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Reiner A, Steinhoff P. The association of social networks and depression in community-dwelling older adults: a systematic review. Syst Rev 2024; 13:161. [PMID: 38902787 PMCID: PMC11188217 DOI: 10.1186/s13643-024-02581-6] [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: 03/13/2024] [Accepted: 06/10/2024] [Indexed: 06/22/2024] Open
Abstract
BACKGROUND AND OBJECTIVE Depression is a globally prevalent mental condition, particularly among older adults. Previous research has identified that social networks have a buffering effect on depression. Existing systematic reviews have either limited their research to specific geographic areas or provided evidence from over a decade ago. The vast body of recent literature particularly from the last decade emphasizes the need for a comprehensive review. This systematic review aims to analyze the association of structural aspects of social networks and depression in older adults. METHODS The electronic databases APA PsycINFO, ProQuest, PSYINDEX, PubMed, Scopus, SocINDEX, and Web of Science were searched from date of data base inception until 11 July 2023. Studies were eligible for inclusion if they reported on community-dwelling older adults (defined as a mean age of at least 60 years old), had an acceptable definition for depression, referred to the term social network in the abstract, and were published in English. Quality was appraised using the Newcastle Ottawa Scale for cross-sectional and longitudinal studies. Outcome data were extracted independently from each study and analyzed by direction of the relationship, social network domain and cross-sectional or longitudinal study design. RESULTS In total, 127 studies were included. The study categorizes structural network aspects into seven domains and finds that larger and more diverse networks, along with closer social ties, help mitigate depression. The literature on the relationships between depression and network density, homogeneity, and geographical proximity is scarce and inconclusive. DISCUSSION AND IMPLICATIONS: Despite inconsistent findings, this review highlights the importance of quantifying complex social relations of older adults. Limitations of this review include publication and language bias as well as the exclusion of qualitative research. Further research should use longitudinal approaches to further investigate the reciprocal relationship between social networks and depression. Following this review, interventions should promote the integration of older adults in larger and more diverse social settings. Other: This work was supported by the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation) under Grant [454899704]. This systematic review was pre-registered. The review-protocol can be accessed at https://doi.org/10.17605/OSF.IO/6QDPK .
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Affiliation(s)
- Amelie Reiner
- Institute of Sociology and Social Psychology, University of Cologne, Albertus-Magnus-Platz, 50923, Cologne, Germany.
| | - Paula Steinhoff
- Institute of Sociology and Social Psychology, University of Cologne, Albertus-Magnus-Platz, 50923, Cologne, Germany
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Lieber SB, Moxley J, Mandl LA, Reid MC, Czaja SJ. Social support and physical activity: does general health matter? Eur Rev Aging Phys Act 2024; 21:16. [PMID: 38902616 PMCID: PMC11188280 DOI: 10.1186/s11556-024-00347-6] [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: 03/14/2023] [Accepted: 04/26/2024] [Indexed: 06/22/2024] Open
Abstract
BACKGROUND Physical activity levels remain suboptimal in older adults. Exploration of potentially modifiable factors such as social support is needed to inform the development and implementation of patient-oriented physical activity interventions for older adults. The impact of general health on the relationship between social support and physical activity is not well understood. We aimed to determine the association between social support and self-reported physical activity in a study of community-dwelling older adults. In addition, we examined whether self-reported general health mediates the relationship between social support and self-reported physical activity. METHOD This cross-sectional study analyzed baseline data collected as part of a randomized controlled trial comparing a digital physical activity intervention, which included social support features, with a tablet-based educational control. Adults ≥ 60 years of age were enrolled at 2 sites. Self-reported general health, social support, physical activity, and sociodemographic characteristics and comorbid conditions were assessed. Pearson and point-biserial correlations were computed to evaluate the relationship between physical activity and general health, social support, and sociodemographic features. Social support (exposure), general health (mediator), and physical activity (outcome) were incorporated into a mediation model. RESULTS Among 181 participants (mean age of 70.1 years), significant correlations were found between physical activity and both general health and social support (r = -0.19 and r = 0.21, respectively; both p < 0.01). General health significantly mediated the relationship between social support and physical activity (unstandardized ß coefficient 416.9; 95% confidence interval 96.4, 842.0). CONCLUSIONS Augmentation of social support, particularly when coupled with other modes of health promotion to improve personal wellbeing, may be a valuable component of physical activity promotion programs. Further longitudinal research is needed to clarify the potential mechanistic pathways linking social support, general health, and physical activity to inform development of evidence-based physical activity interventions for older adults and improve downstream health-related outcomes. TRIAL REGISTRATION ClinicalTrials.gov, ClinicalTrials.gov identifier NCT03538158 . Registered May 25, 2018.
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Affiliation(s)
- Sarah B Lieber
- Division of Rheumatology, Hospital for Special Surgery, 535 East 70th Street, New York, NY, USA.
- Department of Medicine, Weill Cornell Medicine, 530 East 70th Street, New York, NY, USA.
| | - Jerad Moxley
- Department of Medicine, Weill Cornell Medicine, 530 East 70th Street, New York, NY, USA
- Division of Geriatrics and Palliative Medicine, Weill Cornell Medicine, 1300 York Avenue, New York, NY, USA
| | - Lisa A Mandl
- Division of Rheumatology, Hospital for Special Surgery, 535 East 70th Street, New York, NY, USA
- Department of Medicine, Weill Cornell Medicine, 530 East 70th Street, New York, NY, USA
| | - M Carrington Reid
- Department of Medicine, Weill Cornell Medicine, 530 East 70th Street, New York, NY, USA
- Division of Geriatrics and Palliative Medicine, Weill Cornell Medicine, 1300 York Avenue, New York, NY, USA
| | - Sara J Czaja
- Department of Medicine, Weill Cornell Medicine, 530 East 70th Street, New York, NY, USA
- Division of Geriatrics and Palliative Medicine, Weill Cornell Medicine, 1300 York Avenue, New York, NY, USA
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Qiu B, Zhu R, Huang X, Qi Z, Zhang L. Associations between eating alone, its transition and depressive symptoms among Chinese middle-aged and older adults: evidence from two national cohorts. BMC Psychiatry 2024; 24:458. [PMID: 38898438 PMCID: PMC11186271 DOI: 10.1186/s12888-024-05909-7] [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: 11/22/2023] [Accepted: 06/13/2024] [Indexed: 06/21/2024] Open
Abstract
BACKGROUND Few studies have explored the longitudinal association between eating alone and depressive symptoms, and have focused on the effect of eating alone transition. This study aims to explore the longitudinal association between eating alone, its transition and depressive symptoms among two national surveys using a cohort study design. METHODS The participants aged ≥ 45 years were recruited for the 2016 to 2018 waves China Family Panel Data (CFPS) and 2015 to 2018 waves China Health and Retirement Longitudinal Study (CHARLS). Eating alone was assessed by self-reported. Depressive symptoms were evaluated by Center for Epidemiologic Studies Depression Scale. Cox hazard regression was used to explore the associations between eating alone, its transition and depressive symptoms after adjusting for covariates. RESULTS A total of 21,476 participants were included in this study. The Cox model showed that compared with commensality, eating alone was associated with a higher risk of depressive symptoms, both in the CFPS, CHARLS and pooled analysis. In addition, compared with commensality consistently, the transition from commensality to alone and eating alone consistently were associated with a higher risk of depressive symptoms. The sensitivity analyses showed that the association remained robust. CONCLUSIONS Eating alone and a change from commensality to eating alone were associated with higher risks of depressive symptoms among Chinese middle-aged and older adults in two cohorts. This study suggested that providing eating partners may be an effective intervention method to prevent depressive symptoms in middle-aged and older adults.
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Affiliation(s)
- Baohua Qiu
- Shiquan Community Health Service Center, Tongji University School of Medicine, Shanghai, China
- Shanghai Putuo District Health Affairs Management Center, Shanghai, China
| | - Rongyu Zhu
- Clinical Center for Intelligent Rehabilitation Research, Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), Tongji University School of Medicine, Shanghai, China
- School of Public Health and General Practice, Tongji University School of Medicine, Tongji University, Shanghai, China
| | - Xinlu Huang
- Shiquan Community Health Service Center, Tongji University School of Medicine, Shanghai, China
| | - Zhijuan Qi
- Shiquan Community Health Service Center, Tongji University School of Medicine, Shanghai, China.
| | - Lijuan Zhang
- Clinical Center for Intelligent Rehabilitation Research, Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), Tongji University School of Medicine, Shanghai, China.
- School of Public Health and General Practice, Tongji University School of Medicine, Tongji University, Shanghai, China.
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Triolo F, Vetrano DL, Trevisan C, Sjöberg L, Calderón-Larrañaga A, Belvederi Murri M, Fratiglioni L, Dekhtyar S. Mapping 15-year depressive symptom transitions in late life: population-based cohort study. Br J Psychiatry 2024:1-7. [PMID: 38812455 DOI: 10.1192/bjp.2024.84] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/31/2024]
Abstract
BACKGROUND The longitudinal course of late-life depression remains under-studied. AIMS To describe transitions along the depression continuum in old age and to identify factors associated with specific transition patterns. METHOD We analysed 15-year longitudinal data on 2745 dementia-free persons aged 60+ from the population-based Swedish National Study on Aging and Care in Kungsholmen. Depression (minor and major) was diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision; subsyndromal depression (SSD) was operationalised as the presence of ≥2 symptoms without depression. Multistate survival models were used to map depression transitions, including death, and to examine the association of psychosocial (social network, connection and support), lifestyle (smoking, alcohol consumption and physical activity) and clinical (somatic disease count) factors with transition patterns. RESULTS Over the follow-up, 19.1% had ≥1 transitions across depressive states, while 6.5% had ≥2. Each additional somatic disease was associated with a higher hazard of progression from no depression (No Dep) to SSD (hazard ratio 1.09; 1.07-1.10) and depression (Dep) (hazard ratio 1.06; 1.04-1.08), but also with a lower recovery (HRSSD-No Dep 0.95; 0.93-0.97 [where 'HR' refers to 'hazard ratio']; HRDep-No Dep 0.96; 0.93-0.99). Physical activity was associated with an increased hazard of recovery to no depression from SSD (hazard ratio 1.49; 1.28-1.73) and depression (hazard ratio 1.20; 1.00-1.44), while a richer social network was associated with both higher recovery from (HRSSD-No Dep 1.44; 1.26-1.66; HRDep-No Dep 1.51; 1.34-1.71) and lower progression hazards to a worse depressive state (HRNo Dep-SSD 0.81; 0.70-0.94; HRNo Dep-Dep 0.58; 0.46-0.73; HRSSD-Dep 0.66; 0.44-0.98). CONCLUSIONS Older people may present with heterogeneous depressive trajectories. Targeting the accumulation of somatic diseases and enhancing social interactions may be appropriate for both depression prevention and burden reduction, while promoting physical activity may primarily benefit recovery from depressive disorders.
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Affiliation(s)
- Federico Triolo
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Sweden
| | - Davide Liborio Vetrano
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Sweden; and Stockholm Gerontology Research Center, Stockholm, Sweden
| | - Caterina Trevisan
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Sweden; and Department of Medical Sciences, University of Ferrara, Italy
| | - Linnea Sjöberg
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Sweden
| | - Amaia Calderón-Larrañaga
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Sweden; and Stockholm Gerontology Research Center, Stockholm, Sweden
| | - Martino Belvederi Murri
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Italy
| | - Laura Fratiglioni
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Sweden; and Stockholm Gerontology Research Center, Stockholm, Sweden
| | - Serhiy Dekhtyar
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Sweden
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Ji Y, Cho J, Xiang X. Activity Limitations and Depression Among Middle-Aged and Older Adults in China: The Moderating Impact of Assistance Adequacy. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2024:1-17. [PMID: 38600793 DOI: 10.1080/01634372.2024.2340739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 04/04/2024] [Indexed: 04/12/2024]
Abstract
This study aimed to examine the risk and protective factors associated with depression in middle-aged and older Chinese adults with activity limitations. Data were obtained from the 2018 Wave 4 Survey of the China Health and Retirement Longitudinal Study. In the logistic regression analysis, health and functioning, losing a child, and a perceived lack of future assistance with daily activities increased the odds of depression. Conversely, receiving adequate assistance with daily activities lessened the depressive impacts of activity limitations, as indicated by a significant interaction effect. Enhanced long-term support for individuals with disabilities is necessary to improve mental health.
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Affiliation(s)
- Yuanyuan Ji
- School of Management, Nanjing Audit University Jinshen College, Nanjing, China
| | - Joonyoung Cho
- School of Social Work, University of Michigan, Ann Arbor, Michigan, USA
| | - Xiaoling Xiang
- School of Social Work, University of Michigan, Ann Arbor, Michigan, USA
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Cohn-Schwartz E, Mannheim I, Meiry L. Assessment of a digital intervention program with Holocaust survivors. Aging Ment Health 2024; 28:587-594. [PMID: 37545419 DOI: 10.1080/13607863.2023.2240263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Accepted: 06/30/2023] [Indexed: 08/08/2023]
Abstract
OBJECTIVE This study evaluated a digital intervention program with aging Holocaust survivors. Participants received a tablet device and were coupled with a volunteer who assisted them to use the tablet. The study aimed to assess which characteristics of the Holocaust survivors are linked with more frequent use of digital communication at the end of the program. METHODS Information was collected by telephone interviews with 91 survivors before and 54 after participating in the program. We combined this data with digital usage data from the tablets. Regression models examined the characteristics of Holocaust survivors that were related to higher frequency of using digital communication technologies during the intervention. RESULTS The Holocaust survivors expressed high satisfaction with the program. They increased their frequency of using digital communication technologies-text correspondence and video chats with friends and family. Regressions showed that Holocaust survivors who reported increased digital communication were characterized at the start of the intervention by having fewer post-traumatic stress symptoms, higher levels of flourishing (reflecting a more meaningful life and higher well-being), being lonelier, and were also more satisfied with the program at follow-up. CONCLUSION The pilot program benefited the aging Holocaust survivors. Further programs should be developed to increase the digital communication of vulnerable older populations, such as trauma survivors.
