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Wen Z, Wang H, Liang Q, Liu L, Zhang W, Zhang X. Mediating effect of social support and resilience between loneliness and depression in older adults: A systematic review and meta-analytic structural equation modeling. J Affect Disord 2024; 365:246-257. [PMID: 39147150 DOI: 10.1016/j.jad.2024.08.062] [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: 12/07/2023] [Revised: 08/11/2024] [Accepted: 08/12/2024] [Indexed: 08/17/2024]
Abstract
BACKGROUND Loneliness is a powerful stressor for depression in older adults, and resilience and social support may mediate this relationship, while the evidence is limited. Hence, our study aims to explore the mediating role of social support and resilience between loneliness and depression and to test possible moderators. METHODS We searched 12 databases without language and publish time restrictions and obtained the correlation coefficients. This review constructed two-stage meta-analytical structural equality modeling (MASEA) to test the mediating effect of social support and resilience. Additionally, use one-stage MASEA to test the moderator effect of women proportion, published year, and country of study. RESULTS This study included 53 studies and 40, 929 older adults. Loneliness directly affected depression (β = 0.28, 95 % CI: 0.20, 0.36). Social support (β = 0.06, 95 % CI: 0.02, 0.09) and resilience (β = 0.15, 95 % CI: 0.12, 0.18) mediated the relationship. The proportion of women in the sample was moderator (χ2(5) = 11.10, p = 0.05). When the proportion exceeded 60 %, the path coefficient of loneliness and social support (β = -0.45, SE = 0.055) was larger than that of the subgroup below 60 % (β = -0.32, SE = 0.041). LIMITATIONS It was indefinite whether the evidence would be supported in longitudinal designs. Influenced by the original research data, it is impossible to calculate the model parameters of gender discrepancy. CONCLUSIONS Health aging policy-makers adopting social support and resilience intervention will help strengthen the coping skills of older adults confronting loneliness and reduce the risk of depression.
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Affiliation(s)
- Zhifei Wen
- Department of Dermatological, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Hongyan Wang
- Dean Office, Si Chuan Nursing Vocational College, Chengdu, China
| | - Qingfang Liang
- School of Nursing, Chengdu university of Traditional Chinese Medicine, Chengdu, China
| | - Linfeng Liu
- Dean Office, Si Chuan Nursing Vocational College, Chengdu, China
| | - Wen Zhang
- Dean Office, Si Chuan Nursing Vocational College, Chengdu, China
| | - Xiangeng Zhang
- Dean Office, Si Chuan Nursing Vocational College, Chengdu, China.
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Tang T, Fu Z, Jiang J. The effects of psychosocial interventions on geriatric depression in the mainland of China: A systematic review and meta-analysis. J Affect Disord 2024:S0165-0327(24)01251-5. [PMID: 39142589 DOI: 10.1016/j.jad.2024.08.037] [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: 04/25/2023] [Revised: 07/20/2024] [Accepted: 08/11/2024] [Indexed: 08/16/2024]
Abstract
BACKGROUND The effectiveness of psychosocial interventions for geriatric depression across different treatment settings, regions, and comorbidities in China remains unclear. Therefore, we systematically reviewed studies geared towards reducing geriatric depression in China. METHODS Nine databases in Chinese or English from database were searched from inception through January 2021. Randomized controlled trials investigating psychosocial interventions on older adults with depression in China were included. The primary outcome was post-intervention depression measured by self-report instruments. Random-effect model was used to pool the overall effect size Hedge's g. RESULTS In 99 studies with a total of 9369 older adults with depression, psychosocial interventions were effective compared with control conditions (Hedges' g: -1·48 [95 % CI: -1·83 to -1·13]). Comorbidity with physical disease significantly affect the pooled effect size (without comorbidity: Hedges' g = -1.19, 95 % CI: -1.42 to -0.95; with comorbidity: Hedges' g = -2.06, 95 % CI: -2.97 to -1.14; p = 0.062), and heterogeneity was substantial (without comorbidity, I2 = 91·3 %, 95 % CI: 89·5 % to 92·7 %; with comorbidity, I2 = 94·3 %, 95 % CI: 93·1 % to 95·4 %). The quality of evidence according to the GRADE criteria was generally moderate. LIMITATIONS Significant heterogeneity among the studies reviewed was unavoidable, and the possible publication bias could lead to overestimation of the result. CONCLUSION Psychosocial interventions are significantly effective for treating geriatric depression in China regardless of the setting, region, or therapeutic orientation. Policies should support the development and implementation of psychosocial interventions in China, especially in community settings, to reduce disease burden.
