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Zheng Y, Zhang C, Liu Y. Risk prediction models of depression in older adults with chronic diseases. J Affect Disord 2024; 359:182-188. [PMID: 38768825 DOI: 10.1016/j.jad.2024.05.078] [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: 11/05/2023] [Revised: 05/12/2024] [Accepted: 05/17/2024] [Indexed: 05/22/2024]
Abstract
BACKGROUND Detecting potential depression and identifying the critical predictors of depression among older adults with chronic diseases are essential for timely intervention and management of depression. Therefore, risk prediction models (RPMs) of depression in elderly people should be further explored. METHODS A total of 3959 respondents aged 60 years or over from the wave four survey of the China Health and Retired Longitudinal Study (CHARLS) were included in this study. We used five machine learning (ML) algorithms and three data balancing techniques to construct RPMs of depression and calculated feature importance scores to determine which features are essential to depression. RESULTS The prevalence of depression was 19.2 % among older Chinese adults with chronic diseases in the wave four survey. The random forest (RF) model was more accurate than the other models after balancing the data using the Synthetic Minority Oversampling Technique (SMOTE) algorithm, with an area under the receiver operating characteristic curve (AUROC) and area under the precision-recall curve (AUPRC) of 0.957 and 0.920, respectively, a balanced accuracy of 0.891 and a sensitivity of 0.875. Furthermore, we further identified several important predictors between male and female patients via constructed sex-stratified models. LIMITATIONS Further research on the clinical impact studies of our models and external validation are needed. CONCLUSIONS After several techniques were used to address class imbalance issues, most RPMs achieved satisfactory accuracy in predicting depression among elderly people with chronic diseases. RPMs may thus become valuable screening tools for both older individuals and healthcare practitioners to assess the risk of depression.
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Affiliation(s)
- Ying Zheng
- School of Nursing, Bengbu Medical University, Bengbu, China
| | - Chu Zhang
- School of Nursing, Bengbu Medical University, Bengbu, China
| | - Yuwen Liu
- School of Health Management, Bengbu Medical University, Bengbu, China.
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Niering M, Klass A, Wolf-Belala N, Seifert J. Prevalence, severity, and predictors of self-reported depression in ultra-distance runners: An online survey based on 265 athletes. Injury 2024; 55:111790. [PMID: 39146612 DOI: 10.1016/j.injury.2024.111790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Revised: 07/14/2024] [Accepted: 08/03/2024] [Indexed: 08/17/2024]
Abstract
BACKGROUND Literature suggests a high prevalence of mental health disorders among athletes practicing elite and extreme sports. One of the most commonly encountered disorders in this group of individuals is depression. OBJECTIVE The aim of this study was to examine the prevalence, severity, and risk factors of symptoms of self-reported depression among ultra-distance runners. METHODS Data was collected using an online survey (February to April 2023) and included 265 (age 48.35 ± 10.52 years) adult ultra-runners. The Beck Depression Inventory-II (BDI-II) was used to measure self-reported depression. Additional variables comprised basic sociodemographic information and information regarding training, ultramarathon experience, and previous injury. Descriptive and interferential statistics were performed using JASP Version 0.16.4. RESULTS We found that 21.9 % (n = 58) of ultra-runners suffered from self-reported depression (i.e., BDI-II score ≥ 14) with an average BDI-II score of 22.7 ± 7.1 (moderately severe symptoms). Female ultra-runners had a higher prevalence (30.8 %) of self-reported depression than males (16.2 %, p = .001). Logistic regression revealed that ultra-runners without previous sports injury (p = .01) and those of increasing age (p = .003) had a significantly lower risk of self-reported depression. Similarly, linear regression showed the absence of injury (p < .001) and increasing age (p = .02) resulted in significantly lower BDI-II scores. Training volume in distance and hours per week as well as ultra-running experience did not show any significant association. CONCLUSIONS Affecting more than one-fifth of our collective, depressive symptoms appear to be highly prevalent among ultra-runners. Our findings underline the importance of screening for clinical depression, especially among injured athletes. However, the previously assumed peculiarities of the sport in the area of high training volume do not appear to be a significant factor.
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Affiliation(s)
- Marc Niering
- Institute of Biomechanics and Neuroscience, Nordic Science, Hannover, Germany
| | - Alexander Klass
- Triagon Academy Munich, School of Sports, Psychology and Education, Ismaning, Germany
| | - Nacera Wolf-Belala
- Institute of Biomechanics and Neuroscience, Nordic Science, Hannover, Germany
| | - Johanna Seifert
- Institute of Biomechanics and Neuroscience, Nordic Science, Hannover, Germany; Department of Psychiatry, Social Psychiatry and Psychotherapy, Medical School Hannover, Hannover, Germany.
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Gammoh O, Sayaheen B, Alsous M, Al-Smadi A, Al-Jaidi B, Aljabali AAA. The Prevalence and Correlates of Depression, Anxiety, and Insomnia among Camp Residing Palestinian Women Migrants during the Outbreak of the War on Gaza: A Cross-Sectional Study from Jordan. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:1228. [PMID: 39202508 PMCID: PMC11356496 DOI: 10.3390/medicina60081228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2024] [Revised: 07/26/2024] [Accepted: 07/27/2024] [Indexed: 09/03/2024]
Abstract
Background and Objectives: The current war on the Gaza strip and the circulating violent content is believed to negatively impact the mental health of the Palestinians living in refugee camps outside their homeland. This study explores the prevalence and correlates of depression, anxiety, and insomnia in a cohort of female Palestinian refugees in Jordan who have family members entangled in the persistent conflict in the Gaza strip. Materials and Methods: This cross-sectional study employed validated tools to assess depression, anxiety, and insomnia in women residing in a Gaza camp located in Jerash, Jordan. The correlates were determined by regression analysis. Results: The study unearths disconcerting statistics from 177 recruited women, revealing alarmingly high rates of severe depression (73%), anxiety (60%), and insomnia (65%). Multivariable analysis revealed that severe depression was significantly associated with prior diagnosis with chronic diseases (OR = 3.0, CI = 1.36-6.58), and having a first-degree relative in Gaza (OR = 0.42, CI = 0.20-0.85). Additionally, severe insomnia was associated with "losing relatives or friends in the war" (OR = 3.01, CI = 1.41-6.44), and "losing connection with families and friends" (OR = 3.89, CI = 1.58-9.53). Conclusions: The implications of these results are profound, underscoring the immediate and imperative need for both medical and psychiatric interventions aimed at addressing the substantial psychological burden borne by this population because of the ongoing conflict.
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Affiliation(s)
- Omar Gammoh
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, Yarmouk University, Irbid 21163, Jordan;
| | - Bilal Sayaheen
- Department of Translation, Yarmouk University, Irbid 21163, Jordan;
| | - Mervat Alsous
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, Yarmouk University, Irbid 21163, Jordan;
| | - Ahmed Al-Smadi
- Faculty of Nursing, Al al-Bayt University, Mafraq 25113, Jordan
| | - Bilal Al-Jaidi
- Department of Medicinal Chemistry and Pharmacognosy, Faculty of Pharmacy, Yarmouk University, Irbid 21163, Jordan;
| | - Alaa A. A. Aljabali
- Department of Pharmaceutics and Pharmaceutical Technology, Faculty of Pharmacy, Yarmouk University, Irbid 21163, Jordan;
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Cormier K, Brennan C, Sharma A. Hearing loss and psychosocial outcomes: Influences of social emotional aspects and personality. PLoS One 2024; 19:e0304428. [PMID: 38865302 PMCID: PMC11168651 DOI: 10.1371/journal.pone.0304428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 05/11/2024] [Indexed: 06/14/2024] Open
Abstract
The aim of this study was to examine the effects of social isolation, loneliness, anxiety, depression, higher stress, and memory complaints interacting with personality traits as a function of hearing loss. Personality traits have previously been shown to correlate with anxiety and depression, as well as hearing loss, suggesting an effect of personality on the relationship between social emotional outcomes and hearing loss. A cross-sectional survey including validated screening measures was anonymously administered. Measures included personality (Big Five Index-2 Extra-Short Form), stress (Perceived Stress Scale), anxiety and depression (Patient Health Questionnaire for Depression and Anxiety), loneliness (Three-Item Loneliness Scale), social engagement (Lubben Social Network Scale-6), and self-perceived memory complaints (Subjective Cognitive Function). Eight hundred and ninety-one responses were obtained from adults between the ages of 18 and 90 years old (M = 50 years old). Hearing loss was positively correlated with subjective memory complaints only when not accounting for demographic variables, personality traits, psychosocial outcomes, and social emotional outcomes. There were additive effects of hearing loss and negative emotionality on increases in memory complaints in those who self-identified as maybe having hearing loss. Higher degrees of hearing loss also increased loneliness, with greater hearing loss negating the positive correlation between extraversion and social engagement. Overall, our results suggest that hearing loss significantly interacts with personality traits and other social emotional measures. Our results suggest that the impact of hearing loss on memory complaints, social isolation, and loneliness may differ across patients with hearing loss in comparison with those who think they maybe have hearing loss. Information from this study may provide insights for hearing healthcare and mental healthcare professionals to better serve persons with hearing loss who may require additional support or interventions.
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Affiliation(s)
- Kayla Cormier
- Department of Speech Language and Hearing Sciences, University of Colorado Boulder, Boulder, CO, United States of America
| | - Christine Brennan
- Department of Speech Language and Hearing Sciences, University of Colorado Boulder, Boulder, CO, United States of America
| | - Anu Sharma
- Department of Speech Language and Hearing Sciences, University of Colorado Boulder, Boulder, CO, United States of America
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Mihalache A, Huang RS, Patil NS, Popovic MM, Cruz-Pimentel M, Mallipatna A, Kertes PJ, Muni RH, Kohly RP. Physical and Psychosocial Challenges as Predictors of Vision Difficulty in Children: A Nationally Representative Survey Analysis. Ophthalmic Epidemiol 2024:1-8. [PMID: 38833629 DOI: 10.1080/09286586.2024.2354704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 05/02/2024] [Indexed: 06/06/2024]
Abstract
PURPOSE To elicit associations between vision difficulties and physical or psychosocial challenges in children in the United States. METHODS Children aged 2-17 years old from the 2021 National Health Interview Survey with data pertaining to vision difficulty were included in our retrospective, population-based analysis. Our primary aim was investigating physical and psychosocial challenges as predictors of vision difficulty. Logistic regression models were performed on Stata version 17.0 (StataCorp LLC, College Station, Texas). Analyses were accompanied by an odds ratio (OR) and 95% confidence interval (CI). RESULTS A total of 7,373 children had data pertaining to their level of vision difficulty and were included in our sample. In our multivariable analysis, children with a good/fair (OR = 1.84, 95% CI = [1.31, 2.60], p < 0.01), or poor (OR = 5.08, 95% CI = [1.61, 16.04], p < 0.01) general health status had higher odds of vision difficulty relative to children with an excellent/very good health status. Furthermore, children with difficulties hearing (OR = 8.67, 95% CI = [5.25, 14.31], p < 0.01), communicating (OR = 1.96, 95% CI = [1.18, 3.25], p < 0.01), learning (OR = 1.93, 95% CI = [1.27, 2.93], p < 0.01), and making friends (OR = 1.94, 95% CI = [1.12, 3.36], p = 0.02) had higher odds of vision difficulty. Nonetheless, the following factors were only predictors of vision difficulty in our univariable analysis: requiring equipment for mobility (p < 0.01), experiencing anxiety (p < 0.01), and experiencing depression (p < 0.01). CONCLUSION Several factors pertaining to physical and psychosocial challenges in children are associated with vision difficulty. Future research should further explore potential causal links between vision difficulty and physical or psychosocial factors to aid in coordinating public health efforts dedicated to vision health equity.
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Affiliation(s)
- Andrew Mihalache
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Ryan S Huang
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Nikhil S Patil
- Michael DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Marko M Popovic
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Miguel Cruz-Pimentel
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Ashwin Mallipatna
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
- Department of Ophthalmology, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Peter J Kertes
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
- John and Liz Tory Eye Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Rajeev H Muni
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
- Department of Ophthalmology, St. Michael's Hospital/Unity Health Toronto, Toronto, Ontario, Canada
| | - Radha P Kohly
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
- John and Liz Tory Eye Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
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Tsai Do BS, Bush ML, Weinreich HM, Schwartz SR, Anne S, Adunka OF, Bender K, Bold KM, Brenner MJ, Hashmi AZ, Keenan TA, Kim AH, Moore DJ, Nieman CL, Palmer CV, Ross EJ, Steenerson KK, Zhan KY, Reyes J, Dhepyasuwan N. Clinical Practice Guideline: Age-Related Hearing Loss. Otolaryngol Head Neck Surg 2024; 170 Suppl 2:S1-S54. [PMID: 38687845 DOI: 10.1002/ohn.750] [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: 02/28/2024] [Revised: 03/20/2024] [Accepted: 03/21/2024] [Indexed: 05/02/2024]
Abstract
OBJECTIVE Age-related hearing loss (ARHL) is a prevalent but often underdiagnosed and undertreated condition among individuals aged 50 and above. It is associated with various sociodemographic factors and health risks including dementia, depression, cardiovascular disease, and falls. While the causes of ARHL and its downstream effects are well defined, there is a lack of priority placed by clinicians as well as guidance regarding the identification, education, and management of this condition. PURPOSE The purpose of this clinical practice guideline is to identify quality improvement opportunities and provide clinicians trustworthy, evidence-based recommendations regarding the identification and management of ARHL. These opportunities are communicated through clear actionable statements with explanation of the support in the literature, evaluation of the quality of the evidence, and recommendations on implementation. The target patients for the guideline are any individuals aged 50 years and older. The target audience is all clinicians in all care settings. This guideline is intended to focus on evidence-based quality improvement opportunities judged most important by the guideline development group (GDG). It is not intended to be a comprehensive, general guide regarding the management of ARHL. The statements in this guideline are not intended to limit or restrict care provided by clinicians based on their experience and assessment of individual patients. ACTION STATEMENTS The GDG made strong recommendations for the following key action statements (KASs): (KAS 4) If screening suggests hearing loss, clinicians should obtain or refer to a clinician who can obtain an audiogram. (KAS 8) Clinicians should offer, or refer to a clinician who can offer, appropriately fit amplification to patients with ARHL. (KAS 9) Clinicians should refer patients for an evaluation of cochlear implantation candidacy when patients have appropriately fit amplification and persistent hearing difficulty with poor speech understanding. The GDG made recommendations for the following KASs: (KAS 1) Clinicians should screen patients aged 50 years and older for hearing loss at the time of a health care encounter. (KAS 2) If screening suggests hearing loss, clinicians should examine the ear canal and tympanic membrane with otoscopy or refer to a clinician who can examine the ears for cerumen impaction, infection, or other abnormalities. (KAS 3) If screening suggests hearing loss, clinicians should identify sociodemographic factors and patient preferences that influence access to and utilization of hearing health care. (KAS 5) Clinicians should evaluate and treat or refer to a clinician who can evaluate and treat patients with significant asymmetric hearing loss, conductive or mixed hearing loss, or poor word recognition on diagnostic testing. (KAS 6) Clinicians should educate and counsel patients with hearing loss and their family/care partner(s) about the impact of hearing loss on their communication, safety, function, cognition, and quality of life (QOL). (KAS 7) Clinicians should counsel patients with hearing loss on communication strategies and assistive listening devices. (KAS 10) For patients with hearing loss, clinicians should assess if communication goals have been met and if there has been improvement in hearing-related QOL at a subsequent health care encounter or within 1 year. The GDG offered the following KAS as an option: (KAS 11) Clinicians should assess hearing at least every 3 years in patients with known hearing loss or with reported concern for changes in hearing.