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Affiliation(s)
- Ella Cohn-Schwartz
- Gerontology Program, Department of Epidemiology, Biostatistics, and Community Health Sciences, Faculty of Health Sciences, Ben-Gurion University, Be'er Sheva, Israel
| | - Ittay Mannheim
- Gerontology Program, Department of Epidemiology, Biostatistics, and Community Health Sciences, Faculty of Health Sciences, Ben-Gurion University, Be'er Sheva, Israel
- Department of Communication Studies, Ben-Gurion University, Be'er Sheva, Israel
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | - Lian Meiry
- Gerontology Program, Department of Epidemiology, Biostatistics, and Community Health Sciences, Faculty of Health Sciences, Ben-Gurion University, Be'er Sheva, Israel
- Department of Physiotherapy, Faculty of Health Sciences, Ben-Gurion University, Be'er Sheva, Israel
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Ishimoto Y, Kimura Y, Wada T, Hirayama K, Kato E, Tatsuno M, Fujisawa M, Kasahara Y, Nakatsuka M, Nose M, Iwasaki M, Kakuta S, Hirosaki M, Okumiya K, Matsubayashi K, Sakamoto R. Association of decreased frequency of conversation with depression, oral function and eating alone: A cross-sectional study of older adults during the COVID-19 pandemic. Geriatr Gerontol Int 2024; 24 Suppl 1:385-391. [PMID: 38400706 DOI: 10.1111/ggi.14832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 01/19/2024] [Accepted: 01/30/2024] [Indexed: 02/25/2024]
Abstract
AIM This study examined the associations between geriatric factors and decreased opportunities for conversation among older adults amid a period of self-restraint during the COVID-19 pandemic. METHODS A cross-sectional questionnaire-based survey was carried out in October 2020. The participants were 204 residents aged ≥65 years staying at a private care home in Kyoto city, Japan. Logistic regression analysis was carried out with the reduction of conversation opportunities as the dependent variable, and geriatric factors as independent variables after adjusting for age and sex. We compared the decreased frequency of opportunities between residents in the assisted living wing and in the nursing care wing of the private care home. RESULTS The percentages of respondents who reported a decrease in the opportunities for conversation among themselves were 43.9% for residents in the assisted living wing and 19.7% for those in the nursing care wing. After adjusting for age and sex, the opportunities for conversation was significantly associated with the basic activities of daily living (OR 1.07, 95% CI 1.01-1.12), instrumental self-maintenance (OR 1.25, 95% CI 1.08-1.46), intellectual activity (OR 1.35, 95% CI 1.09-1.66), depression (OR 1.13, 95% CI 1.04-1.23), depressive mood (OR 3.83, 95% CI 1.98-7.42), decreased motivation (OR 3.11, 95% CI 1.58-6.12), appetite loss (OR 4.32, 95% CI 1.54-12.07), swallowing function (OR 1.05, 95% CI 1.00-1.10), chewing difficulty (OR 2.50, 95% CI 1.31-4.75) and eating alone (OR 2.5, 95% CI 1.35-4.62). CONCLUSION Decreased opportunities for conversation was more perceived among older adults with higher daily functioning, suggesting that it is associated with depressed mood, oral function and solitary eating. Geriatr Gerontol Int 2024; 24: 385-391.
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Affiliation(s)
- Yasuko Ishimoto
- Department of Health and Sports Science, Faculty of Health Science and Technology, Kawasaki University of Medical Welfare, Okayama, Japan
| | - Yumi Kimura
- Graduate School of Human Sciences, Osaka University, Osaka, Japan
| | - Taizo Wada
- Osaka Home Healthcare Clinic, Osaka, Japan
- Center for Southeast Asian Studies, Kyoto University, Kyoto, Japan
| | - Kiichi Hirayama
- Department of Field Medicine Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Emiko Kato
- Center for Southeast Asian Studies, Kyoto University, Kyoto, Japan
| | - Mai Tatsuno
- Center for Southeast Asian Studies, Kyoto University, Kyoto, Japan
| | - Michiko Fujisawa
- Center for Southeast Asian Studies, Kyoto University, Kyoto, Japan
| | - Yoriko Kasahara
- Department of Nursing, Komazawa Women's University, Tokyo, Japan
| | | | - Mitsuhiro Nose
- Center for Southeast Asian Studies, Kyoto University, Kyoto, Japan
| | - Masanori Iwasaki
- Department of Preventive Dentistry, Faculty of Dental Medicine and Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Satoko Kakuta
- Division of Community Oral Health Development, Kyushu Dental University, Fukuoka, Japan
| | - Mayumi Hirosaki
- Center for Southeast Asian Studies, Kyoto University, Kyoto, Japan
| | - Kiyohito Okumiya
- Center for Southeast Asian Studies, Kyoto University, Kyoto, Japan
| | | | - Ryota Sakamoto
- Center for Southeast Asian Studies, Kyoto University, Kyoto, Japan
- Department of Field Medicine Graduate School of Medicine, Kyoto University, Kyoto, Japan
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Kim J, Kim Y, Li Y. Trends in forgone medical care and unmet needs among Medicare beneficiaries with a history of depression during the COVID-19 pandemic: a national, repeated cross-sectional study. BMJ Open 2024; 14:e078223. [PMID: 38262646 PMCID: PMC10806608 DOI: 10.1136/bmjopen-2023-078223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 01/04/2024] [Indexed: 01/25/2024] Open
Abstract
OBJECTIVES To investigate trends in forgone medical care, basic needs disruption, financial and mental health disruption, engagement of preventive behaviours guidelines, and perceived severity of COVID-19 among community-living Medicare beneficiaries in the USA with and without a self-reported history of depression from Summer 2020 to Winter 2021. DESIGN/SETTING A repeated cross-sectional study using a nationally representative sample of Medicare beneficiaries of three rounds of survey data from the Medicare Current Beneficiary Survey COVID-19 Supplement Public Use Files: Summer 2020, Fall 2020 and Winter 2021. PARTICIPANTS A total of 28 480 community-dwelling Medicare beneficiaries. MAIN OUTCOME MEASURES Forgone medical care, basic needs disruption, financial and mental health disruption, engagement of preventive behaviours guidelines, and perceived severity of COVID-19. RESULTS In the study sample, 7629 (27%) had a history of depression. After adjusting for potential confounders, weighted multivariable logistic regression models showed that Medicare beneficiaries with a history of depression had higher odds of foregone medical care (OR: 1.29, 95% CI 1.16 to 1.42, p<0.001), of basic need disruption (OR: 1.49, 95% CI 1.33 to 1.67, p<0.001), and of financial and mental health disruption (OR: 1.75, 95% CI 1.60 to 1.91, p<0.001) during the COVID-19 pandemic when compared with those without a history of depression. No statistically significant differences were observed in engagement of essential preventive behaviours or perception of COVID-19 severity. CONCLUSIONS COVID-19 pandemic may exacerbate existing barriers to healthcare access and financial and social needs, possibly leading to persistent unmet needs among Medicare beneficiaries with a history of depression beyond the pandemic.
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Affiliation(s)
- Jihye Kim
- University of Nevada Las Vegas, Las Vegas, Nevada, USA
| | - Yeunkyung Kim
- University of Nevada Las Vegas, Las Vegas, Nevada, USA
| | - Yue Li
- University of Rochester Medical Center, Rochester, New York, USA
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Meng D, Sun C. Subjective well-being patterns in older men and women without someone to confide in: a latent class analysis approach. Front Public Health 2024; 11:1286627. [PMID: 38249402 PMCID: PMC10796680 DOI: 10.3389/fpubh.2023.1286627] [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: 08/31/2023] [Accepted: 12/12/2023] [Indexed: 01/23/2024] Open
Abstract
Objective This study aimed to identify the latent subtypes of subjective well-being (SWB) and associated factors in older adults without a confidant in China. Methods The data came from the most recent (seventh) wave (2018) of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). This cross-sectional study included 350 older adults who lacked a close confidant. We utilized latent class analysis and multiple logistic regression models to examine the latent SWB subtypes and associated factors. Results Three distinct patterns of SWB were identified: the very low SWB class (32%), the medium-low SWB class (46%), and the low evaluative and high affective SWB class (22%). The results indicated that compared to the low evaluative and high affective SWB class, respondents who self-rated their health as not good, currently drank alcohol and rated their financial status as poor/very poor were more likely to be in the very low SWB class, while those who participated in social activities were less likely to be in the very low SWB class. Respondents who had limitations in instrumental activity of daily living (IADL) and rated their financial status as poor/very poor were more likely to be in the medium-low SWB class. However, gender did not affect SWB patterns. Conclusion Our findings highlight awareness of the heterogeneity of SWB in older adults without close confidants and provide valuable information for the development of tailored intervention programs to improve their well-being.
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Affiliation(s)
- Dijuan Meng
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China
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Lee H, Kim J, Zrínyi M. Mental health effects of adult children's outmigration on older parents in Central and Eastern Europe. Aging Ment Health 2024; 28:353-359. [PMID: 37811709 DOI: 10.1080/13607863.2023.2260327] [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: 04/06/2023] [Accepted: 09/11/2023] [Indexed: 10/10/2023]
Abstract
OBJECTIVE To examine the association between adult children's migration and depression among older parents in Central and Eastern Europe (CEE) and explore the role of intergenerational support in contributing to their depression. METHODS Data are from the eighth wave of the Survey of Health, Ageing and Retirement in Europe (SHARE), pooling a study sample of 11 CEE countries, with a cross-sectional design. Analysis of covariance (ANCOVA) and hierarchical linear regression were conducted using a study sample of 9133 respondents. RESULTS Older adults whose children migrated over 500 km were more likely to experience depression compared to those with no migrant child or all children within 500 km. Among intergenerational support, frequent parent-child contact mitigated the effects of migration on depression in older parents with all their children who migrated over 500 km. CONCLUSION This study suggests that older parents with migrant children over 500 km away should be considered a vulnerable population at risk for mental health in CEE countries. It is crucial for local governments and policymakers to address these challenges through improving integrated mental health and social programs for better mental health outcomes among older adults in CEE countries.
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Affiliation(s)
- Hayoung Lee
- Faculty of Health Sciences, University of Pécs, Pécs, Hungary
| | - Jaeshin Kim
- Dankook Center for Dispute Resolution, Dankook University, Yongin, South Korea
| | - Miklós Zrínyi
- Faculty of Health Sciences, University of Pécs, Pécs, Hungary
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S De Main A, Powers DA, Xie B, Choi N. Longitudinal associations between mental health and social environment in older adults: a multilevel growth modeling. Aging Ment Health 2023; 27:2278-2288. [PMID: 37293783 DOI: 10.1080/13607863.2023.2220304] [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: 01/31/2023] [Accepted: 05/26/2023] [Indexed: 06/10/2023]
Abstract
OBJECTIVES This study aimed to assess longitudinal relationships between social environment indicators (social connectedness, social engagement, social contribution) and mental health indicators (depression and anxiety) among community-dwelling adults age 55 years and older. METHODS Data were drawn from 3-waves of the national longitudinal survey of Midlife Development in the United States (MIDUS) (N = 2,020; age range = 55-94 years). We developed multilevel growth models to ascertain the relationships of interest, controlling for sociodemographic and physical health factors. RESULTS Over the 20-year period of study, lower levels of emotional social support, social integration and social contribution significantly predicted depression and anxiety, whereas social network and social engagement were not significant predictors of these mental health outcomes in older adults. The models also indicated a moderation effect of the number of chronic conditions on the slopes of depression and anxiety. DISCUSSION Considering our findings, interventions to enhance social contribution and social connectedness could be effective to help older adults maintain positive mental health, as well as programs that facilitate older adults' connections with their families, communities and health care providers. These interventions must also account for multiple chronic conditions since functional limitations drive declining integration in the community and participation in social activities.
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Affiliation(s)
- Atami S De Main
- Weill Cornell Medicine Division of Geriatrics and Palliative Medicine, New York, NY, USA
| | - Daniel A Powers
- Department of Sociology, The University of Texas at Austin, Austin, TX, USA
| | - Bo Xie
- Department of Sociology, The University of Texas at Austin, Austin, TX, USA
- School of Information, The University of Texas at Austin, Austin, TX, USA
| | - Namkee Choi
- School of Social Work, The University of Texas at Austin, Austin, TX, USA
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Pearce E, Birken M, Pais S, Tamworth M, Ng Y, Wang J, Chipp B, Crane E, Schlief M, Yang J, Stamos A, Cheng LK, Condon M, Lloyd-Evans B, Kirkbride JB, Osborn D, Pitman A, Johnson S. Associations between constructs related to social relationships and mental health conditions and symptoms: an umbrella review. BMC Psychiatry 2023; 23:652. [PMID: 37667255 PMCID: PMC10478264 DOI: 10.1186/s12888-023-05069-0] [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: 03/26/2023] [Accepted: 07/31/2023] [Indexed: 09/06/2023] Open
Abstract
BACKGROUND Loneliness and social isolation are increasingly recognised as prevalent among people with mental health problems, and as potential targets for interventions to improve quality of life and outcomes, as well as for preventive strategies. Understanding the relationship between quality and quantity of social relationships and a range of mental health conditions is a helpful step towards development of such interventions. PURPOSE Our aim was to give an overview of associations between constructs related to social relationships (including loneliness and social isolation) and diagnosed mental conditions and mental health symptoms, as reported in systematic reviews of observational studies. METHODS For this umbrella review (systematic review of systematic reviews) we searched five databases (PsycINFO, MEDLINE, EMBASE, CINAHL, Web of Science) and relevant online resources (PROSPERO, Campbell Collaboration, Joanna Briggs Institute Evidence Synthesis Journal). We included systematic reviews of studies of associations between constructs related to social relationships and mental health diagnoses or psychiatric symptom severity, in clinical or general population samples. We also included reviews of general population studies investigating the relationship between loneliness and risk of onset of mental health problems. RESULTS We identified 53 relevant systematic reviews, including them in a narrative synthesis. We found evidence regarding associations between (i) loneliness, social isolation, social support, social network size and composition, and individual-level social capital and (ii) diagnoses of mental health conditions and severity of various mental health symptoms. Depression (including post-natal) and psychosis were most often reported on, with few systematic reviews on eating disorders or post-traumatic stress disorder (PTSD), and only four related to anxiety. Social support was the most commonly included social construct. Our findings were limited by low quality of reviews and their inclusion of mainly cross-sectional evidence. CONCLUSION Good quality evidence is needed on a wider range of social constructs, on conditions other than depression, and on longitudinal relationships between social constructs and mental health symptoms and conditions.
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Affiliation(s)
- Eiluned Pearce
- Division of Psychiatry, University College London, London, UK
| | - Mary Birken
- Division of Psychiatry, University College London, London, UK
| | - Sarah Pais
- Division of Psychiatry, University College London, London, UK
| | - Millie Tamworth
- Division of Psychiatry, University College London, London, UK
| | - Yutung Ng
- Division of Psychiatry, University College London, London, UK
| | - Jingyi Wang
- Key Laboratory of Public Health Safety, NHC Key Laboratory of Health Technology Assessment, School of Public Health, Fudan University, Shanghai, China
| | - Beverley Chipp
- Co-production Group, Loneliness and Social Isolation in Mental Health Research Network, Division of Psychiatry, University College London, London, UK
| | - Ellena Crane
- Division of Psychiatry, University College London, London, UK
| | - Merle Schlief
- Division of Psychiatry, University College London, London, UK
| | - Jinyan Yang
- Division of Psychiatry, University College London, London, UK
| | - Aggelos Stamos
- Division of Psychiatry, University College London, London, UK
| | - Lui Kwan Cheng
- Division of Psychiatry, University College London, London, UK
| | - Maria Condon
- Division of Psychiatry, University College London, London, UK
| | | | | | - David Osborn
- Division of Psychiatry, University College London, London, UK
- Camden and Islington NHS Foundation Trust, London, UK
| | - Alexandra Pitman
- Division of Psychiatry, University College London, London, UK
- Camden and Islington NHS Foundation Trust, London, UK
| | - Sonia Johnson
- Division of Psychiatry, University College London, London, UK.
