Physical activity and depressive symptoms in older adults

Daily vitality fluctuations in older adults with depressive symptoms: A multilevel location-scale model

BACKGROUND

Examining the daily experiences of older adults with depression facilitates the development and application of personalized effective treatments for them. In previous clinical research on depression, traditional mean-based approaches have mainly been employed. However, the within-person residual variance as a random effect provides greater insight into the heterogeneity of daily experiences among geriatric samples.

OBJECTIVE

This study aimed to examine the relationship between depression and daily vitality in older adults. Specifically, it focused on the mean and residual variance of daily vitality measured by the Ecological Momentary Assessment (EMA).

METHODS

Data from 64 older adults aged 65 years or more, who participated in community welfare centers or retirees' associations, were used. Daily vitality was examined using EMA surveys for seven consecutive days (four random surveys per day). The data were analyzed using a location-scale model.

RESULTS

The intraclass correlation computed from the empty model for the EMA data was 0.488, indicating significant variances in daily vitality across time between individuals. Older adults with higher levels of depressive symptoms showed low mean levels of daily vitality and a large log-residual variance of daily vitality.

CONCLUSIONS

The findings from the current study suggest that individuals experiencing depression not only exhibit low vitality in their daily lives but also struggle to maintain stable levels of vitality in their lives. These insights could contribute to the facilitation and advancement of personalized interventions tailored for older adults.

The impact of food insecurity on mental health among older adults residing in low- and middle-income countries: A systematic review

Over the past few years, food insecurity has been increasing globally due to the COVID-19 pandemic, climate change, economic downturns and conflict and a number of other intersecting factors. Older adults residing in low- and middle-income countries are more vulnerable to food insecurity. While the impacts of food insecurity on physical health outcomes have been thoroughly researched, the effect on mental health outcomes remains under-researched, especially among older adults. Hence, this systematic review aims to investigate existing literature to assess how food insecurity impacts the mental health of older persons residing in LMICs. A systematic search of six databases and Google for studies was conducted. The search was limited to studies written in English and published between 2000 to the present. We identified 725 studies, out of which 40 studies were selected for a full-text review and 12 studies were included for a final analysis. The significant finding in all the included studies was that food insecurity is associated with the worsening mental health of older adults. We also found a complex interplay of factors such as gender, age, rural/urban and health conditions associated with the aggravation of several mental health outcomes. The findings of this study illuminate the need for improved food programs to improve food security and, consequently, mental health among older adults.

The Effect of Social Isolation, Loneliness, and Physical Activity on Depressive Symptoms of Older Adults during COVID-19: A Moderated Mediation Analysis

Depressive symptoms have been commonly reported in older adults during the coronavirus disease (COVID-19) pandemic. Social isolation as a result of social distancing to prevent COVID-19 was reported to increase the level of depressive symptoms both directly and indirectly through the mediating effect of loneliness. Depressive symptoms in older adults can be regulated through health behaviors such as physical activity. Therefore, this study used a moderated mediation model to explain depressive symptoms. The English Longitudinal Study of Ageing COVID-19 wave 2 data were used. A total of 296 individuals were excluded due to missing values, leaving a final sample of 6499. Depressive symptoms, social isolation, loneliness, and physical activity were used in the moderated mediation analysis with various demographic and general health variables as covariates. Loneliness was found to significantly mediate the relationship between social isolation and depression. While moderate physical activity significantly moderated the effects of social isolation and loneliness on depressive symptoms, mild physical activity alone significantly moderated the effects of loneliness on depressive symptoms. This study revealed the impact of social isolation on depressive symptoms directly and indirectly mediated by loneliness, with a moderating effect of moderate and mild physical activity in the elderly during COVID-19 in a moderated mediation model.

Developing a nomogram for predicting depression in diabetic patients after COVID-19 using machine learning

Objective

This study identified major risk factors for depression in community diabetic patients using machine learning techniques and developed predictive models for predicting the high-risk group for depression in diabetic patients based on multiple risk factors.

Methods

This study analyzed 26,829 adults living in the community who were diagnosed with diabetes by a doctor. The prevalence of a depressive disorder was the dependent variable in this study. This study developed a model for predicting diabetic depression using multiple logistic regression, which corrected all confounding factors in order to identify the relationship (influence) of predictive factors for diabetic depression by entering the top nine variables with high importance, which were identified in CatBoost.

Results

The prevalence of depression was 22.4% (n = 6,001). This study calculated the importance of factors related to depression in diabetic patients living in South Korean community using CatBoost to find that the top nine variables with high importance were gender, smoking status, changes in drinking before and after the COVID-19 pandemic, changes in smoking before and after the COVID-19 pandemic, subjective health, concern about economic loss due to the COVID-19 pandemic, changes in sleeping hours due to the COVID-19 pandemic, economic activity, and the number of people you can ask for help in a disaster situation such as COVID-19 infection.

Conclusion

It is necessary to identify the high-risk group for diabetes and depression at an early stage, while considering multiple risk factors, and to seek a personalized psychological support system at the primary medical level, which can improve their mental health.

