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Chen S, Sun H, Song Y, Zhang M, Huang W, Zhao C, Wang Y, Wang J, Meng H, Zhou L, Xu Z, Bai Y. Transition and trend analysis of the burden of depression in China and different income countries: Based on GBD database and joinpoint regression model. J Affect Disord 2024; 362:437-449. [PMID: 38960335 DOI: 10.1016/j.jad.2024.06.067] [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: 01/11/2024] [Revised: 06/11/2024] [Accepted: 06/19/2024] [Indexed: 07/05/2024]
Abstract
BACKGROUND Depression is a leading cause of disability and poor health worldwide and is expected to rank first worldwide by 2030. The aim of this study is to analyze the transition and trend of depression burden in China and various income-level countries by utilizing the Global Burden of Disease (GBD) database and the Joinpoint regression model. This analysis seeks to comprehend the variations in the burden of depression across different income regions and evaluate their developmental patterns. METHODS Based on the GBD 2019 open dataset, this study extracted data on YLD (Years Lived with Disability), DALY (Disability-Adjusted Life Years), and incidence related to depression. The analysis focused on the period between 1990 and 2019, covering global data and distinguishing between high-income, upper-middle-income, lower-middle-income, low-income countries, and China. We utilized the Joinpoint regression model to fit the spatiotemporal trend changes among different income-level countries. Pairwise comparisons were conducted to examine the parallelism and to determine if the differences in trend changes among various regions were statistically significant. RESULTS From 1990 to 2019, the age-standardized YLD and DALY for depression female were higher than that in male. The YLD total change rate of depression men was higher than that of women. China exhibited the largest disparity in total YLD change rates between genders, reaching 0.08. During 1990 to 2019, the incidence of depression in 2005-2019 increased among females in middle to high-income countries, low-income countries, and China as compare to that of 1990-2005. Notably, China shown the most increase the incidence rate of females (from -0.4 % to 0.84 %). China experienced the most significant change in the YLD of depression during this period (AAPC = 0.45, 95 % CI = 0.41, 0.48, P < 0.01). China's YLD/Incidence rate was higher compared to the global, HICs, UMCs, LMCs, and LICs. In China, the YLD/incidence rate of depression began to rise in 1994, peaking around 2010, and then gradually declining. Since 2010, the growth rate of depression DALYs in China has been higher than the global average, high-income countries, upper-middle-income countries, lower-middle-income countries, and low-income countries. The DALY's AAPC value for the HLCs was the highest (AAPC = 0.24, 95 % CI = 0.22, 0.25, P < 0.01). The UMCs, in comparison to other regions, incidence rate had the highest AAPC value (AAPC = 0.48, 95 % CI = 0.46, 0.50, P < 0.01). CONCLUSIONS Given the significant variations in the burden of depression across countries with different income levels, future strategies aimed at reducing the burden of depression should adopt tailored and differentiated approaches according to each country's specific needs and developmental stages.
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Affiliation(s)
- Si Chen
- Shandong Second Medical University, Weifang 261053, China; BeiHua University, Jilin 132013, China
| | - Hongwei Sun
- Shandong Second Medical University, Weifang 261053, China.
| | - Yan Song
- BeiHua University, Jilin 132013, China
| | - Min Zhang
- BeiHua University, Jilin 132013, China
| | - Wei Huang
- BeiHua University, Jilin 132013, China
| | | | - Yanyu Wang
- Shandong Second Medical University, Weifang 261053, China
| | | | - HaiBo Meng
- Jilin City Medical Association, Jilin 132011, China
| | - Lei Zhou
- Chinese Center for Disease Control and Prevention (CDC), Beijing 102206, China
| | | | - YuXin Bai
- BeiHua University, Jilin 132013, China
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Lai S, Li J, Shen C, Zhang S, Yang Y, Zhang X, Yang X, Zhou Z, Lu L. School Bullying Victimization and Depression Symptoms in Adolescents: The Mediating Role of Internet Addiction and Moderating Role of Living Areas. Psychiatr Q 2024:10.1007/s11126-024-10083-w. [PMID: 39145816 DOI: 10.1007/s11126-024-10083-w] [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] [Accepted: 07/31/2024] [Indexed: 08/16/2024]
Abstract
School bullying and depression are both serious social and public health problems among adolescents. Prior studies indicated a correlation between bullying and depression. However, the potential moderators remain largely unexplored. This study aimed to identify the mediating effect of Internet addiction and the moderating effect of living in urban or rural areas in the relationship between school bullying victimization and depression symptoms among Chinese adolescents. This cross-sectional study of adolescents was conducted using two-stage random cluster sampling of students in urban and rural public high schools in China. A moderated mediation model was constructed to uncover the underlying mechanism of school bullying victimization and depression symptoms. A total of 2,376 adolescents (52.65% females, mean age ± SD a 14.69 ± 1.76 years) were included in the study. The prevalence of clinical depression symptoms with a cut-off value of 16 on the Center for Epidemiological Studies Depression Scale (CES-D) was 21.76% (95% CI: 20.15, 23.46), and with a cut-off value of 20 on the CES-D was 13.85% (95% CI: 12.51, 15.30) for overall. Our findings indicated a significant positive association between school bullying victimization and depression symptoms (p < 0.01) and a significant mediating effect of Internet addiction in the association between school bullying victimization and depression symptoms (indirect effect = 1.143, 95% CI: 0.677, 1.609; percentage of mediation: 16.7%, 95% CI: 10.3, 23.1). This indirect relationship was partially moderated by the living in urban or rural areas in the mediation process. Specifically, the effect of school bullying victimization on Internet addiction was greater among urban adolescents (simple slope: 0.774, 95% CI: 0.524, 1.024, p < 0.01) than among rural adolescents (simple slope: 0.337, 95% CI: 0.132, 0.543, p < 0.01), but moderating effect of urban-rural areas was not significant on the relationship between Internet addiction and depression symptoms. These findings highlight the mediating role of Internet addiction and the moderating role of living areas in school bullying victimization and adolescents' depression symptoms, which provide evidence for social work, mental health services, and policy interventions for adolescents in China.
