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Prati G. The reciprocal relationships between economic status and mental health: Investigating the between-person and within-person effects in a three-wave longitudinal study. J Affect Disord 2024; 366:16-24. [PMID: 39197548 DOI: 10.1016/j.jad.2024.08.169] [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: 03/02/2023] [Revised: 05/29/2024] [Accepted: 08/24/2024] [Indexed: 09/01/2024]
Abstract
BACKGROUND Social drift/selection (i.e., mental health symptoms cause low economic status) and social causation theories (i.e., low economic status causes mental health symptoms) specify reciprocal relationships between economic status and mental health. Little is known regarding the disaggregation of within-person and between-person effects in the relationship between economic status and mental health in the long run. The current study sought to examine the reciprocal relationships between economic status and mental health over 20 years of adulthood, disaggregating within-person and between-person effects. METHODS Data were from three waves (7108 participants) of the Midlife Development in the United States study. Participants reported information about objective and subjective measures of economic status as well as a wide range of indicators of mental health on the positive dimension, including subjective, social, and psychological well-being, and on the negative side, depression, anxiety, panic attack, anhedonia, somatic amplification, alcohol abuse, and negative affect. Cross-lagged panel models were estimated. RESULTS At between-person levels, both social drift/selection and social causation hypotheses were confirmed when considering subjective measures of economic status. When using objective measures of economic status (i.e., income), the results showed decreased support for social drift/selection and social causation hypotheses. At within-person levels, social drift/selection and social causation hypotheses were generally not supported, with some notable exceptions. LIMITATIONS Restriction of the sample to one country limits the generalizability of the findings. CONCLUSIONS Social causation and social drift/selection processes act simultaneously mainly at a population level, but much less when considering individual changes. Policy and programs should be targeted at addressing inequality in income and mental health within a nation or a community.
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Affiliation(s)
- Gabriele Prati
- Department of Psychology, University of Bologna (Italy), Piazza Aldo Moro, 90, 47521 Cesena, FC, Italy.
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Park SM, Kim DB, Joo MJ, Park EC. Association between living alone and generalized anxiety disorder in Korean adults. J Affect Disord 2024; 362:630-637. [PMID: 39029664 DOI: 10.1016/j.jad.2024.07.112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Revised: 06/25/2024] [Accepted: 07/16/2024] [Indexed: 07/21/2024]
Abstract
BACKGROUND Globally, the rise in single-person households poses a potential risk to mental health, with generalized anxiety disorder (GAD) being a prominent concern. The proliferation of single-person households may exacerbate social isolation and foster loneliness and anxiety. Notably, research investigating the association between single-person households and GAD remains limited. Therefore, this study aimed to investigate the association between single-person households and GAD across sexes in Korea. METHODS We utilized data from the Korea National Health and Nutrition Examination Survey conducted in 2021 and 2022, comprising a sample of 9936 participants aged 19 or older. The Generalized Anxiety Disorder Screening Tool (GAD-7) was employed to assess anxiety levels in adults. Multiple logistic regression analysis was conducted to investigate the correlation between single-person households and GAD. RESULTS The reference variable used in the analysis was multi-person households (consisting of two or more individuals). The association between single-person households and GAD was statistically significant across sexes (male: odds ratio [OR]: 1.92, 95 % CI: 1.15-3.20; female: OR: 1.56, 95 % CI: 1.03-2.36). Participants in single-person households exhibited higher scores on the GAD-7 compared with those in multi-person households. Notably, marital status and education level displayed disparate effects based on sex, whereas physical activity demonstrated consistent effects irrespective of sex. LIMITATIONS Given the use of cross-sectional data, only correlations could be established. CONCLUSION The findings indicate an elevated risk of GAD in single-person households compared with multi-person households. Furthermore, promoting physical activity emerged as a potential strategy for mitigating GAD in single-person households.
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Affiliation(s)
- Su Min Park
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea; Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Dan Bi Kim
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea; Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Min Jeong Joo
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea; Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Eun-Cheol Park
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea; Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
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Mengist B, Lotfaliany M, Pasco JA, Agustini B, Berk M, Williams LJ, Forbes M, Woods RL, Orchard SG, Ryan J, McNeil JJ, Owen AJ, Beilin LJ, Shah RC, Espinoza SE, Ganjali S, Chong TTJ, Mohebbi M. Gait speed, handgrip strength, and their combination, and risk of depression in later life: Evidence from a prospective study of community-dwelling older adults. J Affect Disord 2024; 369:218-226. [PMID: 39353510 DOI: 10.1016/j.jad.2024.09.155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 09/20/2024] [Accepted: 09/22/2024] [Indexed: 10/04/2024]
Abstract
OBJECTIVE This study investigated the association between gait speed, handgrip strength, and their combination, and the risk for developing clinically relevant depressive symptoms in community-dwelling older adults. METHODS A secondary analysis was conducted using data from the ASPirin in Reducing Events in the Elderly study. Participants were community-dwelling older adults in Australia and the United States of America followed for a median (interquartile range) of 3.97 (2.26) years. Baseline handgrip strength and gait speed were used as exposure variables, and their combination categories were also explored. Depression was measured using the modified Center for Epidemiological Studies Depression 10-item scale (CES-D 10). Cox regression was used to estimate Adjusted Hazard Ratios (AHR) with 95 % Confidence Intervals (CI) after adjusting for a range of potential confounders. RESULT A total of 17,231 participants (55.3 % women) were included in the analysis. Slow gait and weak grip at baseline were associated with the risk of depression (AHR: 1.20; CI: 1.11-1.29 and 1.14; 1.06-1.23, respectively). The combination of the two physical performance measures was associated with a 31 % increase in the risk of depression (1.31; 1.16-1.47) and a significant dose-response association was observed for quintiles of gait and grip with depression. LIMITATIONS Although the CES-D 10 is a validated scale, it is a self-reported tool rather than a clinical diagnosis of depression. CONCLUSION Low physical function may be a risk factor for depression in older adults. This highlights the inextricable link between the physical and mental health of older adults, which can inform potential clinical and public health prevention strategies for depression in later life.
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Affiliation(s)
- Belayneh Mengist
- Deakin University, the Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Barwon Health, Geelong, Victoria, Australia; College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia.
| | - Mojtaba Lotfaliany
- Deakin University, the Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Barwon Health, Geelong, Victoria, Australia
| | - Julie A Pasco
- Deakin University, the Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Barwon Health, Geelong, Victoria, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Bruno Agustini
- Deakin University, the Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Barwon Health, Geelong, Victoria, Australia
| | - Michael Berk
- Deakin University, the Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Barwon Health, Geelong, Victoria, Australia
| | - Lana J Williams
- Deakin University, the Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Barwon Health, Geelong, Victoria, Australia
| | - Malcolm Forbes
- Deakin University, the Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Barwon Health, Geelong, Victoria, Australia
| | - Robyn L Woods
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Suzanne G Orchard
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Joanne Ryan
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - John J McNeil
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Alice J Owen
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Lawrence J Beilin
- School of Medicine, Royal Perth Hospital, University of Western Australia, Perth, Australia
| | - Raj C Shah
- Department of Family & Preventive Medicine and the Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, USA
| | - Sara E Espinoza
- Center for Translational Geroscience, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Shiva Ganjali
- Deakin University, the Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Barwon Health, Geelong, Victoria, Australia
| | - Trevor T-J Chong
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia; Department of Neurology, Alfred Health, Melbourne, Victoria, Australia; Department of Clinical Neurosciences, St Vincent's Hospital, Melbourne, Victoria, Australia
| | - Mohammadreza Mohebbi
- Biostatistics Unit, Faculty of Health, Deakin University, Geelong, Victoria, Australia
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Wang L, Wang Y, Luo Y, Li Y, Li J. The mediating and moderating effect of health-promoting lifestyle on frailty and depressive symptoms for Chinese community-dwelling older adults: A cross-sectional study. J Affect Disord 2024; 361:91-96. [PMID: 38857627 DOI: 10.1016/j.jad.2024.06.011] [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: 02/06/2024] [Revised: 05/28/2024] [Accepted: 06/03/2024] [Indexed: 06/12/2024]
Abstract
BACKGROUND This study aims to explore the mediating and moderating effect of health-promoting lifestyles on the relationship between frailty and depressive symptoms to provide a practical reference for effectively promoting the mental health of older adults. METHODS A cross-sectional survey of community-dwelling older adults (n = 3107) was conducted in three cities of Ningxia Province, China. Depressive symptoms, frailty, and health-promoting lifestyles were assessed through the 30-item Geriatric Depression Scale, frailty scale, and health-promoting Lifestyle profile-II, respectively. The Bootstrap methods PROCESS program is employed to test the mediation and moderation model. RESULTS The findings indicated that health-promoting lifestyles are negatively related to depressive symptoms and frailty, while frailty is positively associated with depressive symptoms. Health-promoting lifestyles have mediated the relationship between frailty and depressive symptoms. Besides, the health-promoting lifestyles weakened the positive relationship between frailty and depression symptoms; there existed a moderating effect of health-promoting lifestyles on the relationship between frailty and depression symptoms among older adults. LIMITATIONS Given the cross-sectional study, it is impossible to make causal inferences. CONCLUSIONS A health-promoting lifestyle might be a protective factor for older adults' health in China. The mediating and moderating effect of a health-promoting lifestyle on the relationship between frailty and depression symptoms among older adults should be integrated to achieve maximum utility. Healthcare practitioners and medical service personnel are recommended to advance health education and publicity, encouraging healthy lifestyles among community-dwelling older adults with frailty to prevent depressive symptoms and promote healthy aging.