Risk Factors for Falls and Fall-Related Fractures in Community-Living Older People with Pain: A Prospective Cohort Study

(1) Background: This prospective study aimed to identify predictors of falls and fall-related fractures in community-dwelling older people with pain; (2) Methods: Participants comprised 389 community-dwelling older people aged 70+ years who had musculoskeletal pain in the neck, back, hip, leg/knee and/or feet. Demographic, anthropometric, balance, mobility, cognitive function, psychological status and physical activity level measures were obtained at baseline. Falls were monitored with monthly falls calendars for 12 months. Logistic regression analyses were performed to identify predictors of falls and fall-related fractures during a 12-month follow-up; (3) Results: Of the 389 participants, 175 (45.0%) and 20 (5.1%) reported falls and fall-related fractures during the 12-month follow-up, respectively. Greater postural sway on foam, more depressive symptoms and lower physical activity levels at baseline were associated with falls during the 12-month follow-up. Slower walking speed at baseline was associated with fall-related fractures during the 12-month follow-up. These associations remained significant after adjusting for age, sex, body mass index, comorbidities and medication use; (4) Conclusions: This study suggests poor balance, low mood and a less active lifestyle are predictors of falls, and slower walking speed predicts fall-related fractures among community-dwelling older people with pain.

Sleep, physical activity, and sedentary behaviors as factors related to depression and health-related quality of life among older women living alone: a population-based study

BACKGROUND

Although the number of older women living alone (OWLA) has risen steadily in aging societies, and research has been conducted on depression and health-related quality of life (HRQoL) among older adults, research is scarce on the health behaviors of OWLA, including their sleep, physical activity, and sedentary behaviors. Hence, we aimed to identify factors related to depression and HRQoL among this subset of the population, focusing on their health behaviors, using Andersen's model as a research framework.

METHODS

Data for secondary analysis were from the Korean National Health and Nutritional Examination Survey (2014, 2016, 2018, and 2020). The inclusion criteria were (1) women aged 65 and older and (2) those living alone. We included 794 older South Korean women living alone from 31,051 respondents. We used hierarchical regression analysis, considering sampling weight and a complex sample design, to identify factors related to depression and HRQoL.

RESULTS

Among the health behavior factors of Andersen's model as a research framework, sleep was associated with depression, whereas physical activity and sedentary behaviors were related to HRQoL. Subjective health status, limited activity, and perceived stress were associated with both depression and HRQoL. Household income, as an enabling factor, was only associated with HRQoL. The final regression model explained 39% of the variance in depression (p < 0.001) and 37% of the variance in HRQoL (p < 0.001).

CONCLUSIONS

Our study highlights the importance of strategies to improve specific healthy behaviors that affect depression and HRQoL in OWLA. Appropriate interventions that target increasing physical activity and quality of sleep, and decreasing sedentary behaviors, will be effective to enhance the well-being of OWLA. Healthcare providers should comprehensively understand the characteristics of OWLA and pay more attention to enabling, need, and health behavior factors.

Promoting the well-being of rural elderly people for longevity among different birth generations: A healthy lifestyle perspective

Background

Wellbeing may have a protective role in health maintenance. However, no specific study clarified the particular protective effect of the subjective wellbeing of rural elderly people on survival probability. Few studies have examined the effect of the lifestyle of rural elderly people on their subjective wellbeing from different perspectives. We investigated whether improving subjective wellbeing increased the probability of longevity of rural elderly people and the effects of lifestyle behaviors on the subjective wellbeing of rural elderly people in different birth generations.

Materials and methods

Data were derived from the China Health and Nutrition Survey (CHNS), which is an ongoing open cohort study that adopts a multistage, random clustered sampling process. We used the data of elderly people who were aged 65 or over during 2006-2015 for analysis. The Kaplan-Meier method and log-rank test found that the survival probability of rural elderly people was significantly lower than urban elderly people. Based on a sample of rural elderly people, Cox regression and generalized estimating equations were performed as further analyses.

Results

A total of 892 rural elderly people aged 65 or over were included in the sample in 2006. High subjective wellbeing was a protective factor against death. The subjective wellbeing of rural elderly people born in the 1940s/1930s/1908-1920s birth generations first decreased then increased. For rural elderly people born in the 1940s, there were significant positive effects of a preference for eating vegetables and walking/Tai Chi on subjective wellbeing. For rural elderly people born in the 1930s, preferences for eating vegetables, reading, and watching TV all had significant positive effects on subjective wellbeing. Rural elderly people born in the 1908-1920s who preferred watching TV had more subjective wellbeing.

Conclusion

Improving subjective wellbeing extended the life span and reduced mortality risk in rural elderly people and may be achieved by the shaping of a healthy lifestyle, such as preferences for eating vegetables, walking/Tai Chi, and reading.

The Relationship between Physical Activity and Mental Depression in Older Adults during the Prevention and Control of COVID-19: A Mixed Model with Mediating and Moderating Effects

BACKGROUND

Several studies have found a strong relationship between physical activity and mental depression in older adults. Despite this, the social isolation, limited physical activity, and decreased social interactions caused by the 2020 COVID-19 pandemic control measures of "home isolation and reduction unnecessary travel" had a significant mental impact on older adults.

OBJECTIVE

the goal of this study was to look into the complex effects of physical activity participation on mental health in older adults during COVID-19 prevention and control and the relationship between physical activity and mental depression in older adults through the mediating effect of self-efficacy and the moderating effect of social support.

METHODS

The Physical Activity Rating Scale (PARS-3), the Center for Streaming Depression Scale (CES-D), the Self-Efficacy Scale (GSES), and the Social Support Rating Scale (SSRS) were used to assess 974 older adults in five urban areas of Chengdu, China. The SPSS was used to analyze the collected data using mathematical statistics, linear regression analysis, and the AMOS to construct the research model.

RESULTS

The study's findings revealed that self-efficacy mediated the relationship between physical activity and mental depression in older adults (β = -0.101, 95%CI (-0.149, -0.058)), and social support moderated the relationship between physical activity and mental depression in older adults (t = -9.144, p < 0.01).

