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Kou N, Suo J, Wu M, Song B. The influence of residential Environment and residential experience on psychological depression in older adults: Evidence from China and Europe. Health Place 2024; 88:103264. [PMID: 38744053 DOI: 10.1016/j.healthplace.2024.103264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 04/21/2024] [Accepted: 05/04/2024] [Indexed: 05/16/2024]
Abstract
This cross-national study examined the influence of residential environment and experience on depression in older adults in China and Europe to address existing research gaps. Using data from the China Health and Retirement Longitudinal Study (CHARLS) and Survey of Health, Ageing, and Retirement in Europe (SHARE) and employing ridge regression, it was found that residential environment and experience have a significant influence on older adults' depression. The influence of residential experience aligns with the sensitivity period hypothesis. The environment in which older adults live during specific age periods leaves an imprint on their psyche. This imprint is activated when specific environments are encountered in old age, thereby influencing the level of depression. This study examined how their influence on depression contributes to understanding older adults' housing preferences and can guide housing-related policies.
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Affiliation(s)
- Ningbo Kou
- School of Architecture and Fine Art, Dalian University of Technology, Dalian, China
| | - Jian Suo
- School of Architecture and Fine Art, Dalian University of Technology, Dalian, China.
| | - Mengxue Wu
- School of Architecture and Fine Art, Dalian University of Technology, Dalian, China
| | - Bingwen Song
- School of Architecture and Fine Art, Dalian University of Technology, Dalian, China
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Zhang X, Wang Y, Yang X, Li Y, Gui J, Mei Y, Liu H, Guo LL, Li J, Lei Y, Li X, Sun L, Yang L, Yuan T, Wang C, Zhang D, Li J, Liu M, Hua Y, Zhang L. Obesity and lipid indices as predictors of depressive symptoms in middle-aged and elderly Chinese: insights from a nationwide cohort study. BMC Psychiatry 2024; 24:351. [PMID: 38730360 PMCID: PMC11088055 DOI: 10.1186/s12888-024-05806-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 05/02/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Depressive symptoms are one of the most common psychiatric disorders, with a high lifetime prevalence rate among middle-aged and elderly Chinese. Obesity may be one of the risk factors for depressive symptoms, but there is currently no consensus on this view. Therefore, we investigate the relationship and predictive ability of 13 obesity- and lipid-related indices with depressive symptoms among middle-aged and elderly Chinese. METHODS The data were obtained from The China Health and Retirement Longitudinal Study (CHARLS). Our analysis includes individuals who did not have depressive symptoms at the baseline of the CHARLS Wave 2011 study and were successfully follow-up in 2013 and 2015. Finally, 3790 participants were included in the short-term (from 2011 to 2013), and 3660 participants were included in the long-term (from 2011 to 2015). The average age of participants in short-term and long-term was 58.47 years and 57.88 years. The anthropometric indicators used in this analysis included non-invasive [e.g. waist circumference (WC), body mass index (BMI), and a body mass index (ABSI)], and invasive anthropometric indicators [e.g. lipid accumulation product (LAP), triglyceride glucose index (TyG index), and its-related indices (e.g. TyG-BMI, and TyG-WC)]. Receiver operating characteristic (ROC) analysis was used to examine the predictive ability of various indicators for depressive symptoms. The association of depressive symptoms with various indicators was calculated using binary logistic regression. RESULTS The overall incidence of depressive symptoms was 20.79% in the short-term and 27.43% in the long-term. In males, WC [AUC = 0.452], LAP [AUC = 0.450], and TyG-WC [AUC = 0.451] were weak predictors of depressive symptoms during the short-term (P < 0.05). In females, BMI [AUC = 0.468], LAP [AUC = 0.468], and TyG index [AUC = 0.466] were weak predictors of depressive symptoms during the long-term (P < 0.05). However, ABSI cannot predict depressive symptoms in males and females during both periods (P > 0.05). CONCLUSION The research indicates that in the middle-aged and elderly Chinese, most obesity- and lipid-related indices have statistical significance in predicting depressive symptoms, but the accuracy of these indicators in prediction is relatively low and may not be practical predictors.
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Affiliation(s)
- Xiaoyun Zhang
- Department of Graduate School, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, People's Republic of China
| | - Ying Wang
- Department of Graduate School, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, People's Republic of China
| | - Xue Yang
- Department of Graduate School, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, People's Republic of China
| | - Yuqing Li
- Department of Graduate School, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, People's Republic of China
| | - Jiaofeng Gui
- Department of Graduate School, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, People's Republic of China
| | - Yujin Mei
- Department of Graduate School, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, People's Republic of China
| | - Haiyang Liu
- Student Health Center, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, People's Republic of China
| | - Lei-Lei Guo
- Department of Surgical Nursing, School of Nursing, Jinzhou Medical University, No.40, Section 3, Songpo Road, Linghe District, Jinzhou City, Liaoning Province, People's Republic of China
| | - Jinlong Li
- Department of Occupational and Environmental Health, Key Laboratory of Occupational Health and Safety for Coal Industry in Hebei Province, School of Public Health, North China University of Science and Technology, Tangshan, Hebei Province, People's Republic of China
| | - Yunxiao Lei
- Obstetrics and Gynecology Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, People's Republic of China
| | - Xiaoping Li
- Department of Emergency and Critical Care Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, People's Republic of China
| | - Lu Sun
- Department of Emergency and Critical Care Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, People's Republic of China
| | - Liu Yang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, People's Republic of China
| | - Ting Yuan
- Obstetrics and Gynecology Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, People's Republic of China
| | - Congzhi Wang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, People's Republic of China
| | - Dongmei Zhang
- Department of Pediatric Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, People's Republic of China
| | - Jing Li
- Department of Surgical Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, People's Republic of China
| | - Mingming Liu
- Department of Surgical Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, People's Republic of China
| | - Ying Hua
- Rehabilitation Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, People's Republic of China
| | - Lin Zhang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, People's Republic of China.
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Ding L, Liu J, Yang Y, Cui Z, Du G. Chronically socially isolated mice exhibit depressive-like behavior regulated by the gut microbiota. Heliyon 2024; 10:e29791. [PMID: 38681644 PMCID: PMC11046198 DOI: 10.1016/j.heliyon.2024.e29791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 04/04/2024] [Accepted: 04/15/2024] [Indexed: 05/01/2024] Open
Abstract
Objectives Chronic loneliness is a widespread issue, and the gut-brain axis is known to be crucial in facilitating communication between the gut and brain. However, the precise mechanism by which chronic loneliness affects the gut-brain axis remains uncertain. Methods Fourteen 55-week-old Balb/c mice were used in the experiment, with seven mice being randomly assigned to the chronic social isolation (CSI) group. The CSI group mice underwent 12 weeks of isolation to simulate the psychiatric state of a population in prolonged social isolation. The mental state of the CSI mice was assessed through animal behavior analysis, while plasma cytokines were measured using ELISA. Additionally, the composition of the gut microbiota was analyzed using 16S rRNA sequencing, and the metabolite composition of the intestinal contents was examined using nontargeted metabolomics. The Student-T test was used to determine significant mean differences. Results Mice that were exposed to the CSI exhibited increased immobility time lengths in forced swimming and hanging tail experiments, and decreased movement lengths and number of times traversing the intermediate region, compared to control mice. Additionally, CSI decreased the abundance of the probiotics Ruminococcaceae, Akkermansiaceae, and Christensenellaceae. Additionally, CSI reduced the production of the metabolites oleamide and tryptophan. Furthermore, IL-1β, IL-4, and IL-6 were significantly increased, while TNF-α was significantly decreased. Conclusion CSI induces a dysbiotic gut microbiota and the production of neurorelated metabolites, which in turn increase inflammatory responses and result in depressive behaviors in CSI mice. Therefore, these findings suggest that the gut microbiota may serve as a target for the treatment of long-term social isolation-induced mental disorders.
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Affiliation(s)
- Linwei Ding
- Biotechnology Laboratory, Hainan Medical University, Haikou, China
| | - Jiaqi Liu
- Biotechnology Laboratory, Hainan Medical University, Haikou, China
- Biotechnology Major, Hainan Medical University, Haikou, China
| | - Yunjia Yang
- Biotechnology Laboratory, Hainan Medical University, Haikou, China
- School of Public Health, Hainan Medical University, Haikou, China
| | - Zeying Cui
- Biotechnology Laboratory, Hainan Medical University, Haikou, China
| | - Guankui Du
- Biotechnology Laboratory, Hainan Medical University, Haikou, China
- Biotechnology Major, Hainan Medical University, Haikou, China
- Department of Biochemistry and Molecular Biology, Hainan Medical University, Haikou, China
- Department of Breast Surgery, The First Affiliated Hospital of Hainan Medical University, Haikou, China
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Fu X, Peng S, Feng XL. Socioeconomic inequalities in depressive symptoms in China: The role of social capital. Heliyon 2024; 10:e24918. [PMID: 38314291 PMCID: PMC10837546 DOI: 10.1016/j.heliyon.2024.e24918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 01/12/2024] [Accepted: 01/17/2024] [Indexed: 02/06/2024] Open
Abstract
This cohort study used the China Health and Retirement Longitudinal Study (CHARLS, 2015-2018) to investigate the effects of socioeconomic status and social capital to the incidence of depressive symptoms among middle-aged and older individuals in China, incorporating a sample size of 9949 participants. Socioeconomic status, social capital and other explanatory variables were collected in 2015, while depressive symptoms were assessed in 2018. Basic characteristics and social capital measures were compared between urban and rural residents using the chi-square test. Logistic regression was used to explore the relationship between socioeconomic status, social capital and depressive symptoms, and the Karlson, Holm, and Breen (KHB) method was employed to verify the mediating role of social capital. We reported persistent socioeconomic inequalities in depressive symptoms, with rural residents and the illiterate having 1.45 times and 1.34 times higher odds of depression. We ascertained social capital from both the cognitive and structural constructs, where we enriched the measurement of structural social capital from three specific dimensions, i.e., informal interaction, altruism, and formal social participation. We found that both cognitive and structural social capital were associated with lower incidence of depressive symptoms, where informal interaction had the largest effect. The mediation analysis further illustrated that informal interaction contributed most to explain 6 %-12 % of the socioeconomic inequalities in depressive symptoms. These results highlighted the unsatisfied mental wellbeing of the vulnerable older people living in rural areas. The finding suggested that older people may benefit more from personal interactions than formal participations. To fulfill the Health in All vision, government and social organizations should consider how to create opportunities to better integrate the older people into the community.
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Affiliation(s)
- Xixi Fu
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing, 100191, China
| | - Shunzhuang Peng
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing, 100191, China
| | - Xing Lin Feng
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing, 100191, China
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Tian F, Yang X, Xu F, Dong R, Song Y, Fan C, Zhou Z. Physical activity and its fluctuations in relation to depressive symptoms: A national longitudinal study among Chinese adults. J Affect Disord 2024; 347:192-198. [PMID: 37924983 DOI: 10.1016/j.jad.2023.10.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 09/30/2023] [Accepted: 10/09/2023] [Indexed: 11/06/2023]
Abstract
BACKGROUND Physical activity (PA) may prevent depressive symptoms, however, PA fluctuations may have different effects. Using three waves of nationally representative data, this study aimed to examine the effects of PA fluctuations on depressive symptoms. METHODS Participants comprised 7633 adults free of depressive symptoms at the first two waves (Mage = 45.26, 54.70 % males). They completed the China Family Panel Study in 2016 (T1), 2018 (T2), and 2020 (T3), respectively. Depressive symptoms were measured by the Center for Epidemiologic Studies Depression (CES-D) scale using a cutoff of 16. Participants' PA levels were split into regular PA or infrequent PA groups. Changes in PA levels between T1 and T2 were classified into four groups: maintained infrequent PA, initiated regular PA, ceased regular PA, and persisted regular PA. RESULTS The incidence of depressive symptoms was 20.22 % (19.05 % possible and 1.17 % severe depression). After multivariate adjustment, Poisson regression showed that persistent regular PA had 17.8 % (95 % CI: 0.724, 0.934) lower risks of incident depressive symptoms compared to maintained infrequent PA. And adults who ceased regular PA were more likely to experience depressive symptoms than those who persisted in regular PA (RR = 1.188, 95 % CI: 1.010, 1.398). LIMITATIONS All items were self-reported. CES-D only examined self-diagnosed depressive symptoms, not medical diagnoses. CONCLUSION Adults who persisted in regular PA may have a lower possibility of developing depressive symptoms. The finding might serve as an empirical reference to depression prevention.
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Affiliation(s)
- Fei Tian
- Key Laboratory of Adolescent Cyberpsychology and Behavior (CCNU), Ministry of Education, School of Psychology, Central China Normal University, Wuhan, China; Air Force Early Warning Academy, Wuhan, China.
| | - Xiujuan Yang
- Shenzhen Mental Health Center, Shenzhen Kangning Hospital, Shenzhen, China; State Key Laboratory of Chemical Oncogenomics, Guangdong Provincial Key Laboratory of Chemical Genomics, Peking University Shenzhen Graduate School, Shenzhen, China.
| | - Fang Xu
- Key Laboratory of Adolescent Cyberpsychology and Behavior (CCNU), Ministry of Education, School of Psychology, Central China Normal University, Wuhan, China.
| | - Rouchun Dong
- Key Laboratory of Adolescent Cyberpsychology and Behavior (CCNU), Ministry of Education, School of Psychology, Central China Normal University, Wuhan, China.
| | - Youzhi Song
- Key Laboratory of Adolescent Cyberpsychology and Behavior (CCNU), Ministry of Education, School of Psychology, Central China Normal University, Wuhan, China.
| | - Cuiying Fan
- Key Laboratory of Adolescent Cyberpsychology and Behavior (CCNU), Ministry of Education, School of Psychology, Central China Normal University, Wuhan, China.
| | - Zongkui Zhou
- Key Laboratory of Adolescent Cyberpsychology and Behavior (CCNU), Ministry of Education, School of Psychology, Central China Normal University, Wuhan, China.
