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Cohen G, Rowland ST, Benavides J, Lindert J, Kioumourtzoglou MA, Parks RM. Daily temperature variability and mental health-related hospital visits in New York State. ENVIRONMENTAL RESEARCH 2024; 257:119238. [PMID: 38815717 DOI: 10.1016/j.envres.2024.119238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 05/11/2024] [Accepted: 05/25/2024] [Indexed: 06/01/2024]
Abstract
BACKGROUND Despite plausible behavioral and physiological pathways, limited evidence exists on how daily temperature variability is associated with acute mental health-related episodes. OBJECTIVES We aimed to explore associations between daily temperature range (DTR) and mental health-related hospital visits using data of all hospital records in New York State during 1995-2014. We further examined factors that may modify these associations, including age, sex, hospital visit type and season. METHODS Using a case-crossover design with distributed lag non-linear DTR terms (0-6 days), we estimated associations between ZIP Code-level DTR and hospital visits for mood (4.6 million hospital visits), anxiety (2.4 million), adjustment (∼368,000), and schizophrenia disorders (∼211,000), controlling for daily mean temperature, via conditional logistic regression models. We assessed potential heterogeneity by age, sex, hospital visit type (in-patient vs. out-patient), and season (summer, winter, and transition seasons). RESULTS For all included outcomes, we observed positive associations from period minimum DTR (0.1 °C) until 25th percentile (5.2 °C) and between mean DTR (7.7 °C) and 90th percentile (12.2 °C), beyond which we observed negative associations. For mood disorders, an increase in DTR from 0.1 °C to 12.2 °C was associated with a cumulative 16.0% increase (95% confidence interval [CI]: 12.8, 19.2%) in hospital visit rates. This increase was highest during transition seasons (32.5%; 95%CI: 26.4, 39.0%) compared with summer (10.7%; 95%CI: 4.8, 16.8%) and winter (-1.6%; 95%CI: -7.6, 4.7%). For adjustment and schizophrenia disorders, the strongest associations were seen among the youngest group (0-24 years) with almost no association in the oldest group (65+ years). We observed no evidence for modification by sex and hospital visit type. DISCUSSION Daily temperature variability was positively associated with mental health-related hospital visits within specific DTR ranges in New York State, after controlling for daily mean temperature. Given uncertainty on how climate change modifies temperature variability, additional research is crucial to comprehend the implications of these findings, particularly under different scenarios of future temperature variability.
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Affiliation(s)
- Gali Cohen
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA; Department of Epidemiology and Preventive Medicine, School of Public Health, Faculty of Medicine, Tel Aviv University, Israel
| | - Sebastian T Rowland
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Jaime Benavides
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Jutta Lindert
- Department of Health and Social Work, University of Applied Sciences Emden, Emden, Germany
| | | | - Robbie M Parks
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA.
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Tang L, Zhang L, Liu Y, Li Y, Yang L, Zou M, Yang H, Zhu L, Du R, Shen Y, Li H, Yang Y, Li Z. Optimal dose and type of exercise to improve depressive symptoms in older adults: a systematic review and network meta-analysis. BMC Geriatr 2024; 24:505. [PMID: 38849780 PMCID: PMC11157862 DOI: 10.1186/s12877-024-05118-7] [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: 12/02/2023] [Accepted: 05/29/2024] [Indexed: 06/09/2024] Open
Abstract
