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Sex-specific impacts of social isolation on loneliness, depressive symptoms, cognitive impairment, and biomarkers: Results from the social environment and biomarker of aging study. Arch Gerontol Geriatr 2023; 106:104872. [PMID: 36493576 DOI: 10.1016/j.archger.2022.104872] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 11/03/2022] [Accepted: 11/19/2022] [Indexed: 11/21/2022]
Abstract
OBJECTIVES To investigate sex-specific associations between social isolation and psychological outcomes and biomarkers among community-dwelling middle-aged and older adults using a nationally representative population-based cohort study. METHODS Data from 757 participants from the Social Environment and Biomarkers of Aging Study (SEBAS) were retrieved for analysis, and all participants were stratified by sex. The associations between social isolation and psychological outcomes (loneliness, depressive symptoms, and cognitive impairment) at the 4-year follow-up were examined by multivariate logistic regression models, and associations between social isolation and biomarkers at the 4-year follow-up were examined by multivariate generalized linear models (GLMs). RESULTS For men, social isolation was not associated with the development of loneliness. However, being married (adjusted odds ratio (aOR) 0.32 [95% confidence interval (CI) 0.13-0.74], p<0.001) was associated with a lower risk of loneliness, indicating potential protective effects of marriage for men. On the other hand, social isolation was associated with a 2-fold higher risk of loneliness in women (aOR 2.26 [1.01-5.09], p<0.001). Social isolation was not associated with depressive symptoms after adjusting for other demographics. For men, being married (aOR 0.51 [0.26-0.99], p<0.05) or having good self-reported health (aOR 0.44 [0.21-0.92], p<0.05) was protective against depressive symptoms. For women, only good self-reported health (aOR 0.30 [0.13-0.70], p<0.01) provided protective effects against depressive symptoms. Similarly, other demographic factors (being married and having a higher educational level) but not social isolation were associated with lower risks of cognitive impairment. No significant associations were noted between social isolation and selected biomarkers. CONCLUSIONS Sex-different associations between social isolation and loneliness were noted; the effects of demographic factors, such as being married, self-reported health status, and high education levels, on subsequent loneliness, depression, and cognitive function were also sex-different. Further intervention studies are needed to explore sex-specific approaches to deal with the interplay of social isolation, loneliness, psychological outcomes and other demographic factors.
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Associations of Cardiovascular Agents and Metformin with Depression Symptoms: A Cross-Sectional Analysis from the HUNT Study, Norway. Drugs Real World Outcomes 2022; 9:503-516. [PMID: 35856136 PMCID: PMC9392672 DOI: 10.1007/s40801-022-00321-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/22/2022] [Indexed: 10/28/2022] Open
Abstract
BACKGROUND Cardiovascular agents, including angiotensin-converting enzyme inhibitors, angiotensin II receptor inhibitors, acetylsalicylic acid, statins, and metformin, have demonstrated benefits for depression. However, there is scant evaluation of these drugs' antidepressant properties in large population settings. OBJECTIVE This study aimed to examine cross-sectional associations between depression symptoms and the use of cardiovascular agents and metformin in populations with cardiovascular diseases or diabetes mellitus. METHODS Participants in the Trøndelag Health Study 2006-08 (HUNT3, n = 40,516) and 2017-19 (HUNT4, n = 42,103) were included and data on their drug use from 2006 to 2019 was retrieved from the Norwegian Prescription Database. The outcome was self-reported depression symptoms defined by the Hospital Anxiety and Depression Scale. Associations between cardiovascular agents or metformin use and self-reported depression were analyzed by multi-level logistic regression in sex-stratified samples. RESULTS Among men with cardiovascular diseases, use of acetylsalicylic acid was associated with reduced depression symptoms compared with acetylsalicylic acid non-users (reference) in HUNT3 and HUNT4 [risk ratio = 0.76; 95% confidence interval 0.59-0.94, risk ratio = 0.67; 95% CI 0.52-0.82, respectively]. Similarly, male statin users had a lower likelihood of reporting depression than statin non-users in HUNT3 (risk ratio = 0.70; 95% confidence interval 0.54-0.86) and HUNT4 (risk ratio = 0.67; 95% confidence interval 0.51-0.84). Associations between statins or acetylsalicylic acid use and reduced depression symptoms were detected in women with cardiovascular diseases in HUNT4. We found no statistical support for associations between other cardiovascular agents or metformin use and a reduced or increased depression symptom risk. CONCLUSIONS Results suggest negative associations between acetylsalicylic acid or statin use and depression symptoms. However, longitudinal cohort studies and randomized controlled trials are required to confirm the antidepressant effects of these drugs.