CONCLUSIONS

Physical activity reduces psychological depressive symptoms in older adults and modulates psychological depression in older adults via the mediation efficacy of self-efficacy and the moderating effect of social support.

Accelerometer-Assessed Physical Activity and Cognitive Performance among European Adults Aged 50+: The Mediating Effects of Social Contacts and Depressive Symptoms

Background: Cognitive decline is a major public health concern worldwide and it is vital to identify and better understand effective population-based means to improve cognitive performance in old age. The current study set out to examine the links between accelerometer-based physical activity with cognitive performance in later life, as well the indirect pathways through one’s social network contacts and depression. Method: We used data from 855 participants aged 50 and above who took part in a cross-sectional accelerometer study as part of the Survey of Ageing, Retirement and Health (SHARE). Cognitive function was measured as an average score of fluency, immediate and delayed recall tests, social contacts were the average contact frequency with members of the social support network, and depression was the Euro-D summary score of depressive symptoms. A multiple mediation analysis was conducted to test the direct and indirect associations between total physical activity (intensity gradient) and cognitive function, as well as the mediation of this association by social contacts and depressive symptoms. Results: Intensity of physical activity was directly related to better cognitive performance (B = 0.170, p = 0.007). The association was partially mediated by social contacts (B = 0.022, 95% CI 0.005, 0.046) and depressive symptoms (B = 0.009, 95% CI 0.009, 0.025), such that total physical activity was linked to cognitive health via more frequent contacts with network members and low depressive symptoms. Conclusions: Practitioners might consider encouraging a physically active lifestyle that involves social interactions to support better cognitive aging and mental health.

Depression among Older Adults in Indonesia: Prevalence, Role of Chronic Conditions and Other Associated Factors

Background

Depression is one of the most common illnesses worldwide, with a prevalence of 5.7% among older adults aged over 60. Depression is a severe health condition that can significantly affect the quality of life.

Objective

The objective of this study is to investigate the determinant factors of depression among older adults in Indonesia.

Methods

Data of 4236 adults of 60 years old and over were taken from the fifth wave of the Indonesian Family Life Survey (IFLS-5). Sociodemographic and multiple health-related variables collected through interviews and measurements were analyzed. Multivariate logistic regression was used to evaluate depression and its associated factors.

Results

The prevalence of depression assessed using ten questions from the Center for Epidemiologic Studies Depression Scale (CES-D 10) was 16.3%. Significant associated factors for depression were moderate and low subjective economic status, living in Java or other regions outside Sumatra and Java, no life satisfaction, self-perceived as having poor health, having dependency (IADL scores), and experienced falls and insomnia. Among chronic conditions, stroke, arthritis, and hearing impairment were also more common in depressed older adults.

Conclusion

Predictors of depression identified in this study may be used to help prevent and improve depression in Indonesian older adults, especially those who live on Java. Improvement in healthcare, especially in the prevention and rehabilitation of stroke, arthritis, possible frailty (falls and dependency), hearing impairment, and insomnia, concurrent with early detection of depression in these chronic conditions, may help create a better quality of life among Indonesian older adults.

Cross-sectional associations of personal efforts and beliefs and depressive symptoms among older adults in India

Whilst there is growing evidence on the increased vulnerability of older adults to depression, there is limited research on potentially mitigative factors against symptoms of depression at a population level. This research examined associations of possible protective factors (personal efforts and beliefs) and depressive symptoms among older adults in India. This cross-sectional study used data from the Longitudinal Aging Study in India with 31,464 respondents aged 60 years and above. Depressive symptoms were assessed using the 10-item Centre for Epidemiologic Studies Depression Scale. Multivariable linear regression was used while exploring the associated factors of depressive symptoms. The mean score of depressive symptoms was 2.94 (CI 2.92, 2.96). Older adults who engaged in moderate [aCoef: −0.11, CI −0.18, −0.05], vigorous [aCoef: −0.09, CI −0.16, −0.03], or both types of physical activity [aCoef: −0.10, CI −0.19, −0.02] had lower likelihood of depressive symptoms in comparison to those who were physically inactive. Older adults who participated in social activities were less likely to have depressive symptoms [aCoef: −0.44, CI −0.50, −0.39] compared to their socially inactive counterparts. Further, older adults who perceived religion as very important [aCoef: −0.29, CI −0.41, −0.17], who had high life satisfaction [aCoef: −0.78, CI −0.82, −0.73], who had good self-perceived health [aCoef: −0.29, CI −0.33, −0.25] and those who had high self-perceived social standing [aCoef: −0.39, CI −0.47, −0.31] had lower likelihood of depressive symptoms in comparison to their respective counterparts. Physical activity, social participation, voluntary work and financial contribution to family, religiosity, life satisfaction, self-perceived health and self-perceived social standing are associated with lower likelihood of depressive symptoms among community-dwelling older adults in this study. Future longitudinal studies should explore these factors that can guide interventions against depression in old age.

Disease-inclusive exercise classes improve physical fitness and reduce depressive symptoms in individuals with and without Parkinson's disease-A feasibility study

BACKGROUND AND PURPOSE

Exercise is an adjunctive treatment in the management of Parkinson's disease (PD), but barriers such as health status, fear of overexertion, and lack of transportation to the location prevent regular exercise participation. Disease-inclusive exercise classes may offer an opportunity to make exercise more accessible for older adults with and without diseases. However, the efficacy of such heterogenous exercise classes is still widely unknown. Therefore, it was the aim of this study to analyze the feasibility of disease-inclusive exercise classes in older adults with and without PD.