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Affiliation(s)
- Sha Lai
- Health Management and Policy Institute, School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China
| | - Jun Li
- Health Management and Policy Institute, School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China.
- Xi'an Center for disease control and prevention, Xi'an, China.
- School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China.
| | - Chi Shen
- Health Management and Policy Institute, School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China
| | - Songjie Zhang
- Xi'an Center for disease control and prevention, Xi'an, China
| | - Yan Yang
- Xi'an Center for disease control and prevention, Xi'an, China
| | - Xiaolong Zhang
- Health Management and Policy Institute, School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China
| | - Xiaowei Yang
- Health Management and Policy Institute, School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China
| | - Zhongliang Zhou
- Health Management and Policy Institute, School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China
| | - Li Lu
- Health Management and Policy Institute, School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China.
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Yu H, Zhang Y, Hu M, Xiang B, Wang S, Wang Q. Inter- and intrapopulation differences in the association between physical multimorbidity and depressive symptoms. J Affect Disord 2024; 354:434-442. [PMID: 38508455 DOI: 10.1016/j.jad.2024.03.090] [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: 11/17/2023] [Revised: 03/12/2024] [Accepted: 03/15/2024] [Indexed: 03/22/2024]
Abstract
BACKGROUND The association between physical multimorbidity and depression differs by populations. However, no direct inter- or intrapopulation comparison of the association has been conducted. Thus, this study aims to estimate the association in China and the United States and reveal inter- and intrapopulation differences in the association. METHODS Middle-aged and older adults from the China Health and Retirement Longitudinal Study and the Health and Retirement Study were included. Physical multimorbidity was defined as the simultaneous presence of two or more chronic physical conditions and depressive symptoms was measured by the Center for Epidemiologic Studies Depression Scale. Generalized estimating equation model and stratification multilevel method were the main statistical models. RESULTS The presence of physical multimorbidity was associated with a higher risk of depression in both China (RR = 1.360 [95 % CI: 1.325-1.395]) and the US (RR = 1.613 [95 % CI: 1.529-1.701]). For individuals at a low risk of multimorbidity, multimorbidity was associated with 47.4 % (95 % CI: 1.377-1.579) and 71.1 % (95 % CI: 1.412-2.074) increases in the likelihood of depression in China and the US. The effect size was smaller for individuals at a moderate or high risk. However, the cross-national differences were greater for those with a high risk of multimorbidity. LIMITATIONS The self-report measures, attribution bias. CONCLUSIONS Compared to Chinese adults, the presence of physical multimorbidity led to an additional increase in depressive symptoms for American counterparts. The association was stronger for individuals at a low risk of multimorbidity, but cross-national differences were observed mostly among individuals at a high risk.
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Affiliation(s)
- Haiyang Yu
- Department of Biostatistics, School of Public Health, Shandong University, Jinan, Shandong, China; National Institute of Health Data Science of China, Shandong University, Jinan, China
| | - Yike Zhang
- Department of Biostatistics, School of Public Health, Shandong University, Jinan, Shandong, China; National Institute of Health Data Science of China, Shandong University, Jinan, China
| | - Mengxiao Hu
- Department of Biostatistics, School of Public Health, Shandong University, Jinan, Shandong, China; National Institute of Health Data Science of China, Shandong University, Jinan, China
| | - Bowen Xiang
- Department of Biostatistics, School of Public Health, Shandong University, Jinan, Shandong, China; National Institute of Health Data Science of China, Shandong University, Jinan, China
| | - Sijia Wang
- National Institute of Health Data Science of China, Shandong University, Jinan, China; Institute for Global Health, Faculty of Population Health Sciences, University College London, London, United Kingdom
| | - Qing Wang
- Department of Biostatistics, School of Public Health, Shandong University, Jinan, Shandong, China; National Institute of Health Data Science of China, Shandong University, Jinan, China; Yellow River National Strategic Research Institute, Shandong University, Jinan, Shandong, China.
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Lu H, Dong XX, Li DL, Nie XY, Wang P, Pan CW. Multimorbidity patterns and health-related quality of life among community-dwelling older adults: evidence from a rural town in Suzhou, China. Qual Life Res 2024; 33:1335-1346. [PMID: 38353890 DOI: 10.1007/s11136-024-03608-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/11/2024] [Indexed: 04/26/2024]
Abstract
PURPOSE The high prevalence of multimorbidity in aging societies has posed tremendous challenges to the healthcare system. The aim of our study was to comprehensively assess the association of multimorbidity patterns and health-related quality of life (HRQOL) among rural Chinese older adults. METHODS This was a cross-sectional study. Data from 4,579 community-dwelling older adults aged 60 years and above was collected by the clinical examination and questionnaire survey. Information on 10 chronic conditions was collected and the 3-Level EQ-5D (EQ-5D-3L) was adopted to measure the HRQOL of older adults. An exploratory factor analysis was performed to determine multimorbidity patterns. Regression models were fitted to explore the associations of multimorbidity patterns with specific health dimensions and overall HRQOL. RESULTS A total of 2,503 (54.7%) participants suffered from multimorbidity, and they reported lower HRQOL compared to those without multimorbidity. Three kinds of multimorbidity patterns were identified including cardiovascular-metabolic diseases, psycho-cognitive diseases and organic diseases. The associations between psycho-cognitive diseases/organic diseases and overall HRQOL assessed by EQ-5D-3L index score were found to be significant (β = - 0.097, 95% CI - 0.110, - 0.084; β = - 0.030, 95% CI - 0.038, - 0.021, respectively), and psycho-cognitive diseases affected more health dimensions. The impact of cardiovascular-metabolic diseases on HRQOL was largely non-significant. CONCLUSION Multimorbidity was negatively associated with HRQOL among older adults from rural China. The presence of the psycho-cognitive diseases pattern or the organic diseases pattern contributed to worse HRQOL. The remarkable negative impact of psycho-cognitive diseases on HRQOL necessiates more attention and relevant medical assistance to older rural adults.