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Abstract
Objective: Cardiovascular diseases are associated with an increased risk of depression, but it remains unclear whether treatment with cardiovascular agents decreases or increases this risk. The effects of drugs on individual usage are also often unknown. This review aimed to examine the correlation between depression and common cardiovascular drugs, develop more potent interventions for depression in cardiovascular patients, and further research on the bio-behavioural mechanisms linking cardiovascular drugs to depression. Data sources: The data in this review were obtained from articles included in PubMed, EMBASE, and Web of Science. Study selection: Clinical trials, observational studies, review literature, and guidelines about depression and cardiovascular drugs were selected for the article. Results: We systematically investigated whether the seven most used cardiovascular drugs were associated with altered risk of incident depression in this literature review. Statins have been proven to have antidepressant effects. Some studies believe angiotensin-converting enzyme inhibitors (ACEIs)/angiotensin receptor blocker (ARB) can exert an antidepressant influence by acting on the renin-angiotensin system, but further clinical trials are needed to confirm this. Beta-blockers have previously been associated with depression, but the current study found no significant association between beta blockers and the risk of depression. Aspirin may have antidepressant effects by suppressing the immune response, but its role as an antidepressant remains controversial. calcium channel blockers (CCBs) can regulate nerve signal transduction by adjusting calcium channels, but whether this effect is beneficial or harmful to depression remains unclear. Finally, some cases have reported that nitrates and diuretics are associated with depression, but the current clinical evidence is insufficient. Conclusions: Statins have been proven to have antidepressant effect, and the antidepressant effects of ACEIs/ARB and aspirin are still controversial. CCBs are associated with depression, but it is unclear whether it is beneficial or harmful. No association has been found with β-blockers, diuretics, and nitrates.
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De Giorgi R, Rizzo Pesci N, Quinton A, De Crescenzo F, Cowen PJ, Harmer CJ. Statins in Depression: An Evidence-Based Overview of Mechanisms and Clinical Studies. Front Psychiatry 2021; 12:702617. [PMID: 34385939 PMCID: PMC8353114 DOI: 10.3389/fpsyt.2021.702617] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 06/29/2021] [Indexed: 12/19/2022] Open
Abstract
Background: Depression is a leading cause of disability, burdened by high levels of non-response to conventional antidepressants. Novel therapeutic strategies targeting non-monoaminergic pathways are sorely needed. The widely available and safe statins have several putative mechanisms of action, especially anti-inflammatory, which make them ideal candidates for repurposing in the treatment of depression. A large number of articles has been published on this topic. The aim of this study is to assess this literature according to evidence-based medicine principles to inform clinical practise and research. Methods: We performed a systematic review of the electronic databases MEDLINE, CENTRAL, Web of Science, CINAHL, and ClinicalTrials.gov, and an unstructured Google Scholar and manual search, until the 9th of April 2021, for all types of clinical studies assessing the effects of statins in depression. Results: Seventy-two studies were retrieved that investigated the effects of statins on the risk of developing depression or on depressive symptoms in both depressed and non-depressed populations. Fifteen studies specifically addressed the effects of statins on inflammatory-related symptoms of anhedonia, psychomotor retardation, anxiety, and sleep disturbances in depression. Most studies suggested a positive effect of statins on the occurrence and severity of depression, with fewer studies showing no effect, while a minority indicated some negative effects. Limitations: We provide a narrative report on all the included studies but did not perform any quantitative analysis, which limits the strength of our conclusions. Conclusions: Robust evidence indicates that statins are unlikely to lead to depressive symptoms in the general population. Promising data suggest a potential role for statins in the treatment of depression. Further clinical studies are needed, especially in specific subgroups of patients identified by pre-treatment assessments of inflammatory and lipid profiles.
