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Kuang J, Zhang W, Zhang H, Lin N, Fang J, Song R, Xin Z, Wang J. Psychosocial Clusters and Their Associations with Depression, Anxiety and Stress Among Older Adults in Shanghai Communities: Results from a Longitudinal Study. Psychol Res Behav Manag 2024; 17:2701-2716. [PMID: 39051015 PMCID: PMC11268742 DOI: 10.2147/prbm.s464848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Accepted: 06/18/2024] [Indexed: 07/27/2024] Open
Abstract
Purpose Psychosocial factors have been found to profoundly impact mental health of older adults, but the main focus in the current literature has been on one particular aspect of these factors. This study aimed to identify latent classes of older adults based on four psychosocial factors (loneliness, social isolation, perceived social support, and social capital) and the transition of classes over 6 months. We also sought to assess the predictive role of changes in these classes in relation to depression, anxiety, and stress at 18-month follow-up. Methods We analyzed longitudinal data from 581 community-dwelling older adults in Shanghai, China. The data were collected at baseline (T0), 6-month follow-up (T1) and 18-month follow-up (T2) between March 2021 and April 2023. Using latent class analysis, we identified three underlying classes (Social Connectors, Subjective Social Isolates, and Social Isolates) of the sample. We also established five transition categories from T0 to T1 (Social Connectors T0-T1, Subjective Social Isolates T0-T1, Social Isolates T0-T1, Good Transition, and Bad Transition) using latent transition analysis. Logistic regression was employed to examine the temporal relationships between these transition categories and subsequent symptoms of depression, anxiety and stress, adjusting for age, sex, education, marital status, family income level, sleep quality, health status and outcome variables at T0. Results Multivariable associations revealed that compared to older adults with persistent good social environment (Social Connectors T0-T1), those with persistent high levels of loneliness and social isolation and low levels of perceived social support and social capital (Social Isolates T0-T1), and those who shifted towards a poorer social environment (Bad Transition) were more likely to experience depression, anxiety and stress at T2. Sustained subjective social isolation (Subjective Social Isolates T0-T1) was associated with more severe depressive symptoms at T2. Conclusion Our study indicated that adverse psychosocial environment worsened mental health in older adults. These findings highlight the importance of early identification of older individuals at long-term psychosocial risk and development of tailored interventions to improve their social environment and mental health.
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Affiliation(s)
- Jiawen Kuang
- School of Public Health; NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, People’s Republic of China
| | - Wei Zhang
- School of Public Health; NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, People’s Republic of China
| | - Haoran Zhang
- Lingqiao Community Health Center, Pudong New Area, Shanghai, People’s Republic of China
| | - Nan Lin
- School of Public Health; NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, People’s Republic of China
| | - Jialie Fang
- Jing’an District Center for Disease Control and Prevention, Shanghai, People’s Republic of China
| | - Rui Song
- Xiaodongmen Subdistrict Community Health Center, Huangpu District, Shanghai, People’s Republic of China
| | - Zhaohua Xin
- Lingqiao Community Health Center, Pudong New Area, Shanghai, People’s Republic of China
| | - Jingyi Wang
- School of Public Health; NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, People’s Republic of China
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Koppner J, Lindelöf A, Iredahl F, Tevell M, Nilsson S, Thorsell A, Faresjö Å, Israelsson Larsen H. Factors affecting self-perceived mental health in the general older population during the COVID-19 pandemic: a cross-sectional study. BMC Public Health 2024; 24:660. [PMID: 38429704 PMCID: PMC10905926 DOI: 10.1186/s12889-024-18199-1] [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: 12/23/2023] [Accepted: 02/23/2024] [Indexed: 03/03/2024] Open
Abstract
BACKGROUND Mental health problems among older people are large public health concerns but often go unrecognized and undertreated. During COVID - 19 several restrictions regarding social contacts were launched, primarily for the old. The objective of this study is to investigate which factors that had the main negative affect on mental health in the older population during the pandemic. METHOD A cross-sectional cohort study set in Swedish primary care during the pandemic years 2021-2022. The population constitutes of 70-80-years-old, N = 260. Instruments used are Geriatric depression scale 20 (GDS20); Hospital anxiety and depression scale (HADS), and Perceived stress scale 10 (PSS10). Sociodemography and risk factors are explored. Outcome measures are factors independently associated with decreased mental health. Analyses were performed for the group as a whole and with logistic regression models comparing individuals who stated they were mentally affected by the pandemic to individuals who stated they were not. RESULTS Participants who stated they were mentally affected by the COVID - 19 pandemic reported significantly higher levels of anxiety (p < 0.001), depression (p < 0.001), and stress (p = 0.026) compared to those who stated they were not mentally affected. Explanatory regression models of up to 50% showed that following factors were prominent among individuals who reported a decline in their mental health due to the COVID - 19 pandemic (n = 24); impaired social life (OR 20.29, p < 0.001, CI 4.53-90.81), change in physical activity (OR 5.28, p = 0.01, CI 1.49-18.72), perceived family situation (OR 31.90, p = 0,007, CI 2,53-402.42), mild/moderate and high anxiety (OR 4.94, p = 0.034, CI 1.13-21.60, OR 7.96, p = 0.035, CI 1.16-54.53 respectively), and female gender (OR 6.52, p = 0.029, CI 1.22-34.92). CONCLUSION Anxiety, family situation, social life and change in physical activity were the main factors influencing the 70-80-years-old's self-perceived mental health during the COVID - 19 pandemic. Long-term effects of social restrictions on mental health in the older population need to be further investigated.