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Affiliation(s)
- Liqun Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Ningxia Medical University, Yinchuan 750004, China; Key Laboratory of Environmental Factors and Chronic Disease Control, Ningxia Medical University, Yinchuan 750004, China
| | - Yali Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Ningxia Medical University, Yinchuan 750004, China
| | - Yiling Luo
- Department of Health Management Center, People's Hospital of Ningxia Hui Autonomous Region, Yinchuan 750021, China
| | - Yan Li
- The Center for Disease Control and Prevention of Yinchuan City, Yinchuan 750011, China
| | - Jiangping Li
- Department of Epidemiology and Health Statistics, School of Public Health, Ningxia Medical University, Yinchuan 750004, China; Key Laboratory of Environmental Factors and Chronic Disease Control, Ningxia Medical University, Yinchuan 750004, China.
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Li C, Li X, Zhang Y, Lao W. Interpersonal interactions, sense of loneliness and perceived depressive emotions among older adults: A cultural-psychological perspective from heterogeneous roles of different relationships. SSM Popul Health 2024; 27:101703. [PMID: 39220297 PMCID: PMC11364054 DOI: 10.1016/j.ssmph.2024.101703] [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: 04/04/2024] [Revised: 07/30/2024] [Accepted: 08/01/2024] [Indexed: 09/04/2024] Open
Abstract
In the context of the "Chinese Differential Mode of Association" in traditional Chinese culture, this paper examines the heterogeneous effects of interpersonal interactions in different relationships on older adults' depressive emotions from a cultural-psychological perspective. Results using data from Chinese General Social Survey demonstrate that: interactions with children are the most helpful in reducing perceived depression for the elderly, followed by communications with siblings and relatives. However, interactions with friends and other fellows do not significantly reduce older people's perceived depression. This reflects the "Chinese Differential Mode of Association" in interpersonal relationships. When using different perceived depression measures, and Double Debiased Machine Learning (DDML) approaches for robustness and endogeneity tests, above findings are very robust. The impact mechanism is that interactions with children and siblings reduce depressive emotions by decreasing older adults' sense of loneliness, while communications with others do not have such a significant effect. This paper further discusses the roles of different types of interactions with adult children. It is found that receiving and providing emotional support can prominently decrease depressive emotions for older people, whereas the effects of monetary support and non-material assistance are less pronounced. In addition, interpersonal interactions' impacts are more significant for those who are female, older than 75 and with poorer health, as well as older people who exercise less frequently, have higher social status, and hold more traditional beliefs. In the current context of active promotion of healthy aging, findings of this paper have important implications for a deeper understanding and scientific management of depressive emotions among the elderly.
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Affiliation(s)
- Chao Li
- Business School, Shandong University, 180 Wenhuaxi Road, Weihai, 264209, China
- Centre for Quality of Life and Public Policy Research, Shandong University, 72 Binhai Road, Jimo, Qingdao, 266237, China
| | - Xiang Li
- Business School, Shandong University, 180 Wenhuaxi Road, Weihai, 264209, China
| | - Yuhan Zhang
- HSBC Business School, Peking University, University Town, Nanshan District, Shenzhen, 518055, China
| | - Wenyu Lao
- Business School, Shandong University, 180 Wenhuaxi Road, Weihai, 264209, China
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Wu K, Chen J, Xiao Y, Yan C, Li X, Huang Y, Deng R. Health lifestyles of six Zhiguo ethnic groups in China: a latent class analysis. BMC Public Health 2024; 24:2279. [PMID: 39174913 PMCID: PMC11340163 DOI: 10.1186/s12889-024-19743-9] [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: 08/14/2023] [Accepted: 08/09/2024] [Indexed: 08/24/2024] Open
Abstract
BACKGROUND Zhiguo ethnic groups, commonly known as "the directly-entering-socialism ethnic groups", represent Chinese ethnic minorities who have undergone a unique social development trajectory by transforming directly from primitive societies to the socialist stage. In recent decades, significant lifestyle transformations have occurred among Zhiguo ethnic groups. Understanding their health lifestyles can play a strategic role in China's pursuit of universal health coverage. This study aims to examine patterns of health-related lifestyle among Zhiguo ethnic groups and explore whether sociodemographic features and specific indicators related to health status are associated with particular classes. METHODS A cross-sectional study was conducted in Yunnan Province, China, from July to December 2022. Stratified random sampling method was employed to recruit residents belonging to six Zhiguo ethnic groups aged between 15 and 64. Latent class analysis was performed to identify clusters of health-related behaviors within each ethnic group. Logistic regression was utilized to determine the predictors of health lifestyles. RESULTS A total of 1,588 individuals from the Zhiguo ethnic groups participated in this study. Three latent classes representing prevalent health lifestyles among the Zhiguo ethnic groups were identified: "unhealthy lifestyle" (31.80%), "mixed lifestyle" (57.37%), and "healthy lifestyle" (10.83%). In the overall population, individuals belonging to the "healthy lifestyle" group exhibited a higher likelihood of being non-farmers (OR: 2.300, 95% CI: 1.347-3.927), women (OR: 21.459, 95% CI: 13.678-33.667), married individuals (OR: 1.897, 95% CI: 1.146-3.138), and those residing within a walking distance of less than 15 min from the nearest health facility (OR: 2.133, 95% CI: 1.415-3.215). Conversely, individuals in the age cohorts of 30-39 years (OR: 0.277, 95% CI: 0.137-0.558) and 40-49 years (OR: 0.471, 95% CI: 0.232-0.958) showed a decreased likelihood of adopting a healthy lifestyle. CONCLUSIONS A considerable proportion of the Zhiguo ethnic groups have not adopted healthy lifestyles. Targeted interventions aimed at improving health outcomes within these communities should prioritize addressing the clustering of unfavorable health behaviors, with particular emphasis on single male farmers aged 30-49, and expanding healthcare coverage for individuals residing more than 15 min away from accessible facilities.
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Affiliation(s)
- Kaiwen Wu
- School of Public Health, Kunming Medical University, Kunming, China
- The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Jie Chen
- School of Public Health, Kunming Medical University, Kunming, China
| | - Yan Xiao
- Foreign Languages Department, Kunming Medical University, Kunming, China
| | - Chaofang Yan
- School of Public Health, Kunming Medical University, Kunming, China
| | - Xiaoju Li
- School of Public Health, Kunming Medical University, Kunming, China
| | - Yuan Huang
- School of Public Health, Kunming Medical University, Kunming, China.
| | - Rui Deng
- School of Public Health, Kunming Medical University, Kunming, China.