METHODS

Twenty-one older adults (healthy older adults (HOA): n = 13; PD: n = 8) completed an 8-week multimodal exercise intervention in supervised group sessions. Exercise classes lasted 60 min with the goal of two participations a week. We assessed physical fitness (timed up and go test [TUG], 6-minute walking test [6MWT], single leg stance), depressive symptoms and cognitive functions, and we determined growth factors (BDNF & IGF-1) before and after the intervention to determine the effects and by that, the feasibility of a disease-inclusive exercise program. Repeated measures ANOVA were used to establish changes.

RESULTS

TUG and 6MWT improved significantly after the training in both HOA (p = .008; p < .001) and individuals with PD (p = .024; p < .001). Furthermore, individuals with PD increased single leg stance left (p = .003). HOA (p = .003) and individuals with PD (p = .001) decreased their depressive symptoms between pre- and post-test significantly. Whereas growth factors tended to improve, no differences in cognitive functions were revealed.

CONCLUSION

Disease-inclusive multicomponent exercise improved physical functions and reduced depressive symptoms independent of health status. This should encourage exercise providers, researchers, and clinicians to further investigate disease-inclusive exercise, because they may have an important social impact and represent a more inclusive society.

Analysis of Factors Affecting Depression in Older Adults in South Korea

Objective: This study aimed to analyze the factors affecting depression among South Korean middle-aged and older adults using data from the Korean Longitudinal Study of Aging. Methods: We analyzed data regarding demographic characteristics, lifestyle, quality of life, cognitive level, and depression. Cognitive level and depression were evaluated using the Korean-Mini-Mental Status Examination and Center for Epidemiological Studies Depression Scale, respectively. Results: Depression was correlated with age, gender, residential area, level of education, alcohol intake, regular exercise, life satisfaction, and cognitive level, but not smoking. Furthermore, depression was highly affected by age, residential area, regular exercise, life satisfaction, and cognitive level, with a prediction accuracy of 80.26% achieved through machine learning analysis. Conclusions: Various factors are associated with depression in middle-aged and older adults. Therefore, multifaceted interventions for preventing depression in these age groups are required.

Neighborhood Social Cohesion and Mobility Limitations Among Community-dwelling Older Americans: The Mediating Roles of Depressive Symptoms and Mastery

Neighborhood environment plays an important role in late-life health; yet, the social aspect of neighborhood environment and its impact on mobility limitations have rarely been examined. This nonexperimental, cross-sectional study examines the relationship between neighborhood social cohesion and mobility limitations and the potential mediators (i.e., depressive symptoms, mastery) of this relationship. A total of 8,317 Americans aged 65 years and older were selected from the Health and Retirement Study. Using ordinary least squares regressions, this study shows that neighborhood social cohesion was negatively associated with mobility limitations (B  =  -0.04, p < .01). A Sobel test of mediation indicated that this relationship was significantly mediated by depressive symptoms (z  =  -9.10, p < .001) and mastery (z  =  -8.86, p < .001). Findings suggest that neighborhood cohesion can reduce mobility limitations through mitigating depressive symptoms and increasing mastery. Future research should disentangle the temporal ordering of the mediators.

Development of a Nomogram for Predicting Depression in the Elderly Using Patient Health Questionnaire-9 among a Nationwide Sample of Korean Elderly

This cross-sectional study developed a nomogram that could allow medical professionals in the primary care setting to easily and visually confirm high-risk groups of depression. This study analyzed 4011 elderly people (≥60 years old) who completed a health survey, blood pressure, physical measurement, blood test, and a standardized depression screening test. A major depressive disorder was measured using the Korean version of the Patient Health Questionnaire (PHQ-9). This study built a model for predicting major depressive disorders using logistic regression analysis to understand the relationship of each variable with major depressive disorders. In the result, the prevalence of depression measured by PHQ-9 was 6.8%. The results of multiple logistic regression analysis revealed that the major depressive disorder of the elderly living alone was significantly (p < 0.05) related to monthly mean household income, the mean frequency of having breakfast per week for the past year, moderate-intensity physical activity, subjective level of stress awareness, and subjective health status. The results of this study implied that it would be necessary to continuously monitor these complex risk factors such as household income, skipping breakfast, moderate-intensity physical activity, subjective stress, and subjective health status to prevent depression among older adults living in the community.

Relationship between Psychological Distress and Prolonged Sedentary Bouts in the Elderly: Four Period Analysis

Background: Too much sitting is associated with low mental health in elderly individuals. We clarified the relationship between psychological distress and the rate of prolonged sedentary bouts (PSBs) among the elderly over four periods. Methods: In a secondary analysis, a sample population of 68 adults aged 65 years or older in Japan was used. The following proxy variables were used: PSB (mental health) and the Kessler 6 scale; K6 scores (psychological distress). Results: Using the cross-lagged effects models, from “2016 K6” to “2017 PSB” (p = 0.004), from “2017 K6” to “2018 PSB” (p < 0.001), and from “2018 K6” to “2019 PSB” (p = 0.021) were all significant; however, the reverse were not all significant in one period. In four periods, from “2016 PSB” to “2019 K6” (p = 0.025) was significant; however, the reverse was not significant. Fit indices were obtained: χ² = 7.641 (p = 0.182), goodness of fit index (GFI) = 0.891, comparative fit index (CFI) = 0.901, and root mean square error of approximation (RMSEA) = 0.121 in structural equation modelling. Conclusions: Psychological distress may affect the rate of PSB after one year, and the rate of PSB may affect the rate of psychological distress after three years in elderly individuals.

