Health perception and depressive symptoms among older Korean Americans

Mental health status and quality of life in close contacts of COVID-19 patients in the post-COVID-19 era: a comparative study

Close contacts of those with COVID-19 (CC) may experience distress and long-lasting mental health effects. However, the mental health status and quality of life (QOL) in CC have not been adequately examined. This study examined the mental health status and QOL in CC during the post-COVID-19 period. This cross-sectional study comprised 1169 CC and 1290 who were non-close contacts (non-CC). Demographic data were collected; depression, fatigue, post-traumatic stress symptoms (PTSS) and QOL were assessed using the Patient Health Questionnaire - 9 items (PHQ-9), fatigue numeric rating scale, Post-Traumatic Stress Disorder Checklist - 17 items (PCL-17), and the World Health Organization Quality of Life Questionnaire - brief version (WHOQOL-BREF), respectively. Analysis of covariance was used to compare depressive symptoms, QOL, fatigue, and PTSS between the CC and non-CC groups. Multiple logistic regression analyses were performed to determine the independent correlates for depression, fatigue, PTSS, and QOL in the CC group. Compared to the non-CC group, the CC group reported significantly more severe depression (F(1, 2458) = 5.58, p = 0.018) and fatigue (F(1, 2458) = 9.22, p = 0.002) in the post-COVID-19 period. No significant differences in PTSS and QOL between the CC and non-CC groups were found (F(1, 2458) = 2.93, p = 0.087 for PTSS; F(1, 2458) = 3.45, p = 0.064 for QOL). In the CC group, younger age, financial loss due to COVID-19, and perception of poor or fair health status were significantly associated with depression and fatigue, while frequent use of mass media was significantly associated with fatigue. In conclusion, close contacts of COVID-19 patients experienced high levels of depression and fatigue in the post-COVID-19 period. Due to the negative effects of depression and fatigue on daily functioning, early detection and timely interventions should be provided to this neglected population.

Self-rated health as a mediator between physical health conditions and depressive symptoms in older Chinese and Korean Americans

In the present study, we examined self-rated health as a mediator between physical health conditions (chronic diseases and functional disability) and depressive symptoms in older Chinese and Korean Americans. Using harmonized data (N = 5,063) from the Population Study of Chinese Elderly (PINE) and the Study of Older Korean Americans (SOKA), we tested direct and indirect effect models. In both groups, chronic diseases and functional disability were closely associated with negative ratings of health and symptoms of depression. Analyses with the PROCESS macro showed that the effect of chronic diseases and functional disability on depressive symptoms was mediated by self-rated health in both groups; the indirect effect was greater in the Korean American sample than in the Chinese American sample. These findings contribute to the understanding of the psychological mechanisms that underlie the mind–body connection and highlight the potential importance of subjective health assessment as a useful tool for health promotion.

Role of various lifestyle and behavioral strategies in positive mental health across a preventive to therapeutic continuum

There is growing interest in lifestyle and behavioral strategies not only in prevention but also in the management of psychiatric morbidity. Available literature in this direction was accessed, and the role of various lifestyle and behavioral factors was explored. There is strong evidence of the role of good sleep, nutritious diet, exercise, social connectedness, enhanced self-esteem, sense of purpose in life, resilience, mindfulness, and environmental mastery in the promotion of mental well-being and prevention and management of psychiatric disorders. There is a significant scope of lifestyle and behavioral intervention in ensuring positive mental health spanning from preventive to therapeutic dimension.

Subjective age and depressive symptoms among Chinese older adults: A moderated mediation model of perceived control and self-perceptions of aging

Although subjective age has been shown to play an important role in older adults' experiences of depressive symptoms, the mediating and moderating mechanisms underlying this relationship have not been adequately examined. The present study aimed to investigate the mediating role perceived control plays between subjective age and depressive symptoms, as well as the moderating role self-perceptions of aging plays in this indirect relationship. To examine this, a cross-sectional study was conducted with 609 Chinese older adults, who completed measures of subjective age, perceived control, self-perceptions of aging, and depressive symptoms. The results indicated that: (1) possessing a younger subjective age is significantly associated with less depressive symptoms; (2) perceived control partially mediates the relationship between subjective age and depressive symptoms; and (3) the indirect effect of subjective age on depressive symptoms, through perceived control, is moderated by self-perceptions of aging, while the mediated path is stronger for older adults with less favorable self-perceptions of aging. The findings underscore the importance of identifying the mechanisms that moderate the mediated paths between subjective age and depressive symptoms.