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Yuan L, Yu B, Bing Y, Du M, Zhao Z, Sun J. Gender differences in depressive symptoms among Chinese older adults based on fairlie decomposition analysis. Heliyon 2023; 9:e21555. [PMID: 37954279 PMCID: PMC10637998 DOI: 10.1016/j.heliyon.2023.e21555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 10/23/2023] [Accepted: 10/24/2023] [Indexed: 11/14/2023] Open
Abstract
This study aimed to investigate the factors influencing depressive symptoms among Chinese older adults based on gender differences. Data from the eighth wave of Chinese Longitudinal Health Longevity Survey were used. We analyzed the influencing factors of depressive symptoms reported by older adults using the chi-squared test and logistic model. Fairlie decomposition analysis was performed to quantify the contribution level of each influencing factor. We found that 11.71 % of older adults met the CES-D-10 criteria for depressive symptoms. Females (13.89 %) reported a significantly higher level of depressive symptoms than males (9.24 %). Age, residence, sleeping time, exercise, activities of daily living functional disability, instrumental activity of daily living functional disability, and living status influenced depressive symptoms in older adults. Higher education and lower body mass index were only significant in male, whereas middle annual income and exercising were significant only in female. The Fairlie decomposition model explained the reasons for 75.64 % of the gender differences in depressive symptoms, with instrumental activity of daily living functional disability (33.60 %), age (-17.79 %), and education level (17.41 %) being major factors affecting gender differences in depressive symptoms. This is the first nationwide study to examine gender differences in depressive symptoms among older adults. These results provide a basis for relevant Chinese government departments to formulate policies to prevent and control depressive symptoms.
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Affiliation(s)
- Lei Yuan
- Department of Health Management, Faculty of Military Health Service, Naval Medical University, Shanghai, China
| | - Boyang Yu
- Department of Medical Health Service, General Hospital of Northern Theater Command of PLA, Shenyang, China
| | - Yan Bing
- Department of Health Management, Faculty of Military Health Service, Naval Medical University, Shanghai, China
| | - Maolin Du
- Department of Office, Naval Medical University, Shanghai, China
| | - Zhe Zhao
- Department of Health Management, Faculty of Military Health Service, Naval Medical University, Shanghai, China
| | - Jinhai Sun
- Department of Health Management, Faculty of Military Health Service, Naval Medical University, Shanghai, China
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Wu Y, Su B, Chen C, Zhao Y, Zhong P, Zheng X. Urban-rural disparities in the prevalence and trends of depressive symptoms among Chinese elderly and their associated factors. J Affect Disord 2023; 340:258-268. [PMID: 37536424 DOI: 10.1016/j.jad.2023.07.117] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 07/22/2023] [Accepted: 07/31/2023] [Indexed: 08/05/2023]
Abstract
BACKGROUND This study aimed to examine urban-rural disparities in the prevalence and trends of depressive symptoms (DS) among Chinese elderly and associated factors. METHODS A total of 8025, 7808, and 4887 respondents aged 60 years and above were selected from the China Family Panel Studies (CFPS) in 2016, 2018, and 2020, respectively. DS was assessed using a short version of Center for Epidemiologic Studies Depression Scale (CES-D). Twenty-two associated factors from six categories were included in random forest (RF) models. All urban-rural comparisons were conducted based on good model performance. RESULTS The DS prevalence among all rural elderly was significantly higher than corresponding urban elderly. This disparity continued to widen among younger elderly, while it continued to narrow among older elderly. The top 10 common leading factors were sleep quality, self-rated health, life satisfaction, memory ability, child relationship, IADL disability, marital status, educational level, and gender. Urban-rural disparities in sleep quality, interpersonal trust, and child relationship continued to widen, while disparities in multimorbidity, hospitalization status, and frequency of family dinner continued to narrow. LIMITATION This study may exist recall bias and lacks causal explanation. CONCLUSIONS Significant and continuing disparities in the DS prevalence were observed between urban and rural elderly in China, showing opposite trends in younger and older elderly. The top 10 leading associated factors for DS were nearly consistent across urban and rural elderly, with sleep quality having strongest contribution. Urban-rural disparities in associated factors also showed different trends. This study provides a reference for mental health promotion among Chinese elderly.
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Affiliation(s)
- Yu Wu
- Department of Population Health and Aging Science, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences/Peking Union Medical College, No. 31, Road 3rd, Bei-Ji-Ge, Dongcheng District, Beijing 100730, China
| | - Binbin Su
- Department of Population Health and Aging Science, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences/Peking Union Medical College, No. 31, Road 3rd, Bei-Ji-Ge, Dongcheng District, Beijing 100730, China
| | - Chen Chen
- Department of Population Health and Aging Science, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences/Peking Union Medical College, No. 31, Road 3rd, Bei-Ji-Ge, Dongcheng District, Beijing 100730, China
| | - Yihao Zhao
- Department of Population Health and Aging Science, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences/Peking Union Medical College, No. 31, Road 3rd, Bei-Ji-Ge, Dongcheng District, Beijing 100730, China
| | - Panliang Zhong
- Department of Population Health and Aging Science, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences/Peking Union Medical College, No. 31, Road 3rd, Bei-Ji-Ge, Dongcheng District, Beijing 100730, China
| | - Xiaoying Zheng
- Department of Population Health and Aging Science, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences/Peking Union Medical College, No. 31, Road 3rd, Bei-Ji-Ge, Dongcheng District, Beijing 100730, China.
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Huang D, Wang J, Fang H, Fu Y, Lou J. Longitudinal association of chronic diseases with depressive symptoms in middle-aged and older adults in China: Mediation by functional limitations, social interaction, and life satisfaction. J Glob Health 2023; 13:04119. [PMID: 37766663 PMCID: PMC10534192 DOI: 10.7189/jogh.13.04119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/29/2023] Open
Abstract
Background Several previous studies have shown that the development of depression is often accompanied by chronic diseases; although closely related, the mechanism between them is not clear. Here we investigate the potential role of functional limitations, social interaction, and life satisfaction in the relationship between chronic diseases and depressive symptoms in middle-aged and older adults in China. Methods We selected 2407 respondents aged ≥45 from the China Health and Retirement Longitudinal Study conducted in 2013, 2015, and 2018. We established panel data to estimate the longitudinal impact of chronic diseases on depressive symptoms and the mediating role of functional limitations, social interaction, and life satisfaction. Results Chronic diseases were associated with more depressive symptoms. All of the mediating pathways examined passed functional limitations, and approximately 43.4% of the association between chronic diseases and depressive symptoms was explained by these three mediating variables. Conclusions The impact of chronic diseases on depressive symptoms was primarily mediated by functional limitations, and the mediating role of social interaction and life satisfaction was also confirmed. Therefore, attention should be paid to reducing the level of functional limitation in middle-aged and older adults with chronic diseases and improving life satisfaction by increasing social opportunities to alleviate depressive symptoms in middle-aged and older adults.
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Affiliation(s)
- Derong Huang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC KeyLab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Jian Wang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC KeyLab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Huiling Fang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC KeyLab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Yingjie Fu
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC KeyLab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Jiaxu Lou
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC KeyLab of Health Economics and Policy Research, Shandong University, Jinan, China
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Wang Z, Yang H, Sun C, Hong S. Estimating causal effects of physical disability and number of comorbid chronic diseases on risk of depressive symptoms in an elderly Chinese population: a machine learning analysis of cross-sectional baseline data from the China longitudinal ageing social survey. BMJ Open 2023; 13:e069298. [PMID: 37407052 DOI: 10.1136/bmjopen-2022-069298] [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: 07/07/2023] Open
Abstract
OBJECTIVE This study aimed to explore the causal effects of physical disability and number of comorbid chronic diseases on depressive symptoms in an elderly Chinese population. DESIGN, SETTING AND ANALYSIS Cross-sectional, baseline data were obtained from the China Longitudinal Ageing Social Survey, a stratified, multistage, probabilistic sampling survey conducted in 2014 that covers 28 of 31 provincial areas in China. The causal effects of physical disability and number of comorbid chronic diseases on depressive symptoms were analysed using the conditional average treatment effect method of machine learning. The causal effects model's adjustment was made for age, gender, residence, marital status, educational level, ethnicity, wealth quantile and other factors. OUTCOME Assessment of the causal effects of physical disability and number of comorbid chronic diseases on depressive symptoms. PARTICIPANTS 7496 subjects who were 60 years of age or older and who answered the questions on depressive symptoms and other independent variables of interest in a survey conducted in 2014 were included in this study. RESULTS Physical disability and number of comorbid chronic diseases had causal effects on depressive symptoms. Among the subjects who had one or more functional limitations, the probability of depressive symptoms increased by 22% (95% CI 19% to 24%). For the subjects who had one chronic disease and those who had two or more chronic diseases, the possibility of depressive symptoms increased by 13% (95% CI 10% to 15%) and 20% (95% CI 18% to 22%), respectively. CONCLUSION This study provides evidence that the presence of one or more functional limitations affects the occurrence of depressive symptoms among elderly people. The findings of our study are of value in developing programmes that are designed to identify elderly individuals who have physical disabilities or comorbid chronic diseases to provide early intervention.
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Affiliation(s)
- Zhenjie Wang
- Institute of Population Research, Peking University, Beijing, People's Republic of China
| | - Hanmo Yang
- T. H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
| | - Chenxi Sun
- School of Intelligence Science and Technology and the Key Laboratory of Machine Perception (Ministry of Education), Peking University, Beijing, People's Republic of China
| | - Shenda Hong
- National Institute of Health Data Science, Peking University, Beijing, People's Republic of China
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Zheng F, Xiong H, Jin Y, Zhang M. Exploring the relationship between unemployment perception and health during COVID-19: a comparative study of rural and urban adults in China. Front Psychol 2023; 14:1169845. [PMID: 37388659 PMCID: PMC10301762 DOI: 10.3389/fpsyg.2023.1169845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 05/23/2023] [Indexed: 07/01/2023] Open
Abstract
Introduction The COVID-19 pandemic has significantly impacted global economies and individual health. This study uses data from the China Family Panel Data (CFPS) in 2018 (before the pandemic) and 2020 (during the pandemic) to a) estimate the relationships between the perceived risk of unemployment and individuals' mental health, physical health, and health behaviors; and b) explore the variations of these relationships between rural and urban adults in China. Methods Ordinary linear regression models or Logit models are employed, depending on the nature (continuous vs. discrete) of the dependent variables. Results We find that the perceived risk of unemployment was statistically and positively associated with the risk of depression, and the association was greater for rural adults than for urban adults. Rural-urban variations were observed in various dimensions. For rural adults, the perceived risk of unemployment was statistically and negatively associated with life satisfaction, the probability of gaining weight and becoming obese, the probability of having adequate sleep, and computer-based screen time. These associations were statistically insignificant for urban adults. On the other hand, the perceived risk of unemployment was statistically and negatively associated with self-rated very-good-to-excellent health condition and health-compromising behaviors (e.g., smoking and drinking) for urban adults; but such associations were statistically insignificant for rural adults. Discussion These findings suggest that rural and urban adults exhibited different psychological and behavioral responses to the unemployment risk during the COVID-19 pandemic. Public policies aiming to improve health and employment should be strategically designed to address the unique needs of urban and rural populations.
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Affiliation(s)
- Fengtian Zheng
- School of Agricultural Economics and Rural Development, Renmin University of China, Beijing, China
| | - Huanhuan Xiong
- School of Agricultural Economics and Rural Development, Renmin University of China, Beijing, China
| | - Yanhong Jin
- Department of Agricultural, Food and Resource Economics, School of Environmental and Biological Sciences, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States
| | - Man Zhang
- School of Agricultural Economics and Rural Development, Renmin University of China, Beijing, China
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Wang J, Wu B, Pei Y, Zhong R. Instrumental support primarily provided by adult children and trajectories of depressive symptoms among older adults with disabilities in rural China. Aging Ment Health 2023; 27:646-652. [PMID: 35341408 DOI: 10.1080/13607863.2022.2056140] [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: 11/01/2022]
Abstract
OBJECTIVES This study aimed to examine the trajectories of depressive symptoms over a 5-year period in a sample of community-dwelling older adults with disabilities in rural China, and the association between duration of instrumental support primarily provided by adult children and the trajectories of depressive symptoms. METHODS Data were drawn from three waves of the China Health and Retirement Longitudinal Study (2011-2015). The sample included 1,466 older adults living in rural areas aged 60 and over who had at least one child in all three waves. Duration of instrumental support provided by adult children was measured by the number of waves that older adults received instrumental support primarily from any adult children in the data collection. Growth mixture modelling was used to identify the trajectory classes of depressive symptoms among these older adults, and logistic regression was used to examine the association between duration of instrumental support primarily provided by adult children and the trajectory classes of depressive symptoms. RESULTS This study identified two distinct trajectories of depressive symptoms among the respondents: high but decreasing levels of symptoms and persistently low levels of symptoms. Respondents who received a longer duration of instrumental support primarily from adult children were more likely to have high but decreasing symptoms after controlling for other covariates. CONCLUSION The findings have important implications for promoting the mental health of older adults with disabilities in rural China. There are still very limited long-term care services and programs are available for older adults, particularly in rural China. It is critical to develop these services at both community and institutional levels to meet the care needs of older adults and their families.
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Affiliation(s)
- Jianyun Wang
- School of Public Administration, Shandong Normal University, Jinan, Shandong, China.,NYU Aging Incubator, New York University, New York, NY, USA
| | - Bei Wu
- Rory Meyers College of Nursing, New York University, New York, NY, USA.,NYU Aging Incubator, New York University, New York, NY, USA
| | - Yaolin Pei
- Rory Meyers College of Nursing, New York University, New York, NY, USA
| | - Renyao Zhong
- Faculty of Economics and Management, East China Normal University, Shanghai, China
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Linking chronic diseases, cognitive impairment and depressive symptoms in Chinese older adults: A three-wave population-based longitudinal study. J Affect Disord 2023; 324:496-501. [PMID: 36621673 DOI: 10.1016/j.jad.2022.12.150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 12/28/2022] [Accepted: 12/31/2022] [Indexed: 01/07/2023]
Abstract
OBJECTIVE Despite previous studies illustrate that chronic diseases are risk factors for older adults' psychological health, little is known about its mediating mechanism. This study aims to examine the mediating effect of cognitive impairment. Also, a particular emphasis is placed on whether the Hukou system in China contributes to the adverse effect of chronic diseases on depressive symptoms. METHODS Using the 2014, 2016 and 2018 rounds of the China Longitudinal Aging Social Survey (CLASS), this study estimates fixed-effect panel models for the effect of chronic diseases on depressive symptoms and the mediating effect of cognitive impairment. Meanwhile, the interaction effect of chronic diseases and hukou status on depressive symptoms is also examined. RESULTS The significant relationship between chronic diseases and depressive symptoms is supported in Chinese older adults and this association is found to be mediated by cognitive impairment. Moreover, no urban-rural disparities exist in the effect of chronic diseases on depressive symptoms. LIMITATION All of the measures in this study are relied on self-report, which may result in reporting biases. CONCLUSION This study contributes to our understanding of the relationship between chronic diseases and depressive symptoms and extends the previous literature by considering the Hukou status, a highly distinctive Chinese variable. Practical implications for policy development and intervention design are also provided.