- Camden and Islington NHS Foundation Trust, London, UK.
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Wang B, Ding XX, Zhang H, Liu ZM, Duan PB, Dong YF. Predictors of post-stroke depression: the perspective from the social convoy model. Psychogeriatrics 2023; 23:864-875. [PMID: 37464888 DOI: 10.1111/psyg.13011] [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: 02/24/2023] [Revised: 07/04/2023] [Accepted: 07/06/2023] [Indexed: 07/20/2023]
Abstract
BACKGROUND Post-stroke depression (PSD) as one of the most common neuropsychiatric disorders after a stroke and is caused by many factors. However, the relationships among different factors and their potential contributions to PSD remain unclear. METHODS Two hundred and seventy-six patients were recruited into this study. The general information questionnaire, the Patient Health Questionnaire-9, the Perceived Social Support Scale, the Family Assessment Device, the General Well-Being Scale, the Barthel Index, and the modified Rankin Scale were used to assess the condition of patients. Subsequently, we identify the main causes associated with the PSD and then performed a path analysis to clarify the direct, indirect and total effects among the variables. RESULTS We found that age, stroke with coronary heart disease, neurological function, family function, social support, and general well-being had a significant impact on PSD (P < 0.05). Of these, neurological function had the largest total effect on PSD (β = 0.451), social support contributed the most as a direct effect (β = -0.306), and family function showed the largest indirect effect (β = -0.264). CONCLUSION Individual, disease, and social-psychological factors all contributed to the development of PSD. We should pay more attention to comprehensive assessment, especially for those with poor neurological function, and lacking family or social support. In addition, it would be preferable to provide them with necessary support and care strategies to reduce the incidence of PSD.
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Affiliation(s)
- Bin Wang
- Department of Medical Care, School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China
| | - Xing-Xing Ding
- Department of Medical Care, School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China
| | - Heng Zhang
- Department of Medical Care, School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China
| | - Zhi-Min Liu
- The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Pei-Bei Duan
- The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Yin-Feng Dong
- Department of Medical Care, School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China
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Krishnapillai A, Kee CC, Ariaratnam S, Jaffar A, Omar MA, Sanaudi RB, Sooryanarayana R, Kiau HB, Ghazali SS, Mohd Tohit N, Zainal Abidin SI. Social Support among Older Persons and Its Association with Smoking: Findings from the National Health and Morbidity Survey 2018. Healthcare (Basel) 2023; 11:2249. [PMID: 37628448 PMCID: PMC10454005 DOI: 10.3390/healthcare11162249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 08/01/2023] [Accepted: 08/08/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND Globally, the average age of the world's population of older people continues to rise and having a good social support network becomes increasingly relevant with the aging populace. Overall, in Malaysia, social support prevalence was low among older persons. This study was conducted to determine the association between social support and smoking status among the older Malaysian population. METHODS Data were obtained from the National Health and Morbidity (NHMS) 2018 survey on the health of older Malaysian adults and analyzed. This cross-sectional population-based study used a two-stage stratified random sampling design. Sociodemographic characteristics, smoking status, and social support data were collected from respondents aged 60 years and more. A validated Malay language interviewer-administered questionnaire of 11-items, the Duke Social Support Index, was utilized to assess the social support status. A multivariable logistic regression analysis was used to assess the association of social support and smoking status among the respondents. RESULTS The prevalence of good social support was significantly higher among the 60-69 years old (73.1%) compared to the ≥80 years old respondents (50%). Multivariate logistic regression analysis showed that respondents aged ≥80 years old were 1.7 times more likely to have poor social support compared to those aged 60-69 years. Respondents with no formal education were 1.93 times more likely to have poor social support compared to respondents who had tertiary education. Respondents with an income of MYR 3000. Former smokers had good social support compared to current smokers (73.6% vs. 78.7%). For current smokers, they had poor social support, which is almost 1.42 times higher than that for non-smokers. CONCLUSION There was poor social support among older people who were current smokers, had an increased age, had no formal education and had a low income. The findings obtained from this study could assist policymakers to develop relevant strategies at the national level to enhance the social support status among older smokers and aid in their smoking cessation efforts.
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Affiliation(s)
- Ambigga Krishnapillai
- Department of Family Medicine, Faculty of Medicine and Health, National Defense, University of Malaysia, Sg. Besi 57000, Malaysia;
| | - Chee Cheong Kee
- Sector for Biostatistics and Data Repository, National Institutes of Health, Ministry of Health Malaysia, Shah Alam 40170, Malaysia; (M.A.O.); (R.B.S.)
| | - Suthahar Ariaratnam
- Department of Psychiatry, Faculty of Medicine, Universiti Teknologi MARA (UiTM), Sg. Buloh 47000, Malaysia;
| | - Aida Jaffar
- Department of Family Medicine, Faculty of Medicine and Health, National Defense, University of Malaysia, Sg. Besi 57000, Malaysia;
| | - Mohd Azahadi Omar
- Sector for Biostatistics and Data Repository, National Institutes of Health, Ministry of Health Malaysia, Shah Alam 40170, Malaysia; (M.A.O.); (R.B.S.)
| | - Ridwan B. Sanaudi
- Sector for Biostatistics and Data Repository, National Institutes of Health, Ministry of Health Malaysia, Shah Alam 40170, Malaysia; (M.A.O.); (R.B.S.)
| | - Rajini Sooryanarayana
- Family Health Development Division, Ministry of Health Malaysia, Putrajaya 62590, Malaysia; (R.S.); (S.I.Z.A.)
| | - Ho Bee Kiau
- Klinik Kesihatan Bandar Botanik, Ministry of Health Malaysia, Klang 42000, Malaysia;
| | - Sazlina Shariff Ghazali
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Malaysia;
- Laboratory of Medical Gerontology, Malaysian Research Institute on Ageing (MyAgeing), Universiti Putra Malaysia, Serdang 43400, Malaysia
| | - Noorlaili Mohd Tohit
- Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia;
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Rho Y, Kim M, Beon J, Kim Y, Yoon S, Nam YJ, Hong S, Cho YH, Son SJ, Hong CH, Roh HW. Moderators of the Association Between Contact Frequency With Non-Cohabitating Adult Children and Depressive Symptoms Among Community-Dwelling Older Adults. Psychiatry Investig 2023; 20:758-767. [PMID: 37559480 PMCID: PMC10460971 DOI: 10.30773/pi.2023.0083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 05/08/2023] [Accepted: 05/25/2023] [Indexed: 08/11/2023] Open
Abstract
OBJECTIVE Contact frequency with adult children plays a critical role in late-life depression. However, evidence on possible moderators of this association remains limited. Moreover, considering alterations in contact modes after the coronavirus disease-2019 pandemic, there is a need to investigate this association post-pandemic to develop effective therapeutic interventions. METHODS This study included 7,573 older adults who completed the Living Profiles of the Older People Survey in Korea. Participants' contact frequency and depressive symptoms were analyzed. Regression analysis was performed after adjusting for covariates. The moderating effects of variables were verified using a process macro. RESULTS Multivariable logistic regression analysis revealed that infrequent face-to-face (odd ratio [OR]=1.86, 95% confidence interval [CI]=1.55-2.22) and non-face-to-face contact (OR=1.23, 95% CI=1.04-1.45) in the non-cohabitating adult children group was associated with a higher risk of late-life depression compared to that in the frequent contact group. Linear regression analysis indicated consistent results for face-to-face and non-face-to-face contact (estimate=0.458, standard error [SE]=0.090, p<0.001 and estimate=0.236, SE= 0.074, p=0.001, respectively). Moderation analysis revealed that the association between late-life depression and frequency of face-toface contact was moderated by age, household income quartiles, number of chronic diseases, physical activity frequency, presence of spouse, nutritional status, and whether the effect of frequency of non-face-to-face contact on late-life depression was increased by participation in social activity, frequent physical activity, and good cognitive function (p for interaction<0.05). CONCLUSION Frequent contact with non-cohabitating children lowers the risk of depression later in life. Several variables were identified as significant moderators of contact frequency and depression symptoms.
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Affiliation(s)
- Yujin Rho
- Department of Medicine, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Minji Kim
- Department of Medicine, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Jungeun Beon
- Department of Medicine, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Yeojin Kim
- Department of Psychiatry, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Sunwoo Yoon
- Department of Psychiatry, Ajou University School of Medicine, Suwon, Republic of Korea
| | - You Jin Nam
- Department of Psychiatry, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Sunhwa Hong
- Department of Psychiatry, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Yong Hyuk Cho
- Department of Psychiatry, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Sang Joon Son
- Department of Psychiatry, Ajou University School of Medicine, Suwon, Republic of Korea
- Suwon Geriatric Mental Health Center, Suwon, Republic of Korea
| | - Chang Hyung Hong
- Department of Psychiatry, Ajou University School of Medicine, Suwon, Republic of Korea
- Suwon Geriatric Mental Health Center, Suwon, Republic of Korea
| | - Hyun Woong Roh
- Department of Psychiatry, Ajou University School of Medicine, Suwon, Republic of Korea
- Suwon Geriatric Mental Health Center, Suwon, Republic of Korea
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Jones CA, Jhangri GS, Yamamoto SS, Hogan DB, Hanson H, Levasseur M, Morales E, Légaré F. Social participation of older people in urban and rural areas: Canadian Longitudinal Study on Aging. BMC Geriatr 2023; 23:439. [PMID: 37464306 DOI: 10.1186/s12877-023-04127-2] [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: 11/01/2022] [Accepted: 06/22/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Although the positive influence of social activity on health is now well-established, a complex relationship exists among social participation, personal, social and the environment. Social participation of older adults was examined in rural and urban settings to identify features of the built-environment and perception of neighborhood specific to the locale. RESEARCH DESIGN AND METHODS Using cross-sectional data from the Canadian Longitudinal Study on Aging (CLSA), we examined social participation and health of older people (65 + yrs) in relation to the built environment and sociocultural contexts for urban and rural areas. A social participation index was derived from responses on the frequency of participating in 8 social activities over the past 12 months. Personal, household and neighborhood indicators were examined to develop multivariable regression models for social participation in urban and rural cohorts. RESULTS No meaningful differences were seen with the frequency of social participation between rural and urban settings; however, the type of community-related activities differed in that a greater proportion of urban participants reported sports and educational/cultural events than rural participants. Service club activities were greater for rural than urban participants. Different neighborhood features were statistically significant factors in explaining social participation in rural than in urban locales, although transportation was a significant factor regardless of locale. Trustworthiness, belonging and safety were perceived factors of the neighborhood associated with higher social participation for rural participants. DISCUSSION AND IMPLICATIONS The relationship between home and health becomes stronger as one ages. Social and physical features of built environment specific to urban and rural settings need to be considered when implementing appropriate social activities for older people.
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Affiliation(s)
- C Allyson Jones
- Dept of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, 2-50 Corbett Hall, Edmonton, AB, T6G 2G4, Canada.
| | - Gian S Jhangri
- School of Public Health, University of Alberta, Edmonton, AB, Canada
| | - Shelby S Yamamoto
- School of Public Health, University of Alberta, Edmonton, AB, Canada
| | - David B Hogan
- Division of Geriatric Medicine, Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Heather Hanson
- Alberta Health Services Provincial Seniors Health and Continuing Care, Calgary, AB, Canada
| | - Mélanie Levasseur
- School of Rehabilitation, Université de Sherbrooke, Sherbrooke, QC, Canada
- Research Centre on Aging, Estrie Integrated University Health and Social Services, Centre-Sherbrooke Hospital University Centre, Sherbrooke, QC, Canada
| | - Ernesto Morales
- Department of Rehabilitation, Université Laval, Quebec City, QC, Canada
| | - France Légaré
- Department of Family Medicine and Emergency Medicine, Centre De Recherche Sur Les soins et Les Services de Première Ligne de S'Université Laval (CERSSPL-UL), Université Laval, Quebec City, QC, Canada
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Gu Y, Ali SH, Guo A. Comparing the role of social connectivity with friends and family in depression among older adults in China: evaluating the moderating effect of urban-rural status. Front Psychiatry 2023; 14:1162982. [PMID: 37252146 PMCID: PMC10213784 DOI: 10.3389/fpsyt.2023.1162982] [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: 02/10/2023] [Accepted: 04/14/2023] [Indexed: 05/31/2023] Open
Abstract
Background Social connectivity and support can reduce depressive symptoms. Few studies have examined urban-rural differences in the relationship between social support and depressive symptoms in the context of urbanization for Chinese older adults. The overall aim of this study is to examine urban-rural differences in the relationship between family support and social connectivity on depression among Chinese older adults. Methods This cross-sectional study used data from the 2010 Sample Survey on Aged Population in Urban/Rural China (SSAPUR). Depressive symptoms were measured using the Geriatric Depression Scale short-form (GDS-15). Family support was measured by structural, instrumental, and emotional support. Social connectivity was measured using the Lubben Social Network Scale-6 (LSNS-6). Descriptive analysis was conducted using chi-square and independent t-tests to examine urban-rural differences. Adjusted multiple linear regressions were conducted to examine the moderating effect of urban-rural status on the association between types of family support and social connectivity with depressive symptoms. Results In rural areas, respondents who felt their children exhibited filial piety (β = -1.512, p < 0.001) and had more social connectivity with family (β = -0.074, p < 0.001) were more likely to report fewer depression symptoms. In urban areas, respondents who received instrumental support from their children (β = -1.276, p < 0.01), who thought their children exhibited filial piety (β = -0.836, p < 0.01), and who had more social connectivity with friends (β = -0.040, p < 0.01) were more likely to report fewer depression symptoms. In the fully adjusted regression model, social connectivity with family was associated with decreased depressive symptoms, although to a lesser degree among urban-dwelling older adults (urban-rural interaction effect, β = 0.053, p < 0.05). Social connectivity with friends was similarly associated with decreased depressive symptoms, although this effect was greater among urban-dwelling older adults (urban-rural interaction effect, β = -0.053, p < 0.05). Conclusion The results of this study suggested that older adults both in rural and urban areas with family support and social connectivity were associated with fewer depression symptoms. Differences observed in the role of family and friend social connectivity by urban-rural status may provide practical information for developing targeted social support strategies for improving depressive symptoms among Chinese adults, and call for further mixed-methods research to disentangle mechanisms behind these differing associations.
