical housing environment and living arrangements are significant determinants of health, particularly in developing countries, although results are mixed. We conducted this study to examine the gender differences in geriatric depressive symptoms in rural China, and further explored the influence of housing environments and living arrangements on depressive symptoms. The data used for this study were from the third wave of the nationally representative China Health and Retirement Longitudinal Study (CHARLS) survey in 2015; a total of 2056 females and 2529 males were included in this study. According to the analysis findings, 46.15% of the respondents had depressive symptoms based on the CES-D, with a statistically significant gender difference of 54.32% in females and 39.50% in males. Logistic Regression findings identified that with regard to the items of physical housing environments, toilets without seats (OR = 1.349) and the unavailability of bathing facilities (OR = 1.469) were statistically associated with depressive symptoms among male participants, whereas for female participants the use of polluting fuels (OR = 1.248) and living arrangements (i.e., living with children, OR = 1.430) was statistically associated with depressive symptoms. Statistically significant gender differences were found for having shower or bath facilities and our findings underscored that physical housing environments and living arrangements were associated with depressive symptoms for both genders. Moreover, the study revealed that a slight gender difference exists in terms of geriatric depression in rural China. Females are more likely to become depressed than their male counterparts with the same characteristics.
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Affiliation(s)
- Mingwang Fang
- Department of Health-Related Social and Behavioral Science, West China School of Public Health, Sichuan University, Chengdu 610041, China.
| | - Jinfeng Chen
- Department of Health-Related Social and Behavioral Science, West China School of Public Health, Sichuan University, Chengdu 610041, China.
| | - Ling Guo
- Department of Health management, Chongqing Nursing Vocational College, Chongqing 402763, China.
| | - Xiao Ma
- Department of Health-Related Social and Behavioral Science, West China School of Public Health, Sichuan University, Chengdu 610041, China.
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90
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Depression and sleep duration: findings from middle-aged and elderly people in China. Public Health 2019; 166:148-154. [DOI: 10.1016/j.puhe.2018.10.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 09/16/2018] [Accepted: 10/08/2018] [Indexed: 11/18/2022]
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91
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He M, Ma J, Ren Z, Zhou G, Gong P, Liu M, Yang X, Xiong W, Wang Q, Liu H, Zhang X. Association between activities of daily living disability and depression symptoms of middle-aged and older Chinese adults and their spouses: A community based study. J Affect Disord 2019; 242:135-142. [PMID: 30173061 DOI: 10.1016/j.jad.2018.08.060] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 06/06/2018] [Accepted: 08/12/2018] [Indexed: 11/26/2022]
Abstract
BACKGROUND Little is known about the impact of activities of daily living (ADL) disability on personal and spouse depression symptoms among Chinese. METHODS We used data from the baseline and 2013 follow-up surveys of the China Health and Retirement Longitudinal Study, a nationally representative survey in 17,708 adults aged 45 years and older, to evaluate cross-sectional and prospective association between ADL disability and depression symptoms of subjects and their spouses. The derived basic ADL scale (BADL) and the Center for Epidemiologic Studies Depression Scale short form were utilized to assess ADL disability and depressive symptoms, respectively. Logistic regression was used to calculate odds ratio (OR) and 95% confidence interval (CI), adjusting for depression risk factors and taking into account the complex survey design and response rate. RESULTS There were 15,890 subjects included in the study. Prevalence of baseline depression symptoms was 29.5% (95%CI 27.9-31.1%), 58.0% (95%CI 54.5-61.4%) and 73.6% (95%CI 70.4-76.8%) in subjects with BADL scores of 0, 1 and ≥2, respectively, and 27.0% (95%CI 25.3-28.7%), 34.2% (95%CI 30.0-38.4%) and 43.8% (95%CI 39.1-48.5%) in subjects without ADL disability while having spouses with BADL scores of 0, 1 and ≥2, respectively. Prospectively, BADL score ≥2 was associated with higher risk of depression symptoms of subjects (OR 1.63, 95% CI 1.03-2.57) and their spouses (OR 1.50, 95% CI 1.01-2.22). LIMITATIONS Bias might be introduced because of observational study design, and findings may not be generalizable to younger population. CONCLUSIONS ADL disability might have potential to increase risk of depression symptoms of middle-aged and older Chinese adults and their spouses.
