Association of depressive symptoms with decline of cognitive function-Rugao longevity and ageing study

Linear and non-linear associations of depressive symptoms with oral health knowledge, attitudes, and practices among rural older adults in China: a cross-sectional study

BACKGROUND

Depression affects the oral health of older adults; however, little is known about its impact on oral health among rural older adults in developing countries, which warrants further research. Taking China as an example, there is a large population base of rural older adults suffering from depression, and many rural older people also have long-term oral health problems, which have seriously affected their quality of life in later life. Therefore, this study aimed to explore linear and non-linear associations of depressive symptoms with oral health knowledge, attitudes, and practices among rural older adults in China.

METHODS

From November 2020 to December 2020, 1,902 rural community-dwelling older people aged 60 years and older were investigated, via a cross-sectional survey. The general information, depressive status, oral health knowledge, attitudes, and practices of the participants were obtained through face-to-face structured questionnaires. Among them, the Zung Depression Self-Rating Scale was used to investigate the depressive symptoms of the participants in this survey. The generalized linear model and classification and regression tree model were used, separately.

RESULTS

Based on linear analysis results, we found that minimal to mild depressive symptoms [regression coefficient (β) = -0.345; 95% confidence interval (CI): -0.582 to -0.109, P = 0.004] and depressive symptoms (β = -1.064; 95% CI: -1.982 to -0.146, P = 0.023) were significantly correlated with oral health knowledge. A negative correlation was observed between minimal to mild depressive symptoms (β = -0.385; 95% CI: -0.600 to -0.170, P < 0.001) and oral health attitudes. In addition, while both minimal to mild depressive symptoms (β = 0.018; 95% CI: -0.312 to 0.347, P = 0.916) and depressive symptoms (β = 0.604; 95% CI: -0.675 to 1.883, P = 0.355) were associated with oral health practices. Furthermore, the non-linear analysis showed a combined effect of depressive symptoms on oral health attitudes, indicating that older people of a younger age, not living alone, and not suffering from depressive symptoms are more likely to report better oral health attitudes.

CONCLUSION

Both the linear and non-linear analyses in our study showed that depressive symptoms are significantly correlated with the poor oral health attitudes of older adults in rural communities. Furthermore, depressive symptoms were associated with oral health knowledge in the linear analysis. However, no statistically significant difference was found between depressive symptoms and oral health practices in either analysis. This research deepens our knowledge and understanding of relevant evidence in the mental and oral health of people in later life. In addition, analyzing the factors that affect the oral health of older people from the perspective of their depressive status provides new thinking directions and scientific references for improving the oral health of older adults in practical life.

The association between longitudinal changes in depressive symptoms and cognitive decline among middle-aged and older Chinese adults

OBJECTIVE

Depression is associated with cognitive impairment and dementia, but few studies have been done on Chinese adults. This study evaluates the relationship between depressive symptoms status and cognitive function in middle-aged and elderly Chinese adults.

METHODS

We included 7,968 participants from the Chinese Health and Retirement Longitudinal Survey (CHRALS) with a follow-up of 4 years. Using the Center for Epidemiological Studies Depression Scale to measure depressive symptoms, with a score of 12 or more indicating elevated depressive symptoms. Adjust covariance analysis and generalized linear analysis were used to investigate the relationship between depressive symptoms status (never, new-onset, remission and persistence) and cognitive decline. Restricted cubic spline regression was used to performed the potential nonlinear associations between depressive symptoms and the change scores of cognitive functions.

RESULTS

During the 4-year follow-up, 1148 participants (14.41%) reported persistent depressive symptoms. The participants who have persistent depressive symptoms with more declines in total cognitive scores (least-square mean = -1.99, 95% CI: -3.70 to -0.27). Compared with never depressive symptoms, participants with persistent depressive symptoms experienced a faster decline in cognitive scores (β = -0.68, 95%CI: -0.98 to -0.38), and small difference (d=0.29) at follow-up. But females with new-onset depression had more cognitive decline than those with persistent depression (least-square mean _new-onset - least-square mean _persistent=-0.10), its differences in males (least-square mean _new-onset - least-square mean _persistent=0.03).

CONCLUSIONS

Participants with persistent depressive symptoms experienced a faster decline in cognitive function, but differently in men and women.

Associations between trajectories of depressive symptoms and rate of cognitive decline among Chinese middle-aged and older adults: An 8-year longitudinal study

OBJECTIVE

To investigate the associations between trajectories of depressive symptoms and rate of cognitive decline among Chinese middle-aged and older adults.