Predictors of development and persistence of musculoskeletal pain in community-dwelling older people: A two-year longitudinal study

AIM

The aim of this prospective cohort study was to identify the predictors of the development and persistence of musculoskeletal pain (MSKP) in older people.

METHODS

Participants comprised 431 community-dwelling older people aged 70+ years. Demographic, anthropometric, balance, mobility, cognitive function, psychological status and physical activity level measures were obtained at baseline. Participants were asked about the presence of MSKP in the neck/back, hip, knee/leg and/or feet at baseline and two-year follow-up. Logistic regression analyses were performed to identify predictors of the development and persistence of MSKP at two-year follow-up.

RESULTS

Of 179 participants who reported no MSKP at baseline, 84 (46.9%) reported MSKP at two-year follow-up, which was associated with a higher body mass index (odds ratio (OR) 1.10, 95% confidence interval (CI) 1.02-1.18), more reported depressive symptoms (OR 1.30, 95% CI 1.05-1.61) and lower physical activity levels (OR 0.92, 95% CI 0.84-1.00) at baseline. Of 252 participants who reported MSKP at baseline, 202 (80.2%) reported MSKP at follow-up, which was associated with a slower 6-m walking time (OR 1.27, 95% CI 1.08-1.49) and more reported depressive symptoms (OR 1.39, 95% CI 1.09-1.78). These associations remained significant after adjusting for age, sex, comorbidities and medication use.

CONCLUSIONS

This study suggests that higher body mass index, more depressive symptoms and less physical activity are predictors of developing MSKP, whereas slow gait speed and depressive symptoms are predictors of the persistence of MSKP among older people. The results highlight the importance of weight control, strategies to improve mental wellbeing and an active lifestyle for pain management among older people. Geriatr Gerontol Int 2021; 21: 519-524.

Developing a Predictive Model for Depressive Disorders Using Stacking Ensemble and Naive Bayesian Nomogram: Using Samples Representing South Korea

This study provided baseline data for preventing depression in female older adults living alone by understanding the degree of their depressive disorders and factors affecting these depressive disorders by analyzing epidemiological survey data representing South Koreans. To achieve the study objective, this study explored the main risk factors of depressive disorders using the stacking ensemble machine technique. Moreover, this study developed a nomogram that could help primary physicians easily interpret high-risk groups of depressive disorders in primary care settings based on the major predictors derived from machine learning. This study analyzed 582 female older adults (≥60 years old) living alone. The depressive disorder, a target variable, was measured using the Korean version of Patient Health Questionnaire-9. This study developed five single predictive models (GBM, Random Forest, Adaboost, SVM, XGBoost) and six stacking ensemble models (GBM + Bayesian regression, RandomForest + Bayesian regression, Adaboost + Bayesian regression, SVM + Bayesian regression, XGBoost + Bayesian regression, GBM + RandomForest + Adaboost + SVM + XGBoost + Bayesian regression) to predict depressive disorders. The naive Bayesian nomogram confirmed that stress perception, subjective health, n-6 fatty acid, n-3 fatty acid, mean hours of sitting per day, and mean daily sleep hours were six major variables related to the depressive disorders of female older adults living alone. Based on the results of this study, it is required to evaluate the multiple risk factors for depression including various measurable factors such as social support.

Nursing Home Residents Aged over 80-A Cross-Sectional Analysis on Which Activity Traits Correlate to Positive Affect

Admission to a care facility is assumed to enhance depressive symptoms and dependent behavior in old age. In this context, the relevance of participation in activities that make everyday life in a care facility more pleasant has been pointed out. This study examines if there is a relationship between participation in different activities as well as the frequency of this participation and the positive affect of nursing home residents aged over 80. Data from the unique cross-sectional representative study ‘Quality of life and subjective well-being of the very old in North Rhine-Westphalia’ in Germany (n = 150, aged 90.15 years in average) were used. The data were collected between 08/2017 and 02/2018 using computer-assisted personal interviewing. The variability in and frequency of activity participation functioned as independent, and positive affect as dependent variable. Multiple regression analysis was performed. Residents’ predicted positive affect significantly increased with a higher variability in activity participation. There was no independent effect of frequency in participation. Our findings indicate that there is a significant and positive relationship between participating in a high number of different activities and the overall positive affect of residents aged over 80 years. This does not hold true for the frequency of participation.

An Exploratory Study of the Relative Effects of Various Protective Factors on Depressive Symptoms Among Older People

Objective: The present study investigated the relative importance of various factors found to be negatively associated with depressive symptoms in older adults and assessed the potential moderating effect of sociodemographic characteristics for each factor.

Method: Depressive symptoms were measured with the Center of Epidemiological Studies Depression Scale. Psychological, social, and physical health measures relating to the following factors were also administered: personal growth, purpose in life, self-esteem, self-efficacy, social support, self-rated health, life satisfaction, and physical activity. Multivariate linear regression analysis was used to investigate the most important factors associated with depressive symptoms, and moderation analyses were employed to identify any moderating effects of sociodemographic factors.

Results: Life satisfaction, self-esteem, and purpose in life were found to be negatively associated with depressive symptoms. Only one moderating effect was observed—the negative relationship between life satisfaction and depressive symptoms was significantly stronger among the younger respondents.

Conclusion: These findings suggest that strategies for the prevention or amelioration of depressive symptoms across subgroups of the senior population could be optimized by focusing on enhancing life satisfaction, self-esteem, and purpose in life.