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Affiliation(s)
- Minfu He
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Juan Ma
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Zheng Ren
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Ge Zhou
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Ping Gong
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Meitian Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Xiaodi Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Wenjing Xiong
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Qi Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Hongjian Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Xiumin Zhang
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China.
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Carvalho AF, Stubbs B, Maes M, Solmi M, Vancampfort D, Kurdyak PA, Brunoni AR, Husain MI, Koyanagi A. Different patterns of alcohol consumption and the incidence and persistence of depressive and anxiety symptoms among older adults in Ireland: A prospective community-based study. J Affect Disord 2018; 238:651-658. [PMID: 29957483 DOI: 10.1016/j.jad.2018.06.041] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2018] [Revised: 06/14/2018] [Accepted: 06/15/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND The associations of different patterns of alcohol consumption and the incidence and persistence of depressive and anxiety symptoms in older age remain unclear. METHODS Data on 6095 adults aged ≥ 50 years old from the Irish Longitudinal Study on Aging (TILDA) was analyzed. Participants completed the CAGE instrument to screen for problematic alcohol use at baseline between October 2009 and February 2011. Outcomes were incident (assessed by the CES-D scale) and anxiety (assessed by the Hospital Anxiety and Depressive scale) symptoms after a two-year follow-up as well as persistence of probable depression and anxiety among those with a positive screen for those disorders at baseline. Associations were adjusted for potential confounders through multivariable models. RESULTS In the overall sample, problem drinking did not predict incident and persistent depression and anxiety in this sample. Among females, problem drinking increased the risk for incident depression (OR = 2.11; 95%CI = 1.12-4.00) and anxiety (OR = 2.22; 95%CI = 1.01-4.86). In addition, problem drinking increased the risk of persistent depressive symptoms (OR = 2.43; 95%CI = 1.05-5.06) among females. CONCLUSION Problem drinking may increase the risk of incident probable depression and anxiety among older females. Furthermore, problem drinking led to a higher likelihood of persistent depressive symptoms in older female participants. Interventions targeting problem drinking among older females may prevent the onset and persistence of depression in this population, while also decreasing the incidence of anxiety symptoms.
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Affiliation(s)
- Andre F Carvalho
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada.
| | - Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, United Kingdom; Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford, United Kingdom
| | - Michael Maes
- Department of Psychiatry, Chulalongkorn University, Bangkok, Thailand
| | - Marco Solmi
- Department of Neurosciences, University of Padova, Padova, Italy
| | - Davy Vancampfort
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium; University Psychiatric Center, KU Leuven, Leuven, Kortenberg, Belgium
| | - Paul A Kurdyak
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada; Institute for Clinical Evaluative Sciences (ICES), Toronto, ON, Canada
| | - Andre R Brunoni
- Center for Clinical and Epidemiological Research & Interdisciplinary Center for Applied Neuromodulation, University Hospital, University of São Paulo, São Paulo, Brazil; Laboratory of Neuroscience and National Institute of Biomarkers in Psychiatry, Department and Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil
| | - Muhammad I Husain
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona 08830, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3-5 Pabellón 11, Madrid 28029, Spain
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Kim H, Kwon S, Hong S, Lee S. Health behaviors influencing depressive symptoms in older Koreans living alone: secondary data analysis of the 2014 Korean longitudinal study of aging. BMC Geriatr 2018; 18:186. [PMID: 30126354 PMCID: PMC6102924 DOI: 10.1186/s12877-018-0882-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Accepted: 08/15/2018] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Geriatric depression is a societal problem, specifically in those living alone in Korea. This study aims are to investigate (1) how sociodemographic factors, health status, and health behaviors are differently associated with depressive symptoms in older Koreans living alone compared to those living with others and (2) how living arrangements attenuated or strengthened the associations between four types of health behaviors and depressive symptoms. METHODS This secondary data analysis was conducted using data from the 2014 Korean Longitudinal Study of Aging. A structured survey assessing sociodemographic factors, health status, and health behaviors was conducted with people aged 65 or older who lived alone (n = 1359) and living with others (n = 2864). A multiple linear regression with interaction terms