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Affiliation(s)
- Yuxuan Gu
- Center for Gerontology Research, Department of Social Security, Nanjing Normal University, Nanjing, China
| | - Shahmir H. Ali
- School of Global Public Health, New York University, New York, NY, United States
| | - Aimei Guo
- Center for Gerontology Research, Department of Social Security, Nanjing Normal University, Nanjing, China
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Szymkowicz SM, Gerlach AR, Homiack D, Taylor WD. Biological factors influencing depression in later life: role of aging processes and treatment implications. Transl Psychiatry 2023; 13:160. [PMID: 37160884 PMCID: PMC10169845 DOI: 10.1038/s41398-023-02464-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 04/23/2023] [Accepted: 04/27/2023] [Indexed: 05/11/2023] Open
Abstract
Late-life depression occurring in older adults is common, recurrent, and malignant. It is characterized by affective symptoms, but also cognitive decline, medical comorbidity, and physical disability. This behavioral and cognitive presentation results from altered function of discrete functional brain networks and circuits. A wide range of factors across the lifespan contributes to fragility and vulnerability of those networks to dysfunction. In many cases, these factors occur earlier in life and contribute to adolescent or earlier adulthood depressive episodes, where the onset was related to adverse childhood events, maladaptive personality traits, reproductive events, or other factors. Other individuals exhibit a later-life onset characterized by medical comorbidity, pro-inflammatory processes, cerebrovascular disease, or developing neurodegenerative processes. These later-life processes may not only lead to vulnerability to the affective symptoms, but also contribute to the comorbid cognitive and physical symptoms. Importantly, repeated depressive episodes themselves may accelerate the aging process by shifting allostatic processes to dysfunctional states and increasing allostatic load through the hypothalamic-pituitary-adrenal axis and inflammatory processes. Over time, this may accelerate the path of biological aging, leading to greater brain atrophy, cognitive decline, and the development of physical decline and frailty. It is unclear whether successful treatment of depression and avoidance of recurrent episodes would shift biological aging processes back towards a more normative trajectory. However, current antidepressant treatments exhibit good efficacy for older adults, including pharmacotherapy, neuromodulation, and psychotherapy, with recent work in these areas providing new guidance on optimal treatment approaches. Moreover, there is a host of nonpharmacological treatment approaches being examined that take advantage of resiliency factors and decrease vulnerability to depression. Thus, while late-life depression is a recurrent yet highly heterogeneous disorder, better phenotypic characterization provides opportunities to better utilize a range of nonspecific and targeted interventions that can promote recovery, resilience, and maintenance of remission.
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Affiliation(s)
- Sarah M Szymkowicz
- Center for Cognitive Medicine, Department of Psychiatry and Behavioral Science, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Andrew R Gerlach
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Damek Homiack
- Department of Psychiatry, University of Illinois-Chicago, Chicago, IL, USA
| | - Warren D Taylor
- Center for Cognitive Medicine, Department of Psychiatry and Behavioral Science, Vanderbilt University Medical Center, Nashville, TN, USA.
- Geriatric Research, Education, and Clinical Center, Veterans Affairs Tennessee Valley Health System, Nashville, TN, USA.
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Nakagomi A, Tsuji T, Saito M, Ide K, Kondo K, Shiba K. Social isolation and subsequent health and well-being in older adults: A longitudinal outcome-wide analysis. Soc Sci Med 2023; 327:115937. [PMID: 37167920 DOI: 10.1016/j.socscimed.2023.115937] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 04/26/2023] [Accepted: 04/27/2023] [Indexed: 05/13/2023]
Abstract
BACKGROUND Social isolation has become a serious public health issue. However, most previous studies examine the relationship between social isolation and a single outcome. We aimed to conduct holistic assessments to understand the multidimensional impacts of social isolation on health and well-being. METHODS We used the three-wave data (2013, 2016, and 2019) obtained from the Japan Gerontological Evaluation Study. Our exposure, obtained from the 2016 survey, was the Social Isolation Index (SII) comprising five components: no partner, poor interaction with children, poor interaction with relatives, poor interaction with friends, and no social participation). We assessed 36 health and well-being outcomes across six dimensions obtained from the 2019 survey: physical/cognitive health, health behaviours, mental health, subjective well-being, social isolation, and cognitive social capital. Pre-exposure characteristics and prior outcome levels in 2013 were adjusted. We included 47,318 respondents for 4 outcomes (death, dementia, and functional disability) and 34,187 respondents for 32 other outcomes. The Bonferroni correction was used to correct for multiple tests. RESULTS The total SII scores were associated with a wide range of health and well-being outcomes across the six dimensions. Specifically, we found a robust association between an SII score of four or greater with mortality (Odds ratio: 1.89; 95% CI: 1.46-2.43). Among the five components of the SII, poor interaction with friends and no social participation showed robust associations with a wide range of health and well-being. We also found some robust evidence regarding effect modification by gender and age in the associations between the components of the SII and health and well-being. CONCLUSIONS Social isolation, specifically social interaction with friends and social participation, may affect a wide range of health and well-being among older adults.
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Affiliation(s)
- Atsushi Nakagomi
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan; Department of Cardiology, Chiba University Hospital, Chiba, Japan.
| | - Taishi Tsuji
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan; Faculty of Health and Sport Sciences, University of Tsukuba, Bunkyo City, Tokyo, Japan
| | - Masashige Saito
- Department of Social Welfare, Nihon Fukushi University, Chita-gun, Aichi, Japan; Center for Well-being and Society, Nihon Fukushi University, Nagoya City, Aichi, Japan
| | - Kazushige Ide
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Katsunori Kondo
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan; Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Koichiro Shiba
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
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[Sociodemographic and social correlates of self-reported resilience in old age-results from the population-based LIFE-Adult-Study]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2023; 66:402-409. [PMID: 36877241 PMCID: PMC9987372 DOI: 10.1007/s00103-023-03675-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 02/06/2023] [Indexed: 03/07/2023]
Abstract
INTRODUCTION Resilience describes good adaptation to adversity and is a significant factor for well-being in old age. Initial studies indicate a high relevance of social resources. So far, only few studies have investigated resilience patterns in the elderly population. Therefore, the present study aims to investigate sociodemographic and social correlates of resilience in a large population-based sample aged 65 years and older. METHODS Analyses were conducted on n = 2410 people aged 65 years and older from the follow-up survey of the LIFE-Adult-Study. The survey included the variables resilience (Resilience Scale - RS-11), social support (ENRICHD Social Support Inventory - ESSI), and social network (Lubben Social Network Scale - LSNS-6). The association of sociodemographic and social variables with resilience was analyzed using multiple linear regression analysis. RESULTS The age of 75 years and older was associated with lower resilience compared with the age of 65-74 years. Further, widowed marital status was related to higher resilience. Better social support and a larger social network were significantly associated with higher resilience. No association was found for gender and education. DISCUSSION The results reveal sociodemographic correlates of resilience in the elderly population that can help identify at-risk groups with lower resilience. Social resources are significant in older age for resilient adaptation and represent a starting point for deriving preventive measures. Social inclusion of older people should be promoted to strengthen resilience in this population and provide favorable conditions for successful aging.
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Shioya R, Nakagomi A, Ide K, Kondo K. Video call and depression among older adults during the COVID-19 pandemic in Japan: The JAGES one-year longitudinal study. Soc Sci Med 2023; 321:115777. [PMID: 36841222 PMCID: PMC9933485 DOI: 10.1016/j.socscimed.2023.115777] [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: 08/02/2022] [Revised: 01/07/2023] [Accepted: 02/13/2023] [Indexed: 02/18/2023]
Abstract
Evidence of video call on preventing late-life depression during the COVID-19 pandemic is limited. We examined the associations of social contact (in-person, voice call, and video call) with incidence of depressive symptoms and evaluated whether specific factors (particularly, age and change in the frequency of in-person contact) affect these associations. We used longitudinal data from the 2019 and 2020 waves of the Japan Gerontological Evaluation Study, including 10,523 participants aged ≥65 years in 10 municipalities. Depressive symptoms were measured by the 15-item Geriatric Depression Scale (GDS-15) score ≥5 in main analysis, and GDS-15 score ≥4, 10, or continuous variable in sensitivity analyses. Social contact represented frequency changes before and during the pandemic: non-contact (reference), decreased-contact, maintained-contact, and increased-contact. We employed modified Poisson regression analysis. Compared to non-contact of video call, the association of increased-contact of video call with depressive symptoms was insignificant in main analysis (GDS-15 ≥ 5: risk ratio (RR) = 0.89, 95% confidence interval (CI): 0.79-1.01), whereas significant in sensitivity analyses (GDS-15 ≥ 4: RR = 0.89, 95% CI: 0.82-0.98; GDS-15 ≥ 10: RR = 0.71, 95% CI: 0.53-0.97; GDS-15 = continuous variable: Β = -0.17, 95% CI: -0.33 to -0.002). In-person contact was significantly associated with lower incidence of depressive symptoms (non-contact: reference; maintained-contact: RR = 0.92, 95% CI: 0.85-0.99; increased-contact: RR = 0.84, 95% CI: 0.77-0.91), whereas voice call was not. Age and change in the frequency of in-person contact did not show significant effect modifications on the associations of video call with incidence of depressive symptoms after Bonferroni correction for multiple testing. In conclusion, this study suggests that the evidence supporting video call as a way to protect against depressive symptoms among older adults during the pandemic appears weak compared to the evidence for in-person contact.
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Affiliation(s)
- Ryunosuke Shioya
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, 1-33, Yayoi-Cho, Inage-Ku, Chiba-Shi, Chiba, 263-8522, Japan
| | - Atsushi Nakagomi
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, 1-33, Yayoi-Cho, Inage-Ku, Chiba-Shi, Chiba, 263-8522, Japan.
| | - Kazushige Ide
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, 1-33, Yayoi-Cho, Inage-Ku, Chiba-Shi, Chiba, 263-8522, Japan
| | - Katsunori Kondo
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, 1-33, Yayoi-Cho, Inage-Ku, Chiba-Shi, Chiba, 263-8522, Japan; Department of Gerontological Evaluation, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, 7-430, Morioka-Cho, Obu-Shi, Aichi, 474-8511, Japan
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22
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Győri Á. The impact of social-relationship patterns on worsening mental health among the elderly during the COVID-19 pandemic: Evidence from Hungary. SSM Popul Health 2023; 21:101346. [PMID: 36712146 PMCID: PMC9868011 DOI: 10.1016/j.ssmph.2023.101346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 12/20/2022] [Accepted: 01/20/2023] [Indexed: 01/24/2023] Open
Abstract
Evidence indicates the coronavirus pandemic has severely affected the oldest age group: in Hungary 92.7 per cent of those who died due to COVID-19 infection were 60 years of age or older. The age structure of the deceased was very similar in other countries. As, due to their underlying health status, elderly people are more vulnerable to the serious diseases caused by the coronavirus, strict government restrictions were introduced worldwide to protect them when the epidemic broke out. However, this social isolation can cause severe psychological and emotional strain. The study aim was to examine how patterns of social relationships were related to changes in mental health of the elderly during the COVID-19 pandemic in Hungary. We used the database of SHARE COVID-19 for our analysis. Descriptive and multivariate analyses were conducted. Findings of this study suggest that the network lacking contacts increases the severity of depression, anxiety, sleeping disorders, and loneliness the most among the elderly. Interestingly, the group with an intense close-knit network had a higher risk of worsening mental symptoms compared to multiple contact actives. Moreover, electronic communication - telephone, Skype - did not help either: there was a particularly high probability of worsening depression in this group. Another interesting result is that both in the group dominated by family contacts and among those with multiple relationships, the chances of worsening mental symptoms were lower, thus, personal contact - whether they include family members or other acquaintances - is truly protective. Results demonstrate that both the network characterised by lack of contact network and electronic contact activity contribute to greater risk of worsening mental health within elderly. A network pattern characterised by various types and forms of contacts is the most beneficial to mental health, and intensive contacts of limited scope alone are not sufficient to protect mental health.
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Affiliation(s)
- Ágnes Győri
- Centre for Social Sciences, Hungarian Academy of Sciences Centre of Excellence, Budapest, Hungary
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23
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Haim-Litevsky D, Komemi R, Lipskaya-Velikovsky L. Sense of Belonging, Meaningful Daily Life Participation, and Well-Being: Integrated Investigation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4121. [PMID: 36901132 PMCID: PMC10002207 DOI: 10.3390/ijerph20054121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 02/21/2023] [Accepted: 02/22/2023] [Indexed: 06/18/2023]
Abstract
The association between well-being, sense of belonging, connectedness to community, and meaningful participation in daily life occupations was theoretically proved and demonstrated in several health conditions or specific age groups. This study aimed to investigate an interplay between well-being, sense of belonging, and connectedness, and meaningful participation in a range of daily life occupations among healthy adults of working age in Israel. Participants (N = 121; age: M = 30.8, SD = 10.1; women: N = 94, 77.7%) completed standard instruments to evaluate the main constructs through an internet survey. A variety of communities, that the participants reported to belong to, were not different in the sense of belonging and connectedness, participation dimensions, and well-being. An association was found between sense of belonging and connectedness, the participation subjective dimension, and well-being (0.18 < rp < 0.47, p < 0.05). Sense of belonging explained in a significant way the variance in well-being (F(3) = 14.7, p < 0.001; R2 = 0.274) and was found to be a mediator between participation and well-being (1.86 < Sobel test < 2.39, p < 0.05). The study provides empirical support to the interrelationship between meaningful participation, sense of belonging and connectedness, and well-being in a healthy population. Participation in a range of meaningful activities that contribute to the sense of belonging and connectedness as a universal concept could further promote well-being.
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Affiliation(s)
| | - Reut Komemi
- School of Occupational Therapy, Faculty of Medicine, The Hebrew University, Jerusalem 91904, Israel
| | - Lena Lipskaya-Velikovsky
- School of Occupational Therapy, Faculty of Medicine, The Hebrew University, Jerusalem 91904, Israel
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24
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Das Gupta D, Wong DWS. Age-Dependent Differences in Frequent Mental Distress (FMD) of US Older Adults Living in Multigenerational Families versus Living Alone. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3747. [PMID: 36834440 PMCID: PMC9964232 DOI: 10.3390/ijerph20043747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 02/10/2023] [Accepted: 02/15/2023] [Indexed: 06/18/2023]
Abstract
Frequent mental distress (FMD) is prevalent among older Americans, but less is known about disparities in FMD of older adults living in multigenerational families versus living alone. We pooled cross-sectional data (unweighted, n = 126,144) from the Behavioral Risk Factor Surveillance System (BRFSS) between 2016 and 2020 and compared FMD (≥14 poor mental health days in the past 30 days = 1; 0 otherwise) of older adults (≥65 years) living in multigenerational families versus living alone in 36 states. After controlling for covariates, findings indicate 23% lower odds of FMD among older adults living in multigenerational households compared to counterparts living alone (adjusted odds ratio (AOR): 0.77; 95% confidence interval (CI): 0.60, 0.99). Findings also show that the reduction in the odds of FMD with each 5 year increase in age was larger among older adults living in multigenerational families by 18% (AOR: 0.56; 95% CI: 0.46, 0.70) compared to older adults living alone (AOR: 0.74; 95% CI: 0.71, 0.77), and this difference was significant at the 5% significance level. Multigenerational living may have a protective association with FMD among older adults. Further research is needed to identify multigenerational family and non-kin factors that translate into mental health advantages for older adults.