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Affiliation(s)
| | - Matthew L Bush
- University of Kentucky Medical Center, Lexington, Kentucky, USA
| | | | | | | | | | - Kaye Bender
- Mississippi Public Health Association, Jackson, Mississippi, USA
| | | | | | | | | | - Ana H Kim
- Columbia University Medical Center, New York, New York, USA
| | | | - Carrie L Nieman
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | | | | | | | | | - Joe Reyes
- American Academy of Otolaryngology-Head and Neck Surgery Foundation, Alexandria, Virginia, USA
| | - Nui Dhepyasuwan
- American Academy of Otolaryngology-Head and Neck Surgery Foundation, Alexandria, Virginia, USA
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Ashraf F, Mustafa MS, Shafique MA, Haseeb A, Mussarat A, Noorani A, Sohail Rangwala B, Kashif Rasool F, Siddiq MA, Iqbal J. Association between depression and stroke risk in adults: a systematic review and meta-analysis. Front Neurol 2024; 15:1331300. [PMID: 38725648 PMCID: PMC11079212 DOI: 10.3389/fneur.2024.1331300] [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: 11/02/2023] [Accepted: 04/08/2024] [Indexed: 05/12/2024] Open
Abstract
Introduction Stroke is a significant global health concern, and numerous studies have established a link between depression and an increased risk of stroke. While many investigations explore this link, some overlook its long-term effects. Depression may elevate stroke risk through physiological pathways involving nervous system changes and inflammation. This systematic review and meta-analysis aimed to assess the association between depression and stroke. Methodology We conducted a comprehensive search of electronic databases (PubMed, Embase, Scopus, and PsycINFO) from inception to 9 April 2023, following the Preferred Reporting Items for Systemic Review and Meta-analysis (PRISMA) and Meta-analysis Of Observational Studies in Epidemiology (MOOSE) guidelines. We included all articles assessing the association between different stroke types and depression, excluding post-stroke depression. Two investigators independently extracted data and assessed quality using the Newcastle-Ottawa Scale and Cochrane Risk of Bias tool, utilizing a random-effects model for data synthesis. The primary outcome was the association of depression with stroke, with a secondary focus on the association of antidepressants with stroke. Results The initial search yielded 10,091 articles, and 44 studies were included in the meta-analysis. The pooled analysis revealed a significant association between depression and stroke risk, with an overall hazard ratio of 1.41 (95% CI 1.32, 1.50; p < 0.00001), indicating a moderately positive effect size. Subgroup analyses showed consistent associations with ischemic stroke (HR = 1.30, 95% CI 1.13, 1.50; p = 0.007), fatal stroke (HR = 1.39, 95% CI 1.24, 1.55; p < 0.000001), and hemorrhagic stroke (HR = 1.33, 95% CI 1.01, 1.76; p = 0.04). The use of antidepressants was associated with an elevated risk of stroke (HR = 1.28, 95% CI 1.05, 1.55; p = 0.01). Conclusion and relevance This meta-analysis indicates that depression moderately raises the risk of stroke. Given the severe consequences of stroke in individuals with depression, early detection and intervention should be prioritized to prevent it. Systematic review registration Prospero (CRD42023472136).
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Affiliation(s)
- Farheen Ashraf
- Department of Medicine, Jinnah Sindh Medical University, Karachi, Sindh, Pakistan
| | | | | | - Abdul Haseeb
- Department of Medicine, Jinnah Sindh Medical University, Karachi, Sindh, Pakistan
| | - Abdullah Mussarat
- Department of Medicine, Jinnah Sindh Medical University, Karachi, Sindh, Pakistan
| | - Amber Noorani
- Department of Medicine, Jinnah Sindh Medical University, Karachi, Sindh, Pakistan
| | | | | | | | - Javed Iqbal
- Department of Medicine, King Edward Medical University, Lahore, Punjab, Pakistan
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Pengpid S, Peltzer K. Chronic conditions and incident and persistent depressive symptoms among ageing adults in rural South Africa. PSYCHOL HEALTH MED 2024; 29:712-720. [PMID: 36941203 PMCID: PMC10509316 DOI: 10.1080/13548506.2023.2190595] [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: 12/20/2021] [Accepted: 03/07/2023] [Indexed: 03/23/2023]
Abstract
The study aimed to assess associations between chronic diseases and incident and persistent depressive symptoms (DSs) in a cohort study of ageing adults in South Africa. Participants in the baseline survey (in 2014/2015) were 5,059 persons (≥40 years) and at follow-up 4,176 (in 2018/2019). DSs were measured with the Center for Epidemiological Studies Depression scale. Logistic regression was used to estimate the associations between chronic conditions and incident and persistent DS. The prevalence of DS at baseline was 15.5%, incident DS (without DS and/or PTSD at baseline) was 25.1% and persistent DS (DS at both baseline and follow-up) was 4.8%. In unadjusted logistic regression analysis, diabetes had higher odds of incident DS. Participants with baseline heart attack/stroke/angina, dyslipidemia, tuberculosis, chronic bronchitis, kidney disease and three or more chronic conditions had a higher probability of persistent DS. In conclusion, of the eight chronic conditions evaluated, only diabetes (in unadjusted analysis) was associated with incident DS, and five chronic conditions (heart attack/stroke/angina, dyslipidaemia, tuberculosis, chronic bronchitis and kidney disease) and three or more chronic conditions were associated with persistent DS.
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Affiliation(s)
- Supa Pengpid
- Department of Health Education and Behavioral Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand
- Department of Public Health, Sefako Makgatho Health Sciences University, Pretoria, South Africa
- Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | - Karl Peltzer
- Department of Health Education and Behavioral Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand
- Department of Psychology, University of the Free State, Bloemfontein, South Africa
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan
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Bai S, Wang J, Liu J, Miao Y, Zhang A, Zhang Z. Analysis of depression incidence and influence factors among middle-aged and elderly diabetic patients in China: based on CHARLS data. BMC Psychiatry 2024; 24:146. [PMID: 38383298 PMCID: PMC10880197 DOI: 10.1186/s12888-023-05473-6] [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: 04/27/2023] [Accepted: 12/20/2023] [Indexed: 02/23/2024] Open
Abstract
BACKGROUND To investigate the incidence of depression in middle-aged and elderly patients with diabetes in China and the influencing factors to provide a theoretical basis to improve the mental health of middle-aged and elderly patients with diabetes and formulate prevention, control, and intervention strategies. METHODS The sample of this study was obtained from the China Health and Aging Tracking Survey (CHARLS) 2018 survey data, and middle-aged and older patients with diabetes(responding "Yes" to the questionnaire: "Have you ever been told by a doctor that you have diabetes or elevated blood glucose [including abnormal glucose tolerance and elevated fasting glucose]?") aged ≥ 45 years were selected as study subjects (n = 2,613 ). Depressive symptoms of the study subjects were determined using the simplified version of the Depression Scale for Epidemiological Surveys scores(a score ≥ 10 was defined as depression), influence factors were analyzed using binary logistic regression, and proportion of depressive symptoms was standardized using the sex ratio of the seventh census. RESULTS Among the 2,613 middle-aged and elderly patients with diabetes, 1782 (68.2%) had depressive symptoms and 831 (31.8%) had no depressive symptoms. There were 481 (27.0%) patients aged 45-59 years, 978 (54.9%) aged 60-74 years, and 323 (18.1%) aged ≥ 75 years. The depression rate among middle-aged and elderly Chinese patients with diabetes after standardization correction was 67.5%. Binary logistic regression results showed that age, education level, life satisfaction, marital satisfaction, self-rated health grade, somatic pain, visual impairment, physical disability, and the presence of comorbid chronic diseases were factors that influenced the onset of depression in middle-aged and elderly Chinese patients with diabetes (P < 0.05). CONCLUSION According to a survey analysis of the CHARLS 2018 data, depression is influenced by a combination of factors among middle-aged and elderly patients with diabetes in China. Therefore, for this population, targeted prevention and control should be carried out for key populations, such as middle-aged and elderly people, poor physical health, and low life satisfaction and marital satisfaction, from various dimensions (e.g., demographic and sociological factors, physical health status, and life satisfaction and marital satisfaction).
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Affiliation(s)
- Shuo Bai
- Affiliated Hospital of Yangzhou University, Yangzhou, China
- School of Nursing, Yangzhou University, Yangzhou, China
| | - Jinsong Wang
- Affiliated Hospital of Yangzhou University, Yangzhou, China.
- School of Nursing, Yangzhou University, Yangzhou, China.
| | - Jinteng Liu
- School of Nursing, Yangzhou University, Yangzhou, China
| | - Yamin Miao
- School of Nursing, Yangzhou University, Yangzhou, China
| | - Anqi Zhang
- School of Nursing, Yangzhou University, Yangzhou, China
| | - Ziyi Zhang
- School of Nursing, Yangzhou University, Yangzhou, China
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10
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Lin W, Zhang D, Wang Y, Zhang L, Yang J. Analysis of depression status and influencing factors in middle-aged and elderly patients with chronic diseases. Front Psychol 2024; 15:1308397. [PMID: 38434947 PMCID: PMC10904536 DOI: 10.3389/fpsyg.2024.1308397] [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: 10/06/2023] [Accepted: 01/31/2024] [Indexed: 03/05/2024] Open
Abstract
Objectives To explore prevalence of depression and its influencing factors in middle-aged and elderly patients with chronic diseases. Method Data were extracted from the 2018 China Health and Retirement Tracking Survey (CHARLS) for 6,704 middle-aged and elderly patients ≥45 years with chronic diseases. The influencing variables were selected based on LASSO-logistic regression model, and a nomogram was further drawn to visualize regression results. Results Comorbidity between chronic diseases and depression symptoms were detected in 3058 individuals (45.6%). Female, rural, lower education, poor, insomnia, multiple chronic disease, and functional impairment were associated with a higher proportion of depression. Meanwhile, family interaction, intergenerational financial support, social activity intensity, and satisfaction with life can protect against depression. Conclusion Depressive symptoms are common in Chinese older adults with chronic diseases. They need regular assessment and intervention, especially those with multiple diseases, female, rural, alone, impaired, poor sleep, or poor economy. These high-risk elders also need family, medical, and social support and care.
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Affiliation(s)
- Wenjie Lin
- Department of Physician, Community Health Service Center of Shangdu Street, Fuzhou, Fujian, China
| | - Danling Zhang
- Department of Ultrasonography, Fujian Medical University Union Hospital, Fuzhou, China
| | - YiMin Wang
- Department of Basic Surgery, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, Fujian, China
| | - Li Zhang
- Department of Nephrology, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, Fujian, China
| | - Jianchuan Yang
- Department of Ultrasonography, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, Fujian, China
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Triolo F, Vetrano DL, Sjöberg L, Calderón-Larrañaga A, Belvederi Murri M, Fratiglioni L, Dekhtyar S. Somatic disease burden and depression risk in late life: a community-based study. Epidemiol Psychiatr Sci 2024; 33:e6. [PMID: 38327092 PMCID: PMC10894701 DOI: 10.1017/s2045796024000064] [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: 09/19/2023] [Revised: 12/28/2023] [Accepted: 01/15/2024] [Indexed: 02/09/2024] Open
Abstract
AIMS Co-occurring somatic diseases exhibit complex clinical profiles, which can differentially impact the development of late-life depression. Within a community-based cohort, we aimed to explore the association between somatic disease burden, both in terms of the number of diseases and their patterns, and the incidence of depression in older people. METHODS We analysed longitudinal data of depression- and dementia-free individuals aged 60+ years from the population-based Swedish National Study on Aging and Care in Kungsholmen. Depression diagnoses were clinically ascertained following the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Text Revision over a 15-year follow-up. Somatic disease burden was assessed at baseline through a comprehensive list of chronic diseases obtained by combining information from clinical examinations, medication reviews and national registers and operationalized as (i) disease count and (ii) patterns of co-occurring diseases from latent class analysis. The association of somatic disease burden with depression incidence was investigated using Cox models, accounting for sociodemographic, lifestyle and clinical factors. RESULTS The analytical sample comprised 2904 people (mean age, 73.2 [standard deviation (SD), 10.5]; female, 63.1%). Over the follow-up (mean length, 9.6 years [SD, 4 years]), 225 depression cases were detected. Each additional disease was associated with the occurrence of any depression in a dose-response manner (hazard ratio [HR], 1.16; 95% confidence interval [CI]: 1.08, 1.24). As for disease patterns, individuals presenting with sensory/anaemia (HR, 1.91; 95% CI: 1.03, 3.53), thyroid/musculoskeletal (HR, 1.90; 95% CI: 1.06, 3.39) and cardiometabolic (HR, 2.77; 95% CI: 1.40, 5.46) patterns exhibited with higher depression hazards, compared to those without 2+ diseases (multimorbidity). In the subsample of multimorbid individuals (85%), only the cardiometabolic pattern remained associated with a higher depression hazard compared to the unspecific pattern (HR, 1.71; 95% CI: 1.02, 2.84). CONCLUSIONS Both number and patterns of co-occurring somatic diseases are associated with an increased risk of late-life depression. Mental health should be closely monitored among older adults with high somatic burden, especially if affected by cardiometabolic multimorbidity.
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Affiliation(s)
- Federico Triolo
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Davide Liborio Vetrano
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
- Stockholm Gerontology Research Center, Stockholm, Sweden
| | - Linnea Sjöberg
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Amaia Calderón-Larrañaga
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
- Stockholm Gerontology Research Center, Stockholm, Sweden
| | - Martino Belvederi Murri
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Laura Fratiglioni
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
- Stockholm Gerontology Research Center, Stockholm, Sweden
| | - Serhiy Dekhtyar
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
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Smeal MR, Coto J, Prentiss S, Stern T, VanLooy L, Holcomb MA. Cochlear Implant Referral Criteria for the Spanish-Speaking Adult Population. Otol Neurotol 2024; 45:e71-e77. [PMID: 38082461 DOI: 10.1097/mao.0000000000004065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2024]
Abstract
OBJECTIVE To evaluate the effectiveness of the "60/60 Guideline" in a diverse patient population. STUDY DESIGN Retrospective review. SETTING Tertiary referral center. PATIENTS Data were collected for adult patients (18 years and older) who underwent a cochlear implant evaluation (CIE) between January 2016 and March 2021. MAIN OUTCOME MEASURES Development of the "60/60 Guideline" has provided better clarity on when to refer English-speaking patients for a CIE. Our study evaluated the effectiveness of this referral tool in the Spanish-speaking population. RESULTS In our group of patients who underwent a traditional CIE (n = 402), 209 met unaided and aided traditional cochlear implant (CI) candidacy criteria. Of the 193 individuals who did not meet both components of traditional candidacy criteria, a majority met the aided component (86%) but only 4.6% met the unaided component. When applying the 60/60 Guideline to patients who met traditional criteria, there is a sensitivity rating of 84.7% and a specificity index of 50.3%. For English and Spanish speakers who met traditional criteria but did not meet the 60/60 Guideline, a majority (83.3% English, 87.5% Spanish) had a better ear word recognition score (WRS) greater than 60%, suggesting the unaided WRS is the more restrictive component of the "60/60 Guideline." CONCLUSION Application of the "60/60 Guideline" is an effective method to identify potential CI candidates in the English-speaking population; however, it was less effective in the Spanish-speaking population. Spanish-speaking adults should be referred for a CIE when better ear pure tone average is greater than 60 dB hearing loss, regardless of their unaided WRS. This study highlights the need for inclusion of nonlinguistic test measures in the CI referral criteria and test battery to reduce CI access barriers for patients who speak a language other than English.