was conducted between mean-centered health behaviors and the status of living alone. All statistical analyses were performed using SPSS Statistics 23.0, and the two-tailed level of significance was set at 0.05. RESULTS Those living alone reported higher levels of depressive symptoms than those living with others (Mdiff = 2.129, SE = 0.005, p < 0.001). The variance of depressive symptoms explained by 13 variables was 18.1% for those living alone compared to 23.7% for those living with others. Compared to health behaviors, sociodemographic factors and health status more explained depressive symptoms, specifically with psychiatric disorders, pain, and impaired functionality as risk factors. Smoking, alcohol abstinence, physical inactivity, and social inactivity were associated with more depressive symptoms. Living arrangements moderated the association between depressive symptoms and each health behavior, except for physical inactivity (all p values < 0.001). CONCLUSIONS Older Koreans living alone were exposed to different risk factors for depressive symptoms compared to those living with others. Non-modifiable sociodemographic and health status factors were highly associated with depressive symptoms relative to health behaviors; thus, it is important to conduct early assessment and classification of vulnerable subgroups regarding geriatric depression. Specific assessment instruments should be prepared in practice according to living arrangements among older Koreans. Targeted interventions are essential to addressing living arrangements and modifying health behaviors to reduce smoking, alcohol consumption, and social inactivity, specifically in those living alone.
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Affiliation(s)
- Heejung Kim
- College of Nursing, Yonsei University, Seoul, South Korea
- Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, South Korea
| | - Sooyoung Kwon
- College of Nursing, Yonsei University, Seoul, South Korea
| | - Soyun Hong
- College of Nursing, Yonsei University, Seoul, South Korea
| | - Sangeun Lee
- College of Nursing, Yonsei University, Seoul, South Korea
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Lee YH, Chang YC, Liu CT, Shelley M. Correlates of alcohol consumption and alcohol dependence among older adults in contemporary China: Results from the Chinese Longitudinal Healthy Longevity Survey. J Ethn Subst Abuse 2018; 19:70-85. [DOI: 10.1080/15332640.2018.1456388] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Yen-Han Lee
- Department of Applied Health Sciences, Indiana University School of Public Health, Bloomington, Indiana
| | - Yen-Chang Chang
- Center for General Education, National Tsing Hua University, Hsinchu City, Taiwan
| | - Ching-Ti Liu
- Department of Biostatistics, School of Public Health, Boston University, Boston, Massachusetts
| | - Mack Shelley
- Department of Statistics, Department of Political Science, Iowa State University, Ames, Iowa
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Luo H, Li J, Zhang Q, Cao P, Ren X, Fang A, Liao H, Liu L. Obesity and the onset of depressive symptoms among middle-aged and older adults in China: evidence from the CHARLS. BMC Public Health 2018; 18:909. [PMID: 30041632 PMCID: PMC6057008 DOI: 10.1186/s12889-018-5834-6] [Citation(s) in RCA: 104] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 07/11/2018] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The association between obesity and depression has been documented in previous systematic studies but remains controversial. Many prospective studies have focused on children and youth, and several studies have examined this relationship among older populations. This study of the changes in obesity status aimed to examine the association between depression and obesity among middle-aged and elderly adults in China. METHODS The data originated from the follow-up survey (2011 and 2013-2015) of the China Health and Retirement Longitudinal Study (CHARLS) and included 3337 residents aged at least 45 years who completed a physical examination and were evaluated with the Center for Epidemiological Studies Depression Scale (CES-D-10), which assessed depressive symptoms. Obesity status was defined by body mass index (BMI) and waist circumference (WC) according to Chinese criteria. A time-dependent Cox proportional hazards model was used to estimate the relationship between obesity status and depressive symptoms. RESULTS The rate of depression in men and women was 26.67 and 38.37%, respectively. Based on BMI, the proportion of the population that was overweight and obese was 28.07 and 9.26%, respectively, in males and 35.03 and 16.84%, respectively, in females. Males with obesity were less likely to suffer from depressive symptoms than males with a normal weight (ORHR = 0.506, 95% CI = 0.347~ 0.736). Based on WC, the proportion of abdominal obesity was 49.35% in males and 73.65% in females. Males with abdominal obesity were less likely to suffer from depressive symptoms than males without abdominal obesity (ORHR = 0.775, 95% CI = 0.644~ 0.933). CONCLUSION Obesity is more likely to be associated with the onset of depression in males than in females. However, regardless of underweight or overweight status, the relationship between weight and depressive symptoms is negatively associated among females and males. In conclusion, both BMI and WC can be used as tools for examining the association between obesity and depression.