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Affiliation(s)
- Tan Tang
- School of Ethnology and Sociology, Yunnan University, Yunnan, China
| | - Zhongfang Fu
- School of Psychological and Cognitive Sciences, Beijing Key Laboratory of Behavior and Mental Health, Peking University, Beijing, China.
| | - Jianling Jiang
- Department of Social Work, The Chinese University of Hong Kong, Hong Kong
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Tosangwarn S, Clissett P, Blake H. Understanding the experience of stigma in care homes: A qualitative case study in northeast Thailand. J Psychiatr Ment Health Nurs 2024; 31:475-491. [PMID: 38063286 DOI: 10.1111/jpm.13005] [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: 11/01/2022] [Revised: 11/07/2023] [Accepted: 11/28/2023] [Indexed: 07/03/2024]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: Stigma associated with care homes has been found to influence residents' lives, and it is a known risk factor for depression among older adults worldwide. Older residents in Asia and particularly, in Thai care homes commonly experience stigma due to being strongly influenced by a traditional cultural paradigm of filial piety. The understanding of how residents perceive and experience the stigma associated with residing in care homes, as well as its link to the development of depression, remains very limited. WHAT DOES THE PAPER ADD TO EXISTING KNOWLEDGE?: This research explains the dynamics of the process of the stigma associated with living care homes among Thai older residents. This research highlights the various ways in which stigma impacts residents, their families and care home staff. This study identifies mitigating stigma factors, including social support, coping strategies (karma, mindfulness and religious devotions) and activities that may mitigate perceived stigma associated with care home residency. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: There is a compelling need to improve the well-being of older people living in care homes and to combat the cultural stigma associated with living in care homes through promoting positive attitudes and educational interventions in society, communities and care homes themselves and involving residents' families in the planning and delivery of care for residents. We advocate that the government promotes security and sustainable life for all Thai older adults. ABSTRACT INTRODUCTION: Stigma associated with living in care homes is a known risk factor for depression among care home residents in Asia, including Thailand. However, little is understood about how such stigma is experienced among residents and care home staff. AIMS To examine older adults' perceptions of stigma and to understand how stigma associated with living in care homes causes or exacerbates depressive symptoms. METHODS A qualitative case study approach was used to gain an in-depth view of stigma, from two public care homes in northeast Thailand. Data were collected by in-depth interviews with 50 participants (30 older residents and 20 care home staff), and non-participant observation was conducted over 1 month. Thematic analysis was used to analyse the data. RESULTS The study identified three major themes of stigma, comprising the causes of stigma, reactions toward stigma, and mitigating factors. DISCUSSION Negative beliefs about care homes and residents, contribute to stigma. Residents exhibited negative emotions and behaviours, including depressive symptoms. Residents reported using particular coping strategies that helped them cope with their perceptions of stigma. IMPLICATIONS FOR PRACTICE Future research should focus on strategies or research to combat stigma in order to prevent depression and reduce perceptions of stigma.