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Yang Z, Zhang Y, Xu H, Gan M, Ma J, Liu J, Tan X, Hou W, Ye W, Li L. Generalized anxiety disorder among rural primary and middle school students during the outbreak of COVID-19: a multicenter study in three southern Chinese cities. BMC Public Health 2023; 23:327. [PMID: 36788498 PMCID: PMC9926433 DOI: 10.1186/s12889-023-15215-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 02/06/2023] [Indexed: 02/16/2023] Open
Abstract
BACKGROUND The major public health crisis caused by the rapid spread of the coronavirus disease 2019 (COVID-19) and the large-scale public health measures such as social isolation and school closures enforced by some countries have severely affected on the physical and mental wellbeing of children and adolescents globally. This study aimed to estimate the prevalence of the psychological impact and investigate the similarities and differences in the influential factors for generalized anxiety disorder among rural adolescents as a relatively lesser noticed population the outbreak of COVID-19. METHODS From May 11 to 22, 2020, a total of 1,179 adolescents, including Grade 5-6 in primary school and Grade 7-8 in middle school, were selected by multistage sampling in three Southern Chinese cities (Shantou, Guangdong Province; Hezhou, Guangxi Province; Nanchong, Sichuan Province), and completed the questionnaires including sociodemographic, generalized anxiety disorder, academic stress, coronaphobia, knowledge of COVID-19, and precautionary measures. ANOVA, Chi-square test, Kruskalwallis H test and multivariate linear regression were performed in the statistical analysis. RESULTS The average scores of generalized anxiety disorder during the past two weeks were 3.43 (SD 4.46), 4.47 (SD 5.15), and 4.10 (SD 4.94) in Shantou, Hezhou and Nanchong, respectively. For the pooled data, academic stress (P < 0.001), coronaphobia (P < 0.001), and precautionary measures (P = 0.002) contributed to the prediction of anxiety scores. Academic stress was significantly associated to anxiety symptoms in all cities (P all < 0.001). Coronaphobia was also significantly associated to anxiety symptoms in all cities (P all < 0.001). CONCLUSION This study highlights the urgent need for researchers and policymakers to focus on the mental health of rural children and adolescents during the COVID-19 epidemic. The adolescents with academic stress and coronaphobia, the greater the risk that adolescents will suffer from anxiety, suggesting mental health counseling and professional family support are needed.
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Affiliation(s)
- Zidan Yang
- School of Public Health, Shantou University, Shantou, Guangdong Province, China
- Injury Prevention Research Center, Shantou University Medical College, Shantou, Guangdong Province, China
| | - Yongxin Zhang
- Shantou University Medical College, Shantou, Guangdong, China
| | - Haijie Xu
- Shantou University Medical College, Shantou, Guangdong, China
| | - Menglai Gan
- Shantou University Medical College, Shantou, Guangdong, China
| | - Jianrui Ma
- Shantou University Medical College, Shantou, Guangdong, China
| | - Jiarong Liu
- Shantou University Medical College, Shantou, Guangdong, China
| | - Xiner Tan
- Shantou University Medical College, Shantou, Guangdong, China
| | - Wenjing Hou
- Shantou University Medical College, Shantou, Guangdong, China
| | - Wanbao Ye
- Cancer Hospital of Shantou University Medical College, Shantou, Guangdong Province, China
| | - Liping Li
- School of Public Health, Shantou University, Shantou, Guangdong Province, China.
- Injury Prevention Research Center, Shantou University Medical College, Shantou, Guangdong Province, China.
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The relationship between the joint effect of C-reactive protein and glycated hemoglobin with the risk of depressive symptoms among middle-aged and older adults: Findings from the China health and retirement longitudinal study. J Psychiatr Res 2023; 158:88-94. [PMID: 36577238 DOI: 10.1016/j.jpsychires.2022.12.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 12/22/2022] [Accepted: 12/23/2022] [Indexed: 12/25/2022]
Abstract
OBJECTIVES The present study aimed to explore the relationship between the joint effect of C-reactive protein and glycated hemoglobin with the risk of depressive symptoms among middle-aged and older adults. METHODS A total of 5985 participants aged 45 years or older from the China Health and Retirement longitudinal study 2011 and 2015 were included in this study. Participants were divided into 4 groups according to C-reactive protein and glycated hemoglobin. Multivariate logistic regression model was used to explore the associations between C-reactive protein and glycated hemoglobin and new-onset depression. RESULTS During the follow-up period, 1001(16.73%) participants experienced depressive symptoms. Compared to participants with low C-reactive protein and low glycated hemoglobin, individuals with C-reactive protein and glycated hemoglobin both high levels have a higher risk to suffer from depressive symptoms with corresponding multivariable adjusted odds ratio (OR = 1.17, 95% CI: 1.01-1.36). Adding C-reactive protein and glycated hemoglobin simultaneously to conventional risk model significantly improved risk reclassification for depressive symptoms. The statistically significant interaction with joint effects of C-reactive protein and glycated hemoglobin on depressive symptoms was only found in different sex (P-interaction = 0.006) or age (P-interaction = 0.004) groups. Sensitivity analysis yields similar results. CONCLUSIONS Higher levels of C-reactive protein and glycated hemoglobin jointly increased the risk of depressive symptoms among Chinese middle-aged and older adults. Using the combination indicator of C-reactive protein and glycated hemoglobin could better identify individuals at risk of depressive symptoms.
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Nie W, Hu M, Ye X. Internet use and rural-urban mental health inequalities: Evidence from China. Front Public Health 2023; 11:1107146. [PMID: 36778581 PMCID: PMC9909550 DOI: 10.3389/fpubh.2023.1107146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 01/10/2023] [Indexed: 01/27/2023] Open
Abstract
Introduction In the context of the new digital era, clarifying the relationship between Internet use and urban and rural residents' mental health is of important value for reducing rural-urban health inequalities. This paper aims to study the association between Internet use and rural-urban mental health inequalities. Methods Based on the data of the China Family Panel Studies (CFPS) in 2020, we firstly examined the existence and specific manifestation of mental health inequalities between urban and rural residents. Secondly, we examined the mediating effect of Internet use by the Bootstrap mediating effect measure. Finally, we verified the robustness of the mediating effect. Results There are significant mental health inequalities between urban and rural residents, and urban residents have better mental health than rural residents (p < 0.01). In addition, the test results for the mediating effect of Internet use on mental health inequalities between urban and rural residents were significant (p < 0.01), with a direct effect of -0.028 (p < 0.01) and an indirect effect of -0.49 (p < 0.01), and this result remained significant in the robustness test. Discussion In such a new age of the Internet, mental health inequalities between urban and rural residents objectively did exist, and the use of the internet played a positive mediation effect on the formation of mental health inequalities between urban and rural areas.
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Affiliation(s)
- Weihao Nie
- Faculty of Arts and Humanities, Philosophy, Politics and Economics of Health, University College London, London, United Kingdom
| | - Mingzheng Hu
- China Center for Health Development Studies, Peking University, Beijing, China
| | - Xin Ye
- Institute for Global Public Policy, LSE-Fudan Research Centre for Global Public Policy, Fudan University, Shanghai, China,*Correspondence: Xin Ye ✉
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Association between age and loneliness in different residential type and gender groups: evidence from China. BMC Psychiatry 2023; 23:43. [PMID: 36650472 PMCID: PMC9843997 DOI: 10.1186/s12888-023-04525-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 01/05/2023] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Age has been identified as a prominent predictor of loneliness, although the findings about the relationship between age and loneliness are inconclusive. This study examines the relationship between age and loneliness in the context of China, with a focus on residential and gender differences. METHODS Data were from the Chinese General Social Survey (CGSS) of 2017. A total of 3899 respondents were included. Loneliness was measured using a three-item Short Loneliness Scale. Age, squared terms of age, residential type, gender, and other socio-demographic characteristics were included in the study. Regression analyses were conducted among the total sample and subgroups of different gender and residential type subgroups, to investigate the association between age and loneliness. RESULTS There is a reverse U-shaped tendency between age and loneliness that peaks at the age of 47. This tendency is true of the male subgroup, that peaks at the age of 55, while the female respondents do not share that tendency. The inverted U-shaped distribution holds true for urban but not for rural residents. The female respondents reported a higher level of loneliness than the male. The rural respondents reported higher loneliness than their counterparts. CONCLUSIONS This study demonstrates that an inverted U-shaped tendency between age and loneliness existed for the entire group, and the male and urban subgroups. Implications for service and practice are proposed based on the empirical findings.
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Li S, Yin Y, Cui G, Zhang C, Zhu H, Yao Y. The mediating and moderating effects of resilience between childhood trauma and geriatric depressive symptoms among Chinese community-dwelling older adults. Front Public Health 2023; 11:1137600. [PMID: 37124808 PMCID: PMC10140585 DOI: 10.3389/fpubh.2023.1137600] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 03/16/2023] [Indexed: 05/02/2023] Open
Abstract
Objective This study aims to examine the association between childhood traumatic events (CTEs), childhood trauma severity, and depressive symptoms, as well as to examine the mediating and moderating roles of resilience in these associations. Methods We conducted a cross-sectional study of 1,091 community-dwelling older adults in Jinan, China. The trauma history questionnaire (THQ) was used to measure CTEs and childhood trauma severity. CTEs were defined as the number of traumatic events before the age of 18. We calculated childhood trauma severity by multiplying the number of CTEs by the participants' self-perceived impact level of the events from the THQ. We then applied the 15-item Geriatric Depression Scale and 10-item Connor-Davidson Resilience Scale to assess participants' depressive symptoms and resilience, respectively. Linear regression models were used to examine the associations, and structural equation modeling was used to examine the mediating and moderating roles of resilience. Results Childhood traumatic events, childhood trauma severity, and resilience were all associated with depressive symptoms in older adults. Resilience mediated the relationship between childhood trauma severity and depressive symptoms (β = 0.082, 95% CI = 0.045-0.123), accounting for 26.6% of the overall effect (β = 0.308, 95% CI = 0.190-0.422). However, there was no evidence that resilience mediated the association between CTEs and depressive symptoms. In addition, we did not find that resilience played a moderating role in the associations of CTEs, childhood trauma severity with depressive symptoms. Conclusion Resilience plays a mediating role in the relationship between childhood trauma severity and depressive symptoms. Intervention measures on improving resilience may reduce childhood trauma severity associated with depression risk in older Chinese adults.
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Affiliation(s)
- Shaojie Li
- School of Public Health, Peking University, Beijing, China
- China Center for Health Development Studies, Peking University, Beijing, China
| | - Yongtian Yin
- Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Guanghui Cui
- Department of Integrated Traditional Chinese and Western Medicine, Peking University First Hospital, Beijing, China
| | - Chi Zhang
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital, National Center of Gerontology of National Health Commission, Beijing, China
| | - He Zhu
- China Center for Health Development Studies, Peking University, Beijing, China
- *Correspondence: He Zhu,
| | - Yao Yao
- China Center for Health Development Studies, Peking University, Beijing, China
- Yao Yao,
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Guo H, Feng S, Liu Z. The temperature of internet: Internet use and depression of the elderly in China. Front Public Health 2022; 10:1076007. [PMID: 36620285 PMCID: PMC9811204 DOI: 10.3389/fpubh.2022.1076007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 12/02/2022] [Indexed: 12/24/2022] Open
Abstract
Introduction Depression has become one of the most prevalent mental illnesses affecting the elderly in aging countries, i. e., in countries of the world whose population is slowly aging. It has become an important topic for scientists and policymakers to analyze how best to improve the elderly's mental health and save them from depression. The aim of this paper was to investigate whether and to what extent internet use may affect depression in the elderly. The heterogeneous effects of internet use on the elderly's depression across age, gender, and occupation were also investigated. Methods The data used in the present study were gathered from the China Health and Retirement Longitudinal Study that was conducted in 2018. The propensity score matching technique and the endogenous switch regression model were employed in this study to address potential endogeneity caused by both observed and unobserved factors. Results The results of the present study show that the elderly who are relatively young, male, well educated, live in an urban area, or have a small family are more likely to use the internet. The elderly who have healthy eyes or good eyesight, those who are not employed in the agricultural sector, or those who are retired, and those who are not eligible to receive any subsistence allowance or drink wine have a higher probability of using the internet. We also find that internet use significantly reduces the elderly's depression status by 3.370 points, which is roughly equivalent to a reduction of 37.19%. Heterogeneity analysis on internet use reveals that the health effect is particularly effective for agricultural workers, female, or the older elderly. Conclusion The results of the present study highlight the significant welfare effects brought about by the development of internet infrastructure. To improve the mental health of the elderly, the government should encourage them to adopt the internet. In particular, the needs of the elderly who are older, female, or have agricultural work should be paid more attention to motivate them to use the internet more to alleviate depression.
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Affiliation(s)
- Hongwang Guo
- School of Public Administration and Policy, Renmin University of China, Beijing, China
| | - Shuyi Feng
- China Resources, Environment and Development Academy, Nanjing Agricultural University, Nanjing, China
| | - Ziming Liu
- School of Social and Public Administration, East China University of Science and Technology, Shanghai, China,*Correspondence: Ziming Liu ✉
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Multidimensional evaluation of healthy life expectancy indicators based on mental health among the rural older population: A large-scale cross-sectional study. J Affect Disord 2022; 319:318-324. [PMID: 36116604 DOI: 10.1016/j.jad.2022.09.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 09/09/2022] [Accepted: 09/13/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND This study aimed to estimate healthy life expectancy (HLE) regarding anxiety, depression and their comorbidity among rural older adults. METHODS A total of 12,851 subjects (5790 men and 7061 women) enrolled from the Henan Rural Cohort Study were used to evaluate healthy status expectancy (HSE), and 10,096 (4475 men and 5621 women) of them were used to estimate health-adjusted life expectancy (HALE). The life expectancy was calculated using period life table, and HSE and HALE indicators were calculated via the Sullivan method. RESULTS For participants aged 60, the depression-free life expectancy (DFLE), anxiety-free life expectancy (AFLE), and depression- and anxiety-free life expectancy (DAFLE) were 23.0993, 23.3314, and 22.7206 years, respectively. The quality-adjusted life expectancy (QALE) of those with neither anxiety nor depression, with anxiety, with depression, and with comorbidity was 22.0727, 20.8751, 18.1484, and 17.0823 years, respectively. The ratio of DFLE (AFLE) to LE increased with age among both genders, while the DAFLE/LE showed a decreasing trend. Regardless of HSE or HALE indicators, women tended to have higher HLE, while HLE/LE was lower than men. Furthermore, all HLE indicators associated with anxiety were the largest in both genders compared to indicators regarding depression. LIMITATIONS The HLE may be overestimated ignoring institutional population in the study. CONCLUSION Anxiety and depression played essential roles in the quality of life among rural older adults, especially depression. Comorbidity would intensify the adverse effect in rural areas, especially for older men. More attention should be paid to the psychological problems among rural older population.