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Affiliation(s)
- Huiqiang Luo
- West China School of Public Health (No. 4 West China Teaching Hospital), Sichuan University, Chengdu, 610041, Sichuan, China
| | - Jijie Li
- Department of Medical Records, West China Secondary University Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Qi Zhang
- West China School of Public Health (No. 4 West China Teaching Hospital), Sichuan University, Chengdu, 610041, Sichuan, China
| | - Peiya Cao
- Department of Health Industry, Health and Family Planning Bureau of Wuhou District, Chengdu, 610041, Sichuan, China
| | - Xiaohui Ren
- Department of Health Related Social and Behavioral Science, West China School of Public Health (No. 4 West China Teaching Hospital), Sichuan University, No. 17 Section 3, Renmin South Road, Chengdu, 610041, Sichuan, China.
| | - Aiping Fang
- West China School of Public Health (No. 4 West China Teaching Hospital), Sichuan University, Chengdu, 610041, Sichuan, China
| | - Haiying Liao
- West China School of Public Health (No. 4 West China Teaching Hospital), Sichuan University, Chengdu, 610041, Sichuan, China
| | - Lijuan Liu
- West China School of Public Health (No. 4 West China Teaching Hospital), Sichuan University, Chengdu, 610041, Sichuan, China
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96
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Cheng HG, Phillips MR, Li X, Zhang J, Shi Q, Xu G, Song Z, Ding Z, Pang S. Co-occurrence of DSM-IV mental disorders and alcohol use disorder among adult Chinese males. Psychol Med 2017; 47:2811-2822. [PMID: 28552086 DOI: 10.1017/s0033291717001337] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Studies from high-income countries report moderate-to-strong positive associations between alcohol use disorder (AUD) and other mental disorders, but there is little evidence about the comorbidity of AUD from low-and-middle-income countries. METHODS A sample of 74 752 adults from five provinces that account for >12% of China's adult population was screened using the General Health Questionnaire, and the Structured Clinical Interview for DSM-IV was administered by psychiatrists to a subsample of 9619 males. The associations between AUD and other mental disorders at each site and the characteristics of men with AUD with and without comorbid mental disorders were estimated using logistic regression and summarized across sites using meta-analysis. Generalized estimation equations estimated the associations between the clinical features of alcohol dependence and comorbidity. RESULTS Robust inverse associations were found between current AUD and any mood disorder (adjusted OR = 0.6, 95% CI = 0.4-0.8) and any anxiety disorder (OR = 0.5, 95% CI = 0.3-1.0). Compared with men without AUD, men with AUD without comorbid disorders were more likely to be middle-aged, to be currently married, and to have higher family incomes. Men with comorbid AUD and other disorders were more likely to have the clinical features of alcohol dependence than men with AUD without comorbid disorders. CONCLUSIONS Inverse associations between AUD and other mental disorders and the higher social status of men with AUD than men without AUD found in this large, representative sample of community-dwelling Chinese males highlight the importance of considering the local substance-use culture when designing clinical or preventive interventions for addictive conditions.