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Wang T, Zhang S, Li Q, Liu H, Zhang S, Jian W, Guo J. Socioeconomic inequalities in the relationship between internet usage patterns and depressive symptoms: Evidence from a Chinese longitudinal study. J Glob Health 2024; 14:04127. [PMID: 39149826 PMCID: PMC11327895 DOI: 10.7189/jogh.14.04127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/17/2024] Open
Abstract
Background The increasing prevalence of depressive symptoms has emerged as a critical public health issue globally, highlighting the need for analyses of the factors contributing to depressive symptoms within the Chinese population and the development of targeted recommendations for improving mental well-being. We aimed to explore the correlation between internet use and depressive symptoms and the role of socioeconomic inequalities in this association. Methods We included data on 8019 residents aged 18 years and above, which we retrieved from the 2018 and 2020 waves of the China Family Panel Studies. We used latent profile analysis to categorise individuals' internet usage patterns and multiple linear regression to determine their association with depressive symptoms. Results Higher socioeconomic status (SES) was associated with fewer depressive symptoms (τ = -0.08; 95% confidence interval (CI) = -0.36, -0.18). Individuals in the high-dependence group presented a greater likelihood of developing depressive symptoms (τ = 0.04; 95% CI = 0.007, 0.66). We observed no significant difference in the interaction effect between individual-level SES and the four patterns of internet usage. However, compared with urban-dwelling respondents, those in rural areas had a stronger association between internet usage patterns and depressive symptoms, especially those in the high-dependence group (τ = -0.07; 95% CI = -1.47, -0.20). Conclusions Our findings indicate a significant association between depressive symptoms and internet usage patterns, indicating a need for interventions related to internet use, especially those targeted at reducing the risk of depressive symptoms in individuals of lower SES.
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Zhu J, Xu L, Sun L, Qin D. Negative life events, sleep quality, and depression among older adults in Shandong Province, China: A conditional process analysis based on economic income. Geriatr Gerontol Int 2024; 24:751-757. [PMID: 39089878 DOI: 10.1111/ggi.14914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 04/10/2024] [Accepted: 05/10/2024] [Indexed: 08/04/2024]
Abstract
AIM Negative life events have been reported as a risk factor for depression. However, the mechanism between negative life events and depression is still unclear. This study aimed to explore the mediating role of sleep quality and the moderating role of economic income in the association between negative life events and depression among older adults aged 60 years and over. METHODS A multi-stage stratified sampling method was used to select elderly individuals over 60 years old in Shandong, China, making use of the Household Health Interview Survey (2020). In total, 3868 older adults completed the measures of negative life events, sleep quality, depression, and economic income. RESULTS Negative life events positively predicted depression among the elderly (proportion of direct effect, 55.12%), and poor sleep quality could mediate this association (proportion of indirect effect, 44.87%). Economic income played a moderating role in the relationship between negative life events, sleep quality, and depression (the first and second half of the mediating effect, the direct effect of negative life events on depression). Both effects were weaker among the elderly with higher economic incomes. CONCLUSIONS Negative life events had positive effects on depression in older adults. Economic income moderated the direct effect of negative life events and the mediating effect (first and second half) of sleep quality on depression. When the elderly experience negative life events, interventions for improving their sleep quality and financial support could effectively prevent depression. Geriatr Gerontol Int 2024; 24: 751-757.
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Affiliation(s)
- Jing Zhu
- Linyi City Hospital DRG Management and application Key Laboratory, Linyi People's Hospital, Linyi, China
| | - Lingzhong Xu
- Centre for Health Management and Policy Research, School of Public Health, Jinan, China
- China National Health Commission (NHC), Key Laboratory of Health Economics and Policy Research (Shandong University), Cheeloo College of Medicine, Shandong University, Jinan, China
- Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan, China
| | - Long Sun
- Centre for Health Management and Policy Research, School of Public Health, Jinan, China
- China National Health Commission (NHC), Key Laboratory of Health Economics and Policy Research (Shandong University), Cheeloo College of Medicine, Shandong University, Jinan, China
- Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan, China
| | - Dawei Qin
- Linyi City Hospital DRG Management and application Key Laboratory, Linyi People's Hospital, Linyi, China
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Liu X, Ngoubene-Atioky AJ, Yang X, Deng Y, Tang J, Wu L, Huang J, Zheng Y, Fang J, Kaur A, Chen L. The effect of childhood family adversity on adulthood depression among Chinese older migrant workers: gender differences in the mediating role of social-ecological systems. BMC Public Health 2024; 24:2005. [PMID: 39061001 PMCID: PMC11282819 DOI: 10.1186/s12889-024-19397-7] [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: 10/26/2023] [Accepted: 07/08/2024] [Indexed: 07/28/2024] Open
Abstract
BACKGROUND Older migrant workers (OMWs) in China face unique challenges rooted in their early life experiences, which increase their vulnerability to psychological and behavioral problems in adulthood. By utilizing the cumulative disadvantage model and the social-ecological systems theory, this study explored the effect of childhood family adversity on adulthood depression in the mediating roles of OMWs' social-ecological microsystem and mesosystem and further examined gender differences in these associations. METHODS Data were collected from the China Health and Retirement Longitudinal Study (CHARLS), involving a sample of 4,309 OMWs aged 50 and above. The measures included the Center for Epidemiological Research Depression Scale, childhood family adversity, socioeconomic status, marital quality, and physical and cognitive health. RESULTS Childhood family adversity was positively associated with adulthood depression among OMWs. Social microsystem (physical and cognitive health) and mesosystem (marital quality and socioeconomic status) factors significantly mediated this relationship. Multi-group analysis revealed that the mediating effects of marital quality and socioeconomic status were stronger for female OMWs, while the mediating effects of physical and cognitive health were stronger for male OMWs. CONCLUSIONS The findings suggest that childhood family adversity has a lasting impact on the mental health of OMWs, and that social-ecological systems factors play an important role in this relationship. The study also highlights the need for gender-specific interventions to address the mental health needs of OMWs.
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Affiliation(s)
- Xiaoyue Liu
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | | | - Xudong Yang
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
- Cixi Biomedical Research Institute, Wenzhou Medical University, Ningbo, China
| | | | - Jiayi Tang
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
- Cixi Biomedical Research Institute, Wenzhou Medical University, Ningbo, China
| | - Liujun Wu
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
- Cixi Biomedical Research Institute, Wenzhou Medical University, Ningbo, China
| | - Jiahui Huang
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Yawen Zheng
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Juan Fang
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Amrita Kaur
- School of Psychology, Wenzhou-Kean University, Wenzhou, China.
| | - Li Chen
- School of Mental Health, Wenzhou Medical University, Wenzhou, China.
- The affiliated Wenzhou Kangning Hospital, Wenzhou Medical University, Wenzhou, China.
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10
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Wang X, Jie W, Huang X, Yang F, Qian Y, Yang T, Dai M. Association of psychological resilience with all-cause and cause-specific mortality in older adults: a cohort study. BMC Public Health 2024; 24:1989. [PMID: 39054517 PMCID: PMC11270806 DOI: 10.1186/s12889-024-19558-8] [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: 03/07/2024] [Accepted: 07/22/2024] [Indexed: 07/27/2024] Open
Abstract
BACKGROUND Psychological resilience has been associated with increased longevity in the oldest old; however, its significance in the broader older adult population has not been thoroughly explored. There is a lack of understanding regarding its relationship with cause-specific mortality in older adults. This study aims to address these gaps by investigating the association between psychological resilience and both overall mortality and cause-specific mortality in individuals aged 65 and older. METHODS We enrolled 4,935 participants aged 65 and older in the Chinese Longitudinal Healthy Longevity Survey, with baseline assessments conducted in 2014 and follow-up surveys in 2018. To evaluate the associations between psychological resilience and mortality, we used Cox proportional hazards models. Additionally, we employed restricted cubic spline plots to illustrate the dose-response relationships between these variables. RESULTS During a mean (Standard Deviation) follow-up of 3.2 years (1.2), 1726 participants died. Higher psychological resilience was independently associated with lower all-cause mortality risk (Hazard ratio [HR] 0.74, 95% confidence interval [CI]: 0.67-0.82) and cause-specific mortality from cardiovascular disease (HR 0.74, 95% CI: 0.59-0.93), respiratory diseases (HR 0.63, 95% CI:0.45-0.87), and other causes (HR 0.69, 95% CI: 0.60-0.78), excluding cancer-related mortality. Similar effects were evident when examining the psychological resilience score. The dose-response analysis further indicated a gradual decrease in mortality risk corresponding to higher psychological resilience scores. Interaction analyses revealed that psychological resilience has a more pronounced effect on mortality from other causes among economically independent older adults (P-interaction = 0.02). CONCLUSIONS Enhanced psychological resilience is independently associated with reduced all-cause and some cause-specific mortality in older adults. These findings underscore the importance of addressing psychological factors in the promotion of healthy aging and longevity.