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Affiliation(s)
- Molly R Smeal
- Department of Otolaryngology, University of Miami, Miami, FL
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Xu HW, Liu H, Luo Y, Wang K, To MN, Chen YM, Su HX, Yang Z, Hu YH, Xu B. Comparing a new multimorbidity index with other multimorbidity measures for predicting disability trajectories. J Affect Disord 2024; 346:167-173. [PMID: 37949239 DOI: 10.1016/j.jad.2023.11.014] [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: 04/19/2023] [Revised: 11/05/2023] [Accepted: 11/07/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND The optimal multimorbidity measures for predicting disability trajectories are not universally agreed upon. We developed a multimorbidity index among middle-aged and older community-dwelling Chinese adults and compare its predictive ability of disability trajectories with other multimorbidity measures. METHODS This study included 17,649 participants aged ≥50 years from the China Health and Retirement Longitudinal Survey 2011-2018. Two disability trajectory groups were estimated using the total disability score differences calculated between each follow-up visit and baseline. A weighted index was constructed using logistic regression models for disability trajectories based on the training set (70 %). The index and the condition count were used, along with the pattern identified by the latent class analysis to measure multimorbidity at baseline. Logistic regression models were used in the training set to examine associations between each multimorbidity measure and disability trajectories. C-statistics, integrated discrimination improvements, and net reclassification indices were applied to compare the performance of different multimorbidity measures in predicting disability trajectories in the testing set (30 %). RESULTS In the newly developed multimorbidity index, the weights of the chronic conditions varied from 1.04 to 2.55. The multimorbidity index had a higher predictive performance than the condition count. The condition count performed better than the multimorbidity pattern in predicting disability trajectories. LIMITATION Self-reported chronic conditions. CONCLUSIONS The multimorbidity index may be considered an ideal measurement in predicting disability trajectories among middle-aged and older community-dwelling Chinese adults. The condition count is also suggested due to its simplicity and superior predictive performance.
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Affiliation(s)
- Hui-Wen Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China; Peking University Medical Informatics Center, Beijing, China
| | - Hui Liu
- Peking University Medical Informatics Center, Beijing, China
| | - Yan Luo
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China; Peking University Medical Informatics Center, Beijing, China
| | - Kaipeng Wang
- Graduate School of Social Work, University of Denver, Denver, CO, USA
| | - My Ngoc To
- Graduate School of Social Work, University of Denver, Denver, CO, USA
| | - Yu-Ming Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China; Peking University Medical Informatics Center, Beijing, China
| | - He-Xuan Su
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China; Peking University Medical Informatics Center, Beijing, China
| | - Zhou Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China; Peking University Medical Informatics Center, Beijing, China
| | - Yong-Hua Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China; Peking University Medical Informatics Center, Beijing, China
| | - Beibei Xu
- Peking University Medical Informatics Center, Beijing, China.
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Schroeder T, Haug M, Georgiou A, Seaman K, Gewald H. Evidence of How Physicians and Their Patients Adopt mHealth Apps in Germany: Exploratory Qualitative Study. JMIR Mhealth Uhealth 2024; 12:e48345. [PMID: 38231550 PMCID: PMC10831587 DOI: 10.2196/48345] [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: 04/20/2023] [Revised: 09/30/2023] [Accepted: 11/27/2023] [Indexed: 01/18/2024] Open
Abstract
BACKGROUND The enactment of the "Act to Improve Healthcare Provision through Digitalisation and Innovation " (Digital Healthcare Act; Digitale-Versorgung-Gesetz [DVG]) in Germany has introduced a paradigm shift in medical practice, allowing physicians to prescribe mobile health (mHealth) apps alongside traditional medications. This transformation imposes a dual responsibility on physicians to acquaint themselves with qualifying apps and align them with patient diagnoses, while requiring patients to adhere to the prescribed app use, similar to pharmaceutical adherence. This transition, particularly challenging for older generations who are less skilled with technology, underscores a significant evolution in Germany's medical landscape. OBJECTIVE This study aims to investigate physicians' responses to this novel treatment option, their strategies for adapting to this form of prescription, and the willingness of patients to adhere to prescribed mHealth apps. METHODS Using an exploratory qualitative study design, we conducted semistructured interviews with 28 physicians and 30 potential patients aged 50 years and older from August 2020 to June 2021. RESULTS The findings reveal several factors influencing the adoption of mHealth apps, prompting a nuanced understanding of adoption research. Notably, both physicians and patients demonstrated a lack of information regarding mHealth apps and their positive health impacts, contributing to a deficiency in trust. Physicians' self-perceived digital competence and their evaluation of patients' digital proficiency emerge as pivotal factors influencing the prescription of mHealth apps. CONCLUSIONS Our study provides comprehensive insights into the prescription process and the fundamental factors shaping the adoption of mHealth apps in Germany. The identified information gaps on both the physicians' and patients' sides contribute to a trust deficit and hindered digital competence. This research advances the understanding of adoption dynamics regarding digital health technologies and highlights crucial considerations for the successful integration of digital health apps into medical practice.
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Affiliation(s)
- Tanja Schroeder
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
- Institute for Digital Innovation, Faculty of Information Management, Neu-Ulm University of Applied Sciences, Neu-Ulm, Germany
| | - Maximilian Haug
- Institute for Digital Innovation, Faculty of Information Management, Neu-Ulm University of Applied Sciences, Neu-Ulm, Germany
| | - Andrew Georgiou
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Karla Seaman
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Heiko Gewald
- Institute for Digital Innovation, Faculty of Information Management, Neu-Ulm University of Applied Sciences, Neu-Ulm, Germany
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Gammoh OS, Alqudah A, Abu Shaikh H, Al-Shudifat AE. Severe depressive symptoms in patients with hypertension: Are antihypertensive medications implicated? Int J Psychiatry Med 2024; 59:6-19. [PMID: 37132941 DOI: 10.1177/00912174231173339] [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] [Indexed: 05/04/2023]
Abstract
OBJECTIVE This study examined whether antihypertensive medications and other patient characteristics are associated with severe depressive symptoms in patients with hypertension. METHODS Patients with a diagnosis of hypertension were recruited from the internal medicine outpatient clinics of a hospital in Amman, Jordan, into this cross-sectional study. Depression severity was assessed using the Patient Health Questionnaire-9 (PHQ-9); anxiety by the General Anxiety Disorder-7; sleep quality by the Insomnia Severity Index; and psychological stress by the Perceived Stress Scale. Multivariable binary logistic regression was used to examine the association between the different classes of antihypertensive medication and depressive symptoms. RESULTS Of the 431 participants, 282 (65.4%) were men; 240 (55.7%) reported having type 2 diabetes; 359 (83.3%) had dyslipidemia; 142 (32.9%) were on beta-blockers; 197 (45.2%) were on ACE inhibitors or angiotensin receptor blockers; 203 (47.1%) were on metformin; and 133 (30.9%) were taking sulfonylurea. Severe depressive symptoms, indicated by scoring above the cut-off of 14 on the PHQ-9, were present in 165 (38.3%) patients. Severe depression was associated with younger age (<55 years) (OR = 3.15, 95% CI = 1.83-5.41, P < 0.001), unemployment (OR = 2.15, 95% CI = 1.15-4.00, P = 0.01), diabetes (OR = 1.81, 95% CI = 1.09-3.02, P = 0.02), severe anxiety (OR = 6.40, 95% CI = 3.64-11.28, P < 0.001), and severe insomnia (OR = 4.73, 95% CI = 2.85-7.82, P < 0.001). CONCLUSION Severe depressive symptoms were not associated with antihypertensive medications or other drugs used by hypertensive patients. Younger age, diabetes, anxiety, and insomnia were the primary correlates of depression.
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Affiliation(s)
- Omar Salem Gammoh
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, Yarmouk University, Irbid, Jordan
| | - Abdelrahim Alqudah
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmaceutical Sciences, The Hashemite University, Zarqa, Jordan
| | | | - Abdel-Ellah Al-Shudifat
- Department of Medicine and family medicine, College of Medicine, The Hashemite University, Zarqa, Jordan
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Wang X, Gao D, Wang X, Zhang X, Song B. Hypertension, socioeconomic status and depressive and anxiety disorders: a cross-sectional study of middle-aged and older Chinese women. BMJ Open 2023; 13:e077598. [PMID: 38154906 PMCID: PMC10759086 DOI: 10.1136/bmjopen-2023-077598] [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: 07/10/2023] [Accepted: 11/29/2023] [Indexed: 12/30/2023] Open
Abstract
OBJECTIVES To investigate the association of hypertension with depressive and anxiety disorders in middle-aged and older Chinese women, and to further assess whether the association was influenced by socioeconomic status (SES). DESIGN Nationwide cross-sectional study. SETTING Six provinces of the eastern, central and western regions of China. PARTICIPANTS Women aged 40-70 years were included by a multistage stratified random cluster sampling in 2018 (N=9900). PRIMARY OUTCOME MEASURES Depressive and anxiety disorders were measured by the Patient Health Questionnaire-9 and the Generalized Anxiety Disorder-7, respectively. Logistic regression models were used to evaluate the OR and 95% CI for hypertension and the odds of depressive and anxiety disorders. RESULTS 18.5% of participants reported having hypertension; 20.9% and 15.3% of women experienced depressive and anxiety disorders, respectively. After adjusting for potential confounders, women diagnosed with hypertension were more likely to have depressive (OR=1.27, 95% CI 1.11 to 1.45) and anxiety disorders (OR=1.48, 95% CI 1.28 to 1.71) than those without hypertension. Stratified analyses demonstrated that hypertension was significantly associated with higher odds of depressive disorders in women living in rural areas (OR=1.34, 95% CI 1.13 to 1.59), with lower levels of education (OR=1.28, 95% CI 1.12 to 1.46) and with average monthly household income <¥3000 (OR=1.33, 95% CI 1.12 to 1.59), while hypertension was significantly correlated with increased odds of anxiety disorders in women living in urban (OR=1.41, 95% CI 1.12 to 1.79) and rural areas (OR=1.53, 95% CI 1.27 to 1.84), with lower levels of education (OR=1.47, 95% CI 1.27 to 1.70), and with average monthly household income <¥3000 (OR=1.45, 95% CI 1.20 to 1.75) and ≥¥3000 (OR=1.49, 95% CI 1.18 to 1.86). CONCLUSIONS Hypertension was associated with increased odds of depressive and anxiety disorders among middle-aged and older women, especially in those with low SES. Effective strategies and actions for identification and management of hypertension and depressive and anxiety disorders are needed.
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Affiliation(s)
- Xueyin Wang
- Peking University First Hospital, Beijing, China
| | - Di Gao
- Peking University First Hospital, Beijing, China
| | - Xu Wang
- Peking University First Hospital, Beijing, China
| | | | - Bo Song
- Chinese Center for Disease Control and Prevention, Beijing, China
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Zheng X, Xue B, Xiao S, Li X, Chen Y, Shi L, Liang X, Tian F, Zhang C. Development and validation of a multimorbidity risk prediction nomogram among Chinese middle-aged and older adults: a retrospective cohort study. BMJ Open 2023; 13:e077573. [PMID: 37940154 PMCID: PMC10632863 DOI: 10.1136/bmjopen-2023-077573] [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: 07/13/2023] [Accepted: 10/18/2023] [Indexed: 11/10/2023] Open
Abstract
OBJECTIVES The aim of this study is to establish a self-simple-to-use nomogram to predict the risk of multimorbidity among middle-aged and older adults. DESIGN A retrospective cohort study. PARTICIPANTS We used data from the Chinese Longitudinal Healthy Longevity Survey, including 7735 samples. MAIN OUTCOME MEASURES Samples' demographic characteristics, modifiable lifestyles and depression were collected. Cox proportional hazard models and nomogram model were used to estimate the risk factors of multimorbidity. RESULTS A total of 3576 (46.2%) participants have multimorbidity. The result showed that age, female (HR 0.80, 95% CI 0.72 to 0.89), chronic disease (HR 2.59, 95% CI 2.38 to 2.82), sleep time (HR 0.78, 95% CI 0.72 to 0.85), regular physical activity (HR 0.88, 95% CI 0.81 to 0.95), drinking (HR 1.27 95% CI 1.16 to 1.39), smoking (HR 1.40, 95% CI 1.26 to 1.53), body mass index (HR 1.04, 95% CI 1.03 to 1.05) and depression (HR 1.02, 95% CI 1.01 to 1.03) were associated with multimorbidity. The C-index of nomogram models for derivation and validation sets were 0.70 (95% CI 0.69 to 0.71, p=0.006) and 0.71 (95% CI 0.70 to 0.73, p=0.008), respectively. CONCLUSIONS We have crafted a user-friendly nomogram model for predicting multimorbidity risk among middle-aged and older adults. This model integrates readily available and routinely assessed risk factors, enabling the early identification of high-risk individuals and offering tailored preventive and intervention strategies.
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Affiliation(s)
- Xiao Zheng
- Department of Health Management, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde, Foshan), Foshan, China
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Benli Xue
- School of Health Management, Southern Medical University, Guangzhou, China
- Key Laboratory of Philosophy and Social Sciences of Guangdong Higher Education Institutions for Collaborative Innovation of Health Management Policy and Precision Health Service, Guangzhou, China
| | - Shujuan Xiao
- School of Health Management, Southern Medical University, Guangzhou, China
- Key Laboratory of Philosophy and Social Sciences of Guangdong Higher Education Institutions for Collaborative Innovation of Health Management Policy and Precision Health Service, Guangzhou, China
| | - Xinru Li
- School of Health Management, Southern Medical University, Guangzhou, China
- Key Laboratory of Philosophy and Social Sciences of Guangdong Higher Education Institutions for Collaborative Innovation of Health Management Policy and Precision Health Service, Guangzhou, China
| | - Yimin Chen
- School of Health Management, Southern Medical University, Guangzhou, China
- Key Laboratory of Philosophy and Social Sciences of Guangdong Higher Education Institutions for Collaborative Innovation of Health Management Policy and Precision Health Service, Guangzhou, China
| | - Lei Shi
- Key Laboratory of Philosophy and Social Sciences of Guangdong Higher Education Institutions for Collaborative Innovation of Health Management Policy and Precision Health Service, Guangzhou, China
| | - Xiaoyan Liang
- Department of Health Management, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde, Foshan), Foshan, China
- Key Laboratory of Philosophy and Social Sciences of Guangdong Higher Education Institutions for Collaborative Innovation of Health Management Policy and Precision Health Service, Guangzhou, China
| | - Feng Tian
- Department of Health Management, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde, Foshan), Foshan, China
- Key Laboratory of Philosophy and Social Sciences of Guangdong Higher Education Institutions for Collaborative Innovation of Health Management Policy and Precision Health Service, Guangzhou, China
| | - Chichen Zhang
- School of Health Management, Southern Medical University, Guangzhou, China
- Key Laboratory of Philosophy and Social Sciences of Guangdong Higher Education Institutions for Collaborative Innovation of Health Management Policy and Precision Health Service, Guangzhou, China
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Kengganpanich M, Pengpid S, Peltzer K. Predictors of and healthcare utilisation of depressive symptoms among middle-aged and older adults in Thailand: a national cross-sectional community-based study in 2015. BMJ Open 2023; 13:e071980. [PMID: 37816553 PMCID: PMC10565141 DOI: 10.1136/bmjopen-2023-071980] [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: 01/17/2023] [Accepted: 09/21/2023] [Indexed: 10/12/2023] Open
Abstract
OBJECTIVE The prevalence of depressive symptoms and healthcare utilisation among the ageing population in Thailand is unclear. The study assessed the predictors of and healthcare utilisation of depressive symptoms among an ageing population in Thailand. DESIGN Cross-sectional, population-based study. SETTING National sample of people aged 45 years and older in Thailand from the 2015 Health, Ageing and Retirement in Thailand (HART) study. PARTICIPANTS The sample included 5135 individuals (≥45 years) with complete depressive symptoms data from the 2015 HART study. OUTCOME MEASURES Depressive symptoms were measured with the Centre for Epidemiological Studies Depression Scale. Logistic regression was used to estimate the associations between sociodemographic factors, health factors and depressive symptoms, and the associations between depressive symptoms and different types of healthcare utilisation. RESULTS The study population included 5135 participants with a median age of 66 years. The prevalence of depressive symptoms was 13.9%. The proportion of past 2 year hospital admission was 12.8%, hospital outpatient 49.7%, health centre outpatient 26.2%, private clinic 8.4%, traditional medical practitioner 2.8%, medical home visit 4.9% and past-year medical check-up 50.3%. In adjusted logistic regression analysis, low income, residing in the Southern region, history of a cardiovascular disease, brain diseases and/or psychiatric problems and functional disability were positively associated with depressive symptoms. Male sex, being a Buddhist, urban residence, high religious involvement, moderate and high physical activity were negatively associated with depressive symptoms. In fully adjusted logistic regression models, depressive symptoms were positively associated with hospital inpatient utilisation, hospital outpatient utilisation, health centre utilisation and utilisation of a traditional medicine practitioner. CONCLUSIONS More than one in 10 participants had depressive symptoms. Chronic conditions, sociodemographic factors, physical inactivity and low religious involvement increased the odds of depressive symptoms. Furthermore, depressive symptoms increased the odds of conventional and traditional healthcare utilisation.