A systematic review of correlates of depression among older Chinese and Korean immigrants: what we know and do not know

OBJECTIVES

Guided by the stress and coping theory, this study provides a systematic review of existing research on acculutration, family support, and social support related correlates of depression among older Chinese and Korean immigrants in the United States.

METHOD

A comprehensive literature search was conducted in CINAHL Plus, Abstracts in Social Gerontology, AgeLine, Social Work Abstracts, PubMed, PsychINFO, and Social Science Citation Index databases to identify relevant articles that presented multivariate analysis results.

RESULTS

A total of 55 articles were identified, with the vast majority focusing on older Korean immigrants. The overall evidence showed that length of residence was largely unrelated to depression, and poor Enligsh proficiency also had a weak correlation with depression. However, a low level of acculturation measured by multidimensional scales was consistently associated with more depressive symptoms. Overall, living arrangements and the size and frequency of contact of both kin and non-kin networks were weak correlates of depression. In contrast, negative family and social interactions seem to be more consequential for depression in the two groups than positive relations and support.

CONCLUSION

The findings show that established acculturation instruments are useful tools to identify at-risk older Chinese and Korean immigrants. Future studies need to further examine which aspects of acculturation experience are more influential for immigrants' mental health. Although often conceptualized as important coping resources, family and social networks could present significant stressors for older immigrants. Future research and services could focus on these contexts to improve the mental health of these two rapidly increasing Asian populations.

Depression and Its Correlates Among Brazilian Immigrants in Massachusetts, USA

The goal of this paper is to assess the frequency of depression symptoms among Brazilian immigrants living in Massachusetts, the second largest Brazilian immigrant population in the United States, and to identify correlates of depression. A convenience sample of Brazilian immigrants aged 18 or older residing in Massachusetts was used. Data were collected from December 2013 to March 2014, in the Consulate General of Brazil in Boston and in three religious events, using a structure questionnaire and the Center for Epidemiological Studies Depression Scale (CES-D). Depression symptoms were observed in 35.3% of the respondents, with equal distribution by sex. Correlates of depression were low income, being single, poor English proficiency, and poor self-perception of health. These results suggest a need for community outreach, sensitization, and counseling, in Portuguese and adapted to the culture of Brazilian immigrants.

Systematic Literature Review and Meta-Analysis of Filial Piety and Depression in Older People

Background: Studies have indicated that one of the key factors in relieving depression in older people is social network support, especially from the family. In Chinese society, the traditional value of filial piety strongly influences daily interactions and behavior. The purpose of this study was to examine older people’s perceptions of filial piety and to explore the correlation between filial piety and depression in older people. Method: In this systematic literature review of seven databases (CEPS, Cochrane, PubMed/Medicine, OVID, CINAHL, ProQuest, and PsycINFO), eight studies on the correlation between filial piety and depression in older people were selected, six of which were included in the present meta-analysis. Results: The studies included in this review lacked consistency regarding the screening and measurement instruments used. Two groups of meta-analyses (four studies) illustrated that filial piety was negatively correlated with depression in older people ( r = −0.196, p < .001, 95% confidence interval [CI] [−0.283, −0.106] and r = −0.139, p = .006, 95% CI [−0.235, −0.041]), suggesting that an increase in older people’s perception of their children’s filial piety was correlated with a reduction in their depression. Conclusions: Filial piety was correlated with depression in older people. Future studies should focus on clarifying the concept of filial piety to aid in the application of appropriate measurement tools and the development of intervention measures that could enhance the care provided for depression in older people.

Factors Associated with Healthy Aging among Older Persons in Northeastern Thailand

The aim of this study was to describe factors associated with perceived health and healthy aging among older people in northeastern Thailand. Thailand’s aging population is growing and facing an increasing old-age dependency ratio. Northeastern Thailand, known as Isan, is a region in which the number of older residents is projected to grow rapidly. Older people in this region are likely to confront great threats to their health and well-being. These issues require appropriate attention and actions to promote healthy aging. However, healthy aging in this region has not been studied. A cross-sectional study was conducted on a sample of 453 older people, aged 60 years or older. Participants completed the Healthy Aging Instrument (HAI) and provided relevant demographic characteristics. Mann-Whitney U tests, Kruskal-Wallis tests and multiple regression models were used to analyze the data. Through comparative analyses, significant differences in HAI scores were observed for the following factors: marital status, residential area, disability, income level, and perceived meaningfulness in life. In the multiple regression models, residential area, disability, and marital status explained 24.30 % of the variance in HAI scores. Health promotion strategies and future targeted intervention programs should consider the importance of these factors.