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Affiliation(s)
- H G Cheng
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine,China
| | - M R Phillips
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine,China
| | - X Li
- WHO Collaborating Center for Research and Training in Suicide Prevention, Beijing Hui Long Guan Hospital,Beijing,China
| | - J Zhang
- Shandong Provincial Mental Health Center,Jinan City,Shandong Province,China
| | - Q Shi
- Tong De Hospital of Zhejiang Province,Hangzhou City,Zhejiang Province,China
| | - G Xu
- Tianjin Mental Health Center,Tianjin,China
| | - Z Song
- The 3rd People's Hospital of Qinghai Province,Xining City,Qinghai Province,China
| | - Z Ding
- Tianshui City Mental Hospital,Tianshui City,Gansu Province,China
| | - S Pang
- Qingdao Mental Health Centre,Qingdao City,Shandong Province,China
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97
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Cheng HG, Phillips MR, Zhang Y, Wang Z. Relationship of drinking motives with alcohol consumption and alcohol-related problems identified in a representative community-based study from Ningxia, China. Addict Behav 2017. [PMID: 28648993 DOI: 10.1016/j.addbeh.2017.06.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Drinking motives have been linked to alcohol consumption and drinking-related problems in western countries, but evidence about this relationship is largely lacking for Asian countries. We aim to assess the relationship between drinking motives and drinking-related outcomes in China, where alcohol use disorders are an increasingly important contributor to the overall burden of illness. METHODS Validated Chinese versions of the Drinking Motives Questionnaire-Revised (DMQ-R) and the Alcohol Use Disorder Identification Test (AUDIT) were used to assess drinking motives and drinking-related outcomes among 612 current drinkers identified from a cross-sectional survey of a representative sample of 2425 adults living in Ningxia Province in 2013. Structural equation modeling was used to estimate the relationships linking specific drinking motives ('enhancement', 'conformity', 'social' and 'coping') to drinking-related outcomes ('level of alcohol consumption', 'alcohol dependence' and 'adverse consequences'). FINDINGS The enhancement motive is significantly associated with the level of alcohol consumption (β=0.52, 95% CI=0.27, 0.78). The conformity motive is associated with higher levels of alcohol dependence (β=0.74, 95% CI=0.50, 0.98) and adverse consequences of drinking (β=0.43, 95% CI=0.04, 0.81). The social motive and drinking to cope motive are not significantly associated with any of the three drinking outcomes. INTERPRETATION The relationships between drinking motives and drinking-related outcomes in China are quite different from those reported in western countries. This study highlights the need to consider local context when adapting prevention or intervention strategies developed in western countries to address the problem of the harmful use of alcohol in China.
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Affiliation(s)
- Hui G Cheng
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 3210 Humin Road, Shanghai 201108, China; Department of Epidemiology & Biostatistics, Michigan State University, 909 Fee Road, East Lansing, MI 48824, United States
| | - Michael R Phillips
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 3210 Humin Road, Shanghai 201108, China; Department of Psychiatry, Emory University, 1518 Clifton Road, Atlanta, GA 30322, United States; Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA, 30322, United States.