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Affiliation(s)
- Mondha Kengganpanich
- Department of Health Education and Behavioral Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand
| | - Supa Pengpid
- Department of Health Education and Behavioral Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand
- Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan
- Sefako Makgatho Health Sciences University, Pretoria, Gauteng, South Africa
| | - Karl Peltzer
- Department of Health Education and Behavioral Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand
- Department of Psychology, University of the Free State, Bloemfontein, Free State, South Africa
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan
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Huang D, Wang J, Fang H, Fu Y, Lou J. Longitudinal association of chronic diseases with depressive symptoms in middle-aged and older adults in China: Mediation by functional limitations, social interaction, and life satisfaction. J Glob Health 2023; 13:04119. [PMID: 37766663 PMCID: PMC10534192 DOI: 10.7189/jogh.13.04119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/29/2023] Open
Abstract
Background Several previous studies have shown that the development of depression is often accompanied by chronic diseases; although closely related, the mechanism between them is not clear. Here we investigate the potential role of functional limitations, social interaction, and life satisfaction in the relationship between chronic diseases and depressive symptoms in middle-aged and older adults in China. Methods We selected 2407 respondents aged ≥45 from the China Health and Retirement Longitudinal Study conducted in 2013, 2015, and 2018. We established panel data to estimate the longitudinal impact of chronic diseases on depressive symptoms and the mediating role of functional limitations, social interaction, and life satisfaction. Results Chronic diseases were associated with more depressive symptoms. All of the mediating pathways examined passed functional limitations, and approximately 43.4% of the association between chronic diseases and depressive symptoms was explained by these three mediating variables. Conclusions The impact of chronic diseases on depressive symptoms was primarily mediated by functional limitations, and the mediating role of social interaction and life satisfaction was also confirmed. Therefore, attention should be paid to reducing the level of functional limitation in middle-aged and older adults with chronic diseases and improving life satisfaction by increasing social opportunities to alleviate depressive symptoms in middle-aged and older adults.
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Affiliation(s)
- Derong Huang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC KeyLab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Jian Wang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC KeyLab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Huiling Fang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC KeyLab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Yingjie Fu
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC KeyLab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Jiaxu Lou
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC KeyLab of Health Economics and Policy Research, Shandong University, Jinan, China
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Bizzozero-Peroni B, Fernández-Rodríguez R, Martínez-Vizcaíno V, Garrido-Miguel M, Medrano M, Jiménez-López E, Mesas AE. Nut consumption is associated with a lower risk of depression in adults: A prospective analysis with data from the UK Biobank cohort. Clin Nutr 2023; 42:1728-1736. [PMID: 37542950 DOI: 10.1016/j.clnu.2023.07.020] [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: 10/31/2022] [Revised: 07/04/2023] [Accepted: 07/24/2023] [Indexed: 08/07/2023]
Abstract
BACKGROUND & AIMS Evidence on the association between nut consumption and depression is mainly based on cross-sectional studies. This study aims to analyse whether nut consumption is prospectively associated with the risk of depression in adults. METHODS This study was conducted using the United Kingdom (UK) Biobank resource. Data from middle-aged and older UK adults who participated in this cohort between 2007-2012 (baseline) and 2013-2020 (follow-up) were analysed. Baseline information on nut consumption was obtained with the Oxford WebQ 24-h questionnaire. Depression, defined as a self-reported physician diagnosis of depression or antidepressant use, was assessed at baseline and follow-up. Hazard regression models estimating the predictive ability of nut consumption for the risk of developing depression were adjusted for sociodemographic, lifestyle, and health confounders. RESULTS A total of 13,504 participants (mean age 57.5 ± 7.2 years, 50.7% female) free of depression at baseline were included in the analyses. After a mean follow-up of 5.3 ± 2.4 years, 1122 (8.3%) incident cases of depression were identified. Compared with no nut consumption, the daily consumption of >0 to 1 serving of 30 g of nuts was associated with a lower risk of depression (hazard ratio, HR = 0.83; 95% confidence interval, CI: 0.71-0.97) regardless of all potential confounders considered. In stratified analyses, a decreased risk of depression was more clearly observed in UK adults with adequate weight control, a healthy lifestyle, and better health status than in their counterparts (p < 0.05). CONCLUSIONS Low-to-moderate nut consumption (>0 to 1 serving of 30 g/day) was associated with a 17% lower risk of depression during a 5.3-year follow-up compared with no nut consumption in a large sample of middle-aged and older UK adults. This protective association is enhanced in the absence of other known risk factors for depression.
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Affiliation(s)
- Bruno Bizzozero-Peroni
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, 16071, Spain; Universidad de la República, Instituto Superior de Educación Física, Rivera, 40000, Uruguay
| | | | - Vicente Martínez-Vizcaíno
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, 16071, Spain; Universidad Autónoma de Chile, Facultad de Ciencias de la Salud, Talca, 1101, Chile.
| | - Miriam Garrido-Miguel
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, 16071, Spain; Universidad de Castilla-La Mancha, Facultad de Enfermería, Albacete, 02006, Spain
| | - María Medrano
- University of Navarra, Institute for Sustainability & Food Chain Innovation (ISFOOD), Pamplona, 31006, Spain; University of Navarra, Department of Health Sciences, Campus de Arrosadia, Pamplona, 31008, Spain
| | - Estela Jiménez-López
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, 16071, Spain; Department of Psychiatry, Hospital Virgen de La Luz, CIBERSAM, Cuenca, 16002, Spain
| | - Arthur Eumann Mesas
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, 16071, Spain; Universidade Estadual de Londrina, Postgraduate Program in Public Health, Londrina, Paraná, 86057-970, Brazil
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21
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Jacobs JM, Baider L, Goldzweig G, Sapir E, Rottenberg Y. Late life depression and concepts of aging: an emerging paradigm. Front Med (Lausanne) 2023; 10:1218562. [PMID: 37621462 PMCID: PMC10445155 DOI: 10.3389/fmed.2023.1218562] [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: 05/07/2023] [Accepted: 07/17/2023] [Indexed: 08/26/2023] Open
Abstract
Late life depression (LLD) is an emerging challenge, and recognized as a significant barrier to long-term healthy aging. Viewed within the context of the medical/biological model, advances in brain sciences over the last several decades have led to a deeper understanding of the biology of LLD. These advances in current knowledge include the description of aging brain pathophysiology; the biology and biochemistry of neurotransmitters; the correspondence between changes in neurological structure, function, and neural network; the description of neural, hormonal and inflammatory biomarkers; and identification of typical phenotypic subtypes of LLD. Despite these advances, current treatment of LLD, which remains largely pharmacological with accompanying cognitive and behavioral interventions, has poor success rate for long-term remission among older people. A wider perspective, in keeping with several emerging aging concepts, is suggested as an alternative framework within which to view LLD. A growing body of research supports the important role in LLD of frailty, resilience, intrinsic capacity, and functional integrity. Similarly, important social determinants need to be addressed in the etiology of LLD, rooted largely in negative stereotypes of aging, with consequent repercussions of reduced participation and inclusion, growing social isolation, with loss of identity, meaning and hope. This perspective suggests the importance of a wider integrative conceptualization of depression, set against a background of emerging aging concepts.
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Affiliation(s)
- Jeremy M. Jacobs
- The Jerusalem Institute of Aging Research, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
- Department of Geriatric Rehabilitation and the Center for Palliative Care, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Lea Baider
- Oncology Institute, Assuta Medical Center, Tel Aviv, Israel
| | - Gil Goldzweig
- School of Behavioral Sciences, Academic College of Tel Aviv-Yaffo, Tel Aviv, Israel
| | - Eli Sapir
- Department of Radiation Oncology, Samson Assuta Ashdod University Hospital, Ashdod, Israel
| | - Yakir Rottenberg
- Department of Oncology, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
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22
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Kozela M, Matras A, Koziara K, Małecki MT, Pająk A. Prior Diagnosis of Diabetes but Not Its Control is Associated with Higher Depression Score Among Older Individuals. Diabetes Metab Syndr Obes 2023; 16:2051-2059. [PMID: 37441414 PMCID: PMC10335292 DOI: 10.2147/dmso.s403521] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 06/08/2023] [Indexed: 07/15/2023] Open
Abstract
Purpose The study assessed the relationship between prior diagnosis of diabetes and its control with depression score, differences in socioeconomic, lifestyle, health characteristics and diabetes control by adherence to treatment in population-based sample of older individuals. Patients and Methods The analysis of the sub-sample of Polish cohort of the HAPIEE (Health, Alcohol, and Psychosocial Factors in Eastern Europe) study was conducted; 464 participants were interviewed and random first 360 (78%) underwent physical examination and blood sample tests. Depressive symptoms were assessed using the Center for Epidemiological Studies Depression Scale. The robust regression method was applied to assess the association between depression score and diabetes diagnosis as well as diabetes control. Results There were 97 participants (21.0%) at mean age of 73.6 years (SD=6.31 years) with prior diagnosis of diabetes. Mean HbA1c concentration was 6.65% (SD=1.0) The majority of patients (55.7%) used oral medication with diet. Nearly 20% declared the use of oral treatment alone, and 10.3% used combined treatment of oral medications, insulin, and diet. In this study, 86.6% of the participants with diabetes confirmed self-monitoring of blood glucose levels and 58.8% were on high-quality diet. No differences in socioeconomic, lifestyle, health characteristics or control of diabetes by adherence to diabetes treatment were found. After adjustment for age and gender, diagnosis of diabetes was associated with greater depressive score by about 2 points (β=2.02, 95% CI=0.16;3.88). However, no significant association between depression score and any indicator of diabetes control was found. Conclusion In older individuals with diabetes, depression score was higher compared to those without diabetes, but it was not related to poorer diabetes control. No differences in socioeconomic, lifestyle, health characteristics and control of diabetes by adherence to diabetes treatment may suggest that in this age group some other, less known factors are substantial for achievement of treatment targets.
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Affiliation(s)
- Magdalena Kozela
- Department of Epidemiology and Population Studies, Institute of Public Health Jagiellonian University Medical College, Krakow, Poland
| | - Agnieszka Matras
- Department of Epidemiology and Population Studies, Institute of Public Health Jagiellonian University Medical College, Krakow, Poland
| | - Karolina Koziara
- Department of Epidemiology and Population Studies, Institute of Public Health Jagiellonian University Medical College, Krakow, Poland
| | - Maciej T Małecki
- Department of Metabolic Diseases, Jagiellonian University Medical College, Krakow, Poland
| | - Andrzej Pająk
- Department of Epidemiology and Population Studies, Institute of Public Health Jagiellonian University Medical College, Krakow, Poland
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23
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Podstawski R, Omelan A, Borysławski K, Wąsik J. Relationships between anthropometric and body composition characteristics and age in Polish women over 60 as affected by their socioeconomic and health status and physical activity levels. Front Physiol 2023; 14:1198485. [PMID: 37440998 PMCID: PMC10333718 DOI: 10.3389/fphys.2023.1198485] [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: 04/01/2023] [Accepted: 06/13/2023] [Indexed: 07/15/2023] Open
Abstract
Background: Little is known about changes in anthropometric and body composition (A&BC) characteristics during the aging process. Research indicates that body composition can be linked with socioeconomic status (SES), health status (HS), and physical activity (PA) levels. Aim: The aim of this study was to evaluate age-related changes in A&BC characteristics in female seniors aged 60+ in view of their SES, HS, and PA levels. Methods: The survey was conducted in November and December 2022 on a total of 661 female seniors. A questionnaire survey was conducted to obtain information about the participants' socioeconomic status (chronic diseases, health status, marital status, membership in social organizations, financial status, place of residence, education). The respondents' PA levels were assessed with the International Physical Activity Questionnaire (IPAQ), and their A&BC characteristics were determined in a bioelectrical impedance analysis with the InBody 270 body composition analyzer. The relationships between A&BC characteristics and age were evaluated based on the values of the Pearson correlation coefficient (r). Results: The mean values of Percent Body Fat (PBF), Body Mass Index (BMI), and the waist-hip ratio (WHR) were relatively high (37.2%, 28.5 kg/m2, and 0.8, respectively) and indicative of overweight and gynoid obesity. A higher number of significant negative correlations between A&BC characteristics and age were observed in seniors with lower values of SES, HS, and PA, which points to more rapid involutional changes in this group of respondents. A segmental analysis also revealed significantly lower values of fat-free mass (FFM) and body fat mass (BFM) (both indicators were calculated in percentage and kg), in particular in the upper limbs, in women with lower SES, HS, and PA levels. Conclusion: Environmental factors, including biological, physiological, environmental, psychological, behavioral, and social factors, are significantly associated with aging in women. Age-related changes in A&BC characteristics tend to proceed more rapidly in female seniors with low values of SES and HE and insufficient PA levels.
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Affiliation(s)
- Robert Podstawski
- Department of Physiotherapy, Faculty of Physiotherapy, University of Warmia and Mazury in Olsztyn, Olsztyn, Poland
| | - Aneta Omelan
- Department of Tourism, Recreation and Ecology, Faculty of Geoengineering, University of Warmia and Mazury in Olsztyn, Olsztyn, Poland
| | - Krzysztof Borysławski
- Institute of Health, The Angelus Silesius University of Applied Sciences, Wałbrzych, Poland
| | - Jacek Wąsik
- Department of Kinesiology and Health Prevention, Jan Dlugosz University in Czestochowa, Czestochowa, Poland
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24
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Stieglitz LM, Adams LB, Bärnighausen T, Berghöfer A, Kazonda P, Killewo J, Leyna GH, Lohmann J, Rohr JK, Kohler S. Depressive symptoms and their association with age, chronic conditions and health status among middle-aged and elderly people in peri-urban Tanzania. Glob Ment Health (Camb) 2023; 10:e27. [PMID: 37854410 PMCID: PMC10579685 DOI: 10.1017/gmh.2023.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Revised: 02/28/2023] [Accepted: 04/25/2023] [Indexed: 10/20/2023] Open
Abstract
Background Depression is a global mental health challenge. We assessed the prevalence of depressive symptoms and their association with age, chronic conditions, and health status among middle-aged and elderly people in peri-urban Dar es Salaam, Tanzania. Methods Depressive symptoms were measured in 2,220 adults aged over 40 years from two wards of Dar es Salaam using the ten-item version of the Center of Epidemiologic Studies Depression Scale (CES-D-10) and a cut-off score of 10 or higher. The associations of depressive symptoms with age, 13 common chronic conditions, multimorbidity, self-rated health and any limitation in six activities of daily living were examined in univariable and multivariable logistic regressions. Results The estimated prevalence of depressive symptoms was 30.7% (95% CI 28.5-32.9). In univariable regressions, belonging to age groups 45-49 years (OR 1.35 [95% CI 1.04-1.75]) and over 70 years (OR 2.35 [95% CI 1.66-3.33]), chronic conditions, including ischemic heart disease (OR 3.43 [95% CI 2.64-4.46]), tuberculosis (OR 2.42 [95% CI 1.64-3.57]), signs of cognitive problems (OR 1.90 [95% CI 1.35-2.67]), stroke (OR 1.56 [95% CI 1.05-2.32]) and anemia (OR 1.32 [95% CI 1.01-1.71]) and limitations in activities of daily living (OR 1.35 [95% CI 1.07-1.70]) increased the odds of depressive symptoms. Reporting good or very good health was associated with lower odds of depressive symptoms (OR 0.48 [95% CI 0.35-0.66]). Ischemic heart disease and tuberculosis remained independent predictors of depressive symptoms in multivariable regressions. Conclusion Depressive symptoms affected almost one in three people aged over 40 years. Their prevalence differed across age groups and was moderated by chronic conditions, health status and socioeconomic factors.