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Affiliation(s)
- Suhathai Tosangwarn
- Department of Psychiatric Nursing, Boromarajonani College of Nursing, Nakhon Ratchasima, Faculty of Nursing, Praboromarajchanok Institute, Nakhon Ratchasima, Thailand
| | - Philip Clissett
- School of Social Sciences, Nottingham Trent University, Nottingham, UK
| | - Holly Blake
- School of Health Sciences, University of Nottingham, Nottingham, UK
- NIHR Nottingham Biomedical Research Centre, Nottingham, UK
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Liu L, Wang D, Wu W, Xiang M, Li X, Zhao Y, Wang J, Wang A. Effectiveness of a self-determination theory-based intervention for nursing home residents with depression: A randomized controlled trial. Heliyon 2024; 10:e33818. [PMID: 39027615 PMCID: PMC11255488 DOI: 10.1016/j.heliyon.2024.e33818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 06/10/2024] [Accepted: 06/27/2024] [Indexed: 07/20/2024] Open
Abstract
Objective and rationale The prevalence of depression among older adults residing in nursing homes has risen. While physical activity interventions based on the self-determination theory have been shown to reduce depressive symptoms among students and middle-aged adults, research in nursing home residents is scarce. This study aimed to investigate whether physical activity can alleviate depressive symptoms in nursing home residents over an extended period. Methods Between September 2020 and August 2021, 46 nursing home residents in Shenyang were randomly assigned to either a control group (n = 23) or an intervention group (n = 23). The control group followed a standard physical activity programme, whereas the intervention group underwent a programme based on self-determination theory. Both groups were monitored for 24 weeks post-intervention. Depression scores were assessed using the Geriatric Depression Scale, sociodemographic data collected via a self-designed questionnaire, cognitive function evaluated using the Mini-Mental State Examination, and weight and body fat measured using the Omron KARADA Scan Body Composition and Scale. Results Depression scores were measured at five time points: baseline (T0), weeks 12 (T1), and 24 (T2) of the intervention, and weeks 12 (T3) and 24 (T4) during follow-up. Both groups exhibited a trend of decline by more than five points. The intervention group demonstrated more favourable pre-to-post changes in depression scores compared to the control group. Conclusions A physical activity intervention based on self-determination conceptual framework has been proven to be effective for nursing home residents with depressive symptoms, also aiding in the maintenance of their physical activity levels. This study offers a theoretical foundation for the development of intervention programmes by researchers and identifies potential intervention strategies for caregivers in nursing homes. Trial Registration The Chinese Clinical Trial Registry (ChiCTR2200060598) (June 5, 2022).
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Affiliation(s)
- Lei Liu
- Nursing Teaching and Research Department, The First Hospital of China Medical University, Shenyang, 110001, Liaoning, China
- School of Nursing, Liaoning University of Traditional Chinese Medicine, Shenyang, 110847, Liaoning, China
| | - Daqiu Wang
- School of Nursing, Liaoning University of Traditional Chinese Medicine, Shenyang, 110847, Liaoning, China
| | - Wei Wu
- Institute of Humanitites and Social Sciences, Shenyang University, Shenyang, 110044, Liaoning, China
| | - Mingqiang Xiang
- School of Sport and Health & Guangdong Provincial Key Laboratory of Physical Activity and Health Promotion, Guangzhou Sport University, Guangzhou, 510500, Guangdong, China
| | - Xiaoxue Li
- School of Nursing, Chinese Academy of Medical Science & Peking Union Medical College, 100144, Beijing, China
| | - Yudan Zhao
- Science and Technology Department, Shenyang Medical College, Shenyang, 110034, Liaoning, China
| | - Jiayu Wang
- School of Nursing, Liaoning University of Traditional Chinese Medicine, Shenyang, 110847, Liaoning, China
| | - Aiping Wang
- Nursing Teaching and Research Department, The First Hospital of China Medical University, Shenyang, 110001, Liaoning, China
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Du R, Yang K, Li W, Wang Z, Cai H. Research status and global trends of late-life depression from 2004 to 2023: bibliometric analysis. Front Aging Neurosci 2024; 16:1393110. [PMID: 38752209 PMCID: PMC11095109 DOI: 10.3389/fnagi.2024.1393110] [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: 02/28/2024] [Accepted: 04/10/2024] [Indexed: 05/18/2024] Open
Abstract
Background Global research hotspots and future research trends in the neurobiological mechanisms of late-life depression (LLD) as well as its diagnosis and treatment are not yet clear. Objectives This study profiled the current state of global research on LLD and predicted future research trends in the field. Methods Literature with the subject term LLD was retrieved from the Web of Science Core Collection, and CiteSpace software was used to perform econometric and co-occurrence analyses. The results were visualized using CiteSpace, VOSviewer, and other software packages. Results In total, 10,570 publications were included in the analysis. Publications on LLD have shown an increasing trend since 2004. The United States and the University of California had the highest number of publications, followed consecutively by China and England, making these countries and institutions the most influential in the field. Reynolds, Charles F. was the author with the most publications. The International Journal of Geriatric Psychiatry was the journal with the most articles and citations. According to the co-occurrence analysis and keyword/citation burst analysis, cognitive impairment, brain network dysfunction, vascular disease, and treatment of LLD were research hotspots. Conclusion Late-life depression has attracted increasing attention from researchers, with the number of publications increasing annually. However, many questions remain unaddressed in this field, such as the relationship between LLD and cognitive impairment and dementia, or the impact of vascular factors and brain network dysfunction on LLD. Additionally, the treatment of patients with LLD is currently a clinical challenge. The results of this study will help researchers find suitable research partners and journals, as well as predict future hotspots.