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Affiliation(s)
- Riccardo De Giorgi
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, United Kingdom
- Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, United Kingdom
| | - Nicola Rizzo Pesci
- Department of Neurosciences “Rita Levi Montalcini,” San Luigi Gonzaga University Hospital, University of Turin, Turin, Italy
| | - Alice Quinton
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, United Kingdom
- Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, United Kingdom
| | - Franco De Crescenzo
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, United Kingdom
- Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, United Kingdom
| | - Philip J. Cowen
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, United Kingdom
- Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, United Kingdom
| | - Catherine J. Harmer
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, United Kingdom
- Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, United Kingdom
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Depression prevalence among diabetic patients and comparison of demographics and complications. JOURNAL OF SURGERY AND MEDICINE 2021. [DOI: 10.28982/josam.857193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Mulchandani R, Lyngdoh T, Kakkar AK. Statin use and safety concerns: an overview of the past, present, and the future. Expert Opin Drug Saf 2020; 19:1011-1024. [PMID: 32668998 DOI: 10.1080/14740338.2020.1796966] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 07/13/2020] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Dyslipidemia is a significant risk factor for cardiovascular disorders and contributes to significant morbidity and mortality associated with CAD and stroke worldwide. Statins are the most commonly prescribed drugs for the prevention and management of dyslipidemia globally. Although they provide immense therapeutic benefit, they are associated with clinically significant adverse effects, predominantly muscle, nerve, liver, and cognition-related besides new-onset diabetes. This has sparked various controversies, bringing to the fore, ambiguities that continue to exist in the scientific evidence, in relation to statin-associated harms. Therefore, it becomes essential to have a better understanding of safety issues related to statin use in various populations. AREAS COVERED This review describes the most common adverse effects of statins, examines available evidence and highlights the role of ethnicity, lipophilicity and other biological factors that could mediate and/or influence the relationship. MEDLINE was searched via PubMed to obtain relevant articles on dyslipidemia and statin safety. EXPERT OPINION The effectiveness of statins is presently unmatched. Further research is warranted to gain insights into the diverse pharmacological effects of statins in various population subgroups. This would assist prescribers in making better informed decisions. Specific treatment strategies for vulnerable groups can significantly attenuate harms, improve risk-benefit ratios, and ultimately enhance patient experience.
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Affiliation(s)
- Rubina Mulchandani
- Indian Institute of Public Health-Delhi, Public Health Foundation of India , Gurgaon, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad - 201002, India
| | - Tanica Lyngdoh
- Indian Institute of Public Health-Delhi, Public Health Foundation of India , Gurgaon, India
| | - Ashish Kumar Kakkar
- Department of Pharmacology, Postgraduate Institute of Medical Education and Research , Chandigarh, India
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Agustini B, Lotfaliany M, Woods RL, McNeil JJ, Nelson MR, Shah RC, Murray AM, Ernst ME, Reid CM, Tonkin A, Lockery JE, Williams LJ, Berk M, Mohebbi M. Patterns of Association between Depressive Symptoms and Chronic Medical Morbidities in Older Adults. J Am Geriatr Soc 2020; 68:1834-1841. [PMID: 32402115 DOI: 10.1111/jgs.16468] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 03/18/2020] [Accepted: 03/22/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVES To investigate the association between depressive symptoms and several medical morbidities, and their combination, in a large older population. DESIGN Cross-sectional study of baseline data from the ASPirin in Reducing Events in the Elderly (ASPREE) trial. SETTING Multicentric study conducted in Australia and the United States. PARTICIPANTS A total of 19,110 older adults (mean age = 75 years [standard deviation = ±4.5]). MEASUREMENTS Depressive symptoms were measured using the Center for Epidemiological Studies Depression (CES-D 10) scale. Medical morbidities were defined according to condition-specific methods. Logistic regression was used to calculate odds ratios (ORs) with 95% confidence intervals (CIs) to test associations before and after accounting for possible confounders. RESULTS Depressive symptoms were significantly associated with obesity (OR = 1.19; 95% CI = 1.07-1.32), diabetes (OR = 1.22; 95% CI = 1.05-1.42), gastroesophageal reflux disease (GERD) (OR = 1.41; 95% CI = 1.28-1.57), metabolic syndrome (OR = 1.16; 95% CI = 1.03-1.29), osteoarthritis (OR = 1.41; 95% CI = 1.27-1.57), respiratory conditions (OR = 1.25; 95% CI = 1.10-1.42), history of cancer (OR = 1.19; 95% CI = 1.05-1.34), Parkinson's disease (OR = 2.56; 95% CI = 1.83-3.56), polypharmacy (OR = 1.60; 95% CI = 1.44-1.79), and multimorbidity (OR = 1.29; 95% CI = 1.12-1.49). No significant association was observed between depressive symptoms and hypertension, chronic kidney disease, dyslipidemia, and gout (P > .05). A significant dose-response relationship was evident between the number of medical comorbidities and the prevalence of depression (OR = 1.18; 95% CI = 1.13-1.22). CONCLUSION Late-life depressive symptoms are significantly associated with several medical morbidities, and there appears to be a cumulative effect of the number of somatic diseases on the prevalence of depression. These findings augment the evidence for a complex relationship between mental and physical health in an otherwise healthy older population and might guide clinicians toward early recognition of high-risk individuals. J Am Geriatr Soc 68:1834-1841, 2020.