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Affiliation(s)
- Laura-Marie Stieglitz
- Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
| | - Leslie B Adams
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Till Bärnighausen
- Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
| | - Anne Berghöfer
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | | | - Japhet Killewo
- Department of Epidemiology and Biostatistics, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Germana H Leyna
- Department of Epidemiology and Biostatistics, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Julia Lohmann
- Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK
| | - Julia K Rohr
- Harvard Center for Population and Development Studies, Harvard University, Cambridge, MA, USA
| | - Stefan Kohler
- Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany
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25
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Wang J, Zhang J, Lin H, Han Y, Tu J, Nie X. Economic development, weak ties, and depression: Evidence from China. J Affect Disord 2023; 334:246-257. [PMID: 37146909 DOI: 10.1016/j.jad.2023.04.097] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 04/06/2023] [Accepted: 04/24/2023] [Indexed: 05/07/2023]
Abstract
OBJECTIVES Weak ties are becoming mainstream in daily relationships and play an essential role in the improvement of individuals' mental health. Despite growing concerns on depression, inclusion of weak ties is limited. To address the gap, this study empirically shed light on the role of weak ties on individual depression in the context of economic development. METHOD A cross-sectional study was conducted based on 2018 China Health and Retirement Longitudinal Study (CHARLS) with a sample of 16,545 individuals. A moderated mediation model is constructed to evaluate the impact of economic development (GDP) on the degrees of depression, the mediating effect of weak ties, and the moderating effect of residents' residence types (living in urban or rural areas). RESULTS Economic development exerts a significant direct impact on depression (β=-1.027, p<0.001). Weak ties are significantly negatively correlated with depression (β=-0.574, p<0.001), and act as a mediator between economic development and local individual depression. In addition, the residence type plays a moderating role between economic development and weak ties (β=0.193, p<0.001). That is, living in urban areas would introduce the higher the level of weak ties. CONCLUSIONS Higher economic development is largely conducive to alleviating the degrees of depression, weak ties play a mediating role in economic development and depression, and residence types have a positive moderating effect on the economic development and weak ties.
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Affiliation(s)
- Jiangyan Wang
- School of Statistics and Data Science, Nanjing Audit University, Nanjing 211815, China.
| | - Jiahao Zhang
- School of Statistics and Data Science, Nanjing Audit University, Nanjing 211815, China
| | - Han Lin
- School of Information Engineering, Jiangsu Key Laboratory of Public Project Audit, Nanjing Audit University, Nanjing 211815, China.
| | - Yilong Han
- School of Economics and Management, Tongji University, Shanghai 200092, China.
| | - Juan Tu
- Key Laboratory of Modern Acoustics (MOE), School of Physics, Nanjing University, Nanjing 210093, China.
| | - Xinyu Nie
- Antai College of Economics and Management, Shanghai Jiaotong University Shanghai 200030, China.
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26
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Tang D, Tran Y, Dawes P, Gopinath B. A Narrative Review of Lifestyle Risk Factors and the Role of Oxidative Stress in Age-Related Hearing Loss. Antioxidants (Basel) 2023; 12:antiox12040878. [PMID: 37107253 PMCID: PMC10135296 DOI: 10.3390/antiox12040878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 03/29/2023] [Accepted: 04/03/2023] [Indexed: 04/08/2023] Open
Abstract
Age-related hearing loss affects a significant proportion of adults aged 60 years and above, with a prevalence of 65%. This condition has a negative impact on both physical and mental well-being, and while hearing interventions can help alleviate the effects of hearing loss, they cannot completely restore normal hearing or halt the progression of age-related hearing loss. Oxidative stress and inflammation have been identified as potential contributors to this condition. By addressing modifiable lifestyle risk factors that exacerbate oxidative stress, there may be an opportunity to prevent hearing loss. Therefore, this narrative review provides an overview of the major modifiable lifestyle risk factors associated with age-related hearing loss, that is, exposure to noise and ototoxic chemicals, smoking, diet, physical activity, and the presence of chronic lifestyle diseases, and offers an overview of the role of oxidative stress in the pathophysiology of this condition.
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Affiliation(s)
- Diana Tang
- Macquarie University Hearing, Faculty of Medicine Health and Human Sciences, Macquarie University, Sydney, NSW 2109, Australia
| | - Yvonne Tran
- Macquarie University Hearing, Faculty of Medicine Health and Human Sciences, Macquarie University, Sydney, NSW 2109, Australia
| | - Piers Dawes
- Centre for Hearing Research, School of Health and Rehabilitation Sciences, University of Queensland, St. Lucia, QLD 4072, Australia
| | - Bamini Gopinath
- Macquarie University Hearing, Faculty of Medicine Health and Human Sciences, Macquarie University, Sydney, NSW 2109, Australia
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27
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Moons P, Van Bulck L, Daelman B, Luyckx K. Mental health in adult congenital heart disease. INTERNATIONAL JOURNAL OF CARDIOLOGY CONGENITAL HEART DISEASE 2023. [DOI: 10.1016/j.ijcchd.2023.100455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
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28
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Nahar Z, Monisha ST, Qusar MMAS, Islam MR. Evaluation of serum interleukin‐1 receptor antagonist levels in major depressive disorder: A case‐control study. Health Sci Rep 2023; 6:e1175. [PMID: 37008817 PMCID: PMC10050969 DOI: 10.1002/hsr2.1175] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 02/07/2023] [Accepted: 03/20/2023] [Indexed: 03/31/2023] Open
Abstract
Background and Aims Major depressive disorder (MDD) is characterized by the occurrence of one or more depressive episodes lasting a minimum of 2 weeks and is marked by a persistently low mood and a lack of enjoyment in daily activities. The diagnosis of MDD is not possible by a well‐established laboratory test or biomarker. A wide range of potential biomarkers for depression have been proposed by many studies, but none of them has adequately described the correlation between the biomarkers and depression. The purpose of this study was to evaluate serum interleukin‐1 receptor antagonist (IL‐1RA) levels as an early depression risk factor. Methods The present case‐control study included 88 participants. Among them, 44 MDD patients enrolled from the psychiatry department of a public hospital in Dhaka, Bangladesh, and 44 age‐ and sex‐matched healthy controls (HCs) from various sites in Dhaka city. A qualified psychiatrist evaluated the cases and HCs based on the fifth edition of the diagnostic and statistical manual of mental disorders (DSM‐5). The Hamilton depression (Ham‐D) rating scale was employed to evaluate the intensity of depression. An enzyme‐linked immunosorbent assay kit (Boster Bio, USA) was used to determine serum IL‐1RA concentrations. Results We observed no marked alteration in the serum concentration of IL‐1RA in MDD patients in comparison to HCs (292.81 ± 24.81 and 288 ± 24.87 pg/mL; p > 0.05). Among MDD patients, we found no noteworthy association between the severity of depression and serum IL‐1RA levels. Conclusion The findings of the present study imply that IL‐1RA may not be identified as a promising biomarker for risk assessment of depression. However, its neuroprotective role may be taken into consideration for the understanding of pathophysiology of MDD.
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Affiliation(s)
- Zabun Nahar
- Department of PharmacyUniversity of Asia PacificDhakaBangladesh
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29
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Xu Z, de Melo Ghisi GL, Liu X, Cui L, Grace SL. Impact of omicron wave and associated control measures in Shanghai on health management and psychosocial well-being of patients with chronic conditions. Open Med (Wars) 2023; 18:20230674. [PMID: 37009051 PMCID: PMC10052381 DOI: 10.1515/med-2023-0674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 01/19/2023] [Accepted: 02/06/2023] [Indexed: 03/30/2023] Open
Abstract
The objective of this cross-sectional study was to investigate health management, well-being, and pandemic-related perspectives of chronic disease patients in the context of stringent measures, and associated correlates. A self-report survey was administered during the Omicron wave lockdown in Shanghai, China. Items from the Somatic Symptom Scale (SSS) and Symptom Checklist-90 were administered, as well as pandemic-related items. Overall, 1,775 patients (mostly married females with hypertension) were recruited through a community family physician group. Mean SSS scores were 36.1 ± 10.5/80, with 41.5% scoring in the elevated range (i.e., >36). In an adjusted model, being female, diagnosis of coronary artery disease and arrhythmia, perceived impact of pandemic on life, health condition, change to exercise routine, tolerance of control measures, as well as perception of future and control measures were significantly associated with greater distress. One-quarter perceived the pandemic had a permanent impact on their life, and 44.1% perceived at least a minor impact. One-third discontinued exercise due to the pandemic. While 47.6% stocked up on their medications before the lockdown, their supply was only enough for two weeks; 17.5% of participants discontinued use. Chief among their fears were inability to access healthcare (83.2%), and what they stated they most needed to manage their condition was medication access (65.6%). Since 2020 when we assessed a similar cohort, distress and perceived impact of the pandemic have worsened. Greater access to cardiac rehabilitation in China could address these issues.
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Affiliation(s)
- Zhimin Xu
- Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, 200082, China
| | - Gabriela Lima de Melo Ghisi
- Cardiovascular Prevention and Rehabilitation Program, Toronto Rehabilitation Institute, University Health Network, Toronto, M4G 2R6, Canada
| | - Xia Liu
- Chengdu Wanda UPMC Hospital, Chengdu, 610218, Sichuan Province, China
| | - Lixian Cui
- Division of Arts and Sciences, NYU Shanghai, 200122, Shanghai, China
| | - Sherry L. Grace
- Faculty of Health, York University, 4700 Keele St, North York, M3J 1P3, Canada
- KITE-Toronto Rehabilitation Institute & Peter Munk Cardiac Centre, University Health Network, University of Toronto, Toronto, Canada
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30
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Xu Z, Chen M, Yao Y, Yu L, Yan P, Cui H, Li P, Liao J, Zhang B, Yao Y, Liu Z, Jiang X, Liu T, Xiao C. Temporal relationship between sleep duration and obesity among Chinese Han people and ethnic minorities. BMC Public Health 2023; 23:503. [PMID: 36922806 PMCID: PMC10015728 DOI: 10.1186/s12889-023-15413-4] [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: 11/11/2022] [Accepted: 03/09/2023] [Indexed: 03/17/2023] Open
Abstract
BACKGROUND No studies have assessed the association between sleep duration and obesity in Chinese ethnic minorities. Whether the relationship between sleep duration and obesity is different between Chinese Han people and Chinese ethnic minorities remains unclear. The study aimed to explore the relationship between sleep duration and obesity among Chinese Han people and Chinese ethnic minorities. METHODS We applied data from the Guizhou Population Health Cohort Study (GPHCS), which 9,280 participants were recruited in the baseline survey from 2010 to 2012, and 8,163 completed the follow-up survey from 2016 to 2020. A total of 5,096 participants (3,188 Han Chinese and 1,908 ethnic minorities) were included in the ultimate analysis. Information on sleep duration (total 24-hour sleep time), body mass index (BMI), and waist circumference (WC) was collected at the baseline and follow-up survey, respectively. Cross-lagged panel analyses were conducted to explore the temporal relationship between sleep duration and obesity for Han people and ethnic minorities. RESULTS For Han people, the results from cross-lagged panel analyses indicated that baseline sleep duration was significantly associated with follow-up BMI (βBMI = -0.041, 95% CIBMI: -0.072 ~ -0.009) and follow-up WC (βWC = -0.070, 95%CIWC: -0.103 ~ -0.038), but baseline BMI (βBMI = -0.016, 95% CIBMI: -0.050 ~ 0.018) and baseline WC (βWC = -0.019, 95% CIWC: -0.053 ~ 0.016) were not associated with follow-up sleep duration. In addition, the relationship between baseline sleep duration and follow-up BMI was gender-specific and significant only in the Han people female (βBMI = -0.047, 95% CIBMI: -0.090 ~ -0.003) but not in the Han people male (βBMI = -0.029, 95% CIBMI: -0.075 ~ 0.016). For ethnic minorities, the results indicated that there was no relationship between sleep duration and obesity at all, either from sleep duration to obesity (βBMI = 0.028, 95%CIBMI: -0.012 ~ 0.068; βWC = 0.020, 95%CIWC: -0.022 ~ 0.062), or from obesity to sleep duration (βBMI = -0.022, 95%CIBMI: -0.067 ~ 0.022; βWC = -0.042, 95%CIWC: -0.087 ~ 0.003). CONCLUSION The relationship pattern between sleep duration and obesity across Han people and ethnic minorities is different. Future sleep-aimed overweight and obesity intervention should be conducted according to population characteristics.
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Affiliation(s)
- Zhengxing Xu
- Department of Epidemiology and Biostatistics, Institute of Systems Epidemiology, West China School of Public Health and West China Fourth Hospital, West China-PUMC C. C. Chen Institute of Health, Sichuan University, Chengdu, Sichuan, China
| | - Min Chen
- Guizhou Province Centre for Disease Control and Prevention, 101 Bageyan Road, Yunyan District, 550004, Guiyang, Guizhou Province, China
| | - Yuntong Yao
- Guizhou Province Centre for Disease Control and Prevention, 101 Bageyan Road, Yunyan District, 550004, Guiyang, Guizhou Province, China
| | - Lisha Yu
- Guizhou Province Centre for Disease Control and Prevention, 101 Bageyan Road, Yunyan District, 550004, Guiyang, Guizhou Province, China
| | - Peijing Yan
- Department of Epidemiology and Biostatistics, Institute of Systems Epidemiology, West China School of Public Health and West China Fourth Hospital, West China-PUMC C. C. Chen Institute of Health, Sichuan University, Chengdu, Sichuan, China
| | - Huijie Cui
- Department of Epidemiology and Biostatistics, Institute of Systems Epidemiology, West China School of Public Health and West China Fourth Hospital, West China-PUMC C. C. Chen Institute of Health, Sichuan University, Chengdu, Sichuan, China
| | - Ping Li
- Department of Epidemiology and Biostatistics, Institute of Systems Epidemiology, West China School of Public Health and West China Fourth Hospital, West China-PUMC C. C. Chen Institute of Health, Sichuan University, Chengdu, Sichuan, China
| | - Jiaqiang Liao
- Department of Epidemiology and Biostatistics, Institute of Systems Epidemiology, West China School of Public Health and West China Fourth Hospital, West China-PUMC C. C. Chen Institute of Health, Sichuan University, Chengdu, Sichuan, China
| | - Ben Zhang
- Department of Epidemiology and Biostatistics, Institute of Systems Epidemiology, West China School of Public Health and West China Fourth Hospital, West China-PUMC C. C. Chen Institute of Health, Sichuan University, Chengdu, Sichuan, China
| | - Yuqin Yao
- Department of Epidemiology and Biostatistics, Institute of Systems Epidemiology, West China School of Public Health and West China Fourth Hospital, West China-PUMC C. C. Chen Institute of Health, Sichuan University, Chengdu, Sichuan, China
- Department of Hygienic Toxicology, West China School of Public Health and West China Fourth Hospital, Sichuan University, 610041, Chengdu, China
| | - Zhenmi Liu
- Department of Epidemiology and Biostatistics, Institute of Systems Epidemiology, West China School of Public Health and West China Fourth Hospital, West China-PUMC C. C. Chen Institute of Health, Sichuan University, Chengdu, Sichuan, China
- Department of Maternal, Child and Adolescent Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, No.16, Section 3, Renmin Nan Lu, 610041, Chengdu, Sichuan, China
| | - Xia Jiang
- Department of Epidemiology and Biostatistics, Institute of Systems Epidemiology, West China School of Public Health and West China Fourth Hospital, West China-PUMC C. C. Chen Institute of Health, Sichuan University, Chengdu, Sichuan, China
- Department of Nutrition and Food Hygiene, West China School of Public Health and West China Fourth Hospital, Sichuan University, 610041, Chengdu, China
| | - Tao Liu
- Guizhou Province Centre for Disease Control and Prevention, 101 Bageyan Road, Yunyan District, 550004, Guiyang, Guizhou Province, China.
| | - Chenghan Xiao
- Department of Epidemiology and Biostatistics, Institute of Systems Epidemiology, West China School of Public Health and West China Fourth Hospital, West China-PUMC C. C. Chen Institute of Health, Sichuan University, Chengdu, Sichuan, China.