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Affiliation(s)
| | | | | | - Zhiren Wang
- Huilongguan Clinical Medical School of Peking University, Beijing Huilongguan Hospital, Beijing, China
| | - Haipeng Cai
- Huilongguan Clinical Medical School of Peking University, Beijing Huilongguan Hospital, Beijing, China
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Eliza Georgiou EZ, Politis A, Kosmidis MH, Yannakoulia M, Dardiotis E, Hadjigeorgiou G, Sakka P, Scarmeas N, Economou P, Alexopoulos P. Depressive symptoms in the entire spectrum of cognitive ageing in Greece: evidence from the Hellenic Longitudinal Investigation of Aging and Diet (HELIAD). Int J Psychiatry Clin Pract 2024; 28:27-34. [PMID: 38145312 DOI: 10.1080/13651501.2023.2296889] [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: 08/22/2023] [Accepted: 12/14/2023] [Indexed: 12/26/2023]
Abstract
OBJECTIVES To study (i) the prevalence of mild and moderate-to-severe depressive symptoms in the entire spectrum of cognitive ageing in Greece and (ii) the relationship between these symptoms and demographic and clinical data. METHODS The study was based on the randomly selected cohort of the Hellenic Longitudinal Investigation of Aging and Diet (HELIAD). Depressive symptoms were assessed with the 15-item version of the Geriatric Depression Scale. Participants also received a comprehensive neuropsychological assessment, while the clinical diagnoses of dementia and mild cognitive impairment were established according to international diagnostic criteria. Statistical analyses relied on comparison tests and a logistic (proportional odds) ordinal regression model. RESULTS Depressive symptoms were detected in 19.5% of the 1936 study participants, while 11.3% of both people with MCI and dementia had moderate-to-severe depressive symptoms. The regression model revealed that older adults with more severe depressive symptoms were more likely female, cognitively impaired, less educated, were treated with psychotropic medication and lived in Attica versus Thessaly. CONCLUSIONS Since depressive symptoms were detected in almost one in five older adults, healthcare professionals in Greece should safeguard the timely detection and effective treatment of such symptoms and the post-diagnostic care of older adults with depression.
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Affiliation(s)
- Eleni-Zacharoula Eliza Georgiou
- Department of Medicine, School of Health Sciences, Mental Health Services, Patras University General Hospital, University of Patras, Patras, Greece
| | - Antonios Politis
- First Department of Psychiatry, School of Medicine, Eginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
- Department of Psychiatry, Division of Geriatric Psychiatry and Neuropsychiatry, Johns Hopkins Medical School, Baltimore, MD, USA
| | - Mary H Kosmidis
- School of Psychology, Lab of Cognitive Neuroscience, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | | | | | - Paraskevi Sakka
- Athens Association of Alzheimer's Disease and Related Disorders, Maroussi, Greece
| | - Nikolaos Scarmeas
- 1st Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
- Department of Neurology, Taub Institute for Research in Alzheimer's Disease and the Aging Brain, The Gertrude H. Sergievsky Center, Columbia University, New York, NY, USA
| | - Polychronis Economou
- Department of Civil Engineering (Statistics), School of Engineering, University of Patras, Patras, Greece
| | - Panagiotis Alexopoulos
- Department of Medicine, School of Health Sciences, Mental Health Services, Patras University General Hospital, University of Patras, Patras, Greece
- Medical School, Global Brain Health Institute, Trinity College Dublin, The University of Dublin, Dublin, Republic of Ireland
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- Patras Dementia Day Care Centre, Patras, Greece
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Zeng Y, Lao J, Wu Z, Lin G, Wang Q, Yang M, Zhang S, Xu D, Zhang M, Liang S, Liu Q, Yao K, Li J, Ning Y, Zhong X. Altered resting-state brain oscillation and the associated cognitive impairments in late-life depression with different depressive severity: An EEG power spectrum and functional connectivity study. J Affect Disord 2024; 348:124-134. [PMID: 37918574 DOI: 10.1016/j.jad.2023.10.157] [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: 07/24/2023] [Revised: 10/29/2023] [Accepted: 10/30/2023] [Indexed: 11/04/2023]
Abstract
OBJECTIVE Cognitive impairments are prevalent in late-life depression (LLD). However, it remains unclear whether there are concurrent brain oscillation alterations in resting condition across varying level of depression severity. This cross-sectional study aims to investigate the characteristics of altered resting-state oscillations, including power spectrum and functional connectivity, and their association with the cognitive impairments in LLD with different depression severity. METHODS A total of 65 patients with LLD and 40 elder participants without depression were recruited. Global cognition and subtle cognitive domains were evaluated. A five-minute resting-state electroencephalography (EEG) was conducted under eyes-closed conditions. Measurements included the ln-transformed absolute power for power spectrum analysis and the weighted phase lag index (wPLI) for functional connectivity analysis. RESULTS Attentional and executive dysfunction were exhibited in Moderate-Severe LLD group. Enhanced posterior upper gamma power was observed in both LLD groups. Additionally, enhanced