| | - Yuhong Zhang
- Ningxia Medical University, 1160 Shengli Street, Xingqing District, Yinchuan City, Ningxia 750004, China
| | - Zhizhong Wang
- Ningxia Medical University, 1160 Shengli Street, Xingqing District, Yinchuan City, Ningxia 750004, China
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98
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Liang D, Zhang D. Children's Geographic Proximity and Older Parents' Depressive Symptoms in China. Gerontol Geriatr Med 2017; 3:2333721417729501. [PMID: 28955718 PMCID: PMC5607917 DOI: 10.1177/2333721417729501] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Accepted: 08/01/2017] [Indexed: 11/15/2022] Open
Abstract
Objective: This study examined the association between children's proximity and older parents' depressive symptoms, and whether living with grandchildren modified this association. Method: Study sample was from the 2011 China Health and Retirement Longitudinal Study (N = 5,261). Elders' depressive symptoms were measured using the 10-item Center for Epidemiologic Studies Depression Scale. Children's proximity was measured by the geographic distance from an adult child to elders' residence. Linear and logit regressions were performed. Results: Elders who had their nearest child living 100 km away were 9% more likely to experience severe depressive symptoms (95% CI: [1%, 16%]) than those living together with children. Among those living far away from adult children, living with a grandchild in the same household increased the likelihood of having severe depressive symptoms by 23% (95% CI: [12%, 34%]). Discussion: Relationships between children's proximity and parents' health were identified and modified by whether living with grandchildren.
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Affiliation(s)
- Di Liang
- University of California, Los Angeles, CA, USA
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99
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Phillips MR, Cheng HG, Li X, Zhang J, Shi Q, Xu G, Song Z, Ding Z, Pang S. Prevalence, correlates, comorbidity, and age of onset of alcohol use disorders in adult males from five provinces in China. Drug Alcohol Depend 2017; 173:170-177. [PMID: 28260680 DOI: 10.1016/j.drugalcdep.2016.12.026] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Revised: 12/10/2016] [Accepted: 12/11/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND This study integrates data from high-quality mental health surveys in five provinces in China to examine the prevalence, demographic correlates, age of onset, and comorbidity of alcohol use disorder (AUD). METHODS The five cross-sectional surveys initially screened a representative sample of 74,752 community-living adults (94% response rate) from a sampling population including over 12% of China's adult population. Psychiatrists then administered a detailed diagnostic exam to an enriched sample of 21,015 respondents (95% response rate). The prevalence of AUD in females in China is below 0.5%, so we limited our analysis to 9619 males who completed the diagnostic interview. RESULTS Using meta-analyses to summarize estimates across the five locations, the current (30-day) prevalence of AUD among adult Chinese males was 9.8% (95% CI=5.7-16.9%), but there was wide cross-province variation. After adjusting for age and other demographic variables, the prevalence of AUD was significantly lower in single men than in married men (OR=0.4, CI=0.2-0.7), lower in men who were not currently working than in men who were currently working (OR=0.7, CI=0.5-0.96), and lower in men with comorbid mental disorders than in men without comorbid mental disorders (OR=0.4, CI=0.2-0.8). The risk of developing AUD peaked at 30 years of age. CONCLUSIONS Substantial differences in the demographic correlates and age of onset of AUD in men in China compared to those reported in other countries highlight the importance of understanding the country-specific and region-specific profile of AUD before developing intervention and prevention strategies.
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Affiliation(s)
- Michael R Phillips
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 3210 Humin Road, Shanghai 201102, China; Departments of Psychiatry and Global Health, Emory University, 201 Dowman Drive, Atlanta, GA 30322, USA; Beijing Suicide Research and Prevention Center, WHO Collaborating Center for Research and Training in Suicide Prevention, Beijing Hui Long Guan Hospital, Beijing 100096, China.