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Affiliation(s)
- Bruno Agustini
- School of Medicine, IMPACT the Institute for Mental and Physical Health and Clinical Translation, Barwon Health, Deakin University, Geelong, Victoria, Australia
| | | | - Robyn L Woods
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - John J McNeil
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Mark R Nelson
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Raj C Shah
- Department of Family Medicine and Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA
| | - Anne M Murray
- Berman Center for Outcomes and Clinical Research, Hennepin Healthcare Research Institute, Hennepin Healthcare, Minneapolis, Minnesota, USA
| | - Michael E Ernst
- Department of Pharmacy Practice and Science, College of Pharmacy; and, Department of Family Medicine, Carver College of Medicine, The University of Iowa, Iowa, Iowa, USA
| | - Christopher M Reid
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.,School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Andrew Tonkin
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Jessica E Lockery
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Lana J Williams
- School of Medicine, IMPACT the Institute for Mental and Physical Health and Clinical Translation, Barwon Health, Deakin University, Geelong, Victoria, Australia
| | - Michael Berk
- School of Medicine, IMPACT the Institute for Mental and Physical Health and Clinical Translation, Barwon Health, Deakin University, Geelong, Victoria, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.,Department of Psychiatry, Orygen, the National Centre of Excellence in Youth Health, and the Florey Institute for Neuroscience and Mental Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Mohammadreza Mohebbi
- School of Medicine, IMPACT the Institute for Mental and Physical Health and Clinical Translation, Barwon Health, Deakin University, Geelong, Victoria, Australia.,Biostatistics Unit, Deakin University, Geelong, Victoria, Australia
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Han J, Jia P, Huang Y, Gao B, Yu B, Yang S, Yu J, Xiong J, Liu C, Xie T, Dong P, Yang C, Wang Z, Yang S. Association between social capital and mental health among older people living with HIV: the Sichuan Older HIV-Infected Cohort Study (SOHICS). BMC Public Health 2020; 20:581. [PMID: 32345273 PMCID: PMC7189431 DOI: 10.1186/s12889-020-08705-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Accepted: 04/14/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Mental health problems are common among older people living with HIV and associated with poorer health outcomes. Social capital is an important determinant of mental health problems but under-studied in this population. This study investigated the association between social capital and mental health problems among older people living with HIV in China. METHODS The study was based on the baseline data of a cohort study investigating mental health among older people living with HIV in Sichuan, China during November 2018 to February 2019. Participants were people living with HIV aged ≥50 years living in Sichuan province. Stratified multi-stage cluster sampling was used to recruit participants from 30 communities/towns; 529 out of 556 participants being approached completed the face-to-face interview. Social capital was measured by two validated health-related social capital scales: the Individual and Family scale and the Community and Society scale. Presence of probable depression (CES-D-10 score ≥ 10) and probable anxiety (GAD-7 score ≥ 5) were used as dependent variables. Two-level logistic regression models were applied to examine the association between social capital and probable depression/anxiety. RESULTS The prevalence of probable depression and probable anxiety was 25.9% (137/529) and 36.3% (192/529), respectively. After adjusting for significant covariates, the individual/family level of social capital was inversely associated with both probable depression (odds ratios (OR): 0.89, 95% CI: 0.84-0.93, p < 0.001) and probable anxiety (OR: 0.90, 95% CI: 0.86-0.95, p < 0.001). The community/society level social capital was associated with probable depression (OR: 0.91, 95% CI: 0.84-0.99, p < 0.001) but not probable anxiety (p > 0.05). CONCLUSIONS Interventions building up social capital should be considered to improve mental health of older people living with HIV. Some useful strategies include cognitive processing therapy, improving community networking and engagement, and promoting social bonding with neighborhood.
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Affiliation(s)
- Jiayu Han
- Department of Health Related Social and Behavioral Science, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Peng Jia
- Department of Land Surveying and Geo-Informatics, The Hong Kong Polytechnic University, Hong Kong, China
- International Initiative on Spatial Lifecourse Epidemiology (ISLE), Hong Kong, China
| | - Yuling Huang
- Sichuan Center for Disease Control and Prevention, Chengdu, China
| | - Bo Gao
- Department of Health Related Social and Behavioral Science, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Bin Yu
- Department of Health Related Social and Behavioral Science, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Shifan Yang
- Department of Health Related Social and Behavioral Science, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Jun Yu
- Lu County Center for Disease Control and Prevention, Luzhou, China
| | - Jun Xiong
- Lu County Center for Disease Control and Prevention, Luzhou, China
| | - Chang Liu
- Lu County Center for Disease Control and Prevention, Luzhou, China
| | - Tian Xie
- Pidu District Center for Disease Control and Prevention, Chengdu, China
| | - Peijie Dong
- Department of Health Related Social and Behavioral Science, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Chao Yang
- Department of epidemiology and statistics, School of Public Health, Southwest Medical University, Luzhou, China
| | - Zixin Wang
- Centre for Health Behaviours Research, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Shujuan Yang
- Department of Health Related Social and Behavioral Science, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
- International Initiative on Spatial Lifecourse Epidemiology (ISLE), Hong Kong, China
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