parietal and fronto-parietal/occipital theta connectivity were observed in Moderate-Severe LLD group, which were associated with the attentional impairment. LIMITATIONS Limitations include a small sample size, concomitant medication use, and a relatively higher proportion of females. CONCLUSIONS Current study observed aberrant brain activity patterns in LLD across different levels of depression severity, which were linked to cognitive impairments. The altered posterior brain oscillations may be trait marker of LLD. Moreover, cognitive impairments and associated connectivity alterations were exhibited in moderate-severe group, which may be a state-like marker of moderate-to severe LLD. The study deepens understanding of cognitive impairments with the associated oscillation changes, carrying implications for neuromodulation targets in LLD.
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Affiliation(s)
- Yijie Zeng
- Geriatric Neuroscience Center, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Jingyi Lao
- Geriatric Neuroscience Center, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Zhangying Wu
- Geriatric Neuroscience Center, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Gaohong Lin
- Geriatric Neuroscience Center, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Qiang Wang
- Geriatric Neuroscience Center, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Mingfeng Yang
- Geriatric Neuroscience Center, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Si Zhang
- Geriatric Neuroscience Center, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Danyan Xu
- Geriatric Neuroscience Center, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Min Zhang
- Geriatric Neuroscience Center, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Shuang Liang
- Geriatric Neuroscience Center, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Qin Liu
- Geriatric Neuroscience Center, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Kexin Yao
- Geriatric Neuroscience Center, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Jiafu Li
- Geriatric Neuroscience Center, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yuping Ning
- Geriatric Neuroscience Center, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China; The First School of Clinical Medicine, Southern Medical University, Guangzhou, China; Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China; Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, The Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, China; Key Laboratory of Neurogenetics and channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou.
| | - Xiaomei Zhong
- Geriatric Neuroscience Center, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China; Key Laboratory of Neurogenetics and channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou.
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Guo K, Ouyang J, Minhat HS. The mediating role of health literacy between the presence of chronic disease and psychological distress among older persons in Xi'an city of China. BMC Public Health 2023; 23:2530. [PMID: 38110936 PMCID: PMC10726590 DOI: 10.1186/s12889-023-17315-x] [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: 11/29/2022] [Accepted: 11/23/2023] [Indexed: 12/20/2023] Open
Abstract
BACKGROUND The increased number of older persons in China, and the prevalence of most chronic diseases raised with age significantly increased the total disease burden. When a person ages, psychological distress happens when they are faced with stressors that they cannot cope with. Psychological distress refers to non-specific symptoms of depression, anxiety, and stress. Health literacy influences several health outcomes, such as emotional functioning among the population. The primary purpose of this study is to examine the mediator role of health literacy between the presence of chronic disease and psychological distress among older persons living in Xi'an city. Thus, this study used the Cognitive Behavior Theory (CBT) as a combination of the basic behavioral and cognitive psychology principles to explain the cognitive processes associated with psychological distress. METHODS This study employs a quantitative research design using a cross-sectional survey of 300 older persons over 60 years living in the six urban districts of Xi'an city. Data were collected using the Health Literacy Questionnaire (HLQ) and the Depression Anxiety Stress Scale (DASS-21). This study employed descriptive statistics and inferential methods to analyze the data. The inferential methods applied structural equation modeling (SEM) to test the hypothesis of the mediator role of health literacy between the presence of chronic disease and psychological distress. RESULTS In this study, chronic disease had an effect on health literacy among older persons living in Xi'an city (β=-0.047, p < 0.01); chronic disease impact on psychological distress among older persons living in Xi'an city (β = 0.047, p < 0.01); health literacy was identified effect on psychological distress among older persons in Xi'an city (β=-0.738, p < 0.001); health literacy as a partial mediator between chronic disease and psychological distress (β = 0.07, p < 0.01). CONCLUSION Psychological distress among older persons is affected by chronic disease and health literacy. Health literacy had a partial mediating effect on the presence of chronic disease and psychological distress. Improved health literacy measures should be considered when treating older persons with psychological distress.