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Affiliation(s)
- Jenny Koppner
- Department of Health, Medicine and Caring Sciences, Division of General practice, Linköping University, Linköping, Sweden.
| | - Ann Lindelöf
- Department of Health, Medicine and Caring Sciences, Division of General practice, Linköping University, Linköping, Sweden
| | - Fredrik Iredahl
- Department of Health, Medicine and Caring Sciences, Division of General practice, Linköping University, Linköping, Sweden
| | - Maxine Tevell
- Department of Health, Medicine and Caring Sciences, Division of General practice, Linköping University, Linköping, Sweden
| | - Staffan Nilsson
- Department of Health, Medicine and Caring Sciences, Division of General practice, Linköping University, Linköping, Sweden
| | - Annika Thorsell
- Department of Biomedical and Clinical Sciences/Center for Social and Affective Neuroscience, Medicine, Linköping University, Linköping, Sweden
| | - Åshild Faresjö
- Department of Health, Medicine and Caring Sciences, Division of Society and Health/Public Health, Linköping University, Linköping, Sweden
| | - Hanna Israelsson Larsen
- Department of Health, Medicine and Caring Sciences, Division of General practice, Linköping University, Linköping, Sweden
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Ni Y, Li S, Lv X, Wang Y, Xu L, Xi Y, Sun Y, Bao J, Liao S, Li Y. Efficacy of sensory-based static balance training on the balance ability, aging attitude, and perceived stress of older adults in the community: a randomized controlled trial. BMC Geriatr 2024; 24:49. [PMID: 38212725 PMCID: PMC10782606 DOI: 10.1186/s12877-023-04596-5] [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: 06/26/2023] [Accepted: 12/13/2023] [Indexed: 01/13/2024] Open
Abstract
BACKGROUND This study explores the effect of sensory-based static balance training on the balance ability, aging attitude, and perceived stress of older adults in the community. It provides a practical basis for the in-depth implementation and revision of the community health management model. METHODS A randomized controlled intervention study was conducted from 2022 to 2023. A total of 72 older adults were recruited and randomly divided into an intervention group (36 individuals) and a control group (36 individuals). Balance ability (measured by the Short Physical Performance Battery and One Leg Stand Test), aging attitudes, and perceived stress were assessed at baseline and at the 12-week and 24-week follow-ups. Repeated-measures ANOVA and generalized estimating equations were used to compare outcome measures. RESULTS Sensory-based static balance training was beneficial for balance ability and aging attitude among participants in the intervention group. At the end of the intervention, participants in the intervention group showed significant improvements in SPPB scores and OLST scores compared with the control group (FSPPB = 12.347, P = 0.001, Waldχ2OLST = 45.530, P < 0.001), as well as significant differences in aging attitudes (FAAQ = 18.549, P < 0.001). Multiple comparisons at different time points in the intervention group reveal a significant intervention effect (FSPPB = 29.211, Waldχ2OLST = 80.428, FAAQ = 45.981, all P < 0.05). However, the difference in perceived stress before and after the intervention was not significant (FCPSS = 2.876, P = 0.095). CONCLUSIONS Sensory-based static balance training significantly improved balance ability and aging attitudes among older adults in the community. The effect on perceived stress among older adults in the community was not significant. TRIAL REGISTRATION Registered in the Chinese Clinic on 04/06/2022. The registration number is ChiCTR2200060541.