Neighborhood support network, perceived proximity to community facilities and depressive symptoms among low socioeconomic status Chinese elders

OBJECTIVES

Depressive symptoms are common in older people; most previous research on elderly depression focused on individual-level characteristics or neighborhood socioeconomic status. Modifiable neighborhood characteristics of older people dwelling in low-income communities are under-studied. This study aims to identify potentially modifiable social and physical neighborhood characteristics that influence depressive symptoms independent of individual-level characteristics among older Chinese.

METHOD

Data came from a cross-sectional survey conducted in four low-income public rental housing estates in Hong Kong in 2012. We interviewed a total of 400 elderly residents. The structured questionnaire covered demographics, activities of daily living, recent fall history, neighborhood support networks, and perceived proximity by walk to community facilities. Multiple regression was used to test whether inclusion of neighborhood factors in addition to individual characteristics increases model fit in explaining depressive symptoms in elders with low socioeconomic status.

RESULTS

At individual level, activities of daily living and income significantly predicted depressive symptoms. Receiving support from friends or neighbors is associated with fewer depressive symptoms. However, participants who received organizational support had a 1.17 points of increase on the 15-item Geriatric Depression Scale (GDS-15). At-ease walkable proximity to medical facilities was positively associated with a better GDS score.

CONCLUSION

Neighborhood support networks and perceived proximity by walk to community facilities contribute significantly to depressive symptoms among low-income elders. Programs and policies that facilitate neighborhood support and commuting or promote facility accessibility may help ameliorate depressive symptoms common among low-income elders.

Attitudes to aging in older carers - do they have a role in their well-being?

BACKGROUND

Attitudes to aging have been investigated in non-carer populations and found to have important relationships with physical and mental health. However, these have not been explored in an older carer sample, although it is becoming increasingly important to clarify variables which are linked with positive carer outcomes. This is one of the first studies to report on older carers, their attitudes to aging, and the relationship with carer-related factors.

METHODS

A cross-sectional study of 202 carers with a mean age of 70.8 years was conducted in Victoria, Australia, using carer demographic data, carer factors such as depression (using the Geriatric Depression Scale), burden (using the Zarit Burden Inventory, ZBI), physical health, personality, and attitudes to aging (using the Attitudes to Aging Questionnaire, AAQ). Spearman rank correlation and hierarchical regression analyses were used.

RESULTS

This study showed that carers had overall positive attitudes to aging inspite of their caring role. It also identified that carer factors including depression and burden contributed a significant amount of the variance to attitudes to aging in terms of physical change and psychosocial loss. Personality traits, specifically neuroticism, and extraversion, were also important contributors to attitudes to aging.

CONCLUSIONS

Results from this study demonstrated that inspite of moderate levels of depression and spending significant time caring, carers reported positive attitudes to aging. Treating depression, decreasing burden, and investigating the benefits of caring may assist older carers maintain their well-being.

Desigualdades na autoavaliação de saúde: uma análise para populações do Brasil e de Portugal

Resumo Objetivou-se analisar a prevalência de saúde autoavaliada como ruim, segundo variáveis sociodemográficas e presença de doença crônica, em populações do Brasil e de Portugal. Foram estudados 13.894 indivíduos (≥ 30 anos) das capitais do Nordeste do Brasil (VIGITEL 2011) e 20.579 de Portugal (4o INS 2005/2006). Utilizou-se a Regressão de Poisson para as análises de associação ajustadas por covariáveis. As prevalências brutas de saúde percebida como ruim, para o Nordeste do Brasil e para Portugal, em homens, foram de 4,3% e de 15,5%. A razão de prevalência (RP) foi de 2,72 (IC95%: 2,70-2,74) após a padronização por faixa etária. Para mulheres, as prevalências foram 8,1%, para o Brasil, e 25,1%, para Portugal (RP: 2,40; IC95%: 2,39-2,42). A variável que revelou desigualdades na saúde autoavaliada como ruim, em maior intensidade, foi a escolaridade, em ambas as populações. A presença de doença teve efeito maior nos brasileiros do que nos portugueses, em ambos os sexos. As prevalências de saúde autoavaliada como ruim foram significativamente mais elevadas para Portugal, em todos os agrupamentos estudados.