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Affiliation(s)
- Kun Guo
- College of Humanities and management, Shaanxi university of Chinese medicine, Xianyang, Shaanxi province, China.
| | - Jing Ouyang
- College of Humanities and management, Shaanxi university of Chinese medicine, Xianyang, Shaanxi province, China.
| | - Halimatus Sakdiah Minhat
- Department of Community Health, Faculty of medicine and health sciences, University Putra Malaysia, Kuala Lumpur, Malaysia.
- Malaysian Research Institute on Ageing, University Putra Malaysia, Serving, Selangor, 43400, Malaysia.
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Jellinger KA. The heterogeneity of late-life depression and its pathobiology: a brain network dysfunction disorder. J Neural Transm (Vienna) 2023:10.1007/s00702-023-02648-z. [PMID: 37145167 PMCID: PMC10162005 DOI: 10.1007/s00702-023-02648-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 04/28/2023] [Indexed: 05/06/2023]
Abstract
Depression is frequent in older individuals and is often associated with cognitive impairment and increasing risk of subsequent dementia. Late-life depression (LLD) has a negative impact on quality of life, yet the underlying pathobiology is still poorly understood. It is characterized by considerable heterogeneity in clinical manifestation, genetics, brain morphology, and function. Although its diagnosis is based on standard criteria, due to overlap with other age-related pathologies, the relationship between depression and dementia and the relevant structural and functional cerebral lesions are still controversial. LLD has been related to a variety of pathogenic mechanisms associated with the underlying age-related neurodegenerative and cerebrovascular processes. In addition to biochemical abnormalities, involving serotonergic and GABAergic systems, widespread disturbances of cortico-limbic, cortico-subcortical, and other essential brain networks, with disruption in the topological organization of mood- and cognition-related or other global connections are involved. Most recent lesion mapping has identified an altered network architecture with "depressive circuits" and "resilience tracts", thus confirming that depression is a brain network dysfunction disorder. Further pathogenic mechanisms including neuroinflammation, neuroimmune dysregulation, oxidative stress, neurotrophic and other pathogenic factors, such as β-amyloid (and tau) deposition are in discussion. Antidepressant therapies induce various changes in brain structure and function. Better insights into the complex pathobiology of LLD and new biomarkers will allow earlier and better diagnosis of this frequent and disabling psychopathological disorder, and further elucidation of its complex pathobiological basis is warranted in order to provide better prevention and treatment of depression in older individuals.
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Affiliation(s)
- Kurt A Jellinger
- Institute of Clinical Neurobiology, Alberichgasse 5/13, 1150, Vienna, Austria.
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da Costa ME, Cândido LM, de Avelar NCP, Danielewicz AL. How much time of sedentary behavior is associated with depressive symptoms in community-dwelling older adults in southern Brazil? Geriatr Nurs 2023; 50:25-30. [PMID: 36640515 DOI: 10.1016/j.gerinurse.2022.12.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 12/14/2022] [Accepted: 12/15/2022] [Indexed: 01/15/2023]
Abstract
AIMS Identify sedentary behavior (SB) cut-off points to screen for depressive symptoms in older adults and verify the association between these conditions. METHODS A cross-sectional survey of 308 community-dwelling older adults was conducted. The outcome was the presence of depressive symptoms (≥6 points on the Geriatric Depression Scale-15). The exposure was SB using the self-reported time on a weekday and weekend (International Physical Activity Questionnaire). The cut-off points for SB categorization were determined by the receiver operating characteristic curve and multivariate logistic regression to verify the association. RESULTS Older adults who spent ≥4.5 hours/day in SB (sensitivity = 48.8%; specificity = 67.8%) were 1.81 times more likely (95%CI: 1.03;3.15) to have depressive symptoms compared to those who stayed for shorter periods. CONCLUSIONS There was an association between SB and depressive symptoms; therefore, older adults must have SB <4.5 hours/day to reduce the chances of developing depressive symptoms.