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Chen X, Giles J, Yao Y, Yip W, Meng Q, Berkman L, Chen H, Chen X, Feng J, Feng Z, Glinskaya E, Gong J, Hu P, Kan H, Lei X, Liu X, Steptoe A, Wang G, Wang H, Wang H, Wang X, Wang Y, Yang L, Zhang L, Zhang Q, Wu J, Wu Z, Strauss J, Smith J, Zhao Y. The path to healthy ageing in China: a Peking University-Lancet Commission. Lancet 2022; 400:1967-2006. [PMID: 36423650 PMCID: PMC9801271 DOI: 10.1016/s0140-6736(22)01546-x] [Citation(s) in RCA: 130] [Impact Index Per Article: 65.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 08/07/2022] [Accepted: 08/12/2022] [Indexed: 11/22/2022]
Abstract
Around the world, populations are ageing at a faster pace than in the past and this demographic transition will have impacts on all aspects of societies. In May 2020, the UN General Assembly declared 2021–2030 the Decade of Healthy Ageing, highlighting the importance for policymakers across the world to focus policy on improving the lives of older people, both today and in the future. While rapid population ageing poses challenges, China’s rapid economic growth over the last forty years has created space for policy to assist older persons and families in their efforts to improve health and well-being at older ages. As China is home to 1/5 of the world’s older people, China is often held up as an example for other middle-income countries. This Commission Report aims to help readers to understand the process of healthy ageing in China as a means of drawing lessons from the China experience. In addition, with the purpose of informing the ongoing policy dialogue within China, the Commission Report highlights the policy challenges on the horizon and draws lessons from international experience.
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Affiliation(s)
- Xinxin Chen
- Institute of Social Science Survey, Peking University, Beijing, China
| | | | - Yao Yao
- China Center for Health Development Studies, Peking University, Beijing, China
| | - Winnie Yip
- Department of Global Health and Population, Harvard University, Boston, MA, USA
| | - Qinqin Meng
- Institute of Social Science Survey, Peking University, Beijing, China
| | - Lisa Berkman
- Harvard Center for Population and Development Studies, Harvard University, Boston, MA, USA; Division of Geriatric Medicine, UCLA, Los Angeles, CA, USA
| | - He Chen
- School of Public Administration and Policy, Renmin University of China, Beijing, China
| | - Xi Chen
- Department of Health Policy and Management, Department of Economics, Yale School of Public Health, New Haven, CT, USA
| | - Jin Feng
- School of Economics, Fudan University, Shanghai, China
| | | | | | - Jinquan Gong
- Institute of Social Science Survey, Peking University, Beijing, China
| | - Perry Hu
- Division of Geriatric Medicine, UCLA, Los Angeles, CA, USA
| | - Haidong Kan
- Department of Environmental Health, School of Public Health, Fudan University, Shanghai, China
| | - Xiaoyan Lei
- National School of Development, Peking University, Beijing, China
| | - Xiao Liu
- School of Labor Economics, Capital University of Economics and Business, Beijing, China
| | - Andrew Steptoe
- Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London, UK
| | - Gewei Wang
- Institute of Social Science Survey, Peking University, Beijing, China
| | - Harold Wang
- Program in Bioinformatics, UCLA, Los Angeles, CA, USA
| | - Huali Wang
- Dementia Care & Research Center, Beijing Dementia Key Lab, Peking University Institute of Mental Health (Sixth Hospital), Beijing, China
| | - Xiaoyu Wang
- Institute of Population and Labor Economics, Chinese Academy of Social Sciences, Beijing, China
| | - Yafeng Wang
- Institute of Social Science Survey, Peking University, Beijing, China
| | - Li Yang
- Department of Health Policy and Management, Peking University, Beijing, China
| | - Luxia Zhang
- Renal Division, Department of Medicine, Peking University First Hospital and National Institute of Health Data Science, Peking University, Beijing, China
| | - Quan Zhang
- National School of Development, Peking University, Beijing, China
| | - Jing Wu
- School of Pharmaceutical Science and Technology, Tianjin University, Tianjin, China
| | - Zunyou Wu
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - John Strauss
- Department of Economics, University of Southern California, Los Angeles, CA, USA
| | | | - Yaohui Zhao
- National School of Development, Peking University, Beijing, China.
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Yu H, Xu S, Li H, Wang X, Sun Q, Wang Y. A man-made divide: Investigating the effect of urban–rural household registration and subjective social status on mental health mediated by loneliness among a large sample of university students in China. Front Psychol 2022; 13:1012393. [DOI: 10.3389/fpsyg.2022.1012393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 10/28/2022] [Indexed: 11/18/2022] Open
Abstract
IntroductionThe urban–rural household registration system in China has been documented with profound social consequences in almost all areas of people’s life. This study aims to investigate the underlying mechanism of the rural and urban discrepancies on mental health conditions among a large sample of college students in China.MethodsA survey was distributed among college students in China. A total of 96,218 college students from 63 colleges completed the survey, answering questions on their urban–rural household registration, disposable household income, subjective social status, feelings of loneliness, and anxiety and depression symptoms. Confirmatory Factor Analysis (CFA) and Structural Equation Modelling (SEM) analyses were conducted, testing the effect of urban–rural registration on one’s mental health, mediated by subjective social status, and loneliness.ResultsStructural Equation Modelling (SEM) results revealed that the urban–rural household registration showed a direct effect on anxiety (B = −0.03, 95% CI [−0.038, −0.022], β = −0.03, p < 0.001) and depression (B = −0.03, 95% CI [−0.035, −0.023], β = −0.03, p < 0.001), indicating that rural household registration had a negative association with anxiety and depression symptoms, albeit the standardised estimate being very small. The indirect path from the urban–rural registration mediated through subjective social status and loneliness to anxiety and depression was both significant, with B = 0.01, 95% CI [0.010, 0.010], β = 0.01, p < 0.001, and B = 0.01, 95% CI [0.0090, 0.0090], β = 0.01, p < 0.001, respectively. The results of the indirect paths demonstrated that students of the rural household registration reported higher anxiety and depression symptoms through a lower subjective social status and higher level of loneliness.ConclusionThis study indicated that decreasing the disparity of social status and tackling loneliness is the key to improve the overall mental health of college students. The urban–rural household registration system may have a very small direct effect on the college students’ mental health; but students of urban registration enjoyed higher subjective social status, which had a clear protective effect against anxiety and depression symptoms.
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Fang M, Ferro MA, Dubin JA, Oremus M. The association between adverse childhood experiences and depression symptoms in older adults in China: An analysis of the China health and retirement study. INTERNATIONAL JOURNAL OF MENTAL HEALTH 2022. [DOI: 10.1080/00207411.2022.2123696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- Mingying Fang
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
| | - Mark A. Ferro
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
| | - Joel A. Dubin
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
- Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, Canada
| | - Mark Oremus
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
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23
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Yan J, Ren Q, Lin H, Liu Q, Fu J, Sun C, Li W, Ma F, Zhu Y, Li Z, Zhang G, Du Y, Liu H, Zhang X, Chen Y, Wang G, Huang G. Association between Dietary Patterns and the Risk of Depressive Symptoms in the Older Adults in Rural China. Nutrients 2022; 14:nu14173538. [PMID: 36079798 PMCID: PMC9460296 DOI: 10.3390/nu14173538] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Revised: 08/21/2022] [Accepted: 08/25/2022] [Indexed: 11/29/2022] Open
Abstract
Geriatric depression, a chronic condition, has become a substantial burden in rural China. This study aimed to assess the association between dietary patterns and the risk of geriatric depression in rural China. Between March 2018 and June 2019, 3304 participants were recruited for this cross-sectional study in rural Tianjin, China. Principal component analysis was used to determine the major dietary patterns. The associations between dietary patterns and the risk of geriatric depression were assessed using a logistic regression model. Four dietary patterns were identified: vegetables-fruit, animal food, processed food, and milk-egg. The study found that vegetable-fruit (Q2 vs. Q1: OR = 0.62, 95% CI: 0.46–0.83; Q3 vs. Q1: OR = 0.54, 95% CI: 0.38–0.75; Q4 vs. Q1: OR = 0.39, 95% CI: 0.26–0.57) and animal food patterns (Q3 vs. Q1: OR = 0.69, 95% CI: 0.50–0.95; Q4 vs. Q1: OR = 0.58, 95% CI: 0.41–0.82) were associated with a decreased risk of depression, and inflammatory dietary pattern (Q2 vs. Q1: OR = 1.71, 95% CI: 1.23–2.38; Q3 vs. Q1: OR = 1.70, 95% CI: 1.22–2.36; Q4 vs. Q1: OR = 1.44, 95% CI: 1.03–2.03) was associated with an increased risk of depression. The present findings reinforce the importance of adopting an adequate diet consisting of vegetables, fruit and animal foods, while limiting the intake of pro-inflammatory foods, to decrease the risk of depression.
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Affiliation(s)
- Jing Yan
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin 300070, China
- Department of Social Medicine and Health Administration, School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin 300070, China
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, 22 Qixiangtai Road, Heping District, Tianjin 300070, China
| | - Qinghan Ren
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin 300070, China
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, 22 Qixiangtai Road, Heping District, Tianjin 300070, China
| | - Hongyan Lin
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin 300070, China
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, 22 Qixiangtai Road, Heping District, Tianjin 300070, China
| | - Qian Liu
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin 300070, China
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, 22 Qixiangtai Road, Heping District, Tianjin 300070, China
| | - Jingzhu Fu
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin 300070, China
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, 22 Qixiangtai Road, Heping District, Tianjin 300070, China
| | - Changqing Sun
- Neurosurgical Department, Baodi Clinical College, Tianjin Medical University, 8 Guangchuan Road, Baodi District, Tianjin 301899, China
| | - Wen Li
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin 300070, China
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, 22 Qixiangtai Road, Heping District, Tianjin 300070, China
| | - Fei Ma
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, 22 Qixiangtai Road, Heping District, Tianjin 300070, China
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin 300070, China
| | - Yun Zhu
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, 22 Qixiangtai Road, Heping District, Tianjin 300070, China
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin 300070, China
| | - Zhenshu Li
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin 300070, China
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, 22 Qixiangtai Road, Heping District, Tianjin 300070, China
| | - Guoquan Zhang
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin 300070, China
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, 22 Qixiangtai Road, Heping District, Tianjin 300070, China
| | - Yue Du
- Department of Social Medicine and Health Administration, School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin 300070, China
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, 22 Qixiangtai Road, Heping District, Tianjin 300070, China
| | - Huan Liu
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin 300070, China
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, 22 Qixiangtai Road, Heping District, Tianjin 300070, China
| | - Xumei Zhang
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin 300070, China
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, 22 Qixiangtai Road, Heping District, Tianjin 300070, China
| | - Yongjie Chen
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, 22 Qixiangtai Road, Heping District, Tianjin 300070, China
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin 300070, China
| | - Guangshun Wang
- Department of Tumour, Baodi Clinical College, Tianjin Medical University, 8 Guangchuan Road, Baodi District, Tianjin 301899, China
| | - Guowei Huang
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin 300070, China
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, 22 Qixiangtai Road, Heping District, Tianjin 300070, China
- Correspondence: ; Tel.: +86-22-8333-6603; Fax: +86-22-8333-6603
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Huang H, Wang J, Jiang CQ, Zhu F, Jin YL, Zhu T, Zhang WS, Xu L. Hearing loss and depressive symptoms in older Chinese: whether social isolation plays a role. BMC Geriatr 2022; 22:620. [PMID: 35883170 PMCID: PMC9316428 DOI: 10.1186/s12877-022-03311-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 07/18/2022] [Indexed: 11/17/2022] Open
Abstract
Background Existing evidence links hearing loss to depressive symptoms, with the extent of association and underlying mechanisms remaining inconclusive. We conducted a cross-sectional study to examine the association of hearing loss with depressive symptoms and explored whether social isolation mediated the association. Methods Eight thousand nine hundred sixty-two participants from Guangzhou Biobank Cohort Study were included. Data on self-reported hearing status, the 15-item Geriatric Depression Scale (GDS-15), social isolation and potential confounders were collected by face-to-face interview. Results The mean (standard deviation) age of participants was 60.2 (7.8) years. The prevalence of poor and fair hearing was 6.8% and 60.8%, respectively. After adjusting for age, sex, household income, education, occupation, smoking, alcohol use, self-rated health, comorbidities, compared with participants who had normal hearing, those with poor hearing (β = 0.74, 95% confidence interval (CI) 0.54, 0.94) and fair hearing (β = 0.59, 95% CI 0.48, 0.69) had higher scores of GDS-15. After similar adjustment, those with poor hearing (odds ratio (OR) = 2.13, 95% CI 1.65, 2.74) or fair hearing (OR = 1.68, 95% CI 1.43, 1.99) also showed higher odds of depressive symptoms. The association of poor and fair hearing with depressive symptoms attenuated slightly but not substantially after additionally adjusting for social isolation. In the mediation analysis, the adjusted proportion of the association mediated through social isolation was 9% (95% CI: 6%, 22%). Conclusion Poor hearing was associated with a higher risk of depressive symptoms, which was only partly mediated by social isolation. Further investigation of the underlying mechanisms is warranted. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-03311-0.