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Affiliation(s)
- Debasree Das Gupta
- Department of Kinesiology and Health Science, Emma Eccles Jones College of Education and Human Services, Utah State University, Logan, UT 84322, USA
| | - David W. S. Wong
- Department of Geography and Geoinformation Science, George Mason University, Fairfax, VA 22030, USA
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Tian Z, Qu W, Zhao Y, Zhu X, Wang Z, Tan Y, Jiang R, Tan S. Predicting depression and anxiety of Chinese population during COVID-19 in psychological evaluation data by XGBoost. J Affect Disord 2023; 323:417-425. [PMID: 36462608 PMCID: PMC9710109 DOI: 10.1016/j.jad.2022.11.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 10/27/2022] [Accepted: 11/18/2022] [Indexed: 12/04/2022]
Abstract
BACKGROUND Due to the onset of sudden stress, COVID-19 has greatly impacted the incidence of depression and anxiety. However, challenges still exist in identifying high-risk groups for depression and anxiety during COVID-19. Studies have identified how resilience and social support can be employed as effective predictors of depression and anxiety. This study aims to select the best combination of variables from measures of resilience, social support, and alexithymia for predicting depression and anxiety. METHODS The eXtreme Gradient Boosting (XGBoost1) model was applied to a dataset including data on 29,841 participants that was collected during the COVID-19 pandemic. Discriminant analyses on groups of participants with depression (DE2), anxiety (AN3), comorbid depression and anxiety (DA4), and healthy controls (HC5), were performed. All variables were selected according to their importance for classification. Further, analyses were performed with selected features to determine the best variable combination. RESULTS The mean accuracies achieved by three classification tasks, DE vs HC, AN vs HC, and DA vs HC, were 0.78, 0.77, and 0.89. Further, the combination of 19 selected features almost exhibited the same performance as all 56 variables (accuracies = 0.75, 0.75, and 0.86). CONCLUSIONS Resilience, social support, and some demographic data can accurately distinguish DE, AN, and DA from HC. The results can be used to inform screening practices for depression and anxiety. Additionally, the model performance of a limited scale including only 19 features indicates that using a simplified scale is feasible.
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Affiliation(s)
- Zhanxiao Tian
- Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital, Beijing 100096, China
| | - Wei Qu
- Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital, Beijing 100096, China
| | - Yanli Zhao
- Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital, Beijing 100096, China
| | - Xiaolin Zhu
- Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital, Beijing 100096, China
| | - Zhiren Wang
- Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital, Beijing 100096, China
| | - Yunlong Tan
- Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital, Beijing 100096, China
| | - Ronghuan Jiang
- The First Medical Center of Chinese People's Liberation Army General Hospital, No.100 West Fourth Ring Road, Fengtai District, Beijing 100853, China
| | - Shuping Tan
- Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital, Beijing 100096, China.
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Restout J, Bernache-Assollant I, Morizio C, Boujut A, Angelini L, Tchalla A, Perrochon A. Fully Immersive Virtual Reality Using 360° Videos to Manage Well-Being in Older Adults: A Scoping Review. J Am Med Dir Assoc 2023; 24:564-572. [PMID: 36758621 DOI: 10.1016/j.jamda.2022.12.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 12/20/2022] [Accepted: 12/31/2022] [Indexed: 02/08/2023]
Abstract
OBJECTIVE The development of negative behavioral and psychosocial factors (depression, anxiety, apathy, etc) is associated with poor well-being, which can contribute to health issues in ageing, especially in the context of COVID-19. Despite its relative novelty, fully immersive virtual reality (VR) interventions through 360° immersive videos are becoming more accessible and flexible and constitute an emerging method to potentially enhance well-being. The aim of this scoping review is to assess the effectiveness of 360° interventions on well-being in older adults with or without cognitive impairment, as well as cybersickness and attitudes toward this technology. DESIGN Scoping review. SETTING AND PARTICIPANTS Older adults with or without cognitive impairment. METHODS The PRISMA-SR guideline was followed. Four databases were used, and we selected articles published until April 2022. We have analyzed the effect of 360° videos on the well-being of older adults with respect to the study design, the population, the contents, the duration of intervention, and the outcomes. RESULTS A total of 2262 articles were screened, of which 10 articles were finally included in this review. Most of them are pilot studies and used mixed methods including scales and interviews. The material and content of VR are diversified. Many behavioral and psychological outcomes were assessed, including anxiety, apathy, loneliness, depression, social engagement, quality of life, and emotions. The results were positive or mixed, according to the outcomes. We recorded few adverse events, and the interviews show contrasting results concerning the participants' feelings (ie, degree of immersion, familiarity with technology, and VR content). CONCLUSIONS AND IMPLICATIONS The use of VR 360° videos seems feasible in community-dwelling older adults or residential aged care facilities, as they are safe and provide enjoyment. It constitutes an emerging and promising therapeutic tool to manage psychosocial disorders. This review provides key considerations for the design and implementation of interventions using VR 360° video in clinical practice.
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Affiliation(s)
- J Restout
- Université de Limoges, HAVAE, UR20217, Limoges, France
| | | | - C Morizio
- Université de Limoges, HAVAE, UR20217, Limoges, France
| | - A Boujut
- Université de Limoges, HAVAE, UR20217, Limoges, France; 3iL Groupe, Limoges, France
| | - L Angelini
- School of Management Fribourg, HES-SO, Fribourg, Switzerland; Humantech Institute, HES-SO, Fribourg, Switzerland
| | - A Tchalla
- CHU de Limoges, Pôle HU gérontologie clinique, Limoges, France; Laboratoire VieSanté, UR 24134 (Vieillissement, Fragilité, Prévention, e-Santé), IFR OMEGA HEALTH, Université de Limoges, Limoges, France
| | - A Perrochon
- Université de Limoges, HAVAE, UR20217, Limoges, France.
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27
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Decreasing patterns of depression in living alone across middle-aged and older men and women using a longitudinal mixed-effects model. Soc Sci Med 2023; 317:115513. [PMID: 36450172 DOI: 10.1016/j.socscimed.2022.115513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 10/23/2022] [Accepted: 11/03/2022] [Indexed: 11/22/2022]
Abstract
There is little evidence regarding the association between living arrangement and depression, and no studies have examined the age- and gender-specific differences in this association. The present study sought to examine the longitudinal changes in depression patterns between isolative living versus living in company among middle-aged and older men and women by obtaining data from waves 1-7 of the Korean Longitudinal Study of Aging (KloSA), which comprises a sample of persons at least 45 years of age in the Republic of Korea (2273 middle-aged and 1387 older men, 2805 middle aged and 1862 older women). Depression scores were based on the self-reported Center for Epidemiologic Studies Depression Scale (CES-D-10) short forms. Using mixed-effect linear regression models, we estimated depression patterns by living arrangement across age- and gender groups. Our findings from the mixed-effects model revealed that over a 14-year follow-up period, there were significant decreasing patterns of depression were among middle-aged men and women, and older men living alone compared to living with a spouse and living with others. However, living alone still had the highest depression compared to other living arrangement types. On the other hand, the depression of older women living alone changed to a level similar to those living with others during the follow-up period. In conclusion, these findings indicate that living alone significantly increases the risk of depression, but the risk decreases over time. Additionally, depression patterns by living arrangement proved to differ across age and gender groups.
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28
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[The development of mental health in oldest-old individuals during the COVID-19 pandemic and the role of social support]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2023; 66:241-247. [PMID: 36715721 PMCID: PMC9886206 DOI: 10.1007/s00103-023-03660-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 01/16/2023] [Indexed: 01/31/2023]
Abstract
BACKGROUND The elderly population is one of the high-risk groups with regard to a severe course of disease and increased mortality when infected with the coronavirus SARS-CoV‑2 (Severe Acute Raspiratory Syndrom Coronavirus 2). This group may be at higher risk for psychological strains from the COVID-19 pandemic itself but also from the health protection measures. The aim is to examine how symptoms of depressiveness, anxiety, and somatization change over the course of the pandemic and which role social support plays in that. METHODS Using two written surveys of n = 156 elderly participants in the periods May to June 2020 and March to May 2021, sociodemographic data, factors of psychological strain (depressiveness, anxiety, and somatization), as well as the perceived social support were recorded. The mean age of the respondents was 87.20 years (SD = 4.65; age range = 77.68-96.75 years) and 88.03 years (SD = 4.63; age range = 78.52-97.62 years) for 2020 and 2021, respectively. Data were analyzed using Wilcoxon t‑tests and generalized linear regression models. RESULTS A significant increase in the expression of psychological strain with regards to depressiveness, anxiety, and somatization can be identified. Higher scores of psychological strains in 2020 are associated with a higher psychological strain in 2021. Higher perceived social support in 2020 is associated with lower depressiveness one year later. CONCLUSION An increase in psychological strain has been observed in the elderly population over the course of the COVID-19 pandemic until May 2021. This population should be supported by preventive programs to avert a further increase in symptoms. The expansion of social support could be useful, especially in the prevention of depressive symptoms.
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Yu S, Wang J, Zeng L, Yang P, Tang P, Su S. The prevalence of social frailty among older adults: A systematic review and meta-analysis. Geriatr Nurs 2023; 49:101-108. [PMID: 36470103 DOI: 10.1016/j.gerinurse.2022.11.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 11/10/2022] [Accepted: 11/14/2022] [Indexed: 12/04/2022]
Abstract
Social frailty is a geriatric public health problem that deeply affects healthy aging. Currently, evidence on the prevalence and factors associated with social frailty in older adults remains unclear. Our study aims to estimate the prevalence and related factors of social frailty in older adults. This study retrieved nine electronic databases searched through July 5th, 2022. The prevalence of social frailty was pooled using Stata software. It was found that older adults suffered from a "moderate" level of social frailty. We found a higher prevalence of social frailty in the United Kingdom, Greece, Croatia, The Netherlands, and Spain, in people over 75 years, in hospitals, and during the Coronavirus Disease 2019 (COVID-19). We believed that countries, age, research sites, and the pandemic of COVID-19 were influencing factors of social frailty among older adults. These findings may provide a theoretical basis for the development of ameliorating social frailty among older adults.
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Affiliation(s)
- Shiya Yu
- College of Nursing, Chengdu University of Traditional Chinese Medicine, No.1166 Liutai Road, Wenjiang District, Chengdu City, Sichuan province, 611137, China.
| | - Jialin Wang
- College of Nursing, Chengdu University of Traditional Chinese Medicine, No.1166 Liutai Road, Wenjiang District, Chengdu City, Sichuan province, 611137, China.
| | - Li Zeng
- Sichuan Nursing Vocational College, No.173 Longdu South Road, Longquanyi District, Chengdu City, Sichuan province, 610100, China.
| | - Pengyu Yang
- College of Nursing, Chengdu University of Traditional Chinese Medicine, No.1166 Liutai Road, Wenjiang District, Chengdu City, Sichuan province, 611137, China.
| | - Ping Tang
- Department of Nursing, Anyue County People's Hospital, No.68 Wai Nan Street, Yueyang Town, Anyue County, Ziyang City, Sichuan Province, 642350, China.
| | - Sihui Su
- College of Nursing, Chengdu University of Traditional Chinese Medicine, No.1166 Liutai Road, Wenjiang District, Chengdu City, Sichuan province, 611137, China.
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Weitzel EC, Löbner M, Glaesmer H, Hinz A, Zeynalova S, Henger S, Engel C, Reyes N, Wirkner K, Löffler M, Riedel-Heller SG. The Association of Resilience with Mental Health in a Large Population-Based Sample (LIFE-Adult-Study). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15944. [PMID: 36498017 PMCID: PMC9740913 DOI: 10.3390/ijerph192315944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 11/17/2022] [Accepted: 11/25/2022] [Indexed: 06/17/2023]
Abstract
Resilience describes a good adaptation to adversity. Strengthening resilience is a promising approach in the prevention of mental health problems. Yet, research on the association of resilience with mental health symptoms in the general population is scarce. The aim of our study is to examine comprehensively the association of resilience with depressive symptoms, anxiety, and perceived stress in a large population-based sample. We analyzed data of n = 3762 participants from the follow-up assessment of the LIFE-Adult-Study, a population-based cohort study in Leipzig. Assessments included resilience (RS-11), depressive symptoms (CES-D), anxiety (GAD-7), and perceived stress (PSQ). The association of resilience with mental health symptoms was examined via multiple linear regression analyses. In our analyses, higher resilience predicted less mental health problems and contributed significantly to the explained variance in mental health outcomes. Women, individuals with previous mental disorders, and those without employment had higher mental health symptoms. Resilience is closely associated with mental health problems in the general population. Vulnerable groups should be targeted with public health measures. Strengthening resilience is a promising approach in the large-scale prevention of mental disorders.