| | - Hui G Cheng
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 3210 Humin Road, Shanghai 201102, China; Department of Epidemiology and Biostatistics, Michigan State University, 909 Fee Rd. Room 601, East Lansing, MI 48843, USA
| | - Xianyun Li
- Beijing Suicide Research and Prevention Center, WHO Collaborating Center for Research and Training in Suicide Prevention, Beijing Hui Long Guan Hospital, Beijing 100096, China
| | - Jingxuan Zhang
- Shandong Mental Health Center, 49 Wen Hua Dong Road, Jinan, Shandong 250014, China
| | - Qichang Shi
- Tong De Hospital of Zhejiang Province,234 Gucui Road, Hangzhou, Zhejiang 310012, China
| | - Guangming Xu
- Tianjin Mental Health Center, Liulin Road 13, Hexi district, Tianjin 300222, China
| | - Zhiqiang Song
- The 3rd People's Hospital of Qinghai Province, 41 Guoluo Road, Xining, Qinghai 810007, China
| | - Zhijie Ding
- Tianshui City Mental Hospital, Jingbiao Road 17, Tianshui, Gansu 741000, China
| | - Shutao Pang
- Qingdao Mental Health Centre, Nanjing Road 299, Qingdao, Shandong 266034, China
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100
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Cabello M, Miret M, Caballero FF, Chatterji S, Naidoo N, Kowal P, D'Este C, Ayuso-Mateos JL. The role of unhealthy lifestyles in the incidence and persistence of depression: a longitudinal general population study in four emerging countries. Global Health 2017; 13:18. [PMID: 28320427 PMCID: PMC5358047 DOI: 10.1186/s12992-017-0237-5] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2016] [Accepted: 02/15/2017] [Indexed: 01/10/2023] Open
Abstract
Background Unhealthy lifestyles and depression are highly interrelated: depression might elicit and exacerbate unhealthy lifestyles and people with unhealthy lifestyles are more likely to become depressed over time. However, few longitudinal evidence of these relationships has been collected in emerging countries. The present study aims i) to analyse whether people with unhealthy lifestyles are more likely to develop depression, and ii) to examine whether depressed people with unhealthy lifestyles are more likely to remain depressed. A total of 7908 participants from Ghana, India, Mexico and Russia were firstly evaluated in the World Health Organization’s Study on Global AGEing and Adult Health (SAGE) Wave 0 (2002–2004) and re-evaluated in 2007–2010 (Wave 1). Data on tobacco use, alcohol drinking and physical activity, were collected. Logistic regressions models were employed to assess whether baseline unhealthy lifestyles were related to depression in Wave 1, among people without 12-month depression in Wave 0 and any previous lifetime diagnosis of depression, and to 12-month depression at both study waves (persistent depression). Results Baseline daily and non-daily smoking was associated with depression in Wave 1. Low physical activity and heavy alcohol drinking were associated with persistent depression. Conclusions Unhealthy lifestyles and depression are also positively related in emerging countries. Smoking on a daily and non-daily basis was longitudinally related to depression. Depressed people with low physical activity and with heavy drinking patterns were more likely to become depressed over time. Several interpretations of these results are given. Further studies should check whether a reduction of these unhealthy lifestyles leads to lower depression rates and/or to a better clinical prognosis of depressed people.
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Affiliation(s)
- Maria Cabello
- Centro de Investigación Biomédica en Red de Salud Mental. CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain
| | - Marta Miret
- Centro de Investigación Biomédica en Red de Salud Mental. CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain.,Department of psychiatry, Universidad Autónoma de Madrid, Madrid, Spain
| | - Francisco Felix Caballero
- Centro de Investigación Biomédica en Red de Salud Mental. CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain.,Department of psychiatry, Universidad Autónoma de Madrid, Madrid, Spain
| | - Somnath Chatterji
- Department of Health Statistics and Information Systems, World Health Organization, Geneva, Switzerland
| | - Nirmala Naidoo
- Department of Health Statistics and Information Systems, World Health Organization, Geneva, Switzerland
| | - Paul Kowal
- Department of Health Statistics and Information Systems, World Health Organization, Geneva, Switzerland.,Research Centre for Generational Health and Ageing, Faculty of Health, University of Newcastle, Newcastle, NSW, Australia
| | - Catherine D'Este
- National Centre for Epidemiology and Population Health (NCEPH), Australian National University, Canberra, ACT, Australia
| | - Jose Luis Ayuso-Mateos
- Centro de Investigación Biomédica en Red de Salud Mental. CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain. .,Department of psychiatry, Universidad Autónoma de Madrid, Madrid, Spain. .,Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS Princesa), Diego de Leon, 62, Madrid, 28006, España.
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