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Affiliation(s)
- Hao Huang
- School of Public Health, Sun Yat-Sen University, No. 74 Zhongshan 2ndRoad, Guangzhou, Guangdong Province, China
| | - Jiao Wang
- School of Public Health, Sun Yat-Sen University, No. 74 Zhongshan 2ndRoad, Guangzhou, Guangdong Province, China
| | | | - Feng Zhu
- Guangzhou Twelfth People's Hospital, Guangzhou, 510620, China
| | - Ya Li Jin
- Guangzhou Twelfth People's Hospital, Guangzhou, 510620, China
| | - Tong Zhu
- Guangzhou Twelfth People's Hospital, Guangzhou, 510620, China
| | - Wei Sen Zhang
- Guangzhou Twelfth People's Hospital, Guangzhou, 510620, China.
| | - Lin Xu
- School of Public Health, Sun Yat-Sen University, No. 74 Zhongshan 2ndRoad, Guangzhou, Guangdong Province, China. .,School of Public Health, the University of Hong Kong, Hong Kong, China.
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25
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Zhang J, Chandola T, Zhang N. Understanding the longitudinal dynamics of rural-urban mental health disparities in later life in China. Aging Ment Health 2022:1-10. [PMID: 35822456 DOI: 10.1080/13607863.2022.2098912] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
OBJECTIVES Understanding longitudinal patterns of rural-urban mental health disparities is vital for effective intervention and policy development in China. However, few studies have estimated separate effects of birth-cohort and ageing and examined the role of community resources on health inequalities. METHODS Drawing data from the China Health and Retirement Longitudinal Study (2011-2018), this study employed multilevel modelling to identify the mental health trajectories of rural, peri-urban, urban older adults by cohort and the community effects. RESULTS The changes in the mental health gap between rural, peri-urban and urban older adults over time varied by birth cohorts. Among younger cohorts aged under 65, the mental health disparities between rural, peri-urban and urban residents increased as they got older. Underdeveloped community infrastructure greatly explained the rural health disadvantage. CONCLUSION The study indicates increasing rural-urban health disparities at the onset of later life. Improving community infrastructure in rural and peri-urban areas is vital to minimise rural-urban health gaps.
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Affiliation(s)
- Jingwen Zhang
- Department of Social Statistics, Manchester Institute for Collaborative Research on Ageing (MICRA), School of Social Sciences, The University of Manchester, Manchester, UK
| | - Tarani Chandola
- Faculty of the Social Sciences, The University of Hong Kong, Hong Kong, China
| | - Nan Zhang
- Department of Social Statistics, Manchester Institute for Collaborative Research on Ageing (MICRA), School of Social Sciences, The University of Manchester, Manchester, UK
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26
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Zhou S, Wang Q, Zhang J, Wang Q, Hou F, Han X, Hu S, Shen G, Zhang Y. Depressive Symptoms and Cognitive Decline Among Chinese Rural Elderly Individuals: A Longitudinal Study With 2-Year Follow-Up. Front Public Health 2022; 10:939150. [PMID: 35910927 PMCID: PMC9326072 DOI: 10.3389/fpubh.2022.939150] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Accepted: 06/22/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundDepressive symptoms and mild cognitive impairment (MCI) are highly prevalent in rural China. The study aimed to investigate the longitudinal associations between changes in depressive symptoms and cognitive decline and MCI incidence among Chinese rural elderly individuals.MethodsA 2-year follow-up study was conducted among 1,477 participants from the Anhui Healthy Longevity Survey (AHLS). Depressive symptoms were assessed by the 9-item Patient Health Questionnaire (PHQ-9), and cognitive status was evaluated by the Mini Mental State Examination (MMSE). Multivariable linear regression and logistic regression were employed.ResultsEvery 1-unit PHQ-9 score increase was significantly associated with more cognitive decline (β = 0.157, 95% CI: 0.092, 0.221, p < 0.001) and a higher risk of MCI incidence (OR = 1.063, 95% CI: 1.025, 1.103, p = 0.001). The participants who experienced worsening of depression symptoms had a larger decline in the 2-year MMSE score (β = 0.650, 95% CI: 0.039, 1.261, p = 0.037) and elevated risks of incident MCI (OR = 1.573, 95% CI: 1.113, 2.223, p = 0.010).LimitationsScreening tools rather than standard diagnostic procedures were used in the study. Moreover, the long-term associations still need further exploration since the follow-up time was short.ConclusionsIncreased depressive symptoms were associated with more cognitive decline and higher risks of incident MCI among Chinese rural residents.
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Affiliation(s)
- Shuai Zhou
- Department of Health Service Management, School of Health Service Management, Anhui Medical University, Hefei, China
| | - Qiong Wang
- Department of Health Service Management, School of Health Service Management, Anhui Medical University, Hefei, China
| | - Jingya Zhang
- Department of Health Service Management, School of Health Service Management, Anhui Medical University, Hefei, China
| | - Qing Wang
- Department of Health Service Management, School of Health Service Management, Anhui Medical University, Hefei, China
| | - Fangfang Hou
- Department of Health Service Management, School of Health Service Management, Anhui Medical University, Hefei, China
| | - Xiao Han
- Department of Health Service Management, School of Health Service Management, Anhui Medical University, Hefei, China
| | - Shilian Hu
- Department of Geriatrics, The First Affiliated Hospital of University of Science and Technology of China, Gerontology Institute of Anhui, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
- Anhui Key Laboratory of Tumor Immunotherapy and Nutrition Therapy, Hefei, China
- *Correspondence: Shilian Hu
| | - Guodong Shen
- Department of Geriatrics, The First Affiliated Hospital of University of Science and Technology of China, Gerontology Institute of Anhui, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
- Anhui Key Laboratory of Tumor Immunotherapy and Nutrition Therapy, Hefei, China
- Guodong Shen
| | - Yan Zhang
- Department of Health Service Management, School of Health Service Management, Anhui Medical University, Hefei, China
- Yan Zhang
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27
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Zhang J, Xiao S, Shi L, Xue Y, Zheng X, Dong F, Xue B, Zhang C. Differences in Health-Related Quality of Life and Its Associated Factors Among Older Adults in Urban and Rural Areas. Risk Manag Healthc Policy 2022; 15:1447-1457. [PMID: 35923554 PMCID: PMC9342693 DOI: 10.2147/rmhp.s373077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 07/14/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose Urban-rural health disparity is one of the most prominent challenges in China today. The goal of this study is to find differences in health-related quality of life (HRQoL) and its associated factors among older people in urban and rural areas. Methods A multi-stage stratified sampling method was conducted in Shanxi Province, with a total of 3250 older adults participated in this cross-sectional survey. HRQoL was assessed using the Chinese version of the EQ-5D-5L. Tobit regression models were employed to identify associated factors for HRQoL. Results The mean EQ-5D utility score of the total sample was 0.87± 0.23, with a statistically significant difference observed between urban (0.89 ± 0.22) and rural areas (0.86 ± 0.23). Obesity (Coe=−0.10, p=0.021) and nutrition awareness (Coe=−0.14, p=0.009) were two unique associated factors to rural older adults’ HRQoL. While, age (Urban: Coe=0.13, p=0.001; Rural: Coe=−0.019, p<0.001), socioeconomic status (Urban: Coe=0.13, p<0.001; Rural: Coe=0.14, p<0.001), number of chronic non-communicable diseases (Urban: Coe=−0.20, p<0.001; Rural: Coe=−0.15, p<0.001), sleep quality (Urban: Coe=−0.22, p<0.001; Rural: Coe=0.15, p<0.001) and daytime sleepiness (Urban: Coe=−0.13, p<0.001; Rural: Coe=−0.13, p<0.001) were found to be associated with HRQoL regardless of the residential area. Conclusion This study suggested that rural older adults are facing HRQoL disadvantages compared to those in urban area. Accordingly, more attention should be devoted to rural older adults’ HRQoL, particularly to the unique factors like body weight and nutrition awareness. Targeted policies and interventions should be implemented to improve HRQoL and bridge the urban-rural HRQoL gap.
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Affiliation(s)
- Jiachi Zhang
- School of Health Management, Southern Medical University, Guangzhou, People’s Republic of China
| | - Shujuan Xiao
- School of Health Management, Southern Medical University, Guangzhou, People’s Republic of China
- School of Public Health, Southern Medical University, Guangzhou, People’s Republic of China
| | - Lei Shi
- School of Health Management, Southern Medical University, Guangzhou, People’s Republic of China
| | - Yaqing Xue
- School of Health Management, Southern Medical University, Guangzhou, People’s Republic of China
- School of Public Health, Southern Medical University, Guangzhou, People’s Republic of China
| | - Xiao Zheng
- School of Health Management, Southern Medical University, Guangzhou, People’s Republic of China
- School of Public Health, Southern Medical University, Guangzhou, People’s Republic of China
| | - Fang Dong
- School of Health Management, Southern Medical University, Guangzhou, People’s Republic of China
| | - Benli Xue
- School of Health Management, Southern Medical University, Guangzhou, People’s Republic of China
| | - Chichen Zhang
- School of Health Management, Southern Medical University, Guangzhou, People’s Republic of China
- Department of Health Management, Nanfang Hospital, Southern Medical University, Guangzhou, People’s Republic of China
- Institute of Health Management, Southern Medical University, Guangzhou, People’s Republic of China
- Correspondence: Chichen Zhang, School of Health Management, Southern Medical University, No. 1023 Shatai South Road, Baiyun District, Guangzhou, 510515, People’s Republic of China, Tel +86-20-61648756, Email
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Zheng P, Yang H, Wang Z. Association of empty nest with depressive symptom among Chinese elderly population: The China Longitudinal Aging Social Survey. Medicine (Baltimore) 2022; 101:e29841. [PMID: 35777037 PMCID: PMC9239606 DOI: 10.1097/md.0000000000029841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Currently, empty nest has become one type of the family pattern among the old population and it influences the old population's mental health. The current study aimed to explore the association between the empty nest and depressive symptoms (DSs) among the elderly population in China. Data were obtained from baseline of the China Longitudinal Aging Social Survey. Logistic regression was used to examine the association between the empty nest and DS among Chinese older adults. In the current study, 48% of the subjects were empty-nest elderly. The prevalence of DS was 43.7% among the empty-nest old population, which was higher than the nonempty nesters. A positive association was found between the empty nest and DS; the odds ratio (95% confidence interval) was 1.28 (1.16-1.42). No matter living with a spouse or living alone, empty nesters were more likely to have DS than nonempty nesters. Empty nest is a risk factor for having DS among the old population in China, especially among those who live without a spouse. Our result is valuable for the development of special family support DS prevention programs for those who were empty nest.
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Affiliation(s)
- Pianpian Zheng
- Institute of Population Research, Peking University, Haidian District, Beijing, People’s Republic of China
| | - Hanmo Yang
- National School of Development, Peking University, Haidian District, Beijing, People’s Republic of China
| | - Zhenjie Wang
- Institute of Population Research, Peking University, Haidian District, Beijing, People’s Republic of China
- *Correspondence: Zhenjie Wang, Institute of Population Research, Peking University, No. 5 Yiheyuan Road, Haidian District, Beijing 100871, People’s Republic of China. (e-mail: )
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Wang M, Xu M, Sun L. Loneliness and coping skill mediate the association between child maltreatment and depression for rural males and females. BMC Psychiatry 2022; 22:413. [PMID: 35729560 PMCID: PMC9215002 DOI: 10.1186/s12888-022-04056-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 06/06/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Child maltreatment is a prevalent and notable problem in rural China, and the prevalence and severity of depression in rural areas are higher than the national norm. Several studies have found that loneliness and coping skills respectively mediated the relationship between child maltreatment and depression. However, few studies have examined the roles of loneliness and coping skills in child maltreatment and depression based on gender differences. METHODS All participants were from rural communities aged more than 18 years in Shandong province, and 879 valid samples (female:63.4%) ranging in age from 18 to 91 years old were analyzed. The Childhood Trauma Questionnaire-Short Form (CTQ-SF), the Center for Epidemiologic Studies-Depression (CES-D), the Simple Coping Style Questionnaire (SCSQ), and the Emotional and Social Loneliness Scale (ESLS) were used to evaluate child maltreatment, depression, coping skills and loneliness. RESULTS Child maltreatment was more common and severe in males than females (F = 3.99; p < 0.05). Loneliness and coping skills partially mediated the relationship between child maltreatment and depression in males, but loneliness fully mediated the relationship between child maltreatment and depression in females. CONCLUSION In this study, males were more likely to experience child maltreatment. Child maltreatment and depression were correlated. We also found a mediating role of loneliness and coping skills for males and a mediating role of loneliness in females.
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Affiliation(s)
- Meiqi Wang
- grid.27255.370000 0004 1761 1174Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wenhuaxi Road, Jinan, 250012 Shandong China ,grid.27255.370000 0004 1761 1174National Health Commission of China, Key Lab of Health Economics and Policy Research (Shandong University), Jinan, 250012 Shandong China
| | - Meixia Xu
- grid.495262.e0000 0004 1777 7369Shandong Women’s University, Jinan, 250300 China
| | - Long Sun
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wenhuaxi Road, Jinan, 250012, Shandong, China. .,National Health Commission of China, Key Lab of Health Economics and Policy Research (Shandong University), Jinan, 250012, Shandong, China.
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Zhao L, Wang J, Deng H, Chen J, Ding D. Depressive Symptoms and ADL/IADL Disabilities Among Older Adults from Low-Income Families in Dalian, Liaoning. Clin Interv Aging 2022; 17:733-743. [PMID: 35574289 PMCID: PMC9091470 DOI: 10.2147/cia.s354654] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 04/20/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose This study aimed to assess the prevalence of depressive symptoms and ADL/IADL disabilities and explore their correlation and associated factors for depressive symptoms among community-dwelling older adults from low-income families in Dalian, Liaoning Province, China. Methods This cross-sectional study included 522 participants aged 60 years and older from low-income families in Dalian. The 30-Item Geriatric Depression Scale was employed to measure depressive symptoms. The Katz ADL Scale and IADL Scale were used to evaluate the performance of activities necessary for independent life. SPSS 22.0 was employed to analyze the data. Logistic regression was used to estimate the relationship between depressive symptoms and ADL/IADL disabilities in five models. Results The prevalence of depressive symptoms among older people from low-income families in Dalian was 57.3%. A total of 19.0% had difficulties performing ADLs, and 40.2% had difficulties performing IADLs. Logistic regression analysis revealed that ADL/IADL disabilities were associated with depressive symptoms even after controlling for people’s sociodemographic characteristics, welfare, health conditions and informal care. The following factors were associated with depressive symptoms: education, self-reported health, number of chronic diseases, and emotional support from families. Conclusion Given that older people from low-income families in Dalian have a notable prevalence rate of depressive symptoms, and ADL/IADL disabilities were independently associated with these symptoms, it is crucial to give priority to this particular group in geriatric health services due to economic and health disparities.