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Affiliation(s)
- Elena Caroline Weitzel
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103 Leipzig, Germany
| | - Margrit Löbner
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103 Leipzig, Germany
| | - Heide Glaesmer
- Department of Medical Psychology and Medical Sociology, Medical Faculty, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103 Leipzig, Germany
| | - Andreas Hinz
- Department of Medical Psychology and Medical Sociology, Medical Faculty, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103 Leipzig, Germany
| | - Samira Zeynalova
- Institute of Medical Informatics, Statistics and Epidemiology, University of Leipzig, Härtel-Str. 16–18, 04107 Leipzig, Germany
| | - Sylvia Henger
- Institute of Medical Informatics, Statistics and Epidemiology, University of Leipzig, Härtel-Str. 16–18, 04107 Leipzig, Germany
| | - Christoph Engel
- Institute of Medical Informatics, Statistics and Epidemiology, University of Leipzig, Härtel-Str. 16–18, 04107 Leipzig, Germany
| | - Nigar Reyes
- Institute of Medical Informatics, Statistics and Epidemiology, University of Leipzig, Härtel-Str. 16–18, 04107 Leipzig, Germany
| | - Kerstin Wirkner
- LIFE—Leipzig Research Centre for Civilization Diseases, University of Leipzig, Philipp-Rosenthal-Str. 27, 04103 Leipzig, Germany
| | - Markus Löffler
- Institute of Medical Informatics, Statistics and Epidemiology, University of Leipzig, Härtel-Str. 16–18, 04107 Leipzig, Germany
- LIFE—Leipzig Research Centre for Civilization Diseases, University of Leipzig, Philipp-Rosenthal-Str. 27, 04103 Leipzig, Germany
| | - Steffi G. Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103 Leipzig, Germany
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31
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Wang C, Liu Z, Chen T, Wang J, Zhang X, Han B. Intergenerational support and depressive symptoms in old age: The difference between urban and rural China. Front Public Health 2022; 10:1007408. [PMID: 36466487 PMCID: PMC9709321 DOI: 10.3389/fpubh.2022.1007408] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Accepted: 10/31/2022] [Indexed: 11/17/2022] Open
Abstract
Objectives Intergenerational support is associated with fewer depressive symptoms in old age. Uneven development has resulted in huge urban-rural disparities in China, which could lead to different intergenerational relationships. The present study aimed to examine whether intergenerational support was associated with depressive symptoms differently among urban and rural Chinese older participants. Methods A sample of 3,498 participants from nine pairs of urban subdistricts and rural villages were included in the present study. Depressive symptoms were measured by the 10-item Center for Epidemiological Studies Depression Scale, and the intergenerational support mechanisms (financial, instrumental, and emotional) were assessed with a self-designed questionnaire. Results Significant areas by support effect for depressive symptoms indicated different associations between intergenerational financial and emotional support and depressive symptoms in urban and rural areas. Specifically, urban older participants receiving emotional support from adult children and rural older participants receiving financial support from adult children showed fewer depressive symptoms. In both areas, participants receiving instrumental support showed fewer depressive symptoms. Conclusion Our study is the first to compare the urban-rural disparity in association between intergenerational support and depressive symptoms in a developing country, China. The results support modernization theories proposing weakened economic function but intensified emotional ties in societies with higher level of development. Communication-based intergenerational emotional support should be promoted in urban areas, and formal support systems should provide financial and instrumental support to the vulnerable rural older population.
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Affiliation(s)
- Chenxi Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Zhengkui Liu
- CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Tianyong Chen
- CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China,*Correspondence: Tianyong Chen
| | - Jinfeng Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Xin Zhang
- School of Psychological and Cognitive Sciences and Beijing Key Laboratory of Behavior and Mental Health, Peking University, Beijing, China
| | - Buxin Han
- CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
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Wister A, Li L, Levasseur M, Kadowaki L, Pickering J. The Effects of Loneliness on Depressive Symptoms Among Older Adults During COVID-19: Longitudinal Analyses of the Canadian Longitudinal Study on Aging. J Aging Health 2022; 35:439-452. [PMID: 36383045 PMCID: PMC9672981 DOI: 10.1177/08982643221129686] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Objectives This paper examines the longitudinal effects of changes in the association between loneliness and depressive symptoms during the pandemic among older adults (65+). Methods Baseline (2011–2015) and Follow-up 1 (2015–2018) from the Canadian Longitudinal Study on Aging (CLSA), and the Baseline and Exit waves of the CLSA COVID-19 study (April–December, 2020) ( n = 12,469) were used. Loneliness was measured using the 3-item UCLA Loneliness Scale and depression using the CES_D- 9. Results Loneliness is associated with depressive symptoms pre-pandemic; and changes in level of loneliness between FUP1 and the COVID Exit survey, adjusting for covariates. No interaction between loneliness and caregiving, and with multimorbidity, on depressive symptoms were observed, and several covariates exhibited associations with depressive symptoms. Discussion Strong support is found for an association between loneliness on depressive symptoms among older adults during the pandemic. Public health approaches addressing loneliness could reduce the burden of depression on older populations.
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Affiliation(s)
- Andrew Wister
- Department of Gerontology, Gerontology Research Centre, Simon Fraser University, Vancouver, BC, Canada
| | - Lun Li
- School of Social Work, MacEwan University, Edmonton, AB, Canada
| | - Mélanie Levasseur
- Faculty of Medicine and Health Sciences, School of Rehabilitation, Université de Sherbrooke, Sherbrooke, QC, Canada
- Research Center on Aging, Centre Intégré Universitaire de Santé et de Services Sociaux de l’Estrie, Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada
| | - Laura Kadowaki
- Gerontology Research Centre, Simon Fraser University, Vancouver, BC, Canada
| | - John Pickering
- Gerontology Research Centre, Simon Fraser University, Vancouver, BC, Canada
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Older Adults and Social Isolation and Loneliness During the COVID-19 Pandemic: An Integrated Review of Patterns, Effects, and Interventions. Can J Aging 2022; 42:199-216. [PMID: 36345649 DOI: 10.1017/s0714980822000459] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Abstract
A scoping review was conducted to identify patterns, effects, and interventions to address social isolation and loneliness among community-dwelling older adult populations during the COVID-19 pandemic. We also integrated (1) data from the Canadian Longitudinal Study on Aging (CLSA) and (2) a scan of Canadian grey literature on pandemic interventions. CLSA data showed estimated relative increases in loneliness ranging between 33 and 67 per cent depending on age/gender group. International studies also reported increases in levels of loneliness, as well as strong associations between loneliness and depression during the pandemic. Literature has primarily emphasized the use of technology-based interventions to reduce social isolation and loneliness. Application of socio-ecological and resilience frameworks suggests that researchers should focus on exploring the wider array of potential pandemic age-friendly interventions (e.g., outdoor activities, intergenerational programs, and other outreach approaches) and strength-based approaches (e.g., building community and system-level capacity) that may be useful for reducing social isolation and loneliness.
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Wendel F, Bauer A, Blotenberg I, Brettschneider C, Buchholz M, Czock D, Döhring J, Escales C, Frese T, Hoffmann W, Kaduszkiewicz H, König HH, Löbner M, Luppa M, Schwenker R, Thyrian JR, Weißenborn M, Wiese B, Zöllinger I, Riedel-Heller SG, Gensichen J. Social Network and Participation in Elderly Primary Care Patients in Germany and Associations with Depressive Symptoms-A Cross-Sectional Analysis from the AgeWell.de Study. J Clin Med 2022; 11:jcm11195940. [PMID: 36233810 PMCID: PMC9572848 DOI: 10.3390/jcm11195940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 10/02/2022] [Accepted: 10/05/2022] [Indexed: 11/16/2022] Open
Abstract
This study aims to describe social network and social participation and to assess associations with depressive symptoms in older persons with increased risk for dementia in Germany. We conducted a cross-sectional observational study in primary care patients (aged 60−77) as part of a multicenter cluster-randomized controlled trial (AgeWell.de). We present descriptive and multivariate analyses for social networks (Lubben Social Network Scale and subscales) and social participation (item list of social activities) and analyze associations of these variables with depressive symptoms (Geriatric Depression Scale). Of 1030 included patients, 17.2% were at risk for social isolation (Lubben Social Network Scale < 12). Looking at the subscales, a reduced non-family network was found almost twice as often as a reduced family network. Patients with depressive symptoms had significantly smaller social networks than patients without depression (p < 0.001). They rather engaged in social activities of low involvement level or no weekly social activity at all (p < 0.001). The study shows associations of depressive symptoms with a decreased social network and less social participation in elderly participants. Sufficient non-family contacts and weekly social activities seem to play an important role in mental health and should be encouraged in elderly primary care patients.
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Affiliation(s)
- Flora Wendel
- Institute of General Practice and Family Medicine, University Hospital of LMU Munich, 80336 Munich, Germany
- Correspondence:
| | - Alexander Bauer
- Institute of General Practice and Family Medicine, Martin-Luther-University Halle-Wittenberg, 06112 Halle (Saale), Germany
| | - Iris Blotenberg
- German Center for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, 17489 Greifswald, Germany
| | - Christian Brettschneider
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Maresa Buchholz
- German Center for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, 17489 Greifswald, Germany
| | - David Czock
- Department of Clinical Pharmacology and Pharmacoepidemiology, University Hospital Heidelberg, 69120 Heidelberg, Germany
| | - Juliane Döhring
- Institute of General Practice, University of Kiel, 24105 Kiel, Germany
| | - Catharina Escales
- Institute of General Practice, University of Kiel, 24105 Kiel, Germany
| | - Thomas Frese
- Institute of General Practice and Family Medicine, Martin-Luther-University Halle-Wittenberg, 06112 Halle (Saale), Germany
| | - Wolfgang Hoffmann
- German Center for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, 17489 Greifswald, Germany
- Institute for Community Medicine, University Medicine Greifswald, 17487 Greifswald, Germany
| | | | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Margrit Löbner
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, 04103 Leipzig, Germany
| | - Melanie Luppa
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, 04103 Leipzig, Germany
| | - Rosemarie Schwenker
- Institute of General Practice and Family Medicine, Martin-Luther-University Halle-Wittenberg, 06112 Halle (Saale), Germany
| | - Jochen René Thyrian
- German Center for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, 17489 Greifswald, Germany
| | - Marina Weißenborn
- Department of Clinical Pharmacology and Pharmacoepidemiology, University Hospital Heidelberg, 69120 Heidelberg, Germany
| | - Birgitt Wiese
- MHH Information Technology, Medizinische Hochschule Hannover, 30625 Hannover, Germany
| | - Isabel Zöllinger
- Institute of General Practice and Family Medicine, University Hospital of LMU Munich, 80336 Munich, Germany
| | - Steffi G. Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, 04103 Leipzig, Germany
| | - Jochen Gensichen
- Institute of General Practice and Family Medicine, University Hospital of LMU Munich, 80336 Munich, Germany
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Zheng R, Yu M, Huang L, Wang F, Gao B, Fu D, Zhu J, Liu G. Effect of intergenerational exchange patterns and intergenerational relationship quality on depressive symptoms in the elderly: An empirical study on CHARLS data. Front Public Health 2022; 10:1009781. [PMID: 36262237 PMCID: PMC9574018 DOI: 10.3389/fpubh.2022.1009781] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 09/16/2022] [Indexed: 01/27/2023] Open
Abstract
Background As the population ages with fewer children, depression symptoms are increasing among the elderly who lack companionship. Intergenerational support is closely related to depression in the elderly; hence how the behavioral patterns and emotional quality of intergenerational support affect depressive symptoms in the elderly should be further explored. Objective To study the effects of intergenerational exchange patterns and intergenerational relationship quality on depressive symptoms in the elderly. Methods A total of 8,015 people over 60 years old in CHARLS in 2018 were selected as the object of this study. First, the correlation between demographics, economic conditions, health status, intergenerational support patterns, intergenerational relationship quality, and depressive symptoms in the elderly were analyzed. Three regression analysis models were established to analyze the relationship between control variables, intergenerational support patterns, intergenerational relationship quality, and depressive symptoms in the elderly. Results: Among the intergenerational economic, care, and emotional exchange modes, the risk of depressive symptoms in the elderly in the mutual support group was 31.8, 38.4, and 25.5% lower than that in the non-communication group. Compared with the elderly with very poor intergenerational relationship quality, the elderly with good, very good, and excellent intergenerational relationship quality had 74.5, 84.0, and 85.6% lower risk of depressive symptoms. Discussion Different cultural backgrounds also affect intergenerational exchange patterns and depression in the elderly. During the study of depressive symptoms, two aspects relating to intergenerational support should be considered behaviorally and emotionally: the intergenerational exchange model and the intergenerational relationship quality. As depression in the elderly is affected by multiple factors, the participation and joint efforts of the whole society are required to reduce depressive symptoms in the elderly and realize active aging. Conclusion The intergenerational exchange pattern of mutual support and the higher quality of the intergenerational relationship can significantly reduce the depressive symptoms of the elderly.
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Affiliation(s)
- Ranran Zheng
- School of Public Health and Management, Wenzhou Medical University, Wenzhou, China
| | - Mingyang Yu
- Integrated Office of Party and Government, First Affiliated Hospital Zhejiang Chinese Medicine University, Hangzhou, China
| | - Li Huang
- School of Public Health and Management, Wenzhou Medical University, Wenzhou, China
| | - Fang Wang
- School of Public Health and Management, Wenzhou Medical University, Wenzhou, China
| | - Baizhi Gao
- School of Public Health and Management, Wenzhou Medical University, Wenzhou, China
| | - Duanduan Fu
- School of Public Health and Management, Wenzhou Medical University, Wenzhou, China
| | - Jinghui Zhu
- School of Public Health and Management, Wenzhou Medical University, Wenzhou, China,*Correspondence: Jinghui Zhu
| | - Guilin Liu
- School of Public Health and Management, Wenzhou Medical University, Wenzhou, China,Guilin Liu
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36
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Zhang Z, Li G, Song Z, Han Y, Tang X. Relationship among number of close friends, subclinical geriatric depression, and subjective cognitive decline based on regional homogeneity of functional magnetic resonance imaging data. Front Aging Neurosci 2022; 14:978611. [PMID: 36212042 PMCID: PMC9541299 DOI: 10.3389/fnagi.2022.978611] [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: 06/26/2022] [Accepted: 08/26/2022] [Indexed: 01/10/2023] Open
Abstract
The relationship between geriatric depression and dementia has been widely debated, and the neurological mechanisms underlying subjective cognitive decline (SCD) associated with social relationships remain elusive. Subclinical geriatric depression (SGD) is common in patients with SCD, and close friends (CFs) have a great influence on a person's social life. Studies have proven that communication or leisure activities with CFs can improve the cognitive performance of elderly. However, it remains unclear whether the engagement of specific brain regions mediates having CFs, SGD, and SCD. In this study, we aimed to assess the association between social relationships (that is, CFs), SGD, and SCD from the perspective of brain function. We examined the data of 66 patients with SCD and 63 normal controls (NC). Compared with NC, SGD was significantly inversely correlated with the number of CFs in the SCD group. We calculated regional homogeneity (ReHo) of functional magnetic resonance imaging (MRI) data of each subject. At a corrected threshold, the right occipital gyrus (SOG.R) and right fusiform gyrus (FFG.R) exhibited positive correlation with SGD in patients with SCD. Mediation analyses to query the inter-relationships between the neural markers and clinical variables exhibited a best fit of the model with CFs → FFG.R → SGD → SOG.R → SCD. These findings suggested a pathway whereby social relationships alter the function of specific brain regions, and SGD may be an early symptom of SCD. We observed that the FFG.R mediate social relationships and SGD, and the abnormality of the SOG.R may be a key factor in the SCD caused by depression. Moreover, a greater number of CFs may reduce the risk of developing SGD.