- Department of Maternal, Child and Adolescent Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, No.16, Section 3, Renmin Nan Lu, 610041, Chengdu, Sichuan, China.
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Ma S, Wang W, Gong Q, Xiang D, Yao L, Xu S, Xie X, Wang H, Wang G, Yang J, Liu Z. Inflammatory bowel disease and the long-term risk of depression: A prospective cohort study of the UK biobank. Gen Hosp Psychiatry 2023; 82:26-32. [PMID: 36924701 DOI: 10.1016/j.genhosppsych.2023.03.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 03/06/2023] [Accepted: 03/09/2023] [Indexed: 03/18/2023]
Abstract
OBJECTIVE Depression is more common in patients with chronic inflammatory diseases, but whether inflammatory bowel disease (IBD), a chronic, relapsing immune-mediated disease, is associated with a higher risk of depression remains uncertain. METHOD We studied 497,134 participants in the UK Biobank, including 3561 IBD patients. Multivariate Cox proportional risk models were constructed to investigate the risk associated with IBD and depression adjusting for potential confounding factors including sociodemographic, lifestyle, and family history variables. RESULTS The average age of participants was 56.54 ± 8.09 years; 54.3% were female and 90.4% were white. Over a mean follow-up period of 13.3 years, the cumulative incidence of depression was 8.2% (95% CI: 7.3%-9.1%) in IBD patients compared with 4.9% (95% CI: 4.9%-5.0%) in individuals without IBD. Compared with non-IBD participants, the adjusted hazard ratio (HR) for depression among IBD patients was 1.56 (95% CI: 1.39-1.76), with an adjusted HR of 1.54 (95% CI: 1.25-1.90) in Crohn's disease and 1.52 (95% CI: 1.30-1.78) in ulcerative colitis, respectively. CONCLUSION IBD patients had a significantly higher risk of depression than non-IBD participants after adjusting for multiple confounding factors. We recommend screening for depression in middle-aged adults with IBD and no established history of depression.
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Affiliation(s)
- Simeng Ma
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Wei Wang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Qian Gong
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Dan Xiang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Lihua Yao
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Shuxian Xu
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Xinhui Xie
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Huiling Wang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Gaohua Wang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Jun Yang
- School of Information Engineering, Wuhan University of Technology, Wuhan, China.
| | - Zhongchun Liu
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China; Taikang Center for Life and Medical Sciences, Wuhan University, Wuhan, China.
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Grabowska K, Ziemichód W, Biała G. Recent Studies on the Development of Nicotine Abuse and Behavioral Changes Induced by Chronic Stress Depending on Gender. Brain Sci 2023; 13:brainsci13010121. [PMID: 36672102 PMCID: PMC9857036 DOI: 10.3390/brainsci13010121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 01/04/2023] [Accepted: 01/06/2023] [Indexed: 01/12/2023] Open
Abstract
Nowadays, stressful situations are an unavoidable element of everyday life. Stressors activate a number of complex mental and physiological reactions in the organism, thus affecting the state of health of an individual. Stress is the main risk factor in the development of mental disorders, such as depression and other disorders developing as a result of addiction. Studies indicate that women are twice as likely as men to develop anxiety, depression and therefore addiction, e.g., to nicotine. Even though the data presented is indicative of significant differences between the sexes in the prevalence of these disorders, the majority of preclinical animal models for investigating stress-induced disorders use predominantly male subjects. However, the recent data indicates that this type of studies has also been launched in female rodents. Therefore, conducting research on both sexes allows for a more accurate understanding and assessment of the impact of stress on stress-induced behavioral, peripheral and molecular changes in the body and brain. In this manuscript we have gathered the data from 41 years (from 1981-2022) on the influence of stress on the development of depression and nicotine addiction in both sexes.
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Jang S, Suh EE. Outpatient Service Use in Korean Older Adult Women with Degenerative Arthritis Based on Andersen's Model. Geriatrics (Basel) 2023; 8:9. [PMID: 36648914 PMCID: PMC9844404 DOI: 10.3390/geriatrics8010009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 12/14/2022] [Accepted: 01/04/2023] [Indexed: 01/11/2023] Open
Abstract
To ensure that older adults (aged 65 years or older) can experience a healthy life, they should use medical services that are appropriate, both quantitatively and qualitatively. This study aimed to identify the factors affecting outpatient service use by older adult women with degenerative arthritis using Andersen’s model. A survey was conducted among 232 older adult women with degenerative arthritis in two university hospitals in Seoul. The Korean Activities of Daily Living, Korean Instrumental Activities of Daily Living, and the Geriatric Depression Scale Short Form were used. Data were analyzed using descriptive statistics, χ2-test, t-test, and multiple logistic regression analysis. Among the participants, 69.8% used outpatient services and 30.2% did not. In the univariate analyses, age, marital status, residency, household income, chronic diseases, subjective health status, and disability were significant. Age (odds ratio [OR] = 5.53, p < 0.001), annual household income (OR = 5.64, p < 0.001), chronic diseases (OR = 11.06, p < 0.001), and disability (OR = 3.56, p = 0.016) significantly affected outpatient service use. The results suggest that health promotion interventions for Korean older adult women should focus on predicting outpatient service use according to the patient’s characteristics.
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Affiliation(s)
- Soyoung Jang
- Center for Human-Caring Nurse Leaders for the Future by Brain Korea 21 (BK 21) Four Project, College of Nursing, Seoul National University, Seoul 03080, Republic of Korea
| | - Eunyoung E. Suh
- Center for Human-Caring Nurse Leaders for the Future by Brain Korea 21 (BK 21) Four Project, College of Nursing, Seoul National University, Seoul 03080, Republic of Korea
- Research Institute of Nursing Science, College of Nursing, Seoul National University, Seoul 03080, Republic of Korea
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Wu Y, Jin S, Guo J, Zhu Y, Chen L, Huang Y. The Economic Burden Associated with Depressive Symptoms among Middle-Aged and Elderly People with Chronic Diseases in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12958. [PMID: 36232268 PMCID: PMC9566659 DOI: 10.3390/ijerph191912958] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 10/03/2022] [Accepted: 10/06/2022] [Indexed: 06/16/2023]
Abstract
Coexisting physical diseases and depressive symptoms exacerbate morbidity and disability, but their incremental economic burden remains unclear. We used cross-sectional data from the China Health and Retirement Longitudinal Study (CHARLS) survey in 2018 to estimate the economic burden associated with depressive symptoms among middle-aged and elderly people with chronic diseases. A multivariable regression model was used to assess the annual health care utilization, expenditures, and productivity loss of depressive symptoms among people with 12 common chronic diseases. We found that depressive symptoms were associated with higher incremental economic burdens, as the total health care costs increased by 3.1% to 85.0% and annual productivity loss increased by 1.6% to 90.1%. Those with cancer or malignant tumors had the largest economic burden associated with depressive symptoms, with CNY 17,273.7 additional annual health care costs and a loss of CNY 2196.2 due to additional annual productivity loss. The effect of depressive symptoms on the economic burden of patients with chronic conditions did not increase by the number of chronic conditions. Considering the high economic burden associated with depressive symptoms among patients with chronic conditions, it is important to consider the mental health of patients in chronic disease treatment and management.
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Affiliation(s)
- Yun Wu
- Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, 74, Zhongshan 2nd Road, Guangzhou 510030, China
| | - Sihui Jin
- Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, 74, Zhongshan 2nd Road, Guangzhou 510030, China
| | - Jianwei Guo
- Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, 74, Zhongshan 2nd Road, Guangzhou 510030, China
| | - Yi Zhu
- Department of Epidemiology and Health Statistics, School of Public Health, Huazhong University of Science and Technology, 1037 Luoyu Road, Hongshan District, Wuhan 430074, China
| | - Lijin Chen
- Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, 74, Zhongshan 2nd Road, Guangzhou 510030, China
| | - Yixiang Huang
- Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, 74, Zhongshan 2nd Road, Guangzhou 510030, China
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Powell DS, Betz JF, Yaffe K, Kritchevsky S, Strotmeyer E, Simonsick EM, Rubin S, Houston DK, Pratt SR, Purchase Helzner E, Brewster KK, Lin FR, Gross AL, Deal JA. Hearing loss and risk of depressive symptoms in older adults in the Health ABC study. FRONTIERS IN EPIDEMIOLOGY 2022; 2:980476. [PMID: 38455326 PMCID: PMC10910912 DOI: 10.3389/fepid.2022.980476] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 09/21/2022] [Indexed: 03/09/2024]
Abstract
Objective Hearing loss (HL) is highly prevalent among older adults and may lead to increased risk of depressive symptoms. In both cross-sectional and longitudinal analysis, we quantified the association between HL and depressive symptoms, incorporating the variable nature of depressive symptoms and characterizing by race and gender. Methods Data were from the Health, Aging, and Body Composition study. Depressive symptoms were measured using the Center for Epidemiologic Study Depression Scale short form (CES-D 10), defined as CES-D 10 score ≥10 or treatment for depression. Hearing was defined via four-frequency pure-tone average (PTA) decibel hearing level (dB HL), categorized as normal hearing (PTA ≤25 dB HL), mild HL (PTA26-40 dB HL), and ≥moderate HL (PTA > 40 dB HL). Associations at baseline were quantified using logistic regression, incident depressive symptoms using Cox proportional hazard models, and change in depressive symptoms over time using growth mixture models and multinomial logistic regression. Results Among 2,089 older adults (1,082 women, 793 Black; mean age 74.0 SD: 2.8), moderate or greater HL was associated with greater odds of concurrent [Odds Ratio (OR):2.45, 95% CI:1.33, 4.51] and incident depressive symptoms [Hazard Ratio (HR):1.26, 95% CI:1.00, 1.58]. Three depressive symptom trajectory patterns were identified from growth mixture models: low, moderate increasing, and borderline high depressive symptom levels. Those with moderate or greater HL were more likely to be in the borderline high depressive-symptom trajectory class than the low trajectory class [Relative Risk Ratio (RRR):1.16, 95% CI:1.01, 1.32]. Conclusions HL was associated with greater depressive symptoms. Although findings were not statistically significantly different by gender and race, estimates were generally stronger for women and Black participants. Investigation of psychosocial factors and amelioration by hearing aid use could have significant benefit for older adults' quality of life.
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Affiliation(s)
- Danielle S. Powell
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Joshua F. Betz
- Cochlear Center for Hearing and Public Health, Johns Hopkins University, Baltimore, MD, United States
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Kristine Yaffe
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, United States
- Department of Psychiatry, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
| | - Stephen Kritchevsky
- Section on Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - Elsa Strotmeyer
- Department of Epidemiology, Center for Aging and Population Health, University of Pittsburgh, Pittsburgh, PA, United States
| | - Eleanor M. Simonsick
- Intramural Research Program, National Institute of Aging, Baltimore, MD, United States
| | - Susan Rubin
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, United States
| | - Denise K. Houston
- Section on Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - Sheila R. Pratt
- Department of Communication Sciences and Disorders, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, United States
- Veterans Affairs (VA) Pittsburgh Healthcare System, Pittsburgh, PA, United States
| | - Elizabeth Purchase Helzner
- Department of Epidemiology and Biostatistics, State University of New York (SUNY) Downstate Health Sciences University, Brooklyn, NY, United States
| | - Katharine K. Brewster
- New York State Psychiatric Institute, New York, NY, United States
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, United States
| | - Frank R. Lin
- Cochlear Center for Hearing and Public Health, Johns Hopkins University, Baltimore, MD, United States
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
- Department of Otolaryngology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Alden L. Gross
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Jennifer A. Deal
- Cochlear Center for Hearing and Public Health, Johns Hopkins University, Baltimore, MD, United States
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
- Department of Otolaryngology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
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Davila H, Johnson DR. Maximizing Well-Being in the Context of Long-Term Services and Supports: A Q Methodological Approach. Clin Gerontol 2022; 45:1155-1166. [PMID: 33755524 DOI: 10.1080/07317115.2021.1899092] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVES The goal of this study was to investigate diversity in stakeholders' perspectives on how best to maximize older adults' well-being when they use long-term services and supports (LTSS). METHODS We used Q methodology, an exploratory method, to investigate preference patterns among a purposive sample of older adults, family members, and leadership professionals (n = 57). Participants categorized 52 items related to 9 domains of LTSS quality relevant to well-being into categories of importance. We used factors analysis and qualitative methods to identify groups of individuals who identified similar priorities. RESULTS The analysis identified four shared viewpoints, each prioritizing different aspects of well-being: 1) physical health and safety; 2) independence; 3) emotional well-being; and 4) social engagement. Individual and contextual factors, including stakeholder role, care needs, and expectations for LTSS, appeared to influence participants' perspectives. CONCLUSIONS Distinct viewpoints on how to maximize well-being when older adults use LTSS exist. Our results affirm the importance of person-centered care yet demonstrate that shared preference patterns LTSS exist. CLINICAL IMPLICATIONS Engaging with older adults' values and preferences is critical to improving their experiences with LTSS. Better understanding common preference patterns could help providers deliver person-centered care more efficiently and effectively.
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Affiliation(s)
- Heather Davila
- Center for Healthcare Organization and Implementation Research, Boston University School of Medicine, Boston, Massachusetts, USA
| | - David R Johnson
- Department of Organizational Leadership, Policy, and Development, College of Education and Human Development, University of Minnesota, Minneapolis, Minnesota, USA.,Section of General Internal Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
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McClain AC, Xiao RS, Tucker KL, Falcón LM, Mattei J. Depressive symptoms and allostatic load have a bidirectional association among Puerto Rican older adults. Psychol Med 2022; 52:3073-3085. [PMID: 33443008 PMCID: PMC8277900 DOI: 10.1017/s0033291720005139] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND Depression is strongly associated with chronic disease; yet, the direction of this relationship is poorly understood. Allostatic load (AL) provides a framework for elucidating depression-disease pathways. We aimed to investigate bidirectional, longitudinal associations of baseline depressive symptoms or AL with 5-year AL or depressive symptoms, respectively. METHODS Data were from baseline, 2-year, and 5-year visits of 620 adults (45-75 years) enrolled in the Boston Puerto Rican Health Study. The Center for Epidemiology Studies Depression (CES-D) scale (0-60) captured depressive symptoms, which were categorized at baseline as low (<8), subthreshold (8-15), or depression-likely (⩾16) symptoms. AL was calculated from 11 parameters of biological functioning, representing five physiological systems. Baseline AL scores were categorized by the number of dysregulated parameters: low (0-2), moderate (3-5), or high (⩾6) AL. Multivariable, multilevel random intercept and slope linear regression models were used to examine associations between 3-category baseline CES-D score and 5-year continuous AL score, and between baseline 3-category AL and 5-year continuous CES-D score. RESULTS Baseline subthreshold depressive symptoms [(mean (95% CI)): 4.8 (4.5-5.2)], but not depression-likely symptoms [4.5 (4.2-4.9)], was significantly associated with higher 5-year AL scores, compared to low depressive symptoms [4.3 (3.9-4.7)]. Baseline high AL [19.4 (17.6-21.2)], but not low AL [18.5 (16.5-20.6)], was significantly associated with higher 5-year CES-D score, compared to baseline moderate AL [16.9 (15.3-18.5)]. CONCLUSIONS Depressive symptoms and AL had a bi-directional relationship over time, indicating a nuanced pathway linking depression with chronic diseases among a minority population.