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Affiliation(s)
- Heng Lu
- School of Public Health, Suzhou Medical College of Soochow University, Suzhou, China
| | - Xing-Xuan Dong
- School of Public Health, Suzhou Medical College of Soochow University, Suzhou, China
| | - Dan-Lin Li
- School of Public Health, Suzhou Medical College of Soochow University, Suzhou, China
| | - Xin-Yi Nie
- School of Public Health, Suzhou Medical College of Soochow University, Suzhou, China
| | - Pei Wang
- School of Public Health, Fudan University, Shanghai, China.
- Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China (Fudan University), Shanghai, China.
| | - Chen-Wei Pan
- School of Public Health, Suzhou Medical College of Soochow University, Suzhou, China.
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Chai Y, Xian G, Guo L, Fu G, Liu Y, Wang M, Luo S. The relationship between childhood socioeconomic status and depression level in older adults: the mediating role of adult socioeconomic status and subjective well-being. BMC Geriatr 2024; 24:138. [PMID: 38321378 PMCID: PMC10848464 DOI: 10.1186/s12877-024-04750-7] [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: 10/13/2023] [Accepted: 01/26/2024] [Indexed: 02/08/2024] Open
Abstract
BACKGROUND There is a causal link between childhood socioeconomic status and health status in adulthood and beyond. It's vital to comprehend the relationship between childhood socioeconomic status and mental health among older Chinese individuals from the current generation who have undergone significant social changes in China. This understanding is critical to foster healthy demographic and social development in China. METHODS Using data from the 2020 China Family Panel Studies, we investigate the relationship between childhood socioeconomic status and depression in older adults. Additionally, we examine the mediating role of adult socioeconomic status and subjective well-being. RESULTS 1) Childhood socioeconomic status of Chinese older adults differences by region of residence, while depression levels differences by gender, region of residence, and marital status. 2) Adult socioeconomic status mediated the relationship between childhood socioeconomic status and depression in older adults. 3) Adult socioeconomic status and subjective well-being had a chain-mediated role in the relationship between childhood socioeconomic status and depression in older adults. CONCLUSIONS In terms of childhood socioeconomic status, older adults in urban regions were significantly higher than those in rural regions. As for depression level, female older adults were more depressed than males; married older people have the lowest depression levels, while unmarried and widowed older people have higher depression levels; older adults in rural regions had higher depression levels than those in urban regions. Evidence from our study further suggests that childhood socioeconomic status can suppress the depression level in older adults through adult socioeconomic status; it can also further reduce the depression level in older adults through the chain mediation of adult economic status affecting subjective well-being. As depression is more prevalent among older individuals with a lower childhood socioeconomic status, it is vital to prioritize the extensive impact of childhood socioeconomic status as a distal factor and investigate "upstream" solutions to enhance childhood socioeconomic status and reduce the gap during the early years of life.
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Affiliation(s)
- Yulin Chai
- School of Management, Shandong Second Medical University, Weifang, Shandong, 261053, China
| | - Guowei Xian
- School of Management, Shandong Second Medical University, Weifang, Shandong, 261053, China
| | - Lin Guo
- School of Management, Shandong Second Medical University, Weifang, Shandong, 261053, China
| | - Guoqi Fu
- School of Management, Shandong Second Medical University, Weifang, Shandong, 261053, China
| | - Yanxu Liu
- School of Management, Shandong Second Medical University, Weifang, Shandong, 261053, China
| | - Mengxue Wang
- School of Management, Shandong Second Medical University, Weifang, Shandong, 261053, China
| | - Sheng Luo
- School of Management, Shandong Second Medical University, Weifang, Shandong, 261053, China.
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Saha A, Mandal B, Muhammad T, Ali W. Decomposing the rural-urban differences in depression among multimorbid older patients in India: evidence from a cross-sectional study. BMC Psychiatry 2024; 24:60. [PMID: 38254089 PMCID: PMC10804604 DOI: 10.1186/s12888-023-05480-7] [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: 05/07/2023] [Accepted: 12/25/2023] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND In India, the prevalence of depression among older adults dealing with multiple health conditions varies between rural and urban areas due to disparities in healthcare access and cultural factors. The distinct patterns observed underscore the necessity for tailored research and interventions to address mental health inequalities among multimorbid older patients in diverse geographic contexts. METHODS This study used data from the Longitudinal Ageing Study in India (LASI) wave 1 (2017-18). A total of 7,608 adults aged ≥ 60 years who were diagnosed with two or more chronic conditions (such as hypertension, diabetes, cancer, chronic lung disease, chronic heart diseases, stroke, bone/joint disease, any neurological or psychiatric diseases, and high cholesterol) were included in this study. Descriptive statistics, bivariate analysis, logistic regression estimates, and Fairlie decomposition method were used to accomplish the study's objectives. RESULTS The prevalence of depression among older adults with multimorbidity was 9.48% higher in rural areas (38.33%) than in urban areas (28.85%).. Older adults with multimorbidity belonging to the scheduled caste group were 40% more likely to experience depression. Moreover, those with multimorbidity and any form of disability in activities of daily living (ADL) were 93% more likely to experience depression than those without disability, whereas those with multimorbidity and perceived good general health were 65% less likely to suffer from depression than those with poor self-perceived health. Additionally, decomposition analysis revealed that education (35.99%), caste status (10.30%), IADL disability (19.30%), and perceived discrimination (24.25%) were the primary factors contributing to the differences in depression prevalence among older adults with multimorbidity between rural and urban areas. CONCLUSIONS We found significant rural-urban differences in depression among older Indians with multimorbidity. The findings underscore the need for targeted interventions that address the unique challenges faced by older patients in rural areas, including lack of social capital, discrimination, and limited resources that enable access to healthcare services. Policymakers and healthcare professionals must collaboratively design and implement effective strategies to improve the mental health and overall well-being of rural older adults, particularly those with multiple comorbidities.