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Affiliation(s)
- Maria Eduarda da Costa
- Department of Health Sciences, Federal University of Santa Catarina, Araranguá, Santa Catarina, Brazil
| | - Letícia Martins Cândido
- Postgraduate Program in Rehabilitation Sciences, Federal University of Santa Catarina, Araranguá, Santa Catarina, Brazil
| | | | - Ana Lúcia Danielewicz
- Department of Health Sciences, Federal University of Santa Catarina, Araranguá, Santa Catarina, Brazil; Postgraduate Program in Rehabilitation Sciences, Federal University of Santa Catarina, Araranguá, Santa Catarina, Brazil.
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Yang T, Guo Z, Cao X, Zhu X, Zhou Q, Li X, Wang H, Wang X, Wu L, Wu S, Liu X. Network analysis of anxiety and depression in the functionally impaired elderly. Front Public Health 2022; 10:1067646. [PMID: 36530716 PMCID: PMC9751796 DOI: 10.3389/fpubh.2022.1067646] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 11/14/2022] [Indexed: 12/05/2022] Open
Abstract
Background Evidence from previous studies has confirmed that functionally impaired elderly individuals are susceptible to comorbid anxiety and depression. Network theory holds that the comorbidity emerges from interactions between anxiety and depression symptoms. This study aimed to investigate the fine-grained relationships among anxiety and depression symptoms in the functionally impaired elderly and identify central and bridge symptoms to provide potential targets for intervention of these two comorbid disorders. Methods A total of 325 functionally impaired elderly individuals from five communities in Xi'an, China, were recruited for our investigation. The GAD-7 and PHQ-9 were used to measure anxiety and depression, respectively. SPSS 22.0 software was used for descriptive statistics, and R 4.1.1 software was used for network model construction, expected influence (EI) evaluation and bridge expected influence (BEI) evaluation. Results In the network, there were 35 edges (indicating partial correlations between symptoms) across the communities of anxiety and depression, among which the strongest edge was A1 "Nervousness or anxiety"-D2 "Depressed or sad mood." A2 "Uncontrollable worry" and D2 "Depressed or sad mood" had the highest EI values in the network, while A6 "Irritable" and D7 "Concentration difficulties" had the highest BEI values of their respective community. In the flow network, the strongest direct edge of D9 "Thoughts of death" was with D6 "Feeling of worthlessness." Conclusion Complex fine-grained relationships exist between anxiety and depression in functionally impaired elderly individuals. "Uncontrollable worry," "depressed or sad mood," "irritable" and "concentration difficulties" are identified as the potential targets for intervention of anxiety and depression. Our study emphasizes the necessity of suicide prevention for functionally impaired elderly individuals, and the symptom "feeling of worthlessness" can be used as an effective target.
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Affiliation(s)
- Tianqi Yang
- Department of Military Medical Psychology, Air Force Medical University, Shaanxi, China
| | - Zhihua Guo
- Department of Military Medical Psychology, Air Force Medical University, Shaanxi, China
| | - Xiaoqin Cao
- Xijing Hospital, Air Force Medical University, Shaanxi, China
| | - Xia Zhu
- Department of Military Medical Psychology, Air Force Medical University, Shaanxi, China
| | - Qin Zhou
- Xijing Hospital, Air Force Medical University, Shaanxi, China
| | - Xinhong Li
- Tangdu Hospital, Air Force Medical University, Shaanxi, China
| | - Hui Wang
- Department of Military Medical Psychology, Air Force Medical University, Shaanxi, China
| | - Xiuchao Wang
- Department of Military Medical Psychology, Air Force Medical University, Shaanxi, China
| | - Lin Wu
- Department of Military Medical Psychology, Air Force Medical University, Shaanxi, China
| | - Shengjun Wu
- Department of Military Medical Psychology, Air Force Medical University, Shaanxi, China,Shengjun Wu
| | - Xufeng Liu
- Department of Military Medical Psychology, Air Force Medical University, Shaanxi, China,*Correspondence: Xufeng Liu
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