The experience of Korean immigrant women adjusting to Canadian society

The acculturation process is an important factor in the experience of all immigrants. Although previous studies have indicated the challenges faced by Korean immigrants, little attention has been paid to Korean women's immigration experiences. A focused ethnography was used to examine midlife and older Korean immigrant women's experiences following their immigration to Canada. Fifteen women were interviewed in a city in Western Canada. The findings showed that in coming to Canada, women focused on caring for their children and often sacrificed their personal dreams. They had to be employed to support their families, and received support from family and government. Women participated regularly in a Korean Church and drew on their Christian faith to ease their adjustment. They retained hopes for the future including good health and a better life for their children. Most women indicated that it was difficult to integrate into Canadian society but they never gave up on their adjustment to a new culture. In this manuscript, the adjustment experience of the immigrant women is discussed in the context of an acculturation framework. The findings will enhance health professionals' awareness of adjustment patterns and associated challenges to Korean immigrant women's quality of life.

Self-rated mental health in socio-structural contexts: an examination with Korean American older adults

OBJECTIVES

Following the socio-structural framework of health, the study examined the role of social/interpersonal and environmental/neighborhood factors in predicting self-rated mental health (SRMH) in Korean American older adults.

METHOD

Using the survey data from 420 older Korean Americans (mean age = 71.6, SD = 7.59), multivariate models of SRMH was estimated with sets of predictors: (1) background information (demographic characteristics and chronic conditions), (2) mental health symptom measures (depressive symptoms and anxiety), (3) social/interpersonal factors (social network and filial satisfaction), and (4) environmental/neighborhood factors (neighborhood safety and residential satisfaction).

RESULTS

Social/interpersonal and environmental/neighborhood factors were found to make a significant contribution to the predictive model even after controlling for background information and mental health symptom measures. Those with higher levels of filial satisfaction and more favorable perceptions of neighborhood safety were likely to have positive ratings of SRMH.

CONCLUSION

Findings supported the importance of considering socio-structural contexts in the assessment of SRMH and provided implications for mental health services for the target population.

The Impact of Acculturation on Depressive Symptoms: A Comparison of Older Korean Americans in Two Areas

This study examined how the impact of acculturation on depressive symptoms varied between two samples of older Korean Americans. One sample was from west central Florida (low Korean density area; n = 672), and the other from the New York City metropolitan area (high Korean density area; n = 420). The average level of acculturation was lower among older Korean Americans in New York, compared to those living in Florida. In the hierarchical regression models with the New York sample, acculturation was initially significant in predicting depressive symptoms; however, its impact was gradually attenuated and eventually became nonsignificant with the sequential entry of control variables. On the other hand, in the Florida sample, the impact of acculturation on depressive symptoms remained significant throughout the models. The results suggest that the level and importance of acculturation may differ by geographic locations and invite further contextual research in immigrant populations.

Predictors of subjective age in people aged 40-79 years: a five-year follow-up study. The impact of mastery, mental and physical health

OBJECTIVES

Assessing subjective age perception (SAP) and changes in SAP as well as exploring which variables of socio-demographic, health and personal mastery independently predicted SAP.

METHODS

The panel data are from two waves of the Norwegian Study on the Life Course, Ageing and Generations (NorLAG). Our sample consists of 2471 people aged 40-79 years at baseline who were surveyed in 2002/2003 (T1) and 2007/2008 (T2). Univariate and multiple regressions were performed; multivariate analyses assessing the relative importance of the independent variables (at T1) for the SAP at T2.

RESULTS

Older chronological age, good physical health, good mental health, a high level of personal mastery and having lower education significantly predicted a youthful SAP. For the whole sample, older age and a high level of personal mastery were the most important predictors. For those aged 40-49 being a man, having lower education, good physical health and high personal mastery predicted a younger SAP, whereas in the group aged 50-59 years being married/cohabiting and having a high level of education were predictors of an older SAP. For those aged 60-69, high personal mastery was the only independent predictor of a younger SAP. For those aged 70-79 years, only health - good mental and physical health - independently predicted a younger SAP.