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Affiliation(s)
- Xiang Wang
- Jiujiang CityKey Laboratory of Cell Therapy, Jiujiang NO.1 People's Hospital, Jiujiang, Jiangxi, 332000, China
- Department of Cardiology, Jiujiang NO.1 People's Hospital, Jiujiang, Jiangxi, 332000, China
| | - Wei Jie
- Jiujiang CityKey Laboratory of Cell Therapy, Jiujiang NO.1 People's Hospital, Jiujiang, Jiangxi, 332000, China
- Department of Geriatrics, Jiujiang NO.1 People's Hospital, Jiujiang, Jiangxi, 332000, China
| | - Xionghong Huang
- Jiujiang CityKey Laboratory of Cell Therapy, Jiujiang NO.1 People's Hospital, Jiujiang, Jiangxi, 332000, China
- Department of Geriatrics, Jiujiang NO.1 People's Hospital, Jiujiang, Jiangxi, 332000, China
| | - Feng Yang
- Jiujiang CityKey Laboratory of Cell Therapy, Jiujiang NO.1 People's Hospital, Jiujiang, Jiangxi, 332000, China
- Department of Geriatrics, Jiujiang NO.1 People's Hospital, Jiujiang, Jiangxi, 332000, China
| | - Yueting Qian
- Jiujiang CityKey Laboratory of Cell Therapy, Jiujiang NO.1 People's Hospital, Jiujiang, Jiangxi, 332000, China
- Department of Geriatrics, Jiujiang NO.1 People's Hospital, Jiujiang, Jiangxi, 332000, China
| | - Ting Yang
- Jiujiang CityKey Laboratory of Cell Therapy, Jiujiang NO.1 People's Hospital, Jiujiang, Jiangxi, 332000, China
- Department of Geriatrics, Jiujiang NO.1 People's Hospital, Jiujiang, Jiangxi, 332000, China
| | - Miao Dai
- Jiujiang CityKey Laboratory of Cell Therapy, Jiujiang NO.1 People's Hospital, Jiujiang, Jiangxi, 332000, China.
- Department of Geriatrics, Jiujiang NO.1 People's Hospital, Jiujiang, Jiangxi, 332000, China.
- Chronic Disease Management Center, Jiujiang NO.1 People's Hospital, Jiujiang, Jiangxi, 332000, China.
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11
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Hosseinzadeh-Shanjani Z, Khodayari-Zarnaq R, Khosravi MF, Arab-Zozani M, Alizadeh G. Factors affecting major depression in Iran: a mixed-method study. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2024; 43:73. [PMID: 38802965 PMCID: PMC11131193 DOI: 10.1186/s41043-024-00571-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 05/17/2024] [Indexed: 05/29/2024]
Abstract
Depression is a major cause of disability and, if left untreated, can increase the risk of suicide. Evidence on the determinants of depression is incomplete, making it challenging to interpret results across studies. This study aims to identify the social, economic, environmental, political, and technological factors influencing the great recession in Iran. The study was conducted in two parts. The first step involved a literature review to identify the factors, using PubMed, Scopus, and Web of Science for the search. The reference lists of all identified articles were reviewed to find relevant studies, and the extracted information was summarized and reported descriptively. The second steps involved compiling and consulting 14 experts from different fields, using a framework analysis method. Twenty-four articles were used as primary sources of information, and a total of 28 factors were found to exist. After removing duplicates and related factors, 19 of these were subsequently declared as factors, resulting in a total of 36 determinants being identified. Most of these factors belong to the social category. The health policies implemented have a significant impact on disease risk factors and ultimately their occurrence. Political decisions and policy-making processes play a crucial role in all areas, particularly in addressing disease risk factors. Severe depression can disrupt all aspects of the healthcare system, underscoring the importance of access to care. Policies concerning physical education, transportation, nutrition, employment, green spaces, recreational facilities, and tobacco are vital in this context. The influence of health policies on disease risk factors and disease occurrence is profound. Severe depression can have far-reaching effects on the healthcare system, emphasizing the critical need for access to care. The formulation of policies to combat depression must be thoroughly evaluated in terms of economic, political, social, technological, and environmental factors. The findings suggest that addressing social inequalities and emphasizing the role of political action, as highlighted by the social determinants of health, should be top priorities in addressing depression. Efforts to prevent depression should incorporate ecological approaches that consider the impact of the socioeconomic environment on depressive symptoms.
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Affiliation(s)
| | - Rahim Khodayari-Zarnaq
- Department of Health Policy and Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Farough Khosravi
- Department of Health economics and management, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Morteza Arab-Zozani
- Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Gisoo Alizadeh
- Department of Health Policy and Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran.
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12
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Zhang C, Nie C, Su W, Balezentis T. Are digital technologies an effective inhibitor of depression among middle-aged and older adults? Micro-level evidence from a panel study. Soc Sci Med 2024; 348:116853. [PMID: 38598985 DOI: 10.1016/j.socscimed.2024.116853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Revised: 03/07/2024] [Accepted: 04/01/2024] [Indexed: 04/12/2024]
Abstract
The increased number of middle-aged and older adults leads to depression in this stratum of the population as a topical social and public health issue. However, the new generation of information technologies has exerted a profound impact on the lives of middle-aged and older adults, and offers potential solutions for alleviating their depression. This study utilizes data from the China Health and Retirement Longitudinal Study (CHARLS) collected between 2011 and 2018 and combines them with city-level traits. The results demonstrate that digital technology can reduce depression levels effectively in this group. Mechanism analysis reveals that digital technology could improve life satisfaction and subjective health status levels, which, in turn, reduces depression levels. Heterogeneity analysis shows that the positive effects of digital technology on depression were more pronounced among middle-aged and older adults with urban household registration compared to the rural population. Finally, recommendations are provided for reducing depression levels among middle-aged and older adults.
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Affiliation(s)
- Chonghui Zhang
- College of Statistics and Mathematics, Zhejiang Gongshang University, Hangzhou, 310018, China.
| | - Chenying Nie
- College of Statistics and Mathematics, Zhejiang Gongshang University, Hangzhou, 310018, China.
| | - Weihua Su
- College of Statistics and Mathematics, Zhejiang Gongshang University, Hangzhou, 310018, China.