BACKGROUND Depression is a prevalent issue among older adults, affecting their quality of life and overall well-being. Exercise is an effective means of relieving depressive symptoms in older adults, but the optimal dose for different exercise types remains unclear. As such, the aim of this meta-analysis was to examine the dose-response relationship between overall and specific types of exercise with depression symptoms in older adults. METHODS This systematic review and network meta-analysis included a search of PubMed, Medline, Embase, PsycINFO, Cochrane library, and Web of Science for randomized controlled trials of exercise in older adults with depression symptoms from inception to 15 July 2023. Comprehensive data extraction covered dose, treatment regimen, demographics and study duration. Dosage metrics, encompassing METs-min/week, were scrutinized in correlation with the Minimal Clinically Importance Difference (MCID). RESULTS A total of 47 studies involving 2895 participants and 7 kinds of exercise were included in the review. Without considering the dose, the results of our network meta-analysis indicated that Walking was the most effective in alleviating depression in older adults, in addition to Aerobic exercise (AE), Yoga, Qigong, Resistance training (RT), and Tai Chi (TC), which were equally effective. However, the results of the dose-response analysis found that Aerobic exercise was most effective at a dose of 1000 METs-min/week. It is noteworthy that Walking is significantly effective in alleviating depressive symptoms in older adults at very low doses. In terms of clinical benefits, we found that overall exercise doses in the range of 600 ~ 970 METs-min/week were clinically effective. Considering the specific types of exercise, Aerobic exercise, Resistance training, Walking, and Yoga were found to be effective at doses ranging from 820 ~ 1000 METs-min/week, 520 ~ 1000 METs-min/week, 650 ~ 1000 METs-min/week, 680 ~ 1000 METs-min/week, respectively. At the same time, we found that when the age exceeded 81 years, even when participating in exercise, it did not achieve the effect of alleviating depressive symptoms in older adults. CONCLUSIONS In conclusion, including Walking, AE, Yoga, Qigong, RT, and TC, effectively alleviate depressive symptoms in older adults. Furthermore, we established statistically and clinically significant threshold doses for various exercise types. Early initiation of exercise is beneficial, but its efficacy diminishes from the age of 80, and beyond 81, exercise no longer significantly alleviates depressive symptoms.
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Affiliation(s)
- Lili Tang
- Department of Epidemiology, School of Public Health, Beihua University, No. 3999 Binjiang Road, Jilin, 132000, Jilin Province, China
| | - Lin Zhang
- Department of Rehabilitation, West China Hospital Sichuan University Jintang Hospital, Chengdu City, Sichuan Province, China
| | - Yanbo Liu
- The Pathophysiology Department of Basic Medical College, Beihua University, Jilin City, 132000, Jilin Province, China
| | - Yan Li
- Department of Epidemiology, School of Public Health, Beihua University, No. 3999 Binjiang Road, Jilin, 132000, Jilin Province, China
| | - Lijuan Yang
- Basic Medical School Biochemistry, Beihua University, 132000, Jilin City, Jilin Province, China
| | | | - Huiran Yang
- Department of Epidemiology, School of Public Health, Beihua University, No. 3999 Binjiang Road, Jilin, 132000, Jilin Province, China
| | - Lingyu Zhu
- Department of Epidemiology, School of Public Health, Beihua University, No. 3999 Binjiang Road, Jilin, 132000, Jilin Province, China
| | - Ruihong Du
- Department of Epidemiology, School of Public Health, Beihua University, No. 3999 Binjiang Road, Jilin, 132000, Jilin Province, China
| | - Ye Shen
- Department of Epidemiology, School of Public Health, Beihua University, No. 3999 Binjiang Road, Jilin, 132000, Jilin Province, China
| | - Haoyu Li
- Shenyang Railway Disease Control Center, Jilin, Jilin Province, China
| | - Yong Yang
- Institute for Brain Sciences Research, School of Life Sciences, Henan University, Kaifeng, 475001, Henan Province, China
| | - Zhijun Li
- Department of Epidemiology, School of Public Health, Beihua University, No. 3999 Binjiang Road, Jilin, 132000, Jilin Province, China.