CONCLUSIONS

Most respondents feel younger than their chronological age, the more the older they are. Self-rated physical and mental health and personal mastery are associated with SAP and vary in different age groups.

Depression and frailty in later life: a synthetic review

BACKGROUND

Many of the symptoms, consequences, and risk factors for frailty are shared with late-life depression. However, thus far, few studies have addressed the conceptual and empirical interrelationships between these conditions. This review synthesizes existing studies that examined depression and frailty among older adults and provides suggestions for future research.

METHODS

A search was conducted using PubMed for publications through 2010. Reviewers assessed the eligibility of each report and abstracted information on study design, sample characteristics, and key findings, including how depression and frailty were conceptualized and treated in the analysis.

RESULTS

Of 133 abstracted articles, 39 full-text publications met inclusion criteria. Overall, both cross-sectional (n = 16) and cohort studies (n = 23) indicate that frailty, its components, and functional impairment are risk factors for depression. Although cross-sectional studies indicate a positive association between depression and frailty, findings from cohort studies are less consistent. The majority of studies included only women and non-Hispanic Whites. None used diagnostic measures of depression or considered antidepressant use in the design or analysis of the studies.

CONCLUSIONS

A number of empirical studies support for a bidirectional association between depression and frailty in later life. Extant studies have not adequately examined this relationship among men or racial/ethnic minorities, nor has the potential role of antidepressant medications been explored. An interdisciplinary approach to the study of geriatric syndromes such as late-life depression and frailty may promote cross-fertilization of ideas leading to novel conceptualization of intervention strategies to promote health and functioning in later life.

Perceived neighborhood environment affecting physical and mental health: a study with Korean American older adults in New York City

This study examined how subjective perceptions of the neighborhood environment (e.g., perceived ethnic density, safety, social cohesion, and satisfaction) influenced the physical and mental health of Korean American older adults. Using data from 420 residents of the New York City metropolitan area (M(age) = 71.6, SD = 7.59), health perceptions and depressive symptoms were estimated with hierarchical regression models entered in the order of (1) demographics and acculturation, (2) health-related variables, and (3) perceived neighborhood environment. After controlling for the effects of the individual-level variables, perceived neighborhood environment was found to make a significant contribution to both outcomes. Individuals less satisfied with their overall neighborhood environment were more likely to have negative perceptions of health and depressive symptoms. A strong linkage between perceived neighborhood safety and depressive symptoms was also observed. Findings from the study highlight the importance of subjective evaluations of neighborhood environment and provide implications for health promotion.

Environmental mastery and depression in older adults in residential care

This study investigated the association between environmental mastery and depression in a sample of 96 older adults (aged 64–98 years) in residential care. The participants completed a scale that assessed depression along with measures for risk factors for depression such as functional capacity, self-evaluated physical health, bereavement experiences and environmental mastery. The results showed that 49 per cent of the variance in participants' scores in depression could be attributed to their self-reported level of environmental mastery. Given the complexity of depression and the likelihood of reduced environmental mastery among older adults in residential care, the construct was further assessed as a mediating variable between the risk factors and depression. With environmental mastery taken as such, the explained variance in depression increased to 56 per cent. It was concluded that environmental mastery may be one of the more important factors affecting the mental health of older adults living in residential care and that strategies for increasing the residents' environmental mastery are important to their psychological wellbeing. The discussion notes that among the questions needing further investigation are whether older adults who experience high environmental mastery make the transition from community living to residential nursing home care more successfully than others, and whether perceived mastery diminishes over time or occurs at the point of transition from community independent living to dependent supported living.

Bi-dimensional acculturation and cultural response set in CES-D among Korean immigrants

This study examined a cultural response set to positive affect items and depressive symptom items in CES-D among 172 Korean immigrants. Bi-dimensional acculturation approach, which considers maintenance of Korean Orientation and adoption of American Orientation, was utilized. As Korean immigrants increased their American Orientation, they tended to score higher on positive affect items, with no changes occurring in depressive symptom items. Korean Orientation was not related to either positive affect items or depressive symptom items. Korean immigrants have a response bias toward positive affect items in CES-D, which decreases as they adopt more American Orientation. CES-D lacks cultural equivalence for Korean immigrants.