The relationship between health-promoting lifestyles and depression in the elderly: roles of aging perceptions and social support

PURPOSE

At present, it is not clear about the influence of health-promoting lifestyle, aging perceptions, social support, and other psychosocial factors on elderly depression. This study aims to explore the mediating role of aging perceptions between health-promoting lifestyle and elderly depression, and the moderating role of social support in the mediating process.

METHODS

A cross-sectional survey was conducted among 359 elderly people in six districts of a city. The Chinese version of the Health-Promoting Lifestyle Profile-II (HPLP-IIR), the Brief Aging Perceptions Questionnaire (B-PQ), the Center for Epidemiological Studies Depression Scale (CES-DR), and the Social Support Rate Scale (SSRS) were conducted and recollected on the spot. Stepwise analysis was used to test the mediating effect and moderating effect, and age and gender variables were controlled.

RESULTS

The results showed the following: (1) health-promoting lifestyle is an important influencing factor of elderly depression; (2) aging perceptions plays a mediating role in the relationship between health-promoting lifestyle and elderly depression, accounting for 31.8% of the total utility; and (3) social support plays a moderating role between aging perceptions and elderly depression, with a high level of social support. The effect of aging perceptions on depression is less than that of the elderly with low social support level.

CONCLUSION

Health-promoting lifestyle influence the depression of elderly people through aging perceptions and social support moderates the influence of aging perceptions on the elderly depression.

Influência do nível socioeconômico, idade, gordura corporal e sintomas depressivos na frequência de atividade física em adultos: uma análise de caminhos

Resumo A atividade física é um comportamento complexo e influenciado por variáveis sociodemográficas e clínicas. A melhor compreensão desses fatores possibilita considerar a associação deles com a atividade física. O objetivo deste estudo foi estimar os efeitos do nível socioeconômico, idade, gordura corporal e sintomas depressivos na frequência de atividade física entre adultos. Trata-se de um estudo transversal de base populacional conduzido com 808 indivíduos. Foram avaliadas as inter-relações entre as variáveis nível socioeconômico, idade, gordura corporal e sintomas depressivos no nível de atividade física total, por meio da técnica “path analysis”. Observou-se efeito direto negativo e significativo da idade (β = -0,113; p < 0,004) nos níveis de atividade física. A idade (β = 0,376; p < 0,001) influenciou a gordura corporal, com efeito positivo e significativo. Os sintomas de depressão foram influenciados negativamente pelo nível socioeconômico (β = -0,126; p < 0,001) e positivamente pela idade (β = 0,244; p < 0,001) e gordura corporal (β = 0,169; p < 0,004). O nível socioeconômico, a gordura corporal e os sintomas depressivos não influenciaram diretamente os níveis de atividade física. Concluindo, os resultados mostraram que o avançar da idade contribui para a redução da prática de atividade física.

Long-Term Relationship between Psychological Distress and Continuous Sedentary Behavior in Healthy Older Adults: A Three Panel Study

Background and objectives: Psychological distress (PD) is associated with continuous sedentary behaviors (CSB; based on the ratio of 1.5 metabolic equivalents (METs) sessions or more continuing for over 30 min) in older adults, but the long-term relation is not sufficiently clarified. This study aims to clarify the long-term relationship between PD and the rate of CSB. Materials and Methods: In this secondary analysis, a sample population of 72 healthy elderly people aged 65 years or older participated in a health club of college A from 2016 to 2018. We conducted structural equation modeling (SEM) using the cross-lagged and synchronous effects models. We adopted the following as proxy variables: CSB and PD (based on the Kessler 6 scale (K6) scores). Results: "2016 K6" to"2017 CSB" (standardization factor (β = 0.141, p = 0.025), "2017 K6" to "2018 CSB" (β = 0.187, p < 0.001) and "2016 CSB" to "2018 CSB" (β = 0.188, p < 0.001) were all statistically significant using the cross-lagged effects models. Fit indices were adjusted goodness of fit index (AGFI) = 0.961, comparative fit index (CFI) = 1.000, and root mean square error of approximation (RMSEA) = 0.000. Conclusion: The results suggest that PD may affect the ratio of CSB one year later, and CSB may affect the ratio of PD two year later.

Linking depressive symptoms and cognitive functioning: The mediating role of leisure activity

OBJECTIVES

Greater depressive symptoms are associated with cognitive decline in older adulthood, but it is not clear what underlying factors drive this association. One behavioral pathway through which depressive symptoms may negatively influence cognitive functioning is through activity engagement. Prior research has independently linked greater depressive symptoms to both lower leisure and physical activity and independently linked both lower leisure and physical activity to lower cognition. Therefore, depressive symptoms may negatively influence cognition by reducing engagement in beneficial leisure and/or physical activities that help to maintain cognition.

METHODS

The current study examined associations between depressive symptoms, leisure activity, physical activity, and global cognitive functioning using longitudinal data from the Washington Heights-Inwood Columbia Aging Project (n = 5,458 older adults). A multilevel structural equation model estimated the between-person and within-person effects of depressive symptoms on global cognition through leisure and physical activity.

RESULTS

Leisure activity, but not physical activity, mediated the association between depressive symptoms and global cognition between- and within-persons. When individuals reported high depressive symptoms, they also reported fewer leisure activities, which was associated with lower global cognition.