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13
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Sánchez-Moreno E, Gallardo-Peralta L, Barrón López de Roda A, Rivera Álvarez JM. Socioeconomic status, loneliness, and depression among older adults: a cross-sectional study in Spain. BMC Geriatr 2024; 24:361. [PMID: 38654160 DOI: 10.1186/s12877-024-04978-3] [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: 01/26/2024] [Accepted: 04/15/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND The association between socioeconomic status and depression is weaker in older adults than in younger populations. Loneliness may play a significant role in this relationship, explaining (at least partially) the attenuation of the social gradient in depression. The current study examined the relationship between socioeconomic status and depression and whether the association was affected by loneliness. METHODS A cross-sectional design involving dwelling and nursing homes residents was used. A total of 887 Spanish residents aged over 64 years took part in the study. Measures of Depression (GDS-5 Scale), Loneliness (De Jong-Gierveld Loneliness Scale), Socioeconomic Status (Education and Economic Hardship), and sociodemographic parameters were used. The study employed bivariate association tests (chi-square and Pearson's r) and logistic regression analyses. RESULTS The percentage of participants at risk of suffering depression was significantly higher among those who had not completed primary education (45.5%) and significantly lower among those with university qualifications (16.4%) (X2 = 40.25;p <.001), and respondents who could not make ends meet in financial terms faced a higher risk of depression (X2 = 23.62;p <.001). In terms of the respondents who experienced loneliness, 57.5% were at risk of depression, compared to 19% of those who did not report loneliness (X2 = 120.04;p <.001). The logistic regression analyses showed that having university qualifications meant a 47% reduction in the risk of depression. This risk was 86% higher among respondents experiencing financial difficulties. However, when scores for the loneliness measure were incorporated, the coefficients relating to education and economic hardships ceased to be significant or were significantly reduced. CONCLUSION Loneliness can contribute to explaining the role played by socioeconomic inequalities in depression among older adults.
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Affiliation(s)
- Esteban Sánchez-Moreno
- Department of Sociology: Methods and Theory, Universidad Complutense de Madrid, Madrid, Spain
| | - Lorena Gallardo-Peralta
- Department of Social Work and Social Services, Faculty of Social Work, Universidad Complutense de Madrid, Campus de Somosaguas, 28223, Pozuelo, Madrid, Spain.
| | - Ana Barrón López de Roda
- Department of Social, Organizational and Differential Psychology, Universidad Complutense de Madrid, Madrid, Spain
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14
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Huijie Z, Haojun J, Zhiping Z, Zhaoyu Y. Association between residential environment and emotional wellbeing among older adults in China: the mediating effect of health lifestyle. Front Public Health 2024; 12:1338079. [PMID: 38699418 PMCID: PMC11063323 DOI: 10.3389/fpubh.2024.1338079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 03/13/2024] [Indexed: 05/05/2024] Open
Abstract
Introduction The association between the residential environment and emotional wellbeing (EWB) in older adults has received extensive attention from gerontologists, especially during the COVID-19 pandemic; however, the mediating mechanism of how residential environment affects emotional wellbeing has not been fully explored. This study examined the effects of the residential environment on EWB and the mediating role of health lifestyle. Methods This study analyzed the survey data of 493 rural and 515 urban older adults from 2021 Chinese General Social Survey. General linear regression and structural equation models were used to examine the effects of residential environment and health lifestyle. Results Urban participants exhibited clear advantages in EWB, residential environment, and physical activity. Residential environment significantly affected the EWB of older adults, and health lifestyle played a mediating role in this relationship. The residential environment and health lifestyle did not significantly affect EWB in rural participants. Discussion This study revealed differences in the effects of health lifestyles and residential environments on EWB among older adults in rural and urban settings in China. This study provided empirical evidence of mental health disparities between older rural and urban Chinese residents.
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Affiliation(s)
- Zhu Huijie
- College of Humanities and Social Development, Nanjing Agricultural University, Nanjing, China
- Center for Social Research, Nanjing Agricultural University, Nanjing, China
- Jin Shanbao Institute for Agricultural and Rural Development Research Institute, Nanjing, China
| | - Jiang Haojun
- Tourism and Social Management College, Nanjing Xiaozhuang University, Nanjing, China
| | - Zhu Zhiping
- College of Humanities and Social Development, Nanjing Agricultural University, Nanjing, China
| | - Yao Zhaoyu
- College of Humanities and Social Development, Nanjing Agricultural University, Nanjing, China
- Jin Shanbao Institute for Agricultural and Rural Development Research Institute, Nanjing, China
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15
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Zhu Q, Ting T, Zhong N, Zhang F. Bullying victimization and mental health of Chinese adolescents: The chain of tragedy effect of belief in a just world and health promoting lifestyle. J Affect Disord 2024; 350:16-23. [PMID: 38199425 DOI: 10.1016/j.jad.2024.01.039] [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: 05/11/2023] [Revised: 12/09/2023] [Accepted: 01/03/2024] [Indexed: 01/12/2024]
Abstract
BACKGROUND Experiences of being bullied in school can impair adolescents' subjective well-being and elevate the risk of psychopathology, suggesting the necessity of identifying factors that may protect against the deleterious effects of being bullied. This study expands upon prior research by examining the relationship between bullying victimization and adolescent mental health, specifically from the perspective of individual perceptions of justice and healthy lifestyles in the Chinese cultural context. METHODS A total of 3873 Chinese adolescents in grades 7-11 (51.85 % female) completed bullying victimization, belief in a just world, health promoting lifestyle, depressive symptoms, and subjective well-being measures, and provided information on their demographics, including gender, grade, family structure, parents' educational background. RESULTS After adjusting for demographic variables, bullying victimization was directly and positively related to depression, while directly and negatively related to subjective well-being. Bullying victimization also influenced depression and subjective well-being through three mediation pathways, with belief in a just world and health promoting lifestyle playing multiple mediating roles in the relationship between bullying victimization and mental health outcomes. LIMITATIONS The data used in this study were self-reported by adolescents and measured via cross-sectional designs, thus precluding statistical examination of temporal causal relationships, and assessments of whether reported affects are stable over time. CONCLUSIONS The study suggests that belief in a just world and health promoting lifestyle are important factors in understanding the impact of bullying victimization on adolescent mental health, and underscores the need for targeted bullying interventions for at-risk adolescents.
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Affiliation(s)
- Qiujin Zhu
- Department of Psychology, School of Philosophy, Wuhan University, Wuhan, China
| | - Tingting Ting
- Department of Psychology, School of Philosophy, Wuhan University, Wuhan, China
| | - Nian Zhong
- Department of Psychology, School of Philosophy, Wuhan University, Wuhan, China
| | - Fan Zhang
- College of Business Administration, Shanghai Business School, Shanghai, China.
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Xie QW, Fan XL, Luo X, Chang Q. Mechanisms underlying the relationship between the intersectionality of multiple social identities with depression among US adults: A population-based study on the mediating roles of lifestyle behaviors. J Affect Disord 2024; 349:384-393. [PMID: 38211749 DOI: 10.1016/j.jad.2024.01.078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 12/27/2023] [Accepted: 01/04/2024] [Indexed: 01/13/2024]
Abstract
BACKGROUND Despite substantial efforts to investigate the inequalities in mental health among people with marginalized identities, most research has concentrated on single social identities rather than complete persons. The current study aimed to explore the mechanisms underlying the relationship between the intersectionality of multiple social identities with depression among US adults. METHODS Data for this study came from the National Health and Nutrition Examination Survey waves between 2015 and 2018, including a total of 11,268 US adults. A latent class analysis (LCA) was conducted to identify latent subpopulations based on sex, race/ethnicity, immigrant status, disability, household income, employment status, and education level. Interclass differences in lifestyle factors and depression were examined. Multiple mediation analysis was used to examine the mediating roles of lifestyle behaviors. RESULTS LCA identified four potential subpopulations: "least marginalized", "immigrant minorities", "disabled, less-educated non-workers", and "low-income minorities" groups. There was enormous heterogeneity in mental health among immigrant minority individuals. The "disabled, less-educated non-workers" group had the highest rates of depression; in contrast, the "immigrant minorities" group had the best mental health, even better than that of the "least marginalized" group. Distributions of lifestyle factors followed a similar pattern. In addition, lifestyle behaviors significantly mediated the relationship between intersectional social identities and depression. LIMITATIONS The cross-sectional design prevented establishment of the causality of relationships. CONCLUSIONS This study suggests that applying a person-centered approach is important when examining intersectional inequalities in mental health and highlights the effects of structural social hierarchies on individuals' health behaviors and mental health.