METHODS

A population-based cohort data from the Chinese Health and Retirement Longitudinal Study (CHARLS) were utilized. The cohort was followed up for 8 years and assessments of depressive symptoms and cognitive performance were conducted in 2011, 2013, 2015, and 2018. Group-based trajectory modeling (GBTM) was conducted to identify heterogeneous trajectories of depressive symptoms. Linear mixed models (LMMs) were performed to examine the associations between trajectories of depressive symptoms and rate of decline in global cognitive function, episodic memory, and executive function.

RESULTS

Among 9264 middle-aged and older adults, five depressive symptoms trajectory groups were determined: constantly low (n = 3206, 34.6%), constantly medium (n = 3747, 40.5%), increasing (n = 899, 9.7%), decreasing (n = 929, 10.0%), and constantly high (n = 483, 5.2%). Individuals with increasing depressive symptoms exhibited the fastest decline in global cognitive function and episodic memory, followed by participants reporting constantly high or medium depressive symptoms. A significantly higher rate of decline in executive function was only observed among subjects who had increasing depressive symptoms in comparison with their counterparts with constantly low depressive symptoms. There was no significant difference in rate of cognitive decline between individuals with decreasing depressive symptoms and those demonstrating constantly low depressive symptoms.

CONCLUSION

Increasing depressive symptoms co-occurred with the steepest cognitive decline among Chinese middle-aged and older adults, which potentially suggested that interventions targeting to alleviating cognitive decline should be given priority among individuals with deterioration of depressive symptoms.

Sex-Influenced Risk Factors for Cognitive Impairment Among Community-Dwelling Older Adults

The current study aimed to explore sex-influenced risk factors for cognitive impairment among community-dwelling older adults in Taiwan. This cross-sectional study was a secondary analysis using a population-based design. We accessed and analyzed data from the Taiwan Longitudinal Study on Aging survey of 2011. Participants were older adults aged ≥55 years living in non-indigenous townships. A total of 3,392 community-dwelling older adults were included. Results showed that the prevalence of cognitive impairment in females and males was 15.3% and 5.7%, respectively. Having a low educational level and being single (i.e., single, widowed, or divorced) were risk factors for cognitive impairment in both sexes. Males who had more than two chronic diseases had a higher risk of cognitive impairment. Self-reported hearing loss and depression increased risk of cognitive impairment in older females. Older age, lower educational level, and single marital status were associated with cognitive impairment among community-dwelling older adults in Taiwan. The effects of self-reported hearing loss, depression, and chronic disease on cognitive impairment were influenced by sex. [Journal of Gerontological Nursing, 48(6), 19-25.].

Preventive Measures against the Development of Dementia in Old Age

Dementia is a neurological condition characterized by numerous types of central nervous system diseases, which gradually deteriorates an individual’s reasoning, rational thinking, and judgment abilities. As a serious public health concern that currently affects more than 50 million older adults, dementia is one of the most significant causes of incapacity, disability, and dependency among older adults. As new cases are expected to increase exponentially in the next three decades, dementia, which is not a normal feature of healthy aging despite the fact that it generally affects older adults disproportionately, requires enormous management and care efforts due to its associated socioeconomic, psychological, and physical burdens that involve the patient, their caregivers, guardians, family members, and society at large. Presently, there is no cure for dementia; however, this condition could be prevented. This narrative review aimed to provide a broad overview of studies detailing the alternative lifestyle modification-centered preventive measures against dementia. A comprehensive search of key databases to find articles related to this topic revealed that participating in regular physical activities, healthy eating and dieting, avoiding all forms of smoking, avoiding air pollutants, halting or reducing alcohol consumption, exercising the mind and being socially dynamic, getting enough rest and establishing good sleeping habits, infection prevention, stress prevention, avoidance of injuries, preventing the effects of social isolation and lockdowns, continuing education, and depression prevention are protective measures against the development of dementia.

Status and Factors of Cognitive Function Among Older Adults in Urban China

The present study aimed to examine the current status and influencing mechanisms of different demographic factors associated with cognitive function in urban Chinese older adults. A total of 644 older adults from 14 communities in urban China (e.g., Shanghai, Beijing, and Wuxi) were investigated by using the Mini-Mental State Examination and the Repeatable Battery for the Assessment of Neuropsychological Status. The results indicated that the overall cognitive function of older adults in urban China was normal. We found an aging effect on cognitive level, and cognitive function declined more rapidly after age 80. Older age, unmarried status, and lower occupational cognitive requirements increased the likelihood of cognitive risk. Higher educational levels and active engagement in exercise may contribute to cognitive reserve and have a protective effect on cognitive decline in late life. Further study is needed to develop appropriate interventions to improve the mental health of older people.