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Affiliation(s)
- Lu Zhao
- Department of Medical Sociology, School of Humanities and Social Sciences, Dalian Medical University, Dalian, 116044, People’s Republic of China
| | - Junting Wang
- Department of Social Medicine, School of Public Health, Dalian Medical University, Dalian, 116044, People’s Republic of China
| | - Haoyuan Deng
- Department of Nutrition and Food Health, School of Public Health, Dalian Medical University, Dalian, 116044, People’s Republic of China
| | - Junfeng Chen
- Department of Social Medicine, School of Public Health, Dalian Medical University, Dalian, 116044, People’s Republic of China
- Correspondence: Junfeng Chen; Ding Ding, Department of Social Medicine, School of Public Health, Dalian Medical University, No. 9 West Section Lvshun South Road, Dalian, 116044, People’s Republic of China, Tel +86 13009493030; +86 18249517190, Email ;
| | - Ding Ding
- Department of Social Medicine, School of Public Health, Dalian Medical University, Dalian, 116044, People’s Republic of China
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31
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Ma Y, Li R, Zhan W, Huang X, Zhang L, Liu Z. The Joint Association Between Multiple Dietary Patterns and Depressive Symptoms in Adults Aged 55 and Over in Northern China. Front Nutr 2022; 9:849384. [PMID: 35330707 PMCID: PMC8940515 DOI: 10.3389/fnut.2022.849384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 01/31/2022] [Indexed: 11/29/2022] Open
Abstract
Background Depression is a common psychiatric disorder in older adults that affects their health-related quality of life. Two percent of adults over the age of 55 suffer from major depression, and the prevalence of depression increases with age. Even in the absence of major depressive disorder, 10–15% of older adults have clinically significant depressive symptoms. Objectives Epidemiological studies on the association between different gender eating patterns and depression show inconsistent associations. Our study examined whether different gender eating patterns are related to depression. We consider eating patterns individually and as a joint exposure to predefined eating patterns. Methods Principal component analysis (PCA) was performed on the data of the 24-h diet recall dietary intake, and the dietary pattern was determined. Linear regression models are used to explore the relationship between different diets and depression of men and women; weighted quantile sum (WQS) regression, quantile g calculation (qgcomp) and Bayesian kernel machine regression (BKMR) are performed as Secondary analysis. Results In the dietary patterns model, we found that the vegetable and fruit-based diet has a significant inhibitory effect in women, and the egg-milk-based diet has a significant inhibitory effect in men. We found that when all dietary factors are above the 55th percentile, there is a significant positive correlation between multiple dietary patterns and depression risk. We also determined a positive correlation between meat and obesity risk and a negative correlation between egg and milk and vegetables and fruits. Conclusions In the study population, after controlling for other baseline indicators and predictors of dietary pattern exposure, a fruit and vegetable-based diet was associated with a slightly healthier and lower risk of depression, while a meat-based dietary pattern associated with a higher risk of depression, and this association effect varies between genders.
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Affiliation(s)
- Yuxia Ma
- Department of Nutrition and Food Hygiene, Hebei Province Key Laboratory of Environment and Human Health, School of Public Health, Hebei Medical University, Shijiazhuang, China
| | - Ruiqiang Li
- Department of Nutrition and Food Hygiene, Hebei Province Key Laboratory of Environment and Human Health, School of Public Health, Hebei Medical University, Shijiazhuang, China
| | - Wenqiang Zhan
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xin Huang
- Department of Nutrition and Food Hygiene, Hebei Province Key Laboratory of Environment and Human Health, School of Public Health, Hebei Medical University, Shijiazhuang, China
| | - Limin Zhang
- Department of Nutrition and Food Hygiene, Hebei Province Key Laboratory of Environment and Human Health, School of Public Health, Hebei Medical University, Shijiazhuang, China
| | - Zhan Liu
- Department of Nutrition and Food Hygiene, Hebei Province Key Laboratory of Environment and Human Health, School of Public Health, Hebei Medical University, Shijiazhuang, China
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Social participation, attitudes towards ageing and depressive symptoms among Chinese older adults. AGEING & SOCIETY 2022. [DOI: 10.1017/s0144686x22000071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Abstract
Participation in social activities might increase older adults’ chances to interact with other people and has been found to be important in reducing the likelihood of depression. A picture of older adults’ attitudes towards ageing and their self-esteem constructed through the lens of how they interact with other people might cast light on the sources of older adults’ depression. This study explored the influences of social participation and attitudes towards ageing on depression of Chinese older adults. Using two waves data from the China Longitudinal Ageing Social Survey (CLASS) in 2014 and 2016 (6,908 participants in 2014 and 3,477 participants in both 2014 and 2016), we found that social participation in 2014 could prevent the risk of depression in both the 2014 and 2016 cohorts. In addition, both psychosocial loss and psychosocial growth in 2014 were negatively associated with depression in both 2014 and 2016. However, there was no evidence that social participation moderated the relationship between attitudes towards ageing and depression in either cohort. Social policies need to encourage older adults’ conversion from ‘passive participation’ to ‘active participation’. This could help older adults understand the process of ageing and their value to society, as well as have positive effects on older adults’ mental health.
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Lozupone M, D'Urso F, Copetti M, Sardone R, Arcuti S, Castellana F, Galizia I, Lofano L, Veneziani F, Piccininni C, Barulli MR, Grasso A, Battista P, Tortelli R, Capozzo R, Griseta C, Doricchi F, Quaranta N, Resta E, Daniele A, Seripa D, Solfrizzi V, Bellomo A, Logroscino G, Panza F. The diagnostic accuracy of late-life depression is influenced by subjective memory complaints and educational level in an older population in Southern Italy. Psychiatry Res 2022; 308:114346. [PMID: 34953202 DOI: 10.1016/j.psychres.2021.114346] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 11/29/2021] [Accepted: 12/15/2021] [Indexed: 11/18/2022]
Abstract
The prevalence of late-life depression (LLD) depends on the study sample, measurements, and diagnostic approaches. We estimated the 30 item-Geriatric Depression Scale (GDS-30) accuracy against the gold standard LLD diagnosis made with the Semi-structured Clinical Diagnostic Interview for DSM-IV-TR Axis I Disorders, focusing on the prevalence of a late-life major depressive disorder (MDD), in a population-based sample of 843 subjects aged>65 years, subdivided into three groups: normal cognition, subjective memory complaints, and mild cognitive impairment. At the optimal cut-off score (≥4), the GDS-30 showed 65.1% sensitivity and 68.4% specificity for LLD (63% and 66% for late-life MDD, respectively). Using the standard cut-off score (≥10), the GDS-30 specificity reached 91.2%, while sensitivity dropped to 37.7%, indicating a lower screening accuracy [area under the curve(AUC):0.728, 95% confidence interval(CI):0.67-0-78]. The GDS-30 performance was associated with educational level, but not with age, gender, cognition, apathy, and somatic/psychiatric multimorbidity. For subjective memory complaints subjects, at the optimal cut-off score (≥7), the GDS-30 showed better discrimination performances (AUC=0.792,95%CI:0.60-0.98), but again the educational level affected the diagnostic performance. In subjective memory complaints subjects, symptom-based scales like the GDS-30 may feature a better performance for diagnosing depression in older age, but the GDS-30 seems to require adjustment to the patient's educational level.
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Affiliation(s)
- Madia Lozupone
- Population Health Unit - "Salus in Apulia Study", National Institute of Gastroenterology and Research Hospital IRCCS "S. De Bellis", Castellana Grotte, Bari, Italy; Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari "Aldo Moro", Bari, Italy.
| | - Francesca D'Urso
- Psychiatric Unit, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Massimiliano Copetti
- Biostatistics Unit, Fondazione IRCCS "Casa Sollievo della Sofferenza", San Giovanni Rotondo, Foggia, Italy
| | - Rodolfo Sardone
- Population Health Unit - "Salus in Apulia Study", National Institute of Gastroenterology and Research Hospital IRCCS "S. De Bellis", Castellana Grotte, Bari, Italy
| | - Simona Arcuti
- Biostatistics Unit, Fondazione IRCCS "Casa Sollievo della Sofferenza", San Giovanni Rotondo, Foggia, Italy
| | - Fabio Castellana
- Population Health Unit - "Salus in Apulia Study", National Institute of Gastroenterology and Research Hospital IRCCS "S. De Bellis", Castellana Grotte, Bari, Italy
| | - Ilaria Galizia
- Psychiatric Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari "Aldo Moro", Bari, Italy
| | - Lucia Lofano
- Psychiatric Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari "Aldo Moro", Bari, Italy
| | - Federica Veneziani
- Psychiatric Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari "Aldo Moro", Bari, Italy
| | - Carla Piccininni
- Psychiatric Unit, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Maria Rosaria Barulli
- Department of Clinical Research in Neurology, Center for Neurodegenerative Diseases and the Aging Brain, University of Bari "Aldo Moro", "Pia Fondazione Cardinale G. Panico", Tricase, Lecce, Italy
| | - Alessandra Grasso
- Population Health Unit - "Salus in Apulia Study", National Institute of Gastroenterology and Research Hospital IRCCS "S. De Bellis", Castellana Grotte, Bari, Italy
| | | | - Rosanna Tortelli
- Department of Clinical Research in Neurology, Center for Neurodegenerative Diseases and the Aging Brain, University of Bari "Aldo Moro", "Pia Fondazione Cardinale G. Panico", Tricase, Lecce, Italy
| | - Rosa Capozzo
- Department of Clinical Research in Neurology, Center for Neurodegenerative Diseases and the Aging Brain, University of Bari "Aldo Moro", "Pia Fondazione Cardinale G. Panico", Tricase, Lecce, Italy
| | - Chiara Griseta
- Population Health Unit - "Salus in Apulia Study", National Institute of Gastroenterology and Research Hospital IRCCS "S. De Bellis", Castellana Grotte, Bari, Italy
| | - Fabrizio Doricchi
- Global Brain Health Institute, University of California, San Francisco, USA
| | - Nicola Quaranta
- Otolaryngology Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari "Aldo Moro", Bari, Italy
| | - Emanuela Resta
- Translational Medicine & Management of Health Systems, University of Foggia, Foggia, Italy
| | - Antonio Daniele
- Institute of Neurology, Catholic University of Sacred Heart, Rome, Italy; Institute of Neurology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Davide Seripa
- Geriatric Unit, Fondazione IRCCS "Casa Sollievo della Sofferenza", San Giovanni Rotondo, Foggia, Italy; Hematology and Stem Cell Transplant Unit, Vito Fazzi Hospital, ASL Lecce, Lecce, Italy
| | - Vincenzo Solfrizzi
- "Cesare Frugoni" Internal and Geriatric Medicine and Memory Unit, University of Bari "Aldo Moro", Bari, Italy
| | - Antonello Bellomo
- Psychiatric Unit, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Giancarlo Logroscino
- Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari "Aldo Moro", Bari, Italy; Department of Clinical Research in Neurology, Center for Neurodegenerative Diseases and the Aging Brain, University of Bari "Aldo Moro", "Pia Fondazione Cardinale G. Panico", Tricase, Lecce, Italy.
| | - Francesco Panza
- Population Health Unit - "Salus in Apulia Study", National Institute of Gastroenterology and Research Hospital IRCCS "S. De Bellis", Castellana Grotte, Bari, Italy; Dipartimento di Psicologia, Sapienza University of Rome, Rome, Italy; Laboratorio di Neuropsicologia dell'Attenzione, Fondazione Santa Lucia IRCCS, Neurorehabilitation Hospital, Rome, Italy.
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Yan C, Liao H, Ma Y, Wang J. Association amongst social support inside or outside the family and depression symptoms: longitudinal study of urban–rural differences in China. Qual Life Res 2022; 31:1677-1687. [DOI: 10.1007/s11136-022-03086-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/07/2022] [Indexed: 11/30/2022]
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Ruan H, Shen K, Chen F. Negative Life Events, Social Ties, and Depressive Symptoms for Older Adults in China. Front Public Health 2022; 9:774434. [PMID: 35127620 PMCID: PMC8810507 DOI: 10.3389/fpubh.2021.774434] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 12/27/2021] [Indexed: 11/17/2022] Open
Abstract
Although it is widely acknowledged that older adults who have gone through negative life events are more likely to develop depression, there is limited evidence on whether and which type of social ties moderate this perceived relationship. Based on 2016 and 2018 waves of Chinese Longitudinal Aging Social Survey (4,466 individuals, 8,932 observations), we apply linear fixed effects models and confirm that negative life events are associated with depressive symptoms for older adults (Coef. = 0.35; 95% CIs 0.11–0.61), and social ties are negatively associated with depression (Coef. = −0.08; 95% CIs −0.10 to −0.07). Our study further suggests that the association between negative life events and depressive symptoms is significantly moderated by friendship ties (Coef. = −0.18, 95% CIs −0.30 to −0.07), rather than family ties (Coef. = −0.03, 95% CIs −0.09 to 0.15). Moreover, the buffering effects of friendship ties are more prominent for the less resilient and less privileged groups, namely male, rural, and less educated older adults. Our findings point to the importance of expanding and strengthening social networks for Chinese older adults in promoting their psychological health.
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Affiliation(s)
- Hangqing Ruan
- Department of Sociology, University of Maryland, College Park, MD, United States
| | - Ke Shen
- School of Social Development and Public Policy, Fudan University, Shanghai, China
- *Correspondence: Ke Shen
| | - Feinian Chen
- Department of Sociology, University of Maryland, College Park, MD, United States
- School of Social Development and Public Policy, Fudan University, Shanghai, China
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36
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Wu D, Liu F, Huang S. Assessment of the relationship between living alone and the risk of depression based on longitudinal studies: A systematic review and meta-analysis. Front Psychiatry 2022; 13:954857. [PMID: 36111305 PMCID: PMC9468273 DOI: 10.3389/fpsyt.2022.954857] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 08/11/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Living alone is one of the most common psychosocial factors that may have an impact on lifestyle management and health status. Although many previous cross-sectional studies have found that living alone increases the risk of depression. However, this risk has rarely been assessed on the basis of longitudinal studies. Therefore, we will explore this relationship on the basis of longitudinal studies. METHODS We systematically searched Pubmed, Embase, and Cochrane databases up to May 2022. Adjusted odds ratios (ORs), and 95% confidence intervals (CIs) were pooled by a random-effects model using an inverse variance method. RESULTS Seven studies (six cohort studies and one case-control study) were included in our study. A total of 123,859 without a history of psychosis individuals were included, and the proportion of females was 65.3%. We applied a random-effects model to minimize the heterogeneity. Overall, the pooled data suggest that people living alone are associated with an increased risk of depression compared to those who do not live alone (OR 1.42, 95%CI 1.19-1.70). CONCLUSION Compared to people who live with others, living alone increases the risk of depression. Only cross-sectional studies and a few longitudinal studies currently support this association; more high-quality studies will be required in the future to confirm this causal association.