CONCLUSION

These findings highlight behavioral pathways through which depressive symptoms may negatively influence cognitive functioning. Findings support the view that perhaps depressive symptoms act as a risk factor for cognitive impairment by reducing leisure activity engagement. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Relationship between Psychological Distress and Continuous Sedentary Behavior in Healthy Older Adults

Background: Our purpose is to clarify whether psychological distress (PD) affects the rate of continuous sedentary behavior (CSB). Materials and Methods: In this secondary analysis, a sample population of 80 healthy older adults aged 65 years or older participated in a health club of college A from 2016 to 2017. We conducted Structural Equation Modeling (SEM) using the cross-lagged and synchronous effects models. We adopted the following as proxy variables: CSB (based on the ratio of 1.5 METs sessions or more continuing for over 30 min) CSB and PD (based on the Kessler psychological distress scale: K6). Results: "2016 K6" had a significant influence on "2017 CSB" (standardization factor (β) = 0.136, p = 0.020) using the cross-lagged effects model, and "2017 K6" significantly influenced "2017 CSB" (β = 0.166, p = 0.039) using the synchronous effects model. Fit indices were Adjusted Goodness-of-Fit Index (AGFI) = 0.990, Confirmatory Fit Index (CFI) = 1.000, and Root Mean Square Error of Approximation (RMSEA) = 0.000. Conclusion: The results suggest that PD may affect the ratio of CSB one year later.

The effects of depression, personal characteristics, and some habits on physical activity in the elderly

PURPOSE

The current study investigated the effects of depression, personal characteristics, and some habits on physical activity levels among the elderly.

DESIGN AND METHODS

This study followed a descriptive design. The population of the study consisted of 11 750 individuals at least 65 years old. The sample size of the study was determined to be 967 by power analysis. Descriptive statistics and logistic models were used for data analysis.

RESULTS

Together, age, the presence of a caregiver, chronic disease, and the Geriatric Depression Scale (GDS) score explained 32% of the variance in the physical activity of the elderly. Among these factors, the GDS score alone had the greatest effect.

PRACTICAL IMPLICATIONS

To maintain health, it is important to reduce depression and increase physical activity among the elderly.

Effect of exercise and nutritional supplementation on health-related quality of life and mood in older adults: the VIVE2 randomized controlled trial

Background

Health-related quality of life (HRQoL) and absence of depressive symptoms are of great importance for older people, which may be achieved through lifestyle interventions, e.g., exercise and nutrition interventions. The aim of this investigation was to analyze the effects of a physical activity program in combination with protein supplementation on HRQoL and depressive symptoms in community-dwelling, mobility-limited older adults.

Methods

In the Vitality, Independence, and Vigor 2 Study (VIVE2), community-dwelling men and women with an average age of 77.5 ± 5.4 years, some mobility limitations and low serum vitamin D levels (25(OH)Vit D 22.5–60 nmol/l) from two study sites (Stockholm, Sweden and Boston, USA) were randomized to receive a nutritional supplement or a placebo for 6 months. All took part in a physical activity program 2–3 times/ week. The primary outcome examined in VIVE2 was 400 M walk capacity. HRQoL was measured using the Medical Outcomes Study 36-item Short Form Health Survey (SF36), consisting of the Physical Component Summary (PCS) and Mental Component Summary (MCS), and depressive symptoms were measured using The Centre for Epidemiologic Studies Depression Scale (CES-D). In the sensitivity analyses, the sample was divided into sub-groups based on body measures and function (body mass index (BMI), appendicular lean mass index (ALMI), handgrip strength and gait speed).

Results

For the whole sample, there was a significant improvement in both MCS, mean (95% CI) 2.68 (0.5, 4.9) (p 0.02), and CES-D -2.7 (− 4.5, − 0.9) (p 0.003) during the intervention, but no difference was detected between those who received the nutritional supplement and those who received the placebo. The results revealed no significant change in PCS or variation in effects across the sub-categories.

Conclusions

This study demonstrates that a six-month intervention using a physical activity program had positive effects on mental status. No additional effects from nutritional supplementation were detected.

Trial registration

Registered at ClinicalTrials.gov, March 2 2012, NCT01542892.

Weight Status, Physical Activity, and Depression in Korean Older Adults

Background

This study aimed to explore the associations between weight status, physical activity, and depression in Korean older adults.

Methods

We used the baseline data drawn from the 2008 baseline survey utilized in the Living Profiles of Older People Survey, comprised of 15,146 community-dwelling older people (42.6% men and 57.4% women) aged 60 years and older residing in the Republic of Korea. After excluding respondents with missing data on height, weight, and physical activity (PA), data on 10,197 samples (43.3% men and 56.7% women) were analyzed in this study.

Results

Underweight and completely inactive individuals had poorer sociodemographic and health behavioral characteristics and increased risks of late-life depression compared with normal weight and sufficiently active individuals, respectively. In terms of the aerobic PA guidelines, completely inactive individuals had a significantly higher risk of late-life depression (odds ratio 1.730; 95% confidence interval, 1.412–2.120) compared with sufficiently active individuals, even after adjustments for age, education, household income, night sleeping, living status, marital status, smoking, number of comorbidities, nutritional status, self-reported health status, and cognitive performance as covariates. In addition, those who did not meet the PA guidelines and were underweight or overweight/obese were more likely to have late-life depression compared to those who were active and normal weight.

Conclusions

The current findings of the study suggest that modifiable, lifestyle risk factors, such as physical inactivity, underweight, and overweight/obesity, are positively associated with late-life depression in Korean older adults.

Combined Associations of Physical Activity and Sedentary Behavior With Depressive Symptoms in Older Adults

The aim of this study was to analyze the association of combined physical activity (PA)/sedentary behaviour (SB) with depressive symptoms (DS) in older adults. A cross-sectional study was conducted with 622 individuals ≥ 60 years old. After adjusting for gender, years of study, and monthly household income, prevalence ratios for presence of DS were statistically significant for older adults with <150 min/week in PA and ≥75th percentile of SB on weekdays (PR = 2.11,95%CI: 1.54-2.90) and on weekends (PR = 2.20,95%CI:1.57-3.09). Older adults who do not meet the PA guidelines and spend more time in SB on weekdays or weekend days are more likely to present with DS compared to those who meet the recommendations of PA and spend less time in SB during the day.