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Affiliation(s)
- Qian-Wen Xie
- Department of Social Welfare and Risk Management, School of Public Affairs, Zhejiang University, Hangzhou, China; Research Center for Common Prosperity, Future Regional Development Laboratory, Innovation Center of Yangtze River Delta, Zhejiang University, Jiaxing, China; Center of Social Welfare and Governance, Zhejiang University, Hangzhou, China; Institute for Common Prosperity and Development, Zhejiang University, Hangzhou, China
| | - Xu Li Fan
- Department of Social Welfare and Risk Management, School of Public Affairs, Zhejiang University, Hangzhou, China
| | - Xiangyan Luo
- Department of Social Welfare and Risk Management, School of Public Affairs, Zhejiang University, Hangzhou, China
| | - Qingsong Chang
- School of Sociology and Anthropology, Xiamen University, Xiamen City, China.
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Zhang J, Xu Z, Han P, Fu Y, Wang Q, Wei X, Wang Q, Yang L. Exploring the Modifying Role of GDP and Greenness on the Short Effect of Air Pollutants on Respiratory Hospitalization in Beijing. GEOHEALTH 2024; 8:e2023GH000930. [PMID: 38505689 PMCID: PMC10949333 DOI: 10.1029/2023gh000930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 01/31/2024] [Accepted: 02/28/2024] [Indexed: 03/21/2024]
Abstract
It is unclear whether Gross Domestic Product (GDP) and greenness have additional modifying effects on the association between air pollution and respiratory system disease. Utilizing a time-stratified case-crossover design with a distributed lag linear model, we analyzed the association between six pollutants (PM2.5, PM10, NO2, SO2, O3, and CO) and 555,498 respiratory hospital admissions in Beijing from 1st January 2016 to 31st December 2019. We employed conditional logistic regression, adjusting for meteorological conditions, holidays and influenza, to calculate percent change of hospitalization risk. Subsequently, we performed subgroup analysis to investigate potential effect modifications using a two-sample z test. Every 10 μg/m3 increase in PM2.5, PM10, NO2, SO2, and O3 led to increases of 0.26% (95%CI: 0.17%, 0.35%), 0.15% (95%CI: 0.09%, 0.22%), 0.61% (95%CI: 0.44%, 0.77%), 1.72% (95%CI: 1.24%, 2.21%), and 0.32% (95%CI: 0.20%, 0.43%) in admissions, respectively. Also, a 1 mg/m3 increase in CO levels resulted in a 2.50% (95%CI: 1.96%, 3.04%) rise in admissions. The links with NO2 (p < 0.001), SO2 (p < 0.001), O3 (during the warm season, p < 0.001), and CO (p < 0.001) were significantly weaker among patients residing in areas with higher levels of greenness. No significant modifying role of GDP was observed. Greenness can help mitigate the effects of air pollutants, while the role of GDP needs further investigation.
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Affiliation(s)
- Jiawei Zhang
- Department of Health Policy and ManagementPeking University School of Public HealthBeijingChina
| | - Zhihu Xu
- Department of Occupational and Environmental Health SciencesPeking University School of Public HealthBeijingChina
| | - Peien Han
- Department of Health Policy and ManagementPeking University School of Public HealthBeijingChina
| | - Yaqun Fu
- Department of Health Policy and ManagementPeking University School of Public HealthBeijingChina
| | - Quan Wang
- Department of Health Policy and ManagementPeking University School of Public HealthBeijingChina
- Brown SchoolWashington University in St. LouisSt. LouisMOUSA
| | - Xia Wei
- Department of Health Policy and ManagementPeking University School of Public HealthBeijingChina
- Department of Health Services Research and PolicyLondon School of Hygiene & Tropical MedicineLondonUK
| | - Qingbo Wang
- Department of Health Policy and ManagementPeking University School of Public HealthBeijingChina
| | - Li Yang
- Department of Health Policy and ManagementPeking University School of Public HealthBeijingChina
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Wan H, Hu YH, Li WP, Wang Q, Su H, Chenshu JY, Lu X, Gao W. Quality of life, household income, and dietary habits are associated with the risk of sarcopenia among the Chinese elderly. Aging Clin Exp Res 2024; 36:29. [PMID: 38334908 PMCID: PMC10857955 DOI: 10.1007/s40520-023-02656-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 11/07/2023] [Indexed: 02/10/2024]
Abstract
BACKGROUND Health-related quality of life (HRQoL), which can be influenced by various aspects, especially socioeconomic status and lifestyle, has been identified as an important predictor of the prognosis of older adults. Dietary habit, a major part of lifestyle, can affect the nutritional status, which is closely correlated with the development of geriatric syndromes in the elderly. AIMS The aim of the study was to examine the association of HRQoL, socioeconomic status, and lifestyle with the risk and severity of sarcopenia, a geriatric syndrome characterized by progressive loss of skeletal muscle mass, strength and function. METHODS A cross-sectional retrospective study with 2877 participants aged ≥65 years was performed. HRQoL was assessed using EuroQoL Five Dimensions questionnaire. Socioeconomic status was assessed by the educational attainment, occupation, and household income. Lifestyle was assessed using 12 items closely related to Chinese living habits. The information of daily dietary habits including tea, alcohol, type of diet, and volume of drinking water were collected. The associations of HRQoL, socioeconomic status, and lifestyle with the risk of sarcopenia were examined by multivariate regression logistical analysis. The potential causal role of age, body mass index, and waist circumference in the effect of HRQoL on sarcopenia risk was analyzed by causal mediation analysis. RESULTS High HRQoL [adjusted odds ratio (OR) =0.85, 95% confidence interval (CI) =0.69-0.95, P=0.034] and household income levels (adjusted OR =0.74, 95% CI =0.57-0.95, P=0.019) were inversely associated with the risk of sarcopenia. Meanwhile, more consumption of spicy food (adjusted OR =1.34, 95% CI =1.09-1.81, P =0.037) and occasionally drinking (adjusted OR =1.46, 95% CI =1.07-2.00, P =0.016, as compared to those never drinking) were associated with higher risk of sarcopenia, while skipping breakfast occasionally (adjusted OR =0.37, 95% CI =0.21-0.64, P <0.001, as compared to those eating breakfast every day) and less consumption of salt (adjusted OR =0.71, 95% CI =0.52-0.96, P =0.026, as compared to those consuming high amount of salt) were associated with lower risk of sarcopenia. Further causal mediation analysis aimed to explore how much age, body mass index, and waist circumference might explain the effect of HRQoL on the risk of sarcopenia showed that the estimated proportion that mediated the effect of HRQoL on the risk of sarcopenia by age was 28.0%. CONCLUSIONS In summary, our findings demonstrate that low levels of HRQoL and household income, more intake of salt and spicy food, and occasional intake of alcohol are correlated with higher risk of sarcopenia, while skipping breakfast occasionally is associated with lower risk of sarcopenia in a Chinese population of older adults.
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Affiliation(s)
- Hua Wan
- Department of Health Management, Sir Run Run Hospital, Nanjing Medical University, Nanjing, China
| | - Yan-Hui Hu
- Department of Public Health, Sir Run Run Hospital, Nanjing Medical University, Nanjing, China
| | - Wei-Peng Li
- Department of Geriatrics, Sir Run Run Hospital, Nanjing Medical University, No.109 Longmian Avenue, Nanjing, 211166, China
| | - Quan Wang
- Department of Geriatrics, Sir Run Run Hospital, Nanjing Medical University, No.109 Longmian Avenue, Nanjing, 211166, China
| | - Hong Su
- Department of Health Management, Sir Run Run Hospital, Nanjing Medical University, Nanjing, China
| | - Jun-Yan Chenshu
- Department of Health Management, Sir Run Run Hospital, Nanjing Medical University, Nanjing, China
| | - Xiang Lu
- Department of Geriatrics, Sir Run Run Hospital, Nanjing Medical University, No.109 Longmian Avenue, Nanjing, 211166, China.
| | - Wei Gao
- Department of Geriatrics, School of Medicine, Zhongda Hospital, Southeast University, No.87 Dingjiaqiao, Nanjing, 210009, Jiangsu, China.