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Affiliation(s)
- Amanda C. McClain
- School of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA, USA
| | - Rui S. Xiao
- IQVIA, Real-World Evidence, Cambridge, MA, USA
| | - Katherine L. Tucker
- Department of Biomedical and Nutritional Sciences, University of Massachusetts, Lowell, MA, USA
| | - Luis M. Falcón
- College of Fine Arts, Humanities and Social Sciences, University of Massachusetts, Lowell, MA, USA
| | - Josiemer Mattei
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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38
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Depression/anxiety symptoms and self-reported difficulty managing medication regimen among community-dwelling older adults. Gen Hosp Psychiatry 2022; 78:50-57. [PMID: 35853418 DOI: 10.1016/j.genhosppsych.2022.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 06/17/2022] [Accepted: 07/07/2022] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To examine the associations between depression/anxiety severity and changes in severity and self-reported difficulty managing medications among a representative sample of community-residing US Medicare beneficiaries without a reported dementia diagnosis. METHOD We used the 2018 and 2019 National Health and Aging Trend Study (analysis sample N = 3198, 98% age 70+). Depression/anxiety was measured with the PHQ-4, and difficulty managing medication was self-reported. Following descriptive statistics, we fit a multinomial logistic regression model to examine the associations between depression/anxiety symptoms in 2018 and changes in severity between 2018 and 2019 and self-reported level of difficulty managing medication in 2019. RESULTS Of past-month prescription medication users in 2019, 85.2%, 10.7%, and 4.1% reported no difficulty, a little/some difficulty, and a lot of difficulty or partial/full reliance on other's help for health/functioning reasons, respectively. Both mild and moderate/severe levels of depression/anxiety in 2018 were associated with significantly higher risks of a little/some difficulty and a lot of difficulty/other's help in 2019. Compared to no change in depression/anxiety symptoms between 2018 and 2019, decreased symptoms were associated with lower risk (RRR = 0.47, 95% CI = 0.28-0.78) and increased symptoms were associated with higher risk (RRR = 1.73, 95% CI = 1.12-2.67) of a little/some difficulty managing one's medication. CONCLUSIONS Decrease and increase in depression/anxiety are associated with decreased and increased risk, respectively, of medication self-management difficulty among community-residing older adults. Healthcare providers should more carefully assess for medication management problems in their older adults with depression and anxiety symptoms and provide individually tailored interventions for those with great difficulty self-managing medication.
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Gao J, Zhu D, Deal JA, Lin FR, He P. Hearing impairment, family financial support, and depressive symptoms among Chinese middle-aged and older adults. Int J Geriatr Psychiatry 2022; 37. [PMID: 36004947 DOI: 10.1002/gps.5788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Accepted: 07/11/2022] [Indexed: 11/07/2022]
Abstract
AIMS Hearing impairment (HI) is prevalent among middle-aged and older adults, but few studies have examined its mental health consequences in China. This study investigated the association of HI with depressive symptoms and whether family financial support moderated the association among adults aged 45 in China. METHODS Data were obtained from three waves of the China Health and Retirement Longitudinal Study (2011, 2013 and 2015). Hearing impairment was defined as a self-reported hearing problem in one or both ears. Depressive symptoms were measured with CESD-10. Associations between HI and depressive symptoms were modeled using fixed-effect models. RESULTS People with self-reported hearing loss were more likely than those without hearing loss to have depressive symptoms, with an odds ratio of 1.25 [1.07-1.47]. The association remained significant after adjusting for socio-demographic characteristics, lifestyle behaviors, and health conditions. Family financial support moderated this association. Among those with HI, adults with a higher level of family financial support tend to have better performance on symptoms of depression. CONCLUSIONS HI was positively associated with depressive symptoms among adults aged ≥45 in China, and family financial support played a buffering role in the relationship between HI and depressive symptoms.
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Affiliation(s)
- Jiamin Gao
- School of Social Development and Public Policy, Beijing Normal University, Beijing, China
| | - Dawei Zhu
- China Center for Health Development Studies, Peking University, Beijing, China
| | - Jennifer A Deal
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Frank R Lin
- School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA.,Johns Hopkins Bloomberg School of Public Health, Cochlear Center for Hearing and Public Health, Baltimore, Maryland, USA
| | - Ping He
- China Center for Health Development Studies, Peking University, Beijing, China
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40
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Wu Q, Feng J, Pan CW. Risk factors for depression in the elderly: An umbrella review of published meta-analyses and systematic reviews. J Affect Disord 2022; 307:37-45. [PMID: 35351490 DOI: 10.1016/j.jad.2022.03.062] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 03/21/2022] [Accepted: 03/23/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Depression has been identified as one of the leading causes of the disease burden worldwide. Identification of the potential factors that increased or decreased the risk of depression could be important to provide prevention strategies. We aimed to conduct an umbrella review of risk factors for depression in the elderly and assessed the credibility of evidence of the association between each factor and depression. METHODS We searched PubMed and Web of Science from 1990 to April 11, 2021 for articles investigating associations between potential factors and depression. For each association, we recalculated the summary effect size and 95% confidence intervals using random effects models. The 95% prediction interval and between-heterogeneity were also reported. For publication bias, small-study effect and excess of significance bias were assessed. RESULTS Twenty-five publications met the inclusion criteria, including twenty-two meta-analyses and three qualitative systematic reviews. Approximately 1,199,927 participants and 82 unique factors were reported. Two factors were rated as convincing evidence and four factors showed highly suggestive evidence. These risk factors were aspirin use, individuals aged 80 years and above, sleep disturbances and persistent sleep disturbances, hearing problem, poor vision, and cardiac disease. LIMITATIONS Most studies that we included were of low quality. CONCLUSIONS We found several risk factors for depression with different levels of evidence, in which aspirin use and individuals aged 80 years and above presented the strongest evidence. Further research is warranted to support other findings from this umbrella review using a large, well-designed cohort study.
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Affiliation(s)
- Qian Wu
- School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Jian Feng
- Kunshan Mental Health Center, Suzhou, China.
| | - Chen-Wei Pan
- School of Public Health, Medical College of Soochow University, Suzhou, China.
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Maștaleru A, Abdulan IM, Ștefăniu R, Lefter N, Sandu IA, Pîslaru AI, Leon-Constantin MM, Alexa ID, Ilie AC. Relationship between Frailty and Depression in a Population from North-Eastern Romania. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095731. [PMID: 35565126 PMCID: PMC9099999 DOI: 10.3390/ijerph19095731] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 05/05/2022] [Accepted: 05/06/2022] [Indexed: 11/25/2022]
Abstract
(1) Background: In the older population, depression often affects people with chronic medical illnesses, cognitive impairment, or disability. Frailty is another important issue affecting older adults, being difficult to clinically distinguish from frailty in advanced old age. Well-designed interventional studies and clinical strategies targeting both frailty and depression are rare or nonexistent. (2) Methods: We realized a retrospective study in which we included a total of 411 patients that were admitted to the Geriatric Clinic from “Dr. C. I. Parhon” Hospital from Iasi for a period of 13 months. The aim of our study was to investigate the relationship between depression and frailty in a geriatric population due to the fact that the quality of life is negatively influenced by both frailty and depression. (3) Results: The prevalence of the depressive symptoms screened by the GDS-15 was 66.7%, with women being more depressed than men. Furthermore, an obvious relationship between depression and the dependence degree in performing daily activities has been observed. In addition, the mean MMSE score decreased with an increasing degree of depression. (4) Conclusions: Our study demonstrates the association between frailty and depression, one of them being a risk factor in the development of the other. A poor acknowledgment of the problem and an underdiagnosis of these conditions are important public health concerns due to the high healthcare costs. Thus, an active primary prevention would be imperiously needed in order to diagnose frailty and depression at an early stage, increasing the quality of life of the elderly and also their successful aging.
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Affiliation(s)
- Alexandra Maștaleru
- Department of Medical Specialties I, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania;
| | - Irina Mihaela Abdulan
- Department of Medical Specialties I, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania;
- Correspondence: (I.M.A.); (M.M.L.-C.)
| | - Ramona Ștefăniu
- Department of Medical Specialties II, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iaşi, Romania; (R.Ș.); (N.L.); (I.A.S.); (A.I.P.); (I.D.A.); (A.C.I.)
| | - Nicoleta Lefter
- Department of Medical Specialties II, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iaşi, Romania; (R.Ș.); (N.L.); (I.A.S.); (A.I.P.); (I.D.A.); (A.C.I.)
| | - Ioana Alexandra Sandu
- Department of Medical Specialties II, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iaşi, Romania; (R.Ș.); (N.L.); (I.A.S.); (A.I.P.); (I.D.A.); (A.C.I.)
| | - Anca Iuliana Pîslaru
- Department of Medical Specialties II, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iaşi, Romania; (R.Ș.); (N.L.); (I.A.S.); (A.I.P.); (I.D.A.); (A.C.I.)
| | - Maria Magdalena Leon-Constantin
- Department of Medical Specialties I, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania;
- Correspondence: (I.M.A.); (M.M.L.-C.)
| | - Ioana Dana Alexa
- Department of Medical Specialties II, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iaşi, Romania; (R.Ș.); (N.L.); (I.A.S.); (A.I.P.); (I.D.A.); (A.C.I.)
| | - Adina Carmen Ilie
- Department of Medical Specialties II, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iaşi, Romania; (R.Ș.); (N.L.); (I.A.S.); (A.I.P.); (I.D.A.); (A.C.I.)
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Zhao L, Wang J, Deng H, Chen J, Ding D. Depressive Symptoms and ADL/IADL Disabilities Among Older Adults from Low-Income Families in Dalian, Liaoning. Clin Interv Aging 2022; 17:733-743. [PMID: 35574289 PMCID: PMC9091470 DOI: 10.2147/cia.s354654] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 04/20/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose This study aimed to assess the prevalence of depressive symptoms and ADL/IADL disabilities and explore their correlation and associated factors for depressive symptoms among community-dwelling older adults from low-income families in Dalian, Liaoning Province, China. Methods This cross-sectional study included 522 participants aged 60 years and older from low-income families in Dalian. The 30-Item Geriatric Depression Scale was employed to measure depressive symptoms. The Katz ADL Scale and IADL Scale were used to evaluate the performance of activities necessary for independent life. SPSS 22.0 was employed to analyze the data. Logistic regression was used to estimate the relationship between depressive symptoms and ADL/IADL disabilities in five models. Results The prevalence of depressive symptoms among older people from low-income families in Dalian was 57.3%. A total of 19.0% had difficulties performing ADLs, and 40.2% had difficulties performing IADLs. Logistic regression analysis revealed that ADL/IADL disabilities were associated with depressive symptoms even after controlling for people’s sociodemographic characteristics, welfare, health conditions and informal care. The following factors were associated with depressive symptoms: education, self-reported health, number of chronic diseases, and emotional support from families. Conclusion Given that older people from low-income families in Dalian have a notable prevalence rate of depressive symptoms, and ADL/IADL disabilities were independently associated with these symptoms, it is crucial to give priority to this particular group in geriatric health services due to economic and health disparities.
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Affiliation(s)
- Lu Zhao
- Department of Medical Sociology, School of Humanities and Social Sciences, Dalian Medical University, Dalian, 116044, People’s Republic of China
| | - Junting Wang
- Department of Social Medicine, School of Public Health, Dalian Medical University, Dalian, 116044, People’s Republic of China
| | - Haoyuan Deng
- Department of Nutrition and Food Health, School of Public Health, Dalian Medical University, Dalian, 116044, People’s Republic of China
| | - Junfeng Chen
- Department of Social Medicine, School of Public Health, Dalian Medical University, Dalian, 116044, People’s Republic of China
- Correspondence: Junfeng Chen; Ding Ding, Department of Social Medicine, School of Public Health, Dalian Medical University, No. 9 West Section Lvshun South Road, Dalian, 116044, People’s Republic of China, Tel +86 13009493030; +86 18249517190, Email ;
| | - Ding Ding
- Department of Social Medicine, School of Public Health, Dalian Medical University, Dalian, 116044, People’s Republic of China
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Zhang X, Browning MHEM, Luo Y, Li H. Can sports cartoon watching in childhood promote adult physical activity and mental health? A pathway analysis in Chinese adults. Heliyon 2022; 8:e09417. [PMID: 35607499 PMCID: PMC9123224 DOI: 10.1016/j.heliyon.2022.e09417] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 03/21/2022] [Accepted: 05/10/2022] [Indexed: 11/24/2022] Open
Abstract
Physical activity is essential to maintain physical and mental health. Unfortunately, insufficient physical activity has become a common phenomenon worldwide in the past decade, and the absence of interest in physical activity is assumed a reason. Therefore, strategies for fostering interests and promoting public engagement are in need. We conducted a questionnaire survey during September 2021 that involved 1202 adults to capture data on sports and relevant cartoon watching experiences during childhood; Intensity and frequency of physical activity, depression (PHQ-9), and anxiety (GAD-7) during adulthood. Structural equation modeling was employed to examine pathways between watching sports cartoon in childhood and physical activity and mental health in adulthood. The results suggest that childhood sports cartoon watching may have indirect and positive impacts on adult physical activity and, in turn, on mental health. Childhood sports experience is a critical mediator role linking childhood sports cartoon watching, adult physical activity, and adult mental health. In conclusion, watching sports cartoon may help cultivate sports interests and promote children's participation in sports, and the sports experiences may be a continuous and beneficial factor that connects childhood and adulthood. These findings indicate a framework to understand the durative positive impact of cartoons and maybe other children's film and television works.
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Affiliation(s)
- Xing Zhang
- Institute of Sports Science, College of Physical Education, Southwest University, Chongqing 400715, China.,Department of Basketball and Volleyball, Chengdu Sport University, Sichuan 610041, China
| | - Matthew H E M Browning
- Department of Park, Recreation, and Tourism Management, Clemson University, Clemson, SC 29634, USA
| | - Yong Luo
- Department of Basketball and Volleyball, Chengdu Sport University, Sichuan 610041, China
| | - Hansen Li
- Institute of Sports Science, College of Physical Education, Southwest University, Chongqing 400715, China
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Jiang C, Jiang S. Effects of Adverse Childhood Experiences on Late-life Mental Health: Potential Mechanisms Based on a Nationally Representative Survey in China. Arch Gerontol Geriatr 2022; 100:104648. [DOI: 10.1016/j.archger.2022.104648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Revised: 01/26/2022] [Accepted: 02/03/2022] [Indexed: 11/02/2022]
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Yang C, Sun X, Duan W. Widowhood and Life Satisfaction Among Chinese Elderly Adults: The Influences of Lifestyles and Number of Children. Front Public Health 2022; 9:754681. [PMID: 35155332 PMCID: PMC8826226 DOI: 10.3389/fpubh.2021.754681] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 12/14/2021] [Indexed: 11/26/2022] Open
Abstract
Our study examined how lifestyle and number of children influence the relationship between widowhood and life satisfaction based on self-regulation theory. A sample of 2,968 elderly respondents (male = 1,515, female = 1,453, mean age = 69.12 years, SD = 7.24) participated in Chinese General Social Survey. Our findings suggest that lifestyle is positively related to life satisfaction, and number of children is positively associated with life satisfaction but negatively related to lifestyle. The moderated mediation model demonstrated that lifestyle partly mediated the relationship between widowhood and life satisfaction. Moreover, number of children moderated the relationship between widowhood and lifestyle and between lifestyle and satisfaction with life. Widowed elderly individuals who have more children are likely to show a higher level of satisfaction with life. The present study has significance in practice because it provides empirical implications obtained from a national survey on the universal two-child policy in China as two children might decrease the negative impacts of widowhood on life satisfaction.