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Affiliation(s)
- Amiya Saha
- Department of Family & Generations, International Institute for Population Sciences, Mumbai, 400088, India.
| | - Bittu Mandal
- School of Humanities and Social Sciences, Indian Institute of Technology, Indore, 453552, India
| | - T Muhammad
- Center for Healthy Aging, The Pennsylvania State University, University park, 16802, USA
| | - Waad Ali
- Department of Geography, Sultan Qaboos University, Muscat, 123, Oman
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Wang X, Wang Y. Association between digital engagement and urban-rural disparities in Chinese women's depressive symptoms: A national-level cross-sectional study. Digit Health 2024; 10:20552076241239246. [PMID: 38577314 PMCID: PMC10993679 DOI: 10.1177/20552076241239246] [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: 11/15/2023] [Accepted: 02/27/2024] [Indexed: 04/06/2024] Open
Abstract
Objectives This study aims to investigate the impact of digital engagement on urban-rural disparities in depressive symptoms among Chinese women. Methods Using a dataset from the China Family Panel Studies (CFPS) wave 2020, this study analyzes the impact of digital engagement on the urban-rural disparity in women's depressive symptoms using multiple linear regression and recentered influence function (RIF) models. Furthermore, the extent to which digital engagement affects the urban-rural disparity in women's depressive symptoms was calculated using the RIF decomposition method. Results Analysis showed that rural women had significantly higher levels of depressive symptoms compared to urban women; digital engagement significantly reduced women's depressive symptoms levels and mitigated the urban-rural disparity for women with moderate to high levels of depressive symptoms, and the mitigating effect was stronger for the highly depressed sample, but still widened the urban-rural disparity in women's depressive symptoms overall. In addition, the results of the RIF decomposition showed that digital engagement explained 28.28% of the urban-rural disparity in women's depressive symptoms. Conclusion There is a significant disparity in depressive symptoms levels between urban and rural women in China. Digital engagement reduces women's depressive symptoms, but it also widens the depressive symptoms disparity between urban and rural women overall. Digital engagement is potentially positive for reducing women's depressive symptoms.
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Affiliation(s)
- Xiaochen Wang
- Faculty of Education, Southwest University, Chongqing, China
| | - Yangyang Wang
- School of Communication, Soochow University, Suzhou, China
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Pan C, Cao N. Dual trajectories of depression and social participation among Chinese older adults. Geriatr Nurs 2023; 53:153-161. [PMID: 37540910 DOI: 10.1016/j.gerinurse.2023.07.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 07/15/2023] [Accepted: 07/18/2023] [Indexed: 08/06/2023]
Abstract
OBJECTIVES This study aimed to investigate the dual trajectories of social participation (SP) and depression among older adults, and explore common factors that may influence both trajectories. METHODS The study utilized data from four waves of the China Health and Retirement Longitudinal Study (CHARLS, 2011 to 2018). The dual-trajectory model was employed to estimate the dual trajectories of SP and depression. RESULTS This study identified two SP and three depression trajectories. The results revealed that the reciprocal relationship between SP and depression trajectories is confirmed in all sub-groups of the dual trajectories. Our study identified six distinct sub-groups of individuals based on their SP and depression trajectories and some commen risk factors of SP and depression trajectories. CONCLUSIONS Related intervention policies should consider the dual trajectories of SP and depression and focus on subgroups with high vulnerability, such as high depression but low SP. Additionally, attention should be given to addressing the common risk factors that underlie these trajectories.
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Affiliation(s)
- Chaoping Pan
- School of Public Health and Management, Wenzhou Medical University, Wenzhou City, Zhejiang Province, China
| | - Na Cao
- School of Public Health and Management, Wenzhou Medical University, Wenzhou City, Zhejiang Province, China; School of Public Health, Wuhan University, Wuhan City, Hubei Province, China.
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Roy N, Amin MB, Mamun MA, Sarker B, Hossain E, Aktarujjaman M. Prevalence and factors associated with depression, anxiety, and stress among people with disabilities during COVID-19 pandemic in Bangladesh: A cross-sectional study. PLoS One 2023; 18:e0288322. [PMID: 37418465 DOI: 10.1371/journal.pone.0288322] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 06/23/2023] [Indexed: 07/09/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has had a profound impact on the mental health of individuals across various populations. People with disabilities (PWDs) are particularly vulnerable to these effects, yet there is a lack of studies investigating the mental health of PWDs in Bangladesh. This study aims to investigate the prevalence of and factors associated with depression, anxiety, and stress among PWDs during the COVID-19 pandemic in Bangladesh. METHODS Data was collected through interviews with 391 PWDs between December 2020 and February 2021. Demographic information, clinical characteristics, and scores from the Depression, Anxiety, and Stress Scale (DASS-21) were obtained. Chi-square tests and logistic regression analyses were conducted to examine the relationship between psychological measures and potential risk factors. RESULTS The prevalence was found to be 65.7% for depression, 78.5% for anxiety, and 61.4% for stress, respectively. Several factors were identified as associated with these mental health issues, including gender (male), marital status (being married), low education levels, multiple impairments, comorbid medical illnesses, poor sleep quality, rural residency, hearing disability, disability onset later in life, and testing positive for COVID-19. CONCLUSIONS The prevalence was found to be 65.7% for depression, 78.5% for anxiety, and 61.4% for stress, respectively. Several factors were identified as associated with these mental health issues, including gender (male), marital status (being married), low education levels, multiple impairments, comorbid medical illnesses, poor sleep quality, rural residency, hearing disability, disability onset later in life, and testing positive for COVID-19.