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Zhang J, Zhang Y, Wu Z, Fu X. Enhancing understanding of healthy aging based on time-varying dependencies among multidimensional health, life satisfaction, and health behaviors of older adults aged 60 years and over. BMC Public Health 2024; 24:192. [PMID: 38229050 PMCID: PMC10790531 DOI: 10.1186/s12889-024-17752-2] [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: 08/14/2023] [Accepted: 01/11/2024] [Indexed: 01/18/2024] Open
Abstract
BACKGROUND Healthy aging is a process of not only achieving good health but also increasing the life satisfaction of older adults aged 60 years and over, in which health behaviors play an important role. There is a lack of research on the time-varying dependencies between health, life satisfaction, and health behaviors, impeding a deeper understanding of healthy aging. PURPOSE To develop an integrated framework for modeling the interrelationships among the components of healthy aging between multiple time slices. METHODS Based on the Chinese Longitudinal Healthy Living Survey (CLHLS) data in the three waves of 2011/2012, 2014, and 2017/2018, Bayesian network and dynamic Bayesian network are jointly employed to study the relationships among the components of healthy aging within one time slice, as well as to explore the time-varying dependencies among the components between time slices. RESULTS The results of structure learning reveal the direction of effects between different dimensions of health, with mental health and social health affecting physical health and self-rated health affecting both physical and mental health. In addition, health behaviors are found to affect mental health and social health, while self-rated health can influence life satisfaction. The parameters learned from the data show the magnitude and direction of concurrent effects, one-period lagged effects and two-period lagged effects between the factors, which find that the time-varying dependencies vary but are generally positive, long-term, and accumulative over time. In addition, the results of autoregressive effects show the positive predictive effects of health and life satisfaction. CONCLUSIONS It confirms the influence pathway from health behaviors to multidimensional health to life satisfaction, and the time-varying dependencies among the components of healthy aging, which facilitates a deeper understanding of healthy aging. Combining the results of autoregressive effects and descriptive statistics, it further indicates that healthy aging is a comprehensive result arising from interactions of multiple factors. Policymakers should guide older adults aged 60 years and over to adopt healthier behaviors and ensure the long-term sustainability and continuity of policies.
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Affiliation(s)
- Jianghua Zhang
- School of Management, Shandong University, Jinan, 250100, China
| | - Yunbao Zhang
- School of Management, Shandong University, Jinan, 250100, China
| | - Zhiyi Wu
- School of Management, Shandong University, Jinan, 250100, China
| | - Xuemei Fu
- School of Management, Shandong University, Jinan, 250100, China.
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Gilan NR, Mohamadi J, Irankhah A, Khezeli M, Zangeneh A. Review of the effect cultural capital and subjective socioeconomic status on life satisfaction in Iran: the mediating role of health-promoting lifestyle and the moderating role of ethnicity. BMC Public Health 2023; 23:2563. [PMID: 38135873 PMCID: PMC10740275 DOI: 10.1186/s12889-023-17490-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 12/14/2023] [Indexed: 12/24/2023] Open
Abstract
INTRODUCTION Health-promoting lifestyle can leads to improving the quality of life, life satisfaction, well-being and reducing the burden of health care in the society. This study was carried out to investigate the mediating role of health-promoting lifestyle and moderating role of ethnicity in the effect of cultural capital and subjective socioeconomic status on life satisfaction in Iran. METHODS This cross-sectional study was conducted with 800 respondents in the cities of Kermanshah with Kurdish ethnicity and Tabriz with Azeri ethnicity. The data gathering tool was a questionnaire in five section including demographic checklist, cultural capital questionnaire (2015),Diener's life satisfaction scale, and health-promoting lifestyle questionnaire (HPLP II), and socioeconomic status scale. Data were analyzed by SPSS and AMOS software. RESULTS Life satisfaction had the highest correlation with the objective dimension of cultural capital (p < 0.001 r = 0.298). The direct standardized coefficient of the path of cultural capital to health-promoting lifestyle was 0.44 (P < 0.001). Also the direct standardized coefficient of cultural capital on Life satisfaction was 0.04 that was not significant. The standard coefficient of the path of cultural capital on life satisfaction through health-promoting lifestyle was 0.27(P < 0.001). Ethnicity variable did not moderate the effect of cultural capital on life satisfaction (p > 0.05). CONCLUSION The results of this study showed that paying attention to the concept of health-promoting lifestyle is a necessity to affect life satisfaction. It can play a role as a mediator for the path of cultural capital and socio-economic status on life satisfaction. This study also showed the role of ethnicity as a moderating variable in the relationship between socio-economic status and health-promoting lifestyle.
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Affiliation(s)
- Nader Rajabi Gilan
- Sociology Department, Faculty of Humanities and Social Sciences, University of Kurdistan, sanandaj, Iran
- Social Development & Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Jamal Mohamadi
- Sociology Department, Faculty of Humanities and Social Sciences, University of Kurdistan, sanandaj, Iran.
| | - Adel Irankhah
- Sociology Department, Faculty of Humanities and Social Sciences, University of Kurdistan, sanandaj, Iran
| | - Mehdi Khezeli
- Social Development & Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Alireza Zangeneh
- Social Development & Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Zhu M, Zhao J, Zhu X, Cheng Q, Zhang S, Kong L. Effects of Health-Promoting Lifestyle on Late-Onset Depression in Older Adults: Mediating Effect of Meaning in Life and Interleukin-6 (IL-6). Psychol Res Behav Manag 2023; 16:5159-5168. [PMID: 38146389 PMCID: PMC10749783 DOI: 10.2147/prbm.s441277] [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: 09/21/2023] [Accepted: 12/14/2023] [Indexed: 12/27/2023] Open
Abstract
Purpose Late-onset depression (LOD) with poor treatment response has high incidence and mortality in the China's aged people, this study aims to explore the correlation between health-promoting lifestyle, meaning in life, interleukin-6 (IL-6) and LOD for providing scientific basis of LOD prevention and rehabilitation. Patients and Methods A total of 496 LOD patients (study group) and healthy older adults (control group) were enrolled and investigated by using the Health-promoting lifestyle Profile-II, revised (HPLP-IIR), Meaning in Life Questionnaire-Chinese Version (MLQ-C), and Hamilton Depression Scale (HAMD). The interleukin-6 (IL-6) in the circulating blood was detected by utilizing ELISA kit. Results The results showed that the scores of all factors in HPLP-IIR and MLQ were significantly lower and IL-6 level was higher in the study group than the control group. Scores of most factors in HPLP-IIR and MLQ negatively and IL-6 positively correlated with scores of subscales and total HAMD score. Meaning in life and IL-6 partially mediated the relationship between health-promoting lifestyles and depression severity in the study group, with the mediating effect explains 15.76% and 22.64% of the total effect, respectively. Conclusion Health-promoting lifestyles, meaning in life, and IL-6 are predictors of LOD, and an unhealthy lifestyle could induce LOD through the mediating effect of meaning in life and IL-6 in older adults.