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Affiliation(s)
- Daolin Wu
- Department of Sleep Medicine, Ganzhou People's Hospital, Ganzhou, China
| | - Fuwei Liu
- Department of Cardiology, Ganzhou People's Hospital, Ganzhou, China
| | - Shan Huang
- Department of Psychiatry, The Third People's Hospital of Ganzhou, Ganzhou, China
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Multidomain Social Determinants of Depressive Symptoms for the Elderly with Chronic Diseases: Evidence from the China Health and Retirement Longitudinal Study. Healthcare (Basel) 2021; 9:healthcare9121765. [PMID: 34946491 PMCID: PMC8701898 DOI: 10.3390/healthcare9121765] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 12/17/2021] [Accepted: 12/17/2021] [Indexed: 11/16/2022] Open
Abstract
Elderly individuals with chronic diseases (CDs) have a much higher risk of mental disorders, especially depression. This study aimed to identify the multidomain social determinants of occurrence and degree of depressive symptoms for the Chinese elderly with CDs. Data of 3438 elderly individuals (aged over 60 years) with CDs were drawn from the fourth wave of the China Health and Retirement Longitudinal Study implemented in 2018. Logistic regression was used to describe associations with the occurrence of depressive symptoms within and across multidomain social determinants (demographic, economic, neighborhood, environmental, and social and cultural). The Shapley value decomposition method was used to measure the relative importance of variables of the five domains. A quantile regression model was used to test how the effects of social factors vary across different points of depression score distributions. Approximately 40.1% of Chinese elderly individuals with CDs reported depressive symptoms. Respondents who were female, had a low income, experienced a disability, lived in rural areas, and were not engaged in work had a higher probability of suffering from depressive symptoms. Conversely, increased age, being covered by social security and being well-educated had a protective effect. Data also showed that the effects of these associated factors varied across different points of depression score distributions. The fact that socially disadvantaged people are more vulnerable to severe depressive symptoms implies that psychological health services and intervention strategies should target this population.
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Tang T, Jiang J, Tang X. Prevalence of depressive symptoms among older adults in mainland China: A systematic review and meta-analysis. J Affect Disord 2021; 293:379-390. [PMID: 34246000 DOI: 10.1016/j.jad.2021.06.050] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 01/13/2021] [Accepted: 06/19/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND To date, the reported prevalence of late-life depression in China has varied considerably, and the pooled overall prevalence of depressive symptoms among older adults in China and the tendency of the rate to change in the past 30 years have remained unknown. Thus, our study was designed to form an accurate and comprehensive picture of the recent prevalence of depressive symptoms among older adults in China. METHODS Literature searches were conducted independently by two investigators in English- and Chinese-language databases from database inception to January 2020. The prevalence of depressive symptoms was analysed with a random effects model. RESULTS In the 81 eligible studies (n = 261,697) identified, the pooled overall prevalence of depressive symptoms among older adults in China was 20.0% (95% CI, 17.5%-22.8%), with high heterogeneity, Q = 22,947.0, I2 = 99.7%, p < .001. Subgroup analyses revealed significant differences in the prevalence of late-life depression depending upon gender, marital status, socio-economic status, and measurement scale(s) used. Meta-regression indicated that the prevalence of depressive symptoms among older adults in China increased from the 1990s to the 2000s but slightly decreased from the 2000s to the 2010s. LIMITATIONS Significant heterogeneity among the studies reviewed was unavoidable, and the findings was not generalisable to all regions in China. CONCLUSIONS Depressive symptoms are common among older adults in China, and policies should be developed that consider vulnerable older adults in particular.
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Affiliation(s)
- Tan Tang
- School of Ethnology and Sociology, Yunnan University, Kunming, Yunnan, 650091, China
| | - Jianling Jiang
- Department of Social Work, The Chinese University of Hong Kong, New Territories, HongKong, 999077, China.
| | - Xinfeng Tang
- Department of Psychology, Renmin University of China, Beijing, 100872, China
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Tang X, Qi S, Zhang H, Wang Z. Prevalence of depressive symptoms and its related factors among China's older adults in 2016. J Affect Disord 2021; 292:95-101. [PMID: 34107426 DOI: 10.1016/j.jad.2021.04.041] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 04/22/2021] [Accepted: 04/26/2021] [Indexed: 01/17/2023]
Abstract
BACKGROUND Depression seriously threatens Chinese elderly. This study analysis the prevalence of depressive symptoms (DS) and its related factors among China's aging population. METHODS All participants were from the PINDEC project. Multi-stage clustered sampling was conducted. A total of 20,019 participants aged 60 or above completed the DS screening in 2016, and among them, 19,420 were taken into analysis. Univariate and multivariate logistic regression analysis were performed to explore the related factors of DS. RESULTS Of the 19,420 adults, 9,444 were male (48.63%) and 9,976 were female (51.37%). The prevalence of DS was 15.94%. The risk factors of DS were: female gender (OR=1.198, 1.097-1.308), daily alcohol consumption (OR=1.480, 1.284-1.705), disturbed sleep (OR=1.864, 1.716-2.024), chronic diseases (OR=1.214, 1.181-1.249), greater age (OR=1.012, 1.077-1.018), impaired cognition (OR=2.567,2.202-2.993), poor ADL performance (OR=1.545, 1.380-1.729), and insufficient social communication (OR=1.241, 1.134-1.358). Protective factors of DS included: higher education level, greater BMI (OR=0.986, 0.975-0.997), living in urban areas (OR=0.677, 0.611-0.749), and leisure activities such as playing cards or mahjong (OR=0.816, 0.730-0.912). For the DS risk factors, multiplicative interaction was found between cognition and ADL performance, in addition to cognition and social communication. LIMITATIONS Causality cannot be drawn from this cross-sectional survey. And the elderly who were looked after by nannies or living in nursing homes were not taken into analysis. CONCLUSIONS DS is prevalent among older adults in China. It is recommended that periodic screening for DS should be conducted for elderly individuals. Furthermore, it is suggested that the elderly adopt healthy lifestyles to prevent DS.
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Affiliation(s)
- Xue Tang
- Center for Behavioral Health & School of Social Development and Public Policy, Beijing Normal University, No.19 Xinjiekouwai St., Beijing 100875, China..
| | - Shige Qi
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27 Nanwei Rd, Xicheng District, 100050 Beijing, China
| | - Han Zhang
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27 Nanwei Rd, Xicheng District, 100050 Beijing, China
| | - Zhihui Wang
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27 Nanwei Rd, Xicheng District, 100050 Beijing, China.
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Lin H, Jin M, Liu Q, Du Y, Fu J, Sun C, Ma F, Li W, Liu H, Zhang X, Zhu Y, Chen Y, Sun Z, Wang G, Huang G, Yan J. Gender-specific prevalence and influencing factors of depression in elderly in rural China: A cross-sectional study. J Affect Disord 2021; 288:99-106. [PMID: 33848754 DOI: 10.1016/j.jad.2021.03.078] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 01/23/2021] [Accepted: 03/24/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND With an aging population, late-life depression has been a major health problem in rural China. This study aims to explore the gender-specific prevalence of geriatric depression in rural Tianjin, its influencing factors, and to provide a scientific basis for the prevention and intervention of depression in the elderly. METHODS A cross-sectional study of 4,933 elderly individuals in rural Tianjin was conducted using the cluster sampling method. The independent samples t-test and chi-squared test were used to assess differences in participants' characteristics by depressive symptoms, while multiple linear regressions and multiple logistic regressions were used to analyze the potential influencing factors of depression. RESULTS The prevalence of geriatric depression was found to be 12.2% in the study participants (9.5% in men and 14.5% in women). Gender, education, household income, employment, living alone, social activities, physical exercise and chronic diseases were associated with depression (P<0.05). In addition to the above factors, sleep duration was also related with scores on self-rating depression scale (P<0.05). LIMITATIONS The study used a cross-sectional approach, so causation cannot be concluded. CONCLUSIONS Late-life depression is a serious mental health issue in rural China, highlighting the importance of appropriate diagnosis and treatment as a priority to improve the quality of mental health.
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Affiliation(s)
- Hongyan Lin
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
| | - Mengdi Jin
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
| | - Qian Liu
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
| | - Yue Du
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China; Department of Social Medicine and Health Administration, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Jingzhu Fu
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
| | - Changqing Sun
- Neurosurgical Department of Baodi Clinical College of Tianjin Medical University, Tianjin, China
| | - Fei Ma
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China; Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Wen Li
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
| | - Huan Liu
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
| | - Xumei Zhang
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
| | - Yun Zhu
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China; Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Yongjie Chen
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China; Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Zhuoyu Sun
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China; Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Guangshun Wang
- Department of Tumour, Baodi Clinical College of Tianjin Medical University, Tianjin, China
| | - Guowei Huang
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
| | - Jing Yan
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China; Department of Social Medicine and Health Administration, School of Public Health, Tianjin Medical University, Tianjin, China.
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Pan C, Wang C, Shrestha B, Wang P. 3-D health trajectories and related childhood predictors among older adults in China. Sci Rep 2021; 11:9874. [PMID: 33972630 PMCID: PMC8110566 DOI: 10.1038/s41598-021-89354-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 04/19/2021] [Indexed: 11/30/2022] Open
Abstract
This study aimed to identify the multi-trajectories of 3-D health of older adults in China and to explore whether the childhood predictors are associated with 3-D health trajectory. Data came from five waves of the China Health and Retirement Longitudinal Study (CHARLS, 2011 to 2018). A multi-trajectory modeling approach was carried out to jointly estimate the trajectories of 3-D health. A multinomial regression model was used to investigate the relationships between childhood predictors and the joint trajectories. We identified three typical joint 3-D health trajectories. Female, childhood health, maternal and paternal educations, childhood friendships, family and neighborhood predictors could all affect 3-D health trajectories of older adults directly or indirectly through adult variables. The 3-D health trajectories showed increasing trends, thus the government should perform more interventions toward the childhood predictors for better health of older adults.
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Affiliation(s)
- Chaoping Pan
- School of Health Sciences, Wuhan University, 115 Donghu Road, Wuhan City, 430071, Hubei Province, China
| | - Cen Wang
- School of Health Sciences, Wuhan University, 115 Donghu Road, Wuhan City, 430071, Hubei Province, China
| | - Bhawana Shrestha
- School of Health Sciences, Wuhan University, 115 Donghu Road, Wuhan City, 430071, Hubei Province, China
| | - Peigang Wang
- School of Health Sciences, Wuhan University, 115 Donghu Road, Wuhan City, 430071, Hubei Province, China.
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Pan H, Chen Z. Cultural capital and mediatory role of meaning-making in post-bereavement depression among older adults in rural China. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-01819-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Mu A, Deng Z, Wu X, Zhou L. Does digital technology reduce health disparity? Investigating difference of depression stemming from socioeconomic status among Chinese older adults. BMC Geriatr 2021; 21:264. [PMID: 33882865 PMCID: PMC8059190 DOI: 10.1186/s12877-021-02175-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 03/22/2021] [Indexed: 11/24/2022] Open
Abstract
Background Prior studies on health disparity have shown that socioeconomic status is critical to inequality of health outcomes such as depression. However, two questions await further investigation: whether disparity in depression correlated with socioeconomic status will become larger when depression becomes severer, and whether digital technology will reduce the disparity in depression correlated with socioeconomic status. Our study aims to answer the above two questions. Methods By using the dataset from China Health and Retirement Longitudinal Study 2015, we use quantile regression models to examine the association between socioeconomic status and depression across different quantiles, and test the moderating effect of digital technology. Results Our study obtains four key findings. First, the negative effects of socioeconomic status on depression present an increasing trend at high quantiles. Second, Internet usage exacerbates the disparity in depression associated with education level on average, but reduces this disparity associated with education level at high quantiles. Third, Internet usage reduces the disparity in depression associated with income on average and at high quantiles. Fourth, mobile phone ownership has almost no moderating effect on the relationship between socioeconomic status and depression. Conclusions Our findings suggest the potential use of digital technology in reducing disparity in depression correlated with socioeconomic status among middle-aged and aged individuals in developing countries. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02175-0.
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Affiliation(s)
- Aruhan Mu
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China
| | - Zhaohua Deng
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, 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
| | - Liqin Zhou
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China.
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Liu H, Fan X, Luo H, Zhou Z, Shen C, Hu N, Zhai X. Comparison of Depressive Symptoms and Its Influencing Factors among the Elderly in Urban and Rural Areas: Evidence from the China Health and Retirement Longitudinal Study (CHARLS). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3886. [PMID: 33917216 PMCID: PMC8067981 DOI: 10.3390/ijerph18083886] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 03/30/2021] [Accepted: 04/04/2021] [Indexed: 12/17/2022]
Abstract
Depression amongst the elderly population is a worldwide public health problem, especially in China. Affected by the urban-rural dual structure, depressive symptoms of the elderly in urban and rural areas are significantly different. In order to compare depressive symptoms and its influencing factors among the elderly in urban and rural areas, we used the data from the fourth wave of the China Health and Retirement Longitudinal Study (CHARLS). A total of 7690 participants at age 60 or older were included in this study. The results showed that there was a significant difference in the prevalence estimate of depression between urban and rural elderly (χ2 = 10.9.76, p < 0.001). The prevalence of depression among rural elderly was significantly higher than that of urban elderly (OR-unadjusted = 1.88, 95% CI: 1.67 to 2.12). After adjusting for gender, age, marital status, education level, minorities, religious belief, self-reported health, duration of sleep, life satisfaction, chronic disease, social activities and having income or not, the prevalence of depression in rural elderly is 1.52 times (OR = 1.52, 95% CI: 1.32 to 1.76) than that of urban elderly. Gender, education level, self-reported health, duration of sleep, chronic diseases were associated with depression in both urban and rural areas. In addition, social activities were connected with depression in urban areas, while minorities, marital status and having income or not were influencing factors of depression among the rural elderly. The interaction analysis showed that the interaction between marital status, social activities and urban and rural sources was statistically significant (divorced: coefficient was 1.567, p < 0.05; social activities: coefficient was 0.340, p < 0.05), while gender, education level, minorities, self-reported health, duration of sleep, life satisfaction, chronic disease, social activities having income or not and urban and rural sources have no interaction (p > 0.05). Thus, it is necessary to propose targeted and precise intervention strategies to prevent depression after accurately identifying the factors' effects.