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Affiliation(s)
- Zhao Zhang
- Department of Biomedical Engineering, School of Life Sciences, Beijing Institute of Technology, Beijing, China
| | - Guangfei Li
- Department of Biomedical Engineering, School of Life Sciences, Beijing Institute of Technology, Beijing, China,Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Zeyu Song
- Department of Biomedical Engineering, School of Life Sciences, Beijing Institute of Technology, Beijing, China
| | - Ying Han
- Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Xiaoying Tang
- Department of Biomedical Engineering, School of Life Sciences, Beijing Institute of Technology, Beijing, China,*Correspondence: Xiaoying Tang,
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The effects of social isolation stress and discrimination on mental health. Transl Psychiatry 2022; 12:398. [PMID: 36130935 PMCID: PMC9490697 DOI: 10.1038/s41398-022-02178-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 09/06/2022] [Accepted: 09/12/2022] [Indexed: 11/17/2022] Open
Abstract
Social isolation and discrimination are growing public health concerns associated with poor physical and mental health. They are risk factors for increased morbidity and mortality and reduced quality of life. Despite their detrimental effects on health, there is a lack of knowledge regarding translation across the domains of experimental research, clinical studies, and real-life applications. Here, we review and synthesize evidence from basic research in animals and humans to clinical translation and interventions. Animal models indicate that social separation stress, particularly in early life, activates the hypothalamic-pituitary-adrenal axis and interacts with monoaminergic, glutamatergic, and GABAergic neurotransmitter systems, inducing long-lasting reductions in serotonin turnover and alterations in dopamine receptor sensitivity. These findings are of particular importance for human social isolation stress, as effects of social isolation stress on the same neurotransmitter systems have been implicated in addictive, psychotic, and affective disorders. Children may be particularly vulnerable due to lasting effects of social isolation and discrimination stress on the developing brain. The effects of social isolation and loneliness are pronounced in the context of social exclusion due to discrimination and racism, during widespread infectious disease related containment strategies such as quarantine, and in older persons due to sociodemographic changes. This highlights the importance of new strategies for social inclusion and outreach, including gender, culture, and socially sensitive telemedicine and digital interventions for mental health care.
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Xiao S, Shi L, Dong F, Zheng X, Xue Y, Zhang J, Xue B, Lin H, Ouyang P, Zhang C. The impact of chronic diseases on psychological distress among the older adults: the mediating and moderating role of activities of daily living and perceived social support. Aging Ment Health 2022; 26:1798-1804. [PMID: 34238092 DOI: 10.1080/13607863.2021.1947965] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
OBJECTIVES Previous literature has shown that chronic diseases and psychological distress are correlated. However, the mediating and moderating mechanisms underlying this relationship have not been sufficiently studied. The purpose of this study was to explore the role played by activities of daily living (ADL) and perceived social support. METHOD Face-to-face questionnaire-based surveys were conducted with 3250 valid participants (age ≥60 years). Participants were assessed using the Barthel Index, Perceived Social Support Scale, and Depression Anxiety Stress Scale-21. RESULTS 1) Chronic diseases had a significant direct effect on psychological distress in older adults; 2) the relationship between chronic diseases and psychological distress was partially mediated by ADL; and 3) the impact of chronic diseases on psychological distress was significantly moderated by perceived social support. More importantly, perceived social support was a protective factor that could effectively alleviate the adverse effects of chronic diseases on psychological distress. CONCLUSION The results add to the existing literature by uncovering the underlying mechanisms between chronic diseases and mental health. These findings have implications for early intervention and prevention of mental health problems in older adults.
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Affiliation(s)
- Shujuan Xiao
- School of Health Management, Southern Medical University, Guangzhou, Guangdong, China
| | - Lei Shi
- School of Health Management, Southern Medical University, Guangzhou, Guangdong, China
| | - Fang Dong
- School of Health Management, Southern Medical University, Guangzhou, Guangdong, China
| | - Xiao Zheng
- School of Health Management, Southern Medical University, Guangzhou, Guangdong, China
| | - Yaqing Xue
- School of Health Management, Southern Medical University, Guangzhou, Guangdong, China
| | - Jiachi Zhang
- School of Health Management, Southern Medical University, Guangzhou, Guangdong, China
| | - Benli Xue
- School of Health Management, Southern Medical University, Guangzhou, Guangdong, China
| | - Huang Lin
- School of Health Management, Southern Medical University, Guangzhou, Guangdong, China
| | - Ping Ouyang
- Department of Health Management, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Chichen Zhang
- School of Health Management, Southern Medical University, Guangzhou, Guangdong, China.,Department of Health Management, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.,Institute of Health Management, Southern Medical University, Guangzhou, Guangdong, China
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Nucci D, Santangelo OE, Provenzano S, Nardi M, Firenze A, Gianfredi V. Altered Food Behavior and Cancer: A Systematic Review of the Literature. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191610299. [PMID: 36011935 PMCID: PMC9407804 DOI: 10.3390/ijerph191610299] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 08/16/2022] [Accepted: 08/16/2022] [Indexed: 05/09/2023]
Abstract
There is evidence of an association between cancer and certain types of altered eating behaviors, including orthorexia, food cravings, and food addiction. Given the growing interest in the topic throughout the scientific community we conducted a systematic review to summarize current evidence on the development of altered food behavior, including food addiction and cancer. The Cochrane Collaboration and the Meta-analysis Of Observational Studies in Epidemiology guidelines were followed to perform this systematic review. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was used to report the process and results. The structured literature search was conducted on 19 April 2022, on PubMed/Medline and Scopus, combining free-text terms and medical subject headings. A total of seven articles were included once the selection process was completed. Food craving has been associated with different types of cancer in adults and young patients, as well as with orthorexia; conversely, compulsive eating has only been explored in patients with prolactinoma treated with dopamine agonists. This systematic review explored a new area of research that warrants further investigation. More research is required to better understand the relationship between cancer and food behavior.
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Affiliation(s)
- Daniele Nucci
- Nutritional Support Unit, Veneto Institute of Oncology IOV-IRCCS, Via Gattamelata, 64, 35128 Padua, Italy
| | - Omar Enzo Santangelo
- Regional Health Care and Social Agency of Lodi, ASST Lodi, Piazza Ospitale, 10, 26900 Lodi, Italy
- Correspondence:
| | | | - Mariateresa Nardi
- Nutritional Support Unit, Veneto Institute of Oncology IOV-IRCCS, Via Gattamelata, 64, 35128 Padua, Italy
| | - Alberto Firenze
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (ProMISE) “G. D’Alessandro”, University of Palermo, Via del Vespro, 133, 90127 Palermo, Italy
| | - Vincenza Gianfredi
- Department of Biomedical Sciences for Health, University of Milan, Via Pascal, 36, 20133 Milan, Italy
- CAPHRI Care and Public Health Research Institute, Maastricht University, 6200 MD Maastricht, The Netherlands
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Social capital, perceived neighborhood environment, and depressive symptoms among older adults in rural China: the role of self-rated health. Int Psychogeriatr 2022; 34:691-701. [PMID: 34365988 DOI: 10.1017/s1041610221000958] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES This study examined the relationships between social capital, perceived neighborhood environment, and depressive symptoms among older adults living in rural China, and the moderating effect of self-rated health (SRH) in these relationships. PARTICIPANTS A quota sampling method was applied to recruit 447 participants aged 60 years and older in rural communities in Jilin province, China in 2019. MEASUREMENTS Depressive symptoms were measured by the Center for Epidemiologic Studies Depression Scale. Structural equation modeling was used to build latent constructs of social capital and test the proposed model. Multiple group analysis was used to test the moderation effects. RESULTS Cognitive social capital and structural social capital were both associated with depressive symptoms controlling for participants' demographics, socioeconomic status, and health status. After adding perceived environment variables in the model, the relationship between cognitive social capital and depressive symptoms became nonsignificant, while structural social capital remained became a significant factor (β = -.168, p < .01). Satisfaction with health care was significantly associated with depressive symptoms among those with poor SRH (β = -.272, p < .01), whereas satisfaction with security and transportation were strongly associated with depressive symptoms among those with good SRH (security: β = -.148, p < .01; transportation: β = -.174, p < .01). CONCLUSIONS Study findings highlighted the importance of social capital and neighborhood environment as potential protective factors of depressive symptoms in later life. Policy and intervention implications were also discussed.
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Seifert N, Seddig D, Eckhard J. Does social isolation affect physical and mental health? A test of the social causation hypothesis using dynamic panel models with fixed effects. Aging Ment Health 2022; 26:1353-1367. [PMID: 34551635 DOI: 10.1080/13607863.2021.1961125] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES The widely acknowledged negative association between social isolation and physical and mental health is commonly interpreted in terms of social causation and has served as an important frame of reference for many interventions. However, evidence of social causation is likely biased because most studies cannot differentiate between social causation and health selection. The public attention given to this field of research indicates a need for analytical strategies that improve the understanding of the underlying link between social isolation and physical and mental health. METHODS Using data from the German Socio-Economic Panel (GSOEP) study (2004 to 2012) of 6740 men and 7189 women aged 50 and above, we estimated dynamic panel models with fixed effects that allow us to probe the social causation hypothesis while accounting for direct selection (reverse causality) and indirect selection (unobserved heterogeneity). All analyses were conducted for women and men separately. RESULTS We found that social isolation adversely affected mental health among older men and women to a degree that suggests practical relevance. However, we could not find a similar effect on physical health. A considerable part of the association between social isolation and both health outcomes was attributable to indirect selection, whereas direct selection led to underestimating the relevance of social isolation for mental health. CONCLUSION The results provide more convincing evidence that social isolation has adverse effects on mental health among older people. We conclude that effective interventions targeting social isolation might indeed be suitable for improving mental health among older people.
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Affiliation(s)
- Nico Seifert
- Department of Social Sciences, TU Kaiserslautern, Kaiserslautern, Germany
| | - Daniel Seddig
- Institute of Sociology and Social Psychology, University of Cologne, Cologne, Germany
| | - Jan Eckhard
- Max-Weber-Institute of Sociology, Heidelberg University, Heidelberg, Germany
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Ayhan F, Balsak H, Ayhan V. The effects of compulsory isolation measures during the COVID-19 pandemic: The example of prison workers. Int J Health Plann Manage 2022; 37:2905-2917. [PMID: 35691009 PMCID: PMC9347410 DOI: 10.1002/hpm.3528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 04/07/2022] [Accepted: 05/18/2022] [Indexed: 11/08/2022] Open
Abstract
Objective The aim of this research was to identify depression, anxiety, and perceived social support levels among prison workers and to determine the relationship between anxiety and depression and perceived social support. Methods The descriptive, cross‐sectional research was conducted between 15 November 2020, and 10 February 2021. The study sample consisted of 603 prison workers contacted using the convenience sampling method, consenting to take part in the research, and working under compulsory Covid‐19 isolation measures. A questionnaire produced in an electronic environment consisting of a personal information form, the Generalised Anxiety Disorder Scale (GAD), the Patient Health Questionnaire (PHQ), and the Multidimensional Scale of Perceived Social Support (MSPSS) questions was employed. Results The mean GAD, PHQ and MSPSS scores of the prison workers working under compulsory isolation conditions were 18.38 ± 5.78, 14.30 ± 6.99, and 42.76 ± 20.27, respectively. Of the prison workers in this study, 71.5% exhibited severe depression symptoms and 21.4% moderate depression, while 25.5% exhibited severe anxiety symptoms and 23.4% moderate anxiety symptoms. MSPSS and its subdomains exhibited negative correlation with depression, and the MSPSS friends subdomain was negatively correlated with anxiety. Conclusion Anxiety and depression scores were at high levels in prison workers exposed to compulsory isolation during the Covid‐19 pandemic. This research is the first involving prison workers subjected to compulsory isolation during the COVID‐19 pandemic This study shows that prison workers in Turkey subjected to compulsory isolation during the COVID‐19 pandemic experienced severe anxiety, moderate depression, and moderate social support MSPSS and its subdomains exhibited negative correlation with depression, while the MSPSS friends subdomain was negatively correlated with anxiety Depression and anxiety levels were higher among personnel whose income was lower than outgoings, men, and prison workers with chronic diseases
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Affiliation(s)
- Fatma Ayhan
- Department of Nursing in the Faculty of Health Sciences, Batman University, Batman, Turkey
| | - Habip Balsak
- Midwifery Department in the Faculty of Health Sciences, Batman University, Batman, Turkey
| | - Veli Ayhan
- Batman Penalty and Execution Institution, Batman, Turkey
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Abstract
OBJECTIVES This article examines the influence of social networks on selected aspects of mental health following the outbreak of the coronavirus. METHOD We linked data from a post outbreak telephone survey in 2020 by the Survey of Health, Ageing and Retirement in Europe, with baseline data from SHARE Wave 6 (2016) (n = 33,485). Two mental health measures (depression and anxiety) were regressed on social network variables relevant to the Covid-19 crisis (frequency of face-to-face contact and frequency of contact through electronic means), controlling for confounders. Interactions of age group and social networks were considered. Baseline mental health was controlled, focusing the analysis on post-outbreak mental health change. RESULTS Face-to-face network contact significantly reduced negative mental health changes while electronic contact significantly increased them. The age interactions were insignificant. Country differences were observed. CONCLUSION The findings suggest that face-to-face social networks can moderate the negative impact of the COVID-19 pandemic on important aspects of mental health.
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Affiliation(s)
- Howard Litwin
- Israel Gerontological Data Center, Paul Baerwald School of Social Work and Social Welfare, The Hebrew University of Jerusalem, Mount Scopus, Jerusalem, Israel
| | - Michal Levinsky
- Israel Gerontological Data Center, Paul Baerwald School of Social Work and Social Welfare, The Hebrew University of Jerusalem, Mount Scopus, Jerusalem, Israel
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Ahmed HAAEK, Mohamed BES. Relationship between morality, happiness, and social support among elderly people. MIDDLE EAST CURRENT PSYCHIATRY 2022. [DOI: 10.1186/s43045-022-00195-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Various factors influence the lives of elders, such as social support, which is critical in preventing physical, psychological, and social difficulties. This study aimed to investigate the relationship between morality, happiness, and social support among elderly people. A descriptive correlational design was used in carrying out this study. This study was conducted at the Geriatric Social Club in El-Qawmia; Zagzig City, Alsharkia Governorate. A purposeful sample of 235 elders was recruited for this study. Four tools were used to collect data: A structured interview questionnaire, Philadelphia Geriatric Center Morale Scale (interview version), Multidimensional Scale of Perceived Social Support, and Oxford Happiness Questionnaire.
Results
Results denoted that less than half of studied elders had moderate score as regards morale scale and perceived social support. As well, less than three-fifths of them had moderate score regards total happiness. There were statistically significant relations between morality and both of age, income, chronic diseases, and taking medication. Perceived social support was positively statistically significantly related with elders’ gender, marital status, chronic diseases, medication, and income. There were statistical significant relations between elderly happiness level and working condition, income, and with whom they live. Elders’ perceived social support was highly positively statistically correlated with happiness and morality.
Conclusions
It was concluded that these variables were positively correlated with each one, where increasing perceived social support and feeling of happiness associated with enhancing feeling of morality among elders. The perceived social support and happiness were the key co-existences of elders’ morality. Therefore, it is recommended to implement caring and training programs focusing on enhancing social support in order to develop morale among elders. The country should provide various kinds of assistance to the elderly, such as counseling services.