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Affiliation(s)
- Miao Zhu
- Psychiatry Department, The Oriental People’s Hospital of Xuzhou, Xuzhou, 221004, People’s Republic of China
| | - Juan Zhao
- Psychiatry Department, The Oriental People’s Hospital of Xuzhou, Xuzhou, 221004, People’s Republic of China
| | - Xiaoli Zhu
- Psychological Intervention Center, No.904 Hospital, Changzhou, 213003, People’s Republic of China
| | - Qi Cheng
- Psychological Intervention Center, No.904 Hospital, Changzhou, 213003, People’s Republic of China
| | - Shuyou Zhang
- Psychological Intervention Center, No.904 Hospital, Changzhou, 213003, People’s Republic of China
| | - Lingming Kong
- Psychological Intervention Center, No.904 Hospital, Changzhou, 213003, People’s Republic of China
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22
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Bagheri S, Taridashti S, Farahani H, Watson P, Rezvani E. Multilayer perceptron modeling for social dysfunction prediction based on general health factors in an Iranian women sample. Front Psychiatry 2023; 14:1283095. [PMID: 38161726 PMCID: PMC10756140 DOI: 10.3389/fpsyt.2023.1283095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 11/15/2023] [Indexed: 01/03/2024] Open
Abstract
In the year 2022, this research conducted an in-person study involving 780 single or widowed women, aged between 20 and 70, falling within the bottom three economic deciles and possessing varying levels of education. All participants held educational qualifications below a high school diploma and were beneficiaries of charitable financial support in Khorasan province, Iran. The study aimed to investigate the predictive factors of social dysfunction in this specific demographic. Data collection spanned a 12-month period throughout 2022, with participants completing the GHQ-28 questionnaire during their visits to the charity office. Clinical in-person interviews were also conducted to gather comprehensive data. Data analysis was carried out using IBM SPSS version 27. The research employed a Multilayer Perceptron (MLP) neural network model, considering an extensive set of input factors and covariates. These factors included cognitive functioning, anxiety, depression, age, and education levels. The MLP model exhibited robust performance, achieving high overall accuracy and sensitivity in identifying cases of high social dysfunction. The findings emphasized the significance of cognitive functioning, anxiety, and depression as pivotal predictors of social dysfunction within this specific demographic, while education and age displayed relatively lower importance. The normalized importance scores provided a relative measure of each covariate's impact on the model's predictions. These results furnish valuable insights for the development of targeted interventions and evidence-based policies aimed at addressing social dysfunction and promoting societal well-being among economically disadvantaged, single or widowed women. Notably, the research underscores the potential of MLP modeling in social science research and suggests avenues for further research and refinement to enhance the model's predictive accuracy, particularly for cases of low social dysfunction.
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Affiliation(s)
- Sajjad Bagheri
- Clinical Psychology, Department of Psychology, Hakim-Toos Institute of Higher Education, Mashhad, Iran
| | - Sarvenaz Taridashti
- Industrial and Organizational Psychology, Department of Psychology, Montclair State University, Montclair, NJ, United States
| | | | - Peter Watson
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, United Kingdom
| | - Elham Rezvani
- Clinical Psychology, Department of Psychology, Hakim-Toos Institute of Higher Education, Mashhad, Iran
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23
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Zhang K, Xu X, You H. Social causation, social selection, and economic selection in the health outcomes of Chinese older adults and their gender disparities. SSM Popul Health 2023; 24:101508. [PMID: 37720820 PMCID: PMC10500472 DOI: 10.1016/j.ssmph.2023.101508] [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: 08/02/2023] [Revised: 08/26/2023] [Accepted: 09/02/2023] [Indexed: 09/19/2023] Open
Abstract
Background The economic selection hypothesis, which argues that the initial economic situation determines both subsequent health and economic conditions, has been drawn into the debate on causation-selection issues. This study aims to construct a path model with self-rated health and depression score of older adults as health outcomes to measure and compare the social causation forces of wealth accumulation, social selection forces of adulthood health, and economic selection forces of childhood economics, and to examine their gender disparities. Methods Data was obtained from a sample of 19613 older adults aged 45 years or above from the 2014 life history survey and the 2015 routine follow-up survey of the China Health and Retirement Longitudinal Study. Structural equation modeling analysis was conducted employing the full information maximum likelihood estimation method. Results The presence of social causation, social selection, and economic selection were all statistically supported. In self-rated health, social selection forces held the dominant position, while social causation forces were comparable to economic selection forces. In depression score, social selection still exhibited stronger forces than economic selection, but social causation had forces close to social selection and greater than economic selection. The forces of the three hypotheses in self-rated health did not significantly change with gender, but social causation exerted mightier forces than economic selection within the male group, unlike the female group. The forces of economic selection in depression score were greater in females than males and no significant differences were observed among the forces of the three hypotheses in the female group. Conclusions Social causation, social selection, and economic selection operate simultaneously on the self-rated health and depression score of older adults. However, the force magnitudes of the three hypotheses and/or their rankings differ by health outcomes and gender.
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Affiliation(s)
- Kangkang Zhang
- School of Health Policy & Management, Nanjing Medical University, Nanjing, China
| | - Xinpeng Xu
- School of Public Health, Nanjing Medical University, Nanjing, China
- Institute of Healthy Jiangsu Development, Nanjing Medical University, Nanjing, China
| | - Hua You
- School of Health Policy & Management, Nanjing Medical University, Nanjing, China
- School of Public Health, Nanjing Medical University, Nanjing, China
- Institute of Healthy Jiangsu Development, Nanjing Medical University, Nanjing, China
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24
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Zheng Z, Zhao W, Zhou Q, Yang Y, Chen S, Hu J, Jiang W, Zhang W, Cai J, Qiu J. Sex differences in depression, anxiety and health-promoting lifestyles among community residents: A network approach. J Affect Disord 2023; 340:369-378. [PMID: 37499917 DOI: 10.1016/j.jad.2023.07.107] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 07/14/2023] [Accepted: 07/23/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND Researchers have studied sex differences in typical depressive and anxiety symptoms and their cooccurrence. The World Health Organization (WHO) proposed a mental health promotion objective that suggests considering protective health-promoting factors when developing strategies for preventing mental disorders between sexes. From a network perspective, psychopathology is viewed as a result of interacting symptoms and influential factors. This study adopted network approach to investigate sex differences in health-promoting lifestyles (HPL) and the cooccurrence symptoms of communities in Shanghai. The aim is to provide health-promoting suggestions on better enhancing the life quality for community members. METHODS Depression, anxiety symptoms, and HPL were assessed with PHQ-9, GAD-7 and HPLP-II scales in 2420 adults (1411 females). Networks were constructed by Gaussian Graphical Models and the networks of two sexes using the Network Comparison Test. RESULTS Females scored significantly higher on PHQ-9 (p < 0.001) and GAD-7 (p < 0.001), and no differences were found between the two sexes in HPL scores. Restlessness and low energy yielded the highest strength centrality in the female network, while suicide ideation and restlessness were central in male network. Regarding protective HPL, physical activity and stress management were identified as the central mental health-promoting behaviours in female and male network, respectively. However, stress management was positively related to suicide ideation in the male network. CONCLUSION Communities should be aware of suicide ideation in males because of its high relationships with other symptoms and also provide stress management courses, especially for males. As for women, chronic energy deficiency deserves more attention for its high probability of cooccurrence with other symptoms in the network. Also, advocating physical activities may be particularly beneficial for the overall mental health among women. Future study should collect time-series data and analyze intraindividual networks to specify personalized health promoting strategies for each individual.
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Affiliation(s)
- Ziwei Zheng
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Wenqing Zhao
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qing Zhou
- Shanghai Xuhui Mental Health Center, Shanghai, China
| | - Yang Yang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shuangyi Chen
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jun Hu
- Shanghai Xuhui Mental Health Center, Shanghai, China
| | - Wenhui Jiang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Weibo Zhang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jun Cai
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jianyin Qiu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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25
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Guo Y, Pai M, Xue B, Lu W. Bidirectional association between depressive symptoms and mild cognitive impairment over 20 years: Evidence from the Health and Retirement Study in the United States. J Affect Disord 2023; 338:449-458. [PMID: 37356735 DOI: 10.1016/j.jad.2023.06.046] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 05/20/2023] [Accepted: 06/20/2023] [Indexed: 06/27/2023]
Abstract
BACKGROUND Research examining the association between depressive symptoms and mild cognitive impairment (MCI) has yielded conflicting results. This study aimed to examine the bidirectional association between depressive symptoms and MCI, and the extent to which this bidirectional association is moderated by gender and education. METHODS Data come from the US Health and Retirement Study over a 20-year period (older adults aged ≥50 years). Competing-risks regression is employed to examine the association between baseline high-risk depressive symptoms and subsequent MCI (N = 9317), and baseline MCI and subsequent high-risk depressive symptoms (N = 9428). Interactions of baseline exposures with gender and education are tested. RESULTS After full adjustment, baseline high-risk depressive symptoms were significantly associated with subsequent MCI (SHR = 1.20, 95%CI 1.08-1.34). Participants with baseline MCI are more likely to develop subsequent high-risk depressive symptoms than those without baseline MCI (SHR = 1.16, 95%CI 1.01-1.33). Although gender and education are risk factors for subsequent depression and MCI, neither moderates the bidirectional association. LIMITATIONS