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Affiliation(s)
- Haixia Liu
- School of Public Health and Management, Binzhou Medical University, No. 346, Guanhai Road, Yantai 264003, China; (H.L.); (N.H.)
- School of Public Health, Xi’an Jiaotong University Health Science Center, No. 76, Yantai West Road, Xi’an 710061, China
| | - Xiaojing Fan
- School of Public Policy and Administration, Xi’an Jiaotong University, No. 28, Xianning West Road, Xi’an 710049, China; (X.F.); (C.S.); (X.Z.)
| | - Huanyuan Luo
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool L3 5QA, UK;
| | - Zhongliang Zhou
- School of Public Policy and Administration, Xi’an Jiaotong University, No. 28, Xianning West Road, Xi’an 710049, China; (X.F.); (C.S.); (X.Z.)
| | - Chi Shen
- School of Public Policy and Administration, Xi’an Jiaotong University, No. 28, Xianning West Road, Xi’an 710049, China; (X.F.); (C.S.); (X.Z.)
| | - Naibao Hu
- School of Public Health and Management, Binzhou Medical University, No. 346, Guanhai Road, Yantai 264003, China; (H.L.); (N.H.)
| | - Xiangming Zhai
- School of Public Policy and Administration, Xi’an Jiaotong University, No. 28, Xianning West Road, Xi’an 710049, China; (X.F.); (C.S.); (X.Z.)
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Bincy K, Logaraj M, Ramraj B. Depression and its associated factors among the older adults in rural, Tamilnadu, India. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2021. [DOI: 10.1016/j.cegh.2020.100677] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Rural-Urban Differences in the Factors Affecting Depressive Symptoms among Older Adults of Two Regions in Myanmar. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18062818. [PMID: 33802054 PMCID: PMC7999321 DOI: 10.3390/ijerph18062818] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Revised: 02/27/2021] [Accepted: 03/01/2021] [Indexed: 11/16/2022]
Abstract
The aim of the study was to investigate rural–urban differences in depressive symptoms in terms of the risk factors among older adults of two regions in Myanmar to provide appropriate intervention for depression depending on local characteristics. This cross-sectional study, conducted between September and December, 2018, used a multistage sampling method to recruit participants from the two regions, for face-to-face interviews. Depressive symptoms were assessed using the 15-item version of the Geriatric Depression Scale (GDS). Depressive symptoms were positively associated with living in rural areas (B = 0.42; 95% confidence interval (CI): 0.12,0.72), female (B = 0.55; 95% CI: 0.31,0.79), illness during the preceding year (B = 0.68; 95% CI: 0.45,0.91) and non-Buddhist religion (B = 0.57; 95% CI: 0.001,1.15) and protectively associated with education to middle school level or higher (B = −0.61; 95% CI: −0.94, −0.28) and the frequency of visits to religious facilities (B = −0.20; 95% CI: −0.30, −0.10). In women in urban areas, depressive symptoms were positively associated with illness during the preceding year (B = 0.78; 95% CI: 0.36, 1.20) and protectively associated with education to middle school level or higher (B = −0.67; 95% CI: −1.23, −0.11), middle or high wealth index (B = −0.92; 95% CI: −1.59, −0.25) and the frequency of visits to religious facilities (B = −0.20; 95% CI: −0.38, −0.03). In men in rural areas, illness during the preceding year was positively associated with depressive symptoms (B = 0.87; 95% CI: 0.33, 1.42). In women in rural areas, depressive symptoms were positively associated with illness during the preceding year (B = 0.83; 95% CI: 0.36, 1.30) and protectively associated with primary education (B = −0.62; 95% CI: −1.12, −0.12) and the frequency of visits to religious facilities (B = −0.44; 95% CI: −0.68, −0.21). Religion and wealth could have different levels of association with depression between older adults in the urban and rural areas and men and women. Interventions for depression in older adults should consider regional and gender differences in the roles of religion and wealth in Myanmar.
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Yan C, Liao H, Ma Y, Xiang Q, Wang J. Association among multimorbidity, physical disability and depression trajectories: a study of urban-rural differences in China. Qual Life Res 2021; 30:2149-2160. [PMID: 33677773 PMCID: PMC8298219 DOI: 10.1007/s11136-021-02807-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/19/2021] [Indexed: 12/18/2022]
Abstract
Purpose The purpose of this study was to analyse the trajectories of depression in urban and rural areas, and to analyse the relationship among multimorbidity, disability and other variables and trajectories. Methods Data from the China Health and Retirement Longitudinal Study were used. A latent class growth model was used to characterise the trajectories of urban and rural depression symptoms. Chi-square test was used to test the differences in respondents’ characteristics among depression trajectories groups within urban and rural areas. The relationships among multimorbidity, disability and depression symptom trajectories were analysed via multinomial logistic regression. Results Urban and rural depression trajectories were divided into three categories. Respondents in urban areas were divided into rising, remaining-low and declining group, and those in rural areas were divided into rising, remaining-low and remaining-high group. The depression scores of respondents with multimorbidity were more likely to rise, and this result was similar for the disabled respondents. Respondents who need help on activities of daily living and instrumental activities of daily living in urban areas were more likely to decline in depression scores. In rural areas, however, the values were consistently high. In urban and rural areas, the relationships among marital status, education and age and depression trajectories were different. Conclusions The depression trajectories are different in urban and rural China. Improving the quality of medical services, promoting the distribution of rural social resources and implementing more recreational activities could be beneficial for the promotion of mental health in rural areas.
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Affiliation(s)
- Chaoyang Yan
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Hui Liao
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Ying Ma
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Qin Xiang
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Jing Wang
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China. .,The Key Research Institute of Humanities and Social Science of Hubei Province, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China. .,Institute for Poverty Reduction and Development, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China.
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Liu X, Cao H, Zhu H, Zhang H, Niu K, Tang N, Cui Z, Pan L, Yao C, Gao Q, Wang Z, Sun J, He H, Guo M, Guo C, Liu K, Peng H, Peng W, Sun Y, Xie Y, Li B, Shan G, Zhang L. Association of chronic diseases with depression, anxiety and stress in Chinese general population: The CHCN-BTH cohort study. J Affect Disord 2021; 282:1278-1287. [PMID: 33601707 DOI: 10.1016/j.jad.2021.01.040] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 01/09/2021] [Accepted: 01/12/2021] [Indexed: 01/26/2023]
Abstract
Background Large-scale epidemiological surveys focusing on characteristic differences in psychological and physical health conditions in Chinese adults are lacking. Objective To investigate the association of noncommunicable chronic diseases (NCDs) with depression, anxiety and stress in the Chinese general population. Methods A total of 13784 participants were recruited from the baseline survey of the Cohort Study on Chronic Disease of Communities Natural Population in Beijing, Tianjin and Hebei (CHCN-BTH) from 2017 to 2019. Sociodemographic characteristics, lifestyle and NCDs were assessed via questionnaire. Stress, anxiety and depression were assessed by the Depression-Anxiety-Stress Scale (DASS-21). The relationship of NCDs with psychological symptoms was determined through logistic regression analysis. Results Multivariate logistic regression analysis revealed that the prevalence of stress (OR = 1.640; 95% CI: 1.381-1.949), anxiety (OR = 1.654; 95% CI: 1.490-1.837) and depression (OR = 1.460; 95% CI: 1.286-1.658) symptoms were all significantly higher in patients with NCDs. Multimorbidities were associated with a higher risk of stress (OR = 2.310; 95% CI: 1.820-2.931), anxiety (OR = 2.119; 95% CI: 1.844-2.436) and depression (OR = 2.785; 95% CI: 1.499-2.126) than single NCDs. A course of disease within 1 year or more than 5 years also was associated with a higher risk. Limitations The cross-sectional design could not examine the causal link between psychological symptoms and NCDs. Conclusion Psychological symptoms were more prevalent among individuals with NCDs in the Chinese general population. This study suggests that more attention should be paid to the mental health problems of patients with NCDs.
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Affiliation(s)
- Xiaohui Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University and Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, 100069, China
| | - Han Cao
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University and Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, 100069, China
| | - Huiping Zhu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University and Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, 100069, China
| | - Han Zhang
- Health Management Center, Beijing Aerospace General Hospital, Beijing, 100076, China
| | - Kaijun Niu
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, 300070, China
| | - Naijun Tang
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, and Tianjin Key Laboratory of Environment, Nutrition, and Public Health, Tianjin 300070, China
| | - Ze Cui
- Department of Chronic and Noncommunicable Disease Prevention and Control, Hebei Provincial Center for Disease Prevention and Control, Shijiazhuang, Hebei Province, 050021, China
| | - Li Pan
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing 100730, China
| | - Changqiang Yao
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing 100730, China
| | - Qi Gao
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University and Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, 100069, China
| | - Zhengfang Wang
- Health Management Center, Beijing Aerospace General Hospital, Beijing, 100076, China
| | - Jixin Sun
- Department of Chronic and Noncommunicable Disease Prevention and Control, Hebei Provincial Center for Disease Prevention and Control, Shijiazhuang, Hebei Province, 050021, China
| | - Huijing He
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing 100730, China
| | - Ming Guo
- Department of Disease Prevention and Control, Dingzhou Center for Disease Prevention and Control, Baoding, Hebei Province, 073099, China
| | - Chunyue Guo
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University and Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, 100069, China
| | - Kuo Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University and Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, 100069, China
| | - Hai Peng
- Department of Disease Prevention and Control, Dingzhou Center for Disease Prevention and Control, Baoding, Hebei Province, 073099, China
| | - Wenjuan Peng
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University and Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, 100069, China
| | - Yanyan Sun
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University and Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, 100069, China
| | - Yunyi Xie
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University and Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, 100069, China
| | - Bingxiao Li
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University and Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, 100069, China
| | - Guangliang Shan
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing 100730, China
| | - Ling Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University and Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, 100069, China..
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Su D, Zhang X, He K, Chen Y. Use of machine learning approach to predict depression in the elderly in China: A longitudinal study. J Affect Disord 2021; 282:289-298. [PMID: 33418381 DOI: 10.1016/j.jad.2020.12.160] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 10/28/2020] [Accepted: 12/23/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Early detection of potential depression among elderly people is conducive for timely preventive intervention and clinical care to improve quality of life. Therefore, depression prediction considering sequential progression patterns in elderly needs to be further explored. METHODS We selected 1,538 elderly people from Chinese Longitudinal Healthy Longevity Study (CLHLS) wave 3-7 survey. Long short-term memory (LSTM) and six machine learning (ML) models were used to predict different depression risk factors and the depression risks in the elderly population in the next two years. Receiver operating curve (ROC) and decision curve analysis (DCA) were used to evaluate the prediction accuracy of the reference model and ML models. RESULTS The area under the ROC curve (AUC) values of logistic regression with lasso regularisation (AUC=0.629, p-value=0.020) was the highest among ML models. DCA results showed that the net benefit of six ML models was similar (threshold: 0.00-0.10), the net benefit of lasso regression was the largest (threshold: 0.10-0.17 and 0.22-0.25), and the net benefit of DNN was the largest (threshold: 0.17-0.22 and 0.25-0.40). In two ML models, activities of daily living (ADL)/ instrumental ADL (IADL), self-rated health, marital status, arthritis, and number of cohabiting were the most important predictors for elderly with depression. LIMITATIONS The retrospective waves used in the LSTM model need to be further increased. CONCLUSION The decision support system based on the proposed LSTM+ML model may be very valuable for doctors, nurses and community medical providers for early diagnosis and intervention.
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Affiliation(s)
- Dai Su
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Research Center for Rural Health Services, Hubei Province Key Research Institute of Humanities and Social Sciences, Wuhan, China; Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, USA
| | - Xingyu Zhang
- Department of Systems, Populations, and Leadership, University of Michigan School of Nursing, Ann Arbor, USA
| | - Kevin He
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, USA
| | - Yingchun Chen
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Research Center for Rural Health Services, Hubei Province Key Research Institute of Humanities and Social Sciences, Wuhan, China.
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Wu Y, Zheng H, Liu Z, Wang S, Chen X, Yu H, Liu Y, Hu S. Depression and Anxiety-Free Life Expectancy by Sex and Urban-Rural Areas in Jiangxi, China in 2013 and 2018. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041991. [PMID: 33670818 PMCID: PMC7922042 DOI: 10.3390/ijerph18041991] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 02/10/2021] [Accepted: 02/13/2021] [Indexed: 11/29/2022]
Abstract
Objective: To quantitatively estimate life expectancy (LE) and depression and anxiety-free life expectancy (DAFLE) for the years 2013 and 2018 in Jiangxi Province, China, by sex and urban–rural areas. Additionally, to compare the discrepancy of DAFLE/LE of different sexes and urban-rural areas over various years. Methods: Based on the summary of the health statistics of Jiangxi Province in 2013 and 2018 and the results of the 5th and 6th National Health Service Surveys in Jiangxi Province, the model life table is used to estimate the age-specific mortality rate by sex and urban–rural areas. Sullivan’s method was used to calculate DAFLE. Results: Data from 2013 indicate that those aged 15 can expect to live 56.20 years without depression and anxiety for men and 59.67 years without depression and anxiety for women. Compared to 2013, DAFLE had not fluctuated significantly in 2018. The proportion of life expectancy without depression and anxiety (DAFLE/LE) declined between 2013 and 2018. DAFLE/LE in urban areas was higher than in rural areas. Men had higher DAFLE/LE than women. From 2013 to 2018, the DAFLE aged 15 decreased by 0.18 years for urban men and decreased by 0.52 years for urban women, rural areas also decreased to varying degrees. Conclusions: Even if women had a longer life span than men, they would spend more time with depression or anxiety. DAFLE did not increase with the increase in LE from 2013 to 2018, suggesting an absolute expansion of the burden, especially in rural areas. Depression and anxiety health services in Jiangxi, China will face more serious obstacles and challenges, which may lead to more disability. This requires more attention and more effective measures from the public, medical departments and the government.
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