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Xu Z, Ghisi GLDM, Cui L, Zeng F, Zhou X, Yue Z, Chen H. Effects of COVID-19 pandemic on mental health among adults: A comparative analysis from different communities in Chengmai County, China. JMIR Form Res 2022; 6:e37046. [PMID: 35404834 PMCID: PMC9084446 DOI: 10.2196/37046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 03/22/2022] [Accepted: 04/09/2022] [Indexed: 11/13/2022] Open
Abstract
Background Due to the strict measures employed to control the spread of SARS-CoV-2, the extent of COVID-19 goes beyond morbidity and mortality and affects individuals’ mental health in the long term. Objective This cross-sectional study aimed to investigate the effects of the COVID-19 pandemic on mental health and its contributing factors among older people in Chengmai County, China. Methods A web-based survey was administered through WeChat between March and April 2020. Older people (ie, >50 years) from local and foreign community groups completed the survey, which included items on sociodemographic and clinical characteristics, the 7-item Generalized Anxiety Disorder scale (GAD-7), and the 9-item Patient Health Questionnaire (PHQ-9). Independent t tests and a multiple linear regression analysis were used to investigate differences between anxiety and depression and the factors associated with these symptoms across the 2 groups. Results Overall, 469 responses were received; 119 responses (25.4%) were from male participants and 202 (43.1%) were from those older than 65 years. Of the 469 responses, 245 (52.2%) were from the local community group and 224 (47.8%) from the foreign group. The mean GAD-7 (P=.003) scores were significantly higher in the local group. Anxiety was significantly more present in the local group (61/245, 24.9% compared to 35/224, 15.6% in the foreign group; P=.01). A total of 6 respondents presented severe anxiety and 2 presented severe depression. Conclusions This study demonstrated that both community groups of older adults from the Chinese “Hometown of Longevity” presented anxiety or depressive disorders during the first months of the pandemic. Local community groups presented significantly more mental health disorders, which were associated with a history of previous psychological disorders.
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Affiliation(s)
- Zhimin Xu
- Department of Cardiology, Xinhua Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, CN
| | | | - Lixian Cui
- Division of Arts and Sciences, NYU Shanghai, shanghai, CN
| | - Fang Zeng
- Department of Nursing, People's Hospital of Chengmai County, Jinjiang Town, Chengmai County, hainan, CN
| | - Xiaohan Zhou
- Department of Endocrinology, Xinhua Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, CN
| | - Zhongtang Yue
- Coconut Town Community College of Elderly, 1 Coconut Avenue, Jinjiang Town, Chengmai County, Hainan, CN
| | - Hanbei Chen
- Department of Endocrinology, Xinhua Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, CN
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Aikens JE, Valenstein M, Plegue MA, Sen A, Marinec N, Achtyes E, Piette JD. Technology-Facilitated Depression Self-Management Linked with Lay Supporters and Primary Care Clinics: Randomized Controlled Trial in a Low-Income Sample. Telemed J E Health 2022; 28:399-406. [PMID: 34086485 PMCID: PMC8968843 DOI: 10.1089/tmj.2021.0042] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Purpose: To test whether technology-facilitated self-management support improves depression in primary care settings. Methods: We randomized 204 low-income primary care patients who had at least moderate depressive symptoms to intervention or control. Intervention participants received 12 months of weekly automated interactive voice response telephone calls that assessed their symptom severity and provided self-management strategies. Their patient-nominated supporter (CarePartner) received corresponding guidance on self-management support, and their primary care team received urgent notifications. Those randomized to enhanced usual care received printed generic self-management instructions. Results: One-year attrition rate was 14%. By month 6, symptom severity on the Patient Health Questionnaire-9 (PHQ-9) decreased 2.5 points more in the intervention arm than in the control arm (95% CI -4.2 to -0.8, p = 0.003). This benefit was similar at month 12 (p = 0.004). Intervention was also over twice as likely to lead to ≥50% reduction in symptom severity by month 6 (OR = 2.2 (1.1, 4.7)) and a decrease of ≥5 PHQ-9 points by month 12 (OR = 2.3 (1.2, 4.4)). Conclusions: Technology-facilitated self-management guidance with lay support and clinician notifications improves depression for primary care patients. Subsequent research should examine implementation and generalization to other chronic conditions. clinicaltrials.gov, identifier NCT01834534.
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Affiliation(s)
- James E. Aikens
- Department of Family Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA.,Address correspondence to: James Aikens, PhD, Department of Family Medicine, University of Michigan, 1018 Fuller Street, Ann Arbor, MI 48104-1213, USA
| | - Marcia Valenstein
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor, Michigan, USA.,VA Ann Arbor Center for Clinical Management Research, Ann Arbor, Michigan, USA
| | - Melissa A. Plegue
- Department of Family Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Ananda Sen
- Department of Family Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA.,Department of Biostatistics, University of Michigan, Ann Arbor, Michigan, USA
| | - Nicolle Marinec
- VA Ann Arbor Center for Clinical Management Research, Ann Arbor, Michigan, USA.,Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Eric Achtyes
- Cherry Health, Heart of the City Health Center, Grand Rapids, Michigan, USA.,Division of Psychiatry and Behavioral Medicine, Michigan State University College of Human Medicine, Lansing, Michigan, USA
| | - John D. Piette
- VA Ann Arbor Center for Clinical Management Research, Ann Arbor, Michigan, USA.,Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
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Cené CW, Leng XI, Faraz K, Allison M, Breathett K, Bird C, Coday M, Corbie‐Smith G, Foraker R, Ijioma NN, Rosal MC, Sealy‐Jefferson S, Shippee TP, Kroenke CH. Social Isolation and Incident Heart Failure Hospitalization in Older Women: Women's Health Initiative Study Findings. J Am Heart Assoc 2022; 11:e022907. [PMID: 35189692 PMCID: PMC9075097 DOI: 10.1161/jaha.120.022907] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Background The association of social isolation or lack of social network ties in older adults is unknown. This knowledge gap is important since the risk of heart failure (HF) and social isolation increase with age. The study examines whether social isolation is associated with incident HF in older women, and examines depressive symptoms as a potential mediator and age and race and ethnicity as effect modifiers. Methods and Results This study included 44 174 postmenopausal women of diverse race and ethnicity from the WHI (Women's Health Initiative) study who underwent annual assessment for HF adjudication from baseline enrollment (1993-1998) through 2018. We conducted a mediation analysis to examine depressive symptoms as a potential mediator and further examined effect modification by age and race and ethnicity. Incident HF requiring hospitalization was the main outcome. Social isolation was a composite variable based on marital/partner status, religious ties, and community ties. Depressive symptoms were assessed using CES-D (Center for Epidemiology Studies-Depression). Over a median follow-up of 15.0 years, we analyzed data from 36 457 women, and 2364 (6.5%) incident HF cases occurred; 2510 (6.9%) participants were socially isolated. In multivariable analyses adjusted for sociodemographic, behavioral, clinical, and general health/functioning; socially isolated women had a higher risk of incident HF than nonisolated women (HR, 1.23; 95% CI, 1.08-1.41). Adding depressive symptoms in the model did not change this association (HR, 1.22; 95% CI, 1.07-1.40). Neither race and ethnicity nor age moderated the association between social isolation and incident HF. Conclusions Socially isolated older women are at increased risk for developing HF, independent of traditional HF risk factors. Registration URL: http://www.clinicaltrials.gov; Unique identifier: NCT00000611.
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Affiliation(s)
- Crystal W. Cené
- University of North Carolina at Chapel HillNC,now with University of California, San DiegoLa JollaCA
| | | | | | | | | | | | - Mace Coday
- University of Tennessee Health Science CenterMemphisTN
| | | | - Randi Foraker
- Washington University in St. Louis School of MedicineSt. LouisMO
| | | | | | | | - Tetyana P. Shippee
- Division of Health Policy and ManagementUniversity of MinnesotaMinneapolisMN
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48
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Gabarrell-Pascuet A, Moneta MV, Ayuso-Mateos JL, Miret M, Lara E, Haro JM, Olaya B, Domènech-Abella J. The effect of loneliness and social support on the course of major depressive disorder among adults aged 50 years and older: A longitudinal study. Depress Anxiety 2022; 39:147-155. [PMID: 35029840 DOI: 10.1002/da.23236] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 10/28/2021] [Accepted: 12/17/2021] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Previous research indicates that social support, loneliness, and major depressive disorder (MDD) are interrelated. Little is known about the potential pathways among these factors, in particular in the case of adults aged 50 years and older and suffering from MDD. The objective was to investigate whether loneliness mediates the association between low social support and recurrent episodes of MDD. METHODS We used data from a cohort of the Spanish general population interviewed at three time-points over a 7-year period. We included 404 individuals aged 50+ suffering from MDD in the baseline assessment. A 12-month major depressive episode was assessed with the Composite International Diagnostic Interview (CIDI) at each interview. The University of California, Los Angeles Loneliness Scale was used to measure loneliness, whereas social support was assessed through the Oslo Social Support Scale. We tested cross-lagged and autoregressive longitudinal associations using structural equation modeling. RESULTS We identified two significant longitudinal mediation patterns: lower social support predicted higher subsequent levels of loneliness (Coef. = -0.16; p < .05), which in turn predicted an increase in MDD recurrence (Coef. = 0.05; p < .05). CONCLUSIONS Interventions focused on promoting social support among older adults suffering from MDD may decrease feelings of loneliness and prevent recurrent episodes of MDD.
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Affiliation(s)
- Aina Gabarrell-Pascuet
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Sant Boi de Llobregat, Universitat de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - María V Moneta
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Sant Boi de Llobregat, Universitat de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - José L Ayuso-Mateos
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.,Department of Psychiatry, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Madrid, Spain.,Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain
| | - Marta Miret
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.,Department of Psychiatry, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Madrid, Spain.,Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain
| | - Elvira Lara
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.,Department of Psychiatry, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Madrid, Spain.,Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain
| | - Josep M Haro
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Sant Boi de Llobregat, Universitat de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.,Department of Psychiatry, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Madrid, Spain
| | - Beatriz Olaya
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Sant Boi de Llobregat, Universitat de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Joan Domènech-Abella
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Sant Boi de Llobregat, Universitat de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.,Department of Sociology, Universitat de Barcelona, Barcelona, Spain
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Barrenetxea J, Pan A, Feng Q, Koh WP. Factors associated with depression across age groups of older adults: The Singapore Chinese health study. Int J Geriatr Psychiatry 2022; 37. [PMID: 34816486 DOI: 10.1002/gps.5666] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 11/21/2021] [Indexed: 11/11/2022]
Abstract
OBJECTIVES We studied sociodemographic and health factors associated with depression across three age groups of community-dwelling older adults. METHODS/DESIGN We used data from 16,785 participants from the third follow-up of the Singapore Chinese Health Study (mean age: 73, range: 61-96 years). We defined depression as having a score of ≥5 using the 15-item Geriatric Depression Scale. We used regression splines to examine the pattern of depression risk with age and applied multivariable logistic regression to study factors associated with depression. RESULTS Increasing age was associated with depression in an inverted J-shape relationship with the highest odds ratio (OR) at age 75. Compared to the youngest-old (<70 years), the middle-old (70-80 years) had higher odds of depression [OR = 1.20, 95% confidence interval (CI) = 1.09-1.31], while the oldest-old (>80 years) had no increased risk (OR = 1.01, 95% CI = 0.89-1.15). We also found demographic (men, lower education, unemployment), social (living alone, poor social support, no social activity) and health factors (instrumental limitations, poor physical function, function-limiting pain, chronic diseases, cognitive impairment, poor sleep quality, poor self-rated health) associated with depression. In stratified analysis by age groups, the OR estimates for lower education level, instrumental limitations and cognitive impairment decreased with age, whereas the risk of depression for men increased with age (all p-values for interaction<0.03). CONCLUSIONS Compared to the youngest-old, the likelihood of depression was highest among middle-old adults and decreased to null in the oldest-old. The associations between some factors and depression were attenuated with age, suggesting a coping mechanism among oldest-old survivors.
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Affiliation(s)
- Jon Barrenetxea
- Health Services and Systems Research, Duke-NUS Medical School Singapore, Singapore
| | - An Pan
- Department of Epidemiology and Biostatistics, MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Qiushi Feng
- Department of Sociology & Centre for Family and Population Research, National University of Singapore, Singapore
| | - Woon-Puay Koh
- Healthy Longevity Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Singapore Institute for Clinical Sciences, Agency for Science Technology and Research (A*STAR), Singapore
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50
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Beridze G, Triolo F, Grande G, Fratiglioni L, Calderón-Larrañaga A. COVID-19 collateral damage-psychological burden and behavioural changes among older adults during the first outbreak in Stockholm, Sweden: a cross-sectional study. BMJ Open 2022; 12:e058422. [PMID: 34996805 PMCID: PMC8743841 DOI: 10.1136/bmjopen-2021-058422] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES To explore the indirect negative effects of COVID-19 restrictions (collateral damage) on the lives and health of older adults living in central Stockholm, and to characterise the sociodemographic profile of those with the highest susceptibility to this damage. DESIGN Cross-sectional study. SETTING District of Kungsholmen in Stockholm, Sweden. PARTICIPANTS Older adults aged 68 years and above (n=1231) who participated in the ad hoc COVID-19-related phone questionnaire administered by trained staff between May and June 2020 and who had previously attended the regular follow-up assessment of the Swedish National study on Aging and Care in Kungsholmen (SNAC-K) during 2016-2019. PRIMARY AND SECONDARY OUTCOME MEASURES Three dimensions of collateral damage: psychological burden (feelings of worry, stress and loneliness), reductions in social and physical activities, and reductions in medical and social care use since the beginning of the pandemic. Logistic regression models were used to test the association between age, sex, education and living arrangement, and the risk of collateral damage. RESULTS Vast majority of participants adhered to the national public health recommendations, with over three-quarters practising self-isolation (n=928). Half of the sample reported psychological burden, 55.3% reported reductions in social or physical activity, and 11.3% reported decreased medical or social care use. Over three quarters of participants (77.8%) were affected by at least one of the three collateral damage dimensions. Female sex was the strongest sociodemographic predictor of both individual and co-occurring dimensions of collateral damage. CONCLUSIONS COVID-19 and its restrictions during the first half of 2020 had a negative effect on the health and lives of a majority of the elderly living in central Stockholm. Women were at a higher risk of these negative consequences. We emphasise the need for predefined, evidence-based interventions to support those who are most susceptible to these consequences, both during the pandemic and once the outbreak is overcome.
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Affiliation(s)
- Giorgi Beridze
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Solna, Sweden
| | - Federico Triolo
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Solna, Sweden
| | - Giulia Grande
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Solna, Sweden
| | - Laura Fratiglioni
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Solna, Sweden
- Stockholm Gerontology Research Center, Stockholm, Sweden
| | - Amaia Calderón-Larrañaga
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Solna, Sweden
- Stockholm Gerontology Research Center, Stockholm, Sweden
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