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Affiliation(s)
- Caiyun Yang
- School of Philosophy and Law & Political Science, Shanghai Normal University, Shanghai, China
| | - Xixi Sun
- School of Social and Public Administration, East China University of Science and Technology, Shanghai, China
| | - Wenjie Duan
- School of Social and Public Administration, East China University of Science and Technology, Shanghai, China
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Fukunaga A, Inoue Y, Yamamoto S, Miki T, Hoang DV, Manandhar Shrestha R, Ishiwari H, Ishii M, Miyo K, Konishi M, Ohmagari N, Mizoue T. Association between chronic physical conditions and depressive symptoms among hospital workers in a national medical institution designated for COVID-19 in Japan. PLoS One 2022; 17:e0266260. [PMID: 35390049 PMCID: PMC8989319 DOI: 10.1371/journal.pone.0266260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 03/18/2022] [Indexed: 11/18/2022] Open
Abstract
Objective This study aimed to investigate the cross-sectional association between the presence of chronic physical conditions and depressive symptoms among hospital workers at a national medical institution designated for COVID-19 treatment in Tokyo, Japan. We also accounted for the combined association of chronic physical conditions and SARS-CoV-2 infection risk at work in relation to depressive symptoms, given that occupational infection risk might put additional psychological burden among those with chronic physical conditions with risk of severe COVID-19 outcome. Methods The study sample consisted of 2,440 staff members who participated in a health survey conducted at the national medical institution during period between October 2020 and December 2020. Participants who reported at least one chronic physical condition that were deemed risk factors of severe COVID-19 outcome were regarded as having chronic physical conditions. Depressive symptoms were assessed using the patient health questionnaire-9 (PHQ-9). We performed logistic regression analysis to assess the association between chronic physical conditions and depressive symptoms. Results Our results showed that the presence of chronic physical conditions was significantly associated with depressive symptoms (odds ratio (OR) = 1.49, 95% confidence interval (CI) = 1.10–2.02). In addition, the prevalence of depressive symptoms was significantly higher among healthcare workers with chronic physical conditions who were at a higher occupational infection risk (OR = 1.81, 95% CI = 1.04–3.16). Conclusion Our findings suggest the importance of providing more assistance to those with chronic physical conditions regarding the prevention and control of mental health issues, particularly among frontline healthcare workers engaging in COVID-19-related work.
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Affiliation(s)
- Ami Fukunaga
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
- * E-mail:
| | - Yosuke Inoue
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Shohei Yamamoto
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Takako Miki
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Dong Van Hoang
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Rachana Manandhar Shrestha
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Hironori Ishiwari
- Center for Medical Informatics Intelligence, National Center for Global Health and Medicine, Tokyo, Japan
| | - Masamichi Ishii
- Center for Medical Informatics Intelligence, National Center for Global Health and Medicine, Tokyo, Japan
| | - Kengo Miyo
- Center for Medical Informatics Intelligence, National Center for Global Health and Medicine, Tokyo, Japan
| | - Maki Konishi
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Norio Ohmagari
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Tetsuya Mizoue
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
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Zhang C, Chang Y, Yun Q, Lu J, Zheng X, Xue Y, Zhao X, Yuan W, Zou J, Zheng J. The impact of chronic diseases on depressive symptoms among the older adults: The role of sleep quality and empty nest status. J Affect Disord 2022; 302:94-100. [PMID: 35085671 DOI: 10.1016/j.jad.2022.01.090] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 01/18/2022] [Accepted: 01/22/2022] [Indexed: 10/19/2022]
Abstract
BACKGROUND Depression is the most prevalent mental disorder among older adults. This study aimed to explore the mediating effect of sleep quality on the relationship between chronic diseases and depressive symptoms, and the moderating role of empty nest status in the mediating model. METHODS A cross-sectional survey was conducted among 3637 older adults from Taiyuan, China, using a multi-stage random cluster sampling method. The data was collected with the general questionnaire for the elderly, with the Short Form Geriatric Depression Scale (GDS-15), and the Pittsburgh Sleep Quality Index (PSQI). The Bootstrap program and simple slope method were used to test the mediating effect of sleep quality and the moderating effect of empty nest status. RESULTS The overall prevalence of depressive symptoms in the population was 33.4%. The mediating effect analysis showed that chronic diseases had a significant direct impact on depressive symptoms in the elderly (β = 0.431, P < 0.001). Sleep quality as a mediation effect of 43.4% between chronic diseases and depressive symptoms was proven. The further moderating effect found that chronic diseases had a more significant impact on the sleep quality of the elderly who are in the empty nest status than those who are not (β = -0.431, P < 0.05 ). LIMITATIONS Given the cross-sectional study, the results cannot explain the causal relationships among the study variables. CONCLUSIONS Chronic diseases had a major impact on the depressive symptoms of the elderly. Sleep quality mediated the relationship between chronic diseases and depressive symptoms, and the empty nest status moderated the first half of the path in the mediation model. Therefore, to reduce the incidence of the depressive symptoms of the elderly, sleep quality and empty nest status should be the primary concern.
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Affiliation(s)
- Chichen Zhang
- School of Health Management, Southern Medical University, No.1023, Shatai Road, Guangzhou 510515, Guangdong, China; Department of Health Management, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China; Institute of Health Management, Southern Medical University, Guangzhou, Guangdong, China.
| | - Yunqi Chang
- Department of Preventive Medicine, Changzhi Medical College, Changzhi, Shanxi, China
| | - Qilong Yun
- Department of Mathematics, New York University, New York, NY, USA
| | - Jiao Lu
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Xiao Zheng
- School of Health Management, Southern Medical University, No.1023, Shatai Road, Guangzhou 510515, Guangdong, China
| | - Yaqing Xue
- School of Health Management, Southern Medical University, No.1023, Shatai Road, Guangzhou 510515, Guangdong, China
| | - Xinyue Zhao
- School of Management, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Wenpei Yuan
- School of Management, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Jiayu Zou
- School of Management, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Jianzhong Zheng
- Department of Preventive Medicine, Changzhi Medical College, Changzhi, Shanxi, China
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Feng L, Wu D, Lin J, Li Y, Zhao Y, Zhang P, Yao Y, Fu S. Associations between age-related hearing loss, cognitive decline, and depression in Chinese centenarians and oldest-old adults. Ther Adv Chronic Dis 2022; 13:20406223221084833. [PMID: 35342536 PMCID: PMC8949803 DOI: 10.1177/20406223221084833] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 02/14/2022] [Indexed: 11/20/2022] Open
Abstract
Objective: Age-related hearing loss (ARHL) and age-related cognitive decline (ARCD) are leading causes of disability in older adults. ARHL may increase ARCD risk and cause depression development. This study aimed to explore the associations of ARHL with ARCD and depression in Chinese centenarians and oldest-old adults. Methods: A household survey was conducted on 859 centenarians and oldest-old adults residing in 16 cities and counties in China. Basic information was collected using interview questionnaires, physical examinations, and blood tests conducted by systematically trained local doctors and nurses. Results: In total, 501 (58.3%), 649 (75.6%), and 211 (24.6%) participants had ARHL, ARCD, and depression, respectively. The prevalence of ARCD and depression was significantly higher in participants with ARHL than in those without ARHL (all p < 0.05). Participants with ARHL had significantly lower Mini-Mental State Examination (MMSE) scores indicative of more cognitive decline, and significantly higher 15-item version of the Geriatric Depression Scale (GDS-15) scores suggesting greater levels of depression, than those without ARHL (all p < 0.05). Multivariate logistic regression analyses (Stepwise) indicated that ARHL was significantly and positively associated with ARCD [odds ratio (OR): 1.594, 95% confidence interval (CI): 1.132, 2.245] and depression (OR: 1.623, 95% CI: 1.139, 2.314; all p < 0.05). Multivariate linear regression analyses (Stepwise) indicated that ARHL was significantly and inversely associated with MMSE scores (B: −2.520, 95% CI: −3.356, −1.684) and significantly and positively associated with GDS-15 scores (B: 0.713, 95% CI: 0.328, 1.098; all p < 0.05). Conclusion: ARHL is independently associated with ARCD and depression in Chinese centenarians and oldest-old adults.
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Affiliation(s)
- Long Feng
- Department of Anesthesiology, Hainan Hospital of Chinese People's Liberation Army General Hospital, Sanya, China
| | - Di Wu
- Department of Cardiology, Hainan Hospital of Chinese People's Liberation Army General Hospital, Sanya, China
| | - Jieqiong Lin
- Department of Pathology, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou, China
| | - Yulong Li
- Department of Geriatric Cardiology, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Yali Zhao
- Central Laboratory, Hainan Hospital of Chinese People's Liberation Army General Hospital, Sanya, China
| | - Pei Zhang
- School of Life Science, Beijing Institute of Technology, Beijing, China
| | - Yao Yao
- Center for the Study of Aging and Human Development and Geriatrics Division, School of Medicine, Duke University, Durham, NC, USA
| | - Shihui Fu
- Department of Cardiology, Hainan Hospital of Chinese People's Liberation Army General Hospital, Sanya, China
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Huang ZT, Luo Y, Han L, Wang K, Yao SS, Su HX, Chen S, Cao GY, De Fries CM, Chen ZS, Xu HW, Hu YH, Xu B. Patterns of cardiometabolic multimorbidity and the risk of depressive symptoms in a longitudinal cohort of middle-aged and older Chinese. J Affect Disord 2022; 301:1-7. [PMID: 34999125 DOI: 10.1016/j.jad.2022.01.030] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 01/01/2022] [Accepted: 01/04/2022] [Indexed: 12/11/2022]
Abstract
BACKGROUND Cardiometabolic diseases (CMDs) are associated with depression. However, it is unclear whether coexisting CMDs may increase the risk of depression. We examined associations between cardiometabolic multimorbidity and depressive symptoms among middle-aged and older Chinese. METHODS Participants aged ≥45 years were enrolled from the China Health and Retirement Longitudinal Study 2011-2018 (N = 18,002). Cardiometabolic multimorbidity was defined as the coexistence of ≥2 CMDs, including stroke, heart disease, diabetes, hypertension, and dyslipidemia. Depressive symptoms were assessed by the Center for Epidemiological Studies Depression Scale. We used generalized estimating equation models to examine associations between cardiometabolic multimorbidity and depressive symptoms, including the dose effect of disease count and prevalent disease combinations, as well as individual and additive effects of specific CMDs. RESULTS The prevalence of cardiometabolic multimorbidity was 24.5%. A higher number of CMDs had an additive dose effect on depressive symptoms that persisted consistently in specific CMDs. Stroke only, heart disease only, and diabetes only were each associated with a higher risk of depressive symptoms compared with no CMDs. CMD combinations involving stroke, heart disease, or diabetes were each associated with an increased risk of depressive symptoms compared with the absence of stroke, heart disease, or diabetes. LIMITATION Self-reported chronic conditions. CONCLUSION Stroke, heart disease, and diabetes showed individual and additive effects on CMD combinations, whereas hypertension and dyslipidemia only showed associations with depressive symptoms in combinations with other CMDs. These results suggest person-centered healthcare of mental health prevention and treatment for middle-aged and older adults with individual or multiple CMDs.
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Affiliation(s)
- Zi-Ting Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China; Medical Informatics Center, Peking University, Beijing, China
| | - Yan Luo
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China; Medical Informatics Center, Peking University, Beijing, China
| | - Ling Han
- Department of Internal Medicine, Yale School of Medicine, New Haven, CT, United States of America
| | - Kaipeng Wang
- Graduate School of Social Work, University of Denver, Denver, Colorado, United States of America
| | - Shan-Shan Yao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China; Medical Informatics Center, Peking University, Beijing, China
| | - He-Xuan Su
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China; Medical Informatics Center, Peking University, Beijing, China
| | - Sumin Chen
- Yancheng Dafeng People's Hospital, Yancheng, Jiangsu, China
| | - Gui-Ying Cao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China; Medical Informatics Center, Peking University, Beijing, China
| | - Carson M De Fries
- Graduate School of Social Work, University of Denver, Denver, Colorado, United States of America
| | - Zi-Shuo Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China; Medical Informatics Center, Peking University, Beijing, China
| | - Hui-Wen Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China; Medical Informatics Center, Peking University, Beijing, China
| | - Yong-Hua Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China; Medical Informatics Center, Peking University, Beijing, China
| | - Beibei Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China; Medical Informatics Center, Peking University, Beijing, China.
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50
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Larson S, Nemoianu A, Lawrence DF, Troup MA, Gionfriddo MR, Pousti B, Sun H, Riaz F, Wagner ES, Chrones L, Touya M. Characterizing primary care for patients with major depressive disorder using electronic health records of a US-based healthcare provider. J Affect Disord 2022; 300:377-384. [PMID: 34953925 DOI: 10.1016/j.jad.2021.12.096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 12/14/2021] [Accepted: 12/20/2021] [Indexed: 10/24/2022]
Abstract
BACKGROUND Major depressive disorder (MDD) is predominantly managed in primary care. However, primary care providers (PCPs) may not consistently follow evidence-based treatment algorithms, leading to variable patient management that can impact outcomes. METHODS We retrospectively analyzed adult patients with MDD seen at Geisinger, an integrated health system. Utilizing electronic health record (EHR) data, we classified patients as having MDD based on International Classification of Disease (ICD)-9/10 codes or a Patient Health Questionnaire (PHQ)-9 score ≥5. Outcomes assessed included time to first visit with a PCP or behavioral health specialist following diagnosis, antidepressant medication switching, persistence, healthcare resource utilization (HRU), and treatment costs. RESULTS Among the 38,321 patients with MDD managed in primary care in this study, significant delays between diagnosis with antidepressant prescribing and follow-up PCP visits were observed. There was also considerable variation in care following diagnosis. Overall, 34.9% of patients with an ICD-9/10 diagnosis of MDD and 41.3% with a PHQ-9 score ≥15 switched antidepressants. An ICD-9/10 diagnosis, but not moderately severe to severe depression, was associated with higher costs and HRU. More than 75% of patients with MDD discontinued antidepressant medication within 6 months. LIMITATIONS The study population was comparable with other real-world studies of MDD, but study limitations include its retrospective nature and reliance on the accuracy of EHRs. CONCLUSIONS Management of patients with MDD in a primary care setting is variable. Addressing these gaps will have important implications for ensuring optimal patient management, which may reduce HRU and treatment medication costs, and improve treatment persistence.
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Affiliation(s)
- Sharon Larson
- Main Line Health Center for Population Research at the Lankenau Institute for Medical Research, Wynnewood, PA, and Thomas Jefferson University College of Population Health, Philadelphia, PA, United States.
| | | | - Debra F Lawrence
- Takeda Pharmaceuticals U.S.A., Inc., Lexington, MA, United States
| | | | | | - Bobak Pousti
- Geisinger Health System, Danville, PA, United States
| | - Haiyan Sun
- Geisinger Health System, Danville, PA, United States
| | - Faisal Riaz
- Takeda Pharmaceuticals U.S.A., Inc., Lexington, MA, United States
| | - Eric S Wagner
- Geisinger Health System, Danville, PA, United States
| | - Lambros Chrones
- Takeda Pharmaceuticals U.S.A., Inc., Lexington, MA, United States
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