Factors that Influence Physical Activity among Residents in Assisted Living

The purpose of this study was to examine factors that influence physical activity among residents in assisted living. This was a secondary data analysis using baseline data from a function-focused care intervention study including 171 residents from 4 assisted living facilities. Using structural equation modeling, we found that mood, satisfaction with staff and activities, and social support for exercise were directly associated with time spent in physical activity. Gender, cognition, depression, and comorbidities were indirectly associated with physical activity and accounted for 13% of the total variance in physical activity. Implications for future research and social work practice are presented.

Exploring the context of sedentary behaviour in older adults (what, where, why, when and with whom)

BACKGROUND

Older adults are the most sedentary segment of the population. Little information is available about the context of sedentary behaviour to inform guidelines and intervention. There is a dearth of information about when, where to intervene and which specific behaviours intervention should target. The aim of this exploratory study was to obtain objective information about what older adults do when sedentary, where and when they are sedentary and in what social context.

METHODS

The study was a cross-sectional data collection. Older adults (Mean age = 73.25, SD ± 5.48, median = 72, IQR = 11) volunteers wore activPAL monitors and a Vicon Revue timelapse camera between 1 and 7 days. Periods of sedentary behaviour were identified using the activPAL and the context extracted from the pictures taken during these periods. Analysis of context was conducted using the Sedentary Behaviour International Taxonomy classification system.

RESULTS

In total, 52 days from 36 participants were available for analysis. Participants spent 70.1 % of sedentary time at home, 56.9 % of sedentary time on their own and 46.8 % occurred in the afternoon. Seated social activities were infrequent (6.9 % of sedentary bouts) but prolonged (18 % of sedentary time). Participants appeared to frequently have vacant sitting time (41 % of non-screen sedentary time) and screen sitting was prevalent (36 % of total sedentary time).

CONCLUSIONS

This study provides valuable information to inform future interventions to reduce sedentary behaviour. Interventions should consider targeting the home environment and focus on the afternoon sitting time, though this needs confirmation in a larger study. Tackling social isolation may also be a target to reduce sedentary time.

Self-Care, Sense Of Coherence And Depression In Patients Hospitalized For Decompensated Heart Failure

OBJECTIVE To analyze the self-care behaviors according to gender, the symptoms of depression and sense of coherence and compare the measurements of depression and sense of coherence according to gender. METHOD A correlational, cross-sectional study that investigated 132 patients with decompensated heart failure (HF). Data were collected through interviews and consultation to medical records, and analyzed using the chi-square and the Student's t tests with significance level of 0.05. Participants were 75 men and 57 women, aged 63.2 years on average (SD = 13.8). RESULTS No differences in self-care behavior by gender were found, except for rest after physical activity (p = 0.017). Patients who practiced physical activity showed fewer symptoms of depression (p<0.001). There were no differences in sense of coherence according to self-care behavior and gender. Women had more symptoms of depression than men (p = 0.002). CONCLUSION Special attention should be given to women with HF considering self-care and depressive symptoms.

Effects of Square-Stepping Exercise on balance and depressive symptoms in older adults

The aim of this study was analyze the effects of Square-Stepping Exercise (SSE) on depressive symptoms, balance and functional mobility in older adults. Participants were distributed into two groups: Trained Group (TG), who performed a 16-week intervention with SSE and Control Group (CG), who performed only evaluations. The Berg Balance Scale and Time Up and Go Test (TUG) constituted the evaluation protocol to verify balance and functional mobility. Geriatric Depression Scale-short form (GDS-15) was applied for measure depressive symptoms. Evaluations were realized pre and post 16-week. Significant improvements were observed in the TG with the maintenance of GDS-15 scores and on the time to perform the TUG test which reflects better functional mobility than the CG. This could lead to conclude that the SSE is an important tool for improve balance, prevent falls and decrease depression symptoms.

Depression in silent lacunar infarction: a cross-sectional study of its association with location of silent lacunar infarction and vascular risk factors

Most previous studies reported a close link between fresh infarcts and post-stroke depression. However, studies on the relation of depression and silent lacunar infarction (SLI) are limited. This study aims to analyze the effects of SLI and the vascular risk factors on depression. A total of 243 patients with SLI were divided into depression and non-depression groups. The presence and location of SLI were evaluated with magnetic resonance imaging. Depression was assessed with the Patient Health Questionnaire-9 and vascular risks factors were collected. We used t tests and χ² test to compare the baseline characteristics of the two groups and the multivariate logistic regression model to identify the risk factors for depression. Univariate analysis results showed that the proportion of patients with SLI in basal ganglia was significantly higher in the depression group (65.0 versus 32.8 %; P < 0.001) than in the non-depression group, and multiple prevalent factors had significant differences between the two groups. However, on multivariate logistic analysis, some of these factors were eliminated, and SLI in basal ganglia remained an independent predictor of depression with an odds ratio of 3.128 (P = 0.018). In addition, vascular risk factors, including high body mass index level, presence of inflammation markers (e.g., CRP, TNF-α, Hs-CRP, and IL-6), and lack of physical activity, were associated with depression. Our findings suggest that SLI in basal ganglia is associated with a higher risk of depression. Vascular risk factors, which are intertwined, may propose the pathological basis of depression in SLI.