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Lin J, Yang H, Zhang Y, Cao Z, Li D, Sun L, Zhang X, Wang Y. Association of time spent in outdoor light and genetic risk with the incidence of depression. Transl Psychiatry 2023; 13:40. [PMID: 36737433 PMCID: PMC9898270 DOI: 10.1038/s41398-023-02338-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 01/24/2023] [Accepted: 01/26/2023] [Indexed: 02/05/2023] Open
Abstract
Depression is the consequence of both environment and genes working together. Genetic factors increase depression risk, but it is unclear whether this association can be offset by time spent in outdoor light. The study was undertaken to investigate the optimal time spent in outdoor light for lowering the risk of depression and the joint association of time spent in outdoor light and depression genetic risk. In UK Biobank, 380,976 depression-free individuals were included in this study. Polygenic risk score (PRS) was categorized into three groups in terms of tertiles. Time spent in outdoor light on a typical day in summer or winter originated from the questionnaire survey. Depression was defined as hospital admission. The potential dose-response relationship between time spent in outdoor light and depression risk was shown by a restricted cubic spline. Data were analyzed using Cox regressions and Laplace regression. After the median follow-up of 12.6 years, 13,636 individuals suffered from depression in the end. A nonlinear (J-shaped relationship) trend was observed between time spent in outdoor light and depression risk. On average, 1.5 h/day of outdoor light was related to the minimum risk of depression. Individuals below and above this optimal time both had elevated depression risk (below, HR = 1.09, 95% CI: 1.02-1.16; above, HR = 1.13, 95% CI: 1.07-1.20), and the time to incident depression were both shortened by 0.46 years (50th percentile differences [PD] = -0.46, 95% CI: -0.78, -0.14) and 0.63 years (50th PD = -0.63, 95% CI: -0.90, -0.35) years, respectively. In a comparison of individuals with the lowest tertile of PRS and average 1.5 h/day outdoor light, the HRs and 95% CIs of depression were 1.36 (1.21-1.53) and 1.43 (1.29-1.58) in those with the highest tertile of PRS and below/above this reference value, respectively. Significant multiplicative interactions were observed between intermediate genetic risks and longer time spent in outdoor light. We found that an average of 1.5 h/day spent in outdoor light was associated with a lower depression risk whatever the degree of depression genetic predisposition. Moderate time spent in outdoor light may contribute to a decreased depression risk even among people with a higher genetic risk of depression.
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Affiliation(s)
- Jing Lin
- School of Public Health, Tianjin Medical University, Tianjin, China
| | - Hongxi Yang
- Department of Bioinformatics, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China
| | - Yuan Zhang
- Raymond G. Perelman Center for Cellular and Molecular Therapeutics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Zhi Cao
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Dun Li
- School of Integrative Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Li Sun
- School of Nursing, Tianjin Medical University, Tianjin, China
| | - Xinyu Zhang
- School of Public Health, Tianjin Medical University, Tianjin, China
| | - Yaogang Wang
- School of Public Health, Tianjin Medical University, Tianjin, China.
- School of Integrative Medicine, Public Health Science and Engineering College, Tianjin University of Traditional Chinese Medicine, Tianjin, China.
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Hwang HJ, Choi YJ, Hong D. The Association between Self-Rated Health Status, Psychosocial Stress, Eating Behaviors, and Food Intake According to the Level of Sunlight Exposure in Korean Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:ijerph20010262. [PMID: 36612583 PMCID: PMC9819439 DOI: 10.3390/ijerph20010262] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 12/17/2022] [Accepted: 12/22/2022] [Indexed: 06/01/2023]
Abstract
Sunlight exposure has been reported to have various beneficial effects on human health. This study investigated the relationship between self-rated health status, psychosocial stress, eating behaviors, and food intake according to sunlight exposure in 948 adults. Sunlight exposure was classified as less than one hour, less than three hours, and greater than three hours. Of the participants, 49.2% had fewer than three hours of daily exposure to sunlight. Regarding participants exposed to sunlight for less than one hour, the largest response was that they did not engage in outdoor activities on weekdays or weekends, and the rate of being outdoors in the shade on sunny days was the highest in this group at 42.7%. Furthermore, the participants exposed to sunlight for less than one hour had a lower health response than the other two groups, and there were significantly more participants classified in the stress risk group. Regarding eating habits, those with less than an hour of exposure to sunlight frequently ate fried foods, fatty foods, added salt, and snacks, and had significantly lower total dietary scores or three regular meals. Additionally, their frequency of consumption of cereals, milk and dairy products, orange juice, and pork was also significantly lower than the other groups. Thus, it is necessary to provide sufficient guidelines for adequate sunlight exposure and food intake because participants with low sunlight exposure may have low vitamin D synthesis and insufficient food intake.
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Affiliation(s)
- Hyo-Jeong Hwang
- Department of Food and Nutrition, Sahmyook University, Seoul 01795, Republic of Korea
| | - Yean-Jung Choi
- Department of Food and Nutrition, Sahmyook University, Seoul 01795, Republic of Korea
| | - Dongwan Hong
- Department of Medical Informatics, College of Medicine, Catholic University of Korea, Seoul 06591, Republic of Korea
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