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Affiliation(s)
- Nitai Roy
- Department of Biochemistry and Food Analysis, Patuakhali Science and Technology University, Patuakhali, Bangladesh
| | - Md Bony Amin
- Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Patuakhali, Bangladesh
| | - Mohammed A Mamun
- CHINTA Research Bangladesh, Dhaka, Bangladesh
- Department of Public Health and Informatics, Jahangirnagar University, Dhaka, Bangladesh
| | - Bibhuti Sarker
- Department of Economics, University of Manitoba, Winnipeg, Canada
- Department of Economics, Bangabandhu Sheikh Mujibur Rahman Science and Technology University, Gopalganj, Bangladesh
| | - Ekhtear Hossain
- Department of Biological Sciences and Chemistry, Southern University and A&M College, Baton Rouge, LA, United States of America
| | - Md Aktarujjaman
- Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Patuakhali, Bangladesh
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Wang J, Luo N, Sun Y, Bai R, Li X, Liu L, Wu H, Liu L. Exploring the reciprocal relationship between activities of daily living disability and depressive symptoms among middle-aged and older Chinese people: a four-wave, cross-lagged model. BMC Public Health 2023; 23:1180. [PMID: 37337186 DOI: 10.1186/s12889-023-16100-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 06/11/2023] [Indexed: 06/21/2023] Open
Abstract
BACKGROUND Early studies have shown a relationship between activities of daily living (ADL) disability and depressive symptoms in older people. However, discussions on the direction of this relationship are insufficient. The study's objective was to assess the reciprocal relationship between ADL disability and depressive symptoms among middle-aged and older Chinese people. METHOD Data was collected in four waves of a nationwide survey, the China Health and Retirement Longitudinal Study (CHARLS), which was carried out in 2011, 2013, 2015, and 2018. In total, this study included 4,124 participants aged ≥ 45 years at baseline. A summing score of the eleven items for basic activities of daily living (BADL) and instrumental activities of daily living (IADL) was calculated to indicate the degree of ADL disability. The 10-item Centre for Epidemiological Studies Depression Scale (CESD-10) was adopted to measure depressive symptoms. The reciprocal relationship between ADL disability and depressive symptoms was tested by cross-lagged models. RESULT At baseline, 911 (22.1%) participants were classified as having difficulties with ADL, and the prevalence of depressive symptoms was 34.4% (1,418). Among middle-aged and older people in China, there was a significant reciprocal and longitudinal relationship between ADL disability and depressive symptoms. People who had difficulty with ADL faced a higher risk of depressive symptoms, and those who suffered from depressive symptoms were accompanied by an increase in ADL disability in the following years. The subgroup analysis on age also showed that ADL disability was reciprocally and longitudinally related to depressive symptoms. However, only women showed similar results in the subgroup analysis on gender. CONCLUSION This study shows that ADL disability is bi-directionally related to depressive symptoms in middle-aged and older Chinese people over time. The results suggest we should identify ADL disability and bad psychological conditions in time to prevent subsequent mutual damage among middle-aged and older Chinese people, a vulnerable group rising in the future.
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Affiliation(s)
- Jiayi Wang
- Department of Social Medicine, School of Health Management, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, 110122, Liaoning, China
| | - Nansheng Luo
- Department of Social Medicine, School of Health Management, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, 110122, Liaoning, China
| | - Yu Sun
- Department of Social Medicine, School of Health Management, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, 110122, Liaoning, China
| | - Ru Bai
- Department of Social Medicine, School of Health Management, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, 110122, Liaoning, China
| | - Xueying Li
- Department of Social Medicine, School of Health Management, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, 110122, Liaoning, China
| | - Libing Liu
- Department of Social Medicine, School of Health Management, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, 110122, Liaoning, China
| | - Hui Wu
- Department of Social Medicine, School of Health Management, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, 110122, Liaoning, China.
| | - Li Liu
- Department of Social Medicine, School of Health Management, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, 110122, Liaoning, China.
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Ho HE, Yeh CJ, Cheng-Chung Wei J, Chu WM, Lee MC. Association between multimorbidity patterns and incident depression among older adults in Taiwan: the role of social participation. BMC Geriatr 2023; 23:177. [PMID: 36973699 PMCID: PMC10045862 DOI: 10.1186/s12877-023-03868-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 03/02/2023] [Indexed: 03/29/2023] Open
Abstract
Abstract
Background
Previous research has found different multimorbidity patterns that negatively affects health outcomes of older adults. However, there is scarce evidence, especially on the role of social participation in the association between multimorbidity patterns and depression. Our study aimed to explore the relationship between multimorbidity patterns and depression among older adults in Taiwan, including the social participation effect on the different multimorbidity patterns.
Methods
Data were retracted from the Taiwan longitudinal study on ageing (TLSA) for this population-based cohort study. 1,975 older adults (age > 50) were included and were followed up from 1996 to 2011. We used latent class analysis to determine participants’ multimorbidity patterns in 1996, whereas their incident depression was determined in 2011 by CES-D. Multivariable logistic regression was used to analyse the relationship between multimorbidity patterns and depression.
Results
The participants’ average age was 62.1 years in 1996. Four multimorbidity patterns were discovered through latent class analysis, as follows: (1) Cardiometabolic group (n = 93), (2) Arthritis-cataract group (n = 105), (3) Multimorbidity group (n = 128) and (4) Relatively healthy group (n = 1649). Greater risk of incident depression was found among participants in the Multimorbidity group (OR: 1.62; 95% CI: 1.02–2.58) than the Relatively healthy group after the multivariable analysis. Compare to participants in the relatively healthy group with social participation, participants in the arthritis-cataract group without social participation (OR: 2.22, 95% CI: 1.03–4.78) and the multimorbidity group without social participation (OR: 2.21, 95% CI: 1.14–4.30) had significantly increased risk of having depression.
Conclusion
Distinct multimorbidity patterns among older adults in Taiwan are linked with the incident depression during later life, and social participation functioned as a protective factor.
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Ji Y, Feng Y, Wu S, Wu Y, Wang J, Zhao X, Liu Y. Longitudinal trajectories of depressive symptoms: the role of multimorbidity, mobility and subjective memory. BMC Geriatr 2023; 23:22. [PMID: 36635652 PMCID: PMC9837987 DOI: 10.1186/s12877-023-03733-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 01/06/2023] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND The high prevalence of depression among older people in China places a heavy burden on the health system. Multimorbidity, mobility limitation and subjective memory impairment are found to be risk indicators for depression. However, most studies on this topic focused on depression at a single point in time, ignoring the dynamic changes in depressive symptoms and the relationship between the trajectories and these three conditions. Therefore, we aimed to identify distinct trajectories of depressive symptoms in older people and investigate their associations with multimorbidity, mobility limitation and subjective memory impairment. METHODS Data was drawn from China Health and Retirement Longitudinal Study conducted during 2011-2018. A total of 5196 participants who completed 4 visits, conducted every 2-3 years were included in this study. Group-based trajectory modeling was conducted to identify distinct trajectories of depressive symptoms z-scores. Multinomial logistic regression was used to investigate the relationships. RESULTS Four distinct trajectories of depressive symptoms z-scores were identified, labeled as persistently low symptoms (68.69%, n = 3569), increasing symptoms (12.14%, n = 631), decreasing symptoms (14.05%, n = 730) and persistently high symptoms (5.12%, n = 266). Participants with multimorbidity had unfavorable trajectories of depressive symptoms compared with those without multimorbidity, with adjusted odds ratios (95% CIs) of 1.40 (1.15, 1.70), 1.59 (1.33, 1.90) and 2.19 (1.65, 2.90) for the increasing symptoms, decreasing symptoms and persistently high symptoms, respectively. We also observed a similar trend among participants with mobility limitations. Compared with participants who had poor subjective memory, participants with excellent/very good/good subjective memory had a lower risk of developing unfavorable trajectories of depressive symptoms. The adjusted odds ratios (95% CIs) of the increasing symptoms, decreasing symptoms and persistently high symptoms were 0.54 (0.40, 0.72), 0.50 (0.38, 0.65) and 0.48 (0.31, 0.73), respectively. CONCLUSIONS Multimorbidity, mobility limitation and subjective memory impairment were found to be potential risk factors for unfavorable depression trajectories.
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Affiliation(s)
- Yiman Ji
- grid.27255.370000 0004 1761 1174Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012 Shandong China ,grid.27255.370000 0004 1761 1174Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, 250000 Shandong China
| | - Yiping Feng
- grid.27255.370000 0004 1761 1174Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012 Shandong China ,grid.27255.370000 0004 1761 1174Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, 250000 Shandong China
| | - Sijia Wu
- grid.27255.370000 0004 1761 1174Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012 Shandong China ,grid.27255.370000 0004 1761 1174Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, 250000 Shandong China
| | - Yutong Wu
- grid.27255.370000 0004 1761 1174Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012 Shandong China ,grid.27255.370000 0004 1761 1174Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, 250000 Shandong China
| | - Jiongjiong Wang
- grid.27255.370000 0004 1761 1174Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012 Shandong China ,grid.27255.370000 0004 1761 1174Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, 250000 Shandong China
| | - Xiangjuan Zhao
- Department of gynecology, Maternal and Child Health Care Hospital of Shandong Province, Jinan, 250014 Shandong China
| | - Yunxia Liu
- grid.27255.370000 0004 1761 1174Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012 Shandong China ,grid.27255.370000 0004 1761 1174Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, 250000 Shandong China
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An association between multi-morbidity and depressive symptoms among Indian adults based on propensity score matching. Sci Rep 2022; 12:15518. [PMID: 36109532 PMCID: PMC9478135 DOI: 10.1038/s41598-022-18525-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 08/16/2022] [Indexed: 11/09/2022] Open
Abstract
AbstractKeeping in view the cascade of disturbances caused by the co-existence of multi-morbidity and depression among aged population, this study aims to ascertain the independent impact of multi-morbidity as a risk factor for the development of depressive symptoms among adults living in India. The present study utilizes data from the nationally representative survey “Longitudinal Ageing Study in India” (LASI, Wave-1, 2017–2018). The eligible sample size was 62,244 adults aged 45 years and above. Descriptive statistics along with bivariate analysis was used to understand the prevalence of depressive symptoms. Further, binary logistic regression and Propensity Score Matching (PSM) methods were applied to examine the independent effect of multi-morbidity on depressive symptoms while controlling the selected background characteristics. Overall, around one-third respondents had at least one chronic disease and one-fifth had multi-morbidity. The most prevalent chronic disease reported in the sampled population was hypertension followed by diabetes and joint disease. It is observed that older adults with multiple chronic diseases had 77% higher odds of having depressive symptoms as compared to those without a history of chronic disease in the multivariable logistic regression model. Results obtained from PSM indicate that the risk of having depressive symptoms was 3.7% higher for adults with multi- morbidity. Depressive symptom was identified to be associated with a wider range of multiple physical health problems and people with multi-morbidity are at a higher risk of having depressive symptoms. It is imperative that multi-morbidity can be used as a screener for identifying people with depressive symptoms.
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Behera S, Pradhan J. A combination of moderate and vigorous physical activities reduces the burden of multimorbidity: findings from Longitudinal Ageing Study in India. JOURNAL OF HEALTH, POPULATION AND NUTRITION 2022; 41:42. [PMID: 36096879 PMCID: PMC9465913 DOI: 10.1186/s41043-022-00323-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 09/01/2022] [Indexed: 06/14/2024] Open
Abstract
Abstract
Background
Physical inactivity is a significant factor contributing to the prevalence of non-communicable diseases (NCDs). The objective of this study is to examine the association between physical activity and multimorbidity among Indian adults aged 45 years and above by residence.
Methods
Data from Longitudinal Ageing Study in India (LASI) 2017–2018, wave 1, a nationally representative study, are used to examine the above objective. A total of 59,073 adults aged 45 years and above are enlisted in the study. Physical activities and other demographic and socioeconomic variables have been used to describe the distribution of multimorbidity and investigate their relationship. Logistic regression is employed to examine the adjusted impact of physical activity on multimorbidity among Indian adults (45 + years) by residence.
Results
The level of physical activity is inversely related to the prevalence of multimorbidity in India. The rate of multimorbidity ranges from 4 to 12% among moderately active individuals in rural areas, whereas it ranges from 9 to 34% in urban areas across the age groups of 45 to 75+ years. Notably, the individuals who engage in both moderate and vigorous activities have a lower prevalence of multimorbidity than those who engage in only moderate activities.
Conclusion
Our study shows that physical inactivity has an association with the rise in multimorbidity in both rural and urban areas; however, the intensity of multimorbidity is higher in urban areas. The policymakers should consider the influence of moderate and vigorous physical activity as a key prevention measure of non-communicable disease and multimorbidity.
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Lu S. Longitudinal associations between perception of future time and subjective well-being among middle-aged and older people in China: the moderating roles of individual health and socioeconomic status. Qual Life Res 2022; 31:3009-3018. [PMID: 35648281 DOI: 10.1007/s11136-022-03163-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/13/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE This study examined the longitudinal association between perception of future time (PFT) and subjective well-being among middle- and old-aged people in China, and investigated the moderating roles of individual health resources and socioeconomic status (SES) in the association between PFT and subjective well-being. METHODS Data for this study drew from a final sample of 10,644 respondents aged 45 years and above from four waves (2011-2018) of the China Health and Retirement Longitudinal Study (CHARLS). Subjective well-being was measured by depressive symptoms and life satisfaction. Multilevel linear modelling (MLM) was applied to analyse the main effects of PFT on depressive symptoms and life satisfaction over time and the moderating effects of individual health resources and SES. RESULTS After controlling for the covariates, perceived future time as extended was associated with fewer depressive symptoms (β = - 0.85, p < 0.001) and higher levels of life satisfaction (β = 0.07, p < 0.001). Significant moderating effects of individual health resources (self-rated health, functional limitations and chronic diseases) and SES (urban-rural hukou) were found in associations between PFT and depressive symptoms. CONCLUSION Perceived future time as extended was associated with better subjective well-being. These associations differed in relation to different individual health resources and SES. This study extends understanding of Socioemotional Selectivity Theory and helps identify vulnerable people when they feel near to death.
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Affiliation(s)
- Shiyu Lu
- Department of Social and Behavioral Sciences, City University of Hong Kong, Kowloon, Hong Kong.
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16
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Lu J, Liu L, Wang Y, Zhou Z. Social Engagement and Urban-Rural Disparity in Self-Management Behaviors: Study of Middle-Aged and Older Chinese Hypertension Patients. Front Public Health 2022; 9:801307. [PMID: 35155352 PMCID: PMC8828651 DOI: 10.3389/fpubh.2021.801307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 12/30/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND This study examines the effect of social engagement on urban-rural disparities in self-management behaviors (medication use, self-monitoring, physical activity, and tobacco and alcohol avoidance) among middle-aged and older Chinese patients with hypertension. METHODS Data from 2011 to 2018 were extracted from the four latest waves of the China Health and Retirement Longitudinal Study. Chi-square tests and t-tests were performed to examine urban-rural gaps in self-management behaviors. Random-effects panel logit regression models were adopted to confirm the effect of social engagement on urban-rural disparity in self-management behaviors and to explore whether this effect has narrowed or widened with "bilateral flow" between urban and rural residents. A Fairlie decomposition technique was also used to calculate the extent to which social engagement reflects urban-rural disparities. RESULTS There was significant urban-rural disparity in medication use and tobacco avoidance behaviors among the sampled patients. Medication use behavior (p < 0.001) among urban middle-aged and older patients was significantly better, whereas tobacco avoidance behavior (p < 0.05) was significantly lower compared with the rural population. Social engagement significantly enlarged the urban-rural gap in tobacco avoidance behavior (p < 0.01), but significantly narrowed the urban-rural gap in medication use behavior (p < 0.001). The Fairlie decomposition revealed that ~75.000% and 29.412% of the explained urban-rural gap in tobacco avoidance and medication use, respectively, could be attributed to social engagement. The negative effect of social engagement on urban-rural disparity in medication use increased when urban residents moved to rural areas (p < 0.05). CONCLUSIONS The urban-rural disparities in self-management behaviors of middle-aged and older Chinese hypertensive patients were mainly manifested in medication use and tobacco avoidance behaviors. The gaps in these two behaviors partly changed with social engagement, while the migration of urban population to rural areas weakens the positive role of social engagement in narrowing the urban-rural gap in medication use behavior. The insights of this paper on social engagement and urban-rural disparity in self-management behaviors, and the effect of urban-rural migration thereof, deserve the attention of health policymakers and researchers.
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Affiliation(s)
- Jiao Lu
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China
| | - Linhui Liu
- School of Management, Shanxi Medical University, Taiyuan, China
| | - Yuan Wang
- School of Management, Shanxi Medical University, Taiyuan, China
| | - Zhongliang Zhou
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China
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Yan C, Liao H, Ma Y, Wang J. Association amongst social support inside or outside the family and depression symptoms: longitudinal study of urban–rural differences in China. Qual Life Res 2022; 31:1677-1687. [DOI: 10.1007/s11136-022-03086-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/07/2022] [Indexed: 11/30/2022]
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18
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Lin H, Xiao S, Shi L, Zheng X, Xue Y, Yun Q, Ouyang P, Wang D, Zhu H, Zhang C. Impact of Multimorbidity on Symptoms of Depression, Anxiety, and Stress in Older Adults: Is There a Sex Difference? Front Psychol 2022; 12:762310. [PMID: 34992564 PMCID: PMC8724032 DOI: 10.3389/fpsyg.2021.762310] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 11/22/2021] [Indexed: 12/25/2022] Open
Abstract
Introduction: Multimorbidity has become a key issue in the health care sector globally, and it can also lead to psychological distress in older adults. This study aimed to assess the impact of multimorbidity on depression, anxiety, and stress symptoms and identify whether there is a sex difference in these associations. Methods: A cross-sectional study using a multistage random sampling method was conducted among 3,266 older adults in China. Multiple linear regression models were used to estimate the independent associations between multimorbidity and depression, anxiety, and stress symptoms. Furthermore, interaction analysis was employed to investigate the interaction effect of multimorbidity and sex on depression, anxiety, and stress symptoms. Results: A total of 3,250 participants aged 60 years and older were included in this study. Our findings suggest that multimorbidity is strongly positively associated with depression, anxiety, and stress symptoms. In addition, the positive relations between multimorbidity and depression, anxiety, and stress symptoms are stronger for older female than male adults. Conclusion: Old adults with multimorbidity are more likely have depression, anxiety, and stress symptoms. This study offers new insight for the mental health from the perspective of multimorbidity among older people, implies that encouraging the accessibility of treatment for multimorbidity in older people with different sex may be effective in promoting mental health in China.
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Affiliation(s)
- Huang Lin
- Shool of Public Health, Southern Medical University, Guangzhou, China.,School of Health Management, Southern Medical University, Guangzhou, China.,The First School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Shujuan Xiao
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Lei Shi
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Xiao Zheng
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Yaqing Xue
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Qilong Yun
- Tandon School of Engineering, New York University, New York, NY, United States
| | - Ping Ouyang
- Department of Health Management, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Dong Wang
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Hong Zhu
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Chichen Zhang
- School of Health Management, Southern Medical University, Guangzhou, China.,Department of Health Management, Nanfang Hospital, Southern Medical University, Guangzhou, China.,Institute of Health Management, Southern Medical University, Guangzhou, China
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Zhang C, Xiao S, Shi L, Xue Y, Zheng X, Dong F, Zhang J, Xue B, Lin H, Ouyang P. Urban-Rural Differences in Patterns and Associated Factors of Multimorbidity Among Older Adults in China: A Cross-Sectional Study Based on Apriori Algorithm and Multinomial Logistic Regression. Front Public Health 2021; 9:707062. [PMID: 34527650 PMCID: PMC8437131 DOI: 10.3389/fpubh.2021.707062] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Accepted: 08/04/2021] [Indexed: 11/17/2022] Open
Abstract
Introduction: Multimorbidity has become one of the key issues in the public health sector. This study aimed to explore the urban–rural differences in patterns and associated factors of multimorbidity in China and to provide scientific reference for the development of health management strategies to reduce health inequality between urban and rural areas. Methods: A cross-sectional study, which used a multi-stage random sampling method, was conducted effectively among 3,250 participants in the Shanxi province of China. The chi-square test was used to compare the prevalence of chronic diseases among older adults with different demographic characteristics. The Apriori algorithm and multinomial logistic regression were used to explore the patterns and associated factors of multimorbidity among older adults, respectively. Results: The findings showed that 30.3% of older adults reported multimorbidity, with significantly higher proportions in rural areas. Among urban older adults, 10 binary chronic disease combinations with strong association strength were obtained. In addition, 11 binary chronic disease combinations and three ternary chronic disease combinations with strong association strength were obtained among rural older adults. In rural and urban areas, there is a large gap in patterns and factors associated with multimorbidity. Conclusions: Multimorbidity was prevalent among older adults, which patterns mainly consisted of two or three chronic diseases. The patterns and associated factors of multimorbidity varied from urban to rural regions. Expanding the study of urban–rural differences in multimorbidity will help the country formulate more reasonable public health policies to maximize the benefits of medical services for all.
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Affiliation(s)
- Chichen Zhang
- School of Health Management, Southern Medical University, Guangzhou, China.,Department of Health Management, Nanfang Hospital, Southern Medical University, Guangzhou, China.,Institute of Health Management, Southern Medical University, Guangzhou, China
| | - Shujuan Xiao
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Lei Shi
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Yaqing Xue
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Xiao Zheng
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Fang Dong
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Jiachi Zhang
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Benli Xue
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Huang Lin
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Ping Ouyang
- Department of Health Management, Nanfang Hospital, Southern Medical University, Guangzhou, China
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