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Affiliation(s)
- Yingyuan Ni
- Department of Nursing, College of Medical Science, Huzhou University, No. 759 Second Ring Road, Huzhou City, Zhejiang Province, 313000, China
| | - Shasha Li
- Department of Nursing, College of Medical Science, Huzhou University, No. 759 Second Ring Road, Huzhou City, Zhejiang Province, 313000, China.
| | - Xiaoying Lv
- Department of Nursing, Huzhou Central Hospital, No. 1558 Sanhuan North Road, Wuxing District, Huzhou, Zhejiang, 313000, China
| | - Yuecong Wang
- Department of Nursing, College of Medical Science, Huzhou University, No. 759 Second Ring Road, Huzhou City, Zhejiang Province, 313000, China
| | - Lijun Xu
- Department of Nursing, College of Medical Science, Huzhou University, No. 759 Second Ring Road, Huzhou City, Zhejiang Province, 313000, China
| | - Yingxue Xi
- Department of Nursing, College of Medical Science, Huzhou University, No. 759 Second Ring Road, Huzhou City, Zhejiang Province, 313000, China
| | - Yanhua Sun
- Department of Nursing, Huzhou Central Hospital, No. 1558 Sanhuan North Road, Wuxing District, Huzhou, Zhejiang, 313000, China
- Department of Orthopedics, Huzhou Central Hospital, Huzhou, No. 1558 Sanhuan North Road, Wuxing District, Zhejiang, 313000, China
| | - Jianyi Bao
- Department of Nursing, College of Medical Science, Huzhou University, No. 759 Second Ring Road, Huzhou City, Zhejiang Province, 313000, China
| | - Shufang Liao
- Department of Nursing, College of Medical Science, Huzhou University, No. 759 Second Ring Road, Huzhou City, Zhejiang Province, 313000, China
| | - Yue Li
- Department of Nursing, College of Medical Science, Huzhou University, No. 759 Second Ring Road, Huzhou City, Zhejiang Province, 313000, China
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Ruan J, Xu YM, Zhong BL. Loneliness in older Chinese adults amid the COVID-19 pandemic: Prevalence and associated factors. Asia Pac Psychiatry 2023; 15:e12543. [PMID: 37562972 DOI: 10.1111/appy.12543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 06/19/2023] [Accepted: 07/29/2023] [Indexed: 08/12/2023]
Abstract
INTRODUCTION Data on loneliness among older adults in China during the COVID-19 pandemic are still scarce. This study aimed to examine the prevalence of loneliness and identify its associated factors among older Chinese adults during the COVID-19 pandemic. METHODS During the COVID-19 pandemic, 1268 older Chinese adults (aged 50+ years) were recruited through snowball sampling. The Chinese version of the validated six-item De Jong Gierveld Loneliness Scale was used to assess participants' recent feelings of loneliness, and a cut-off score of two or more was used to indicate the presence of loneliness. RESULTS Loneliness was experienced by 37.9% of the participants in recent days. Factors significantly associated with loneliness included male sex (vs. female, OR: 1.62, p < .001), an education level of middle school and below (vs. college and above, OR: 1.50, p = .007), residing in the COVID-19 epicenter (vs. other provinces, OR: 1.48, p = .004), concern about contracting COVID-19 (OR: 1.68, p = .001), poor knowledge of COVID-19 (OR: 2.39, p = .012), and physical health problems (OR: 1.65, p < .001). DISCUSSION Loneliness is common among older Chinese adults amid the COVID-19 pandemic. Targeted intervention programs may be more effective in reducing loneliness among older adults who are worried about contracting COVID-19, have poor COVID-19 knowledge, and experience physical health problems.
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Affiliation(s)
- Juan Ruan
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, China
- Center for Psychological Consultation and Therapy, Wuhan Hospital for Psychotherapy, Wuhan, China
| | - Yan-Min Xu
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, China
- Center for Psychological Consultation and Therapy, Wuhan Hospital for Psychotherapy, Wuhan, China
| | - Bao-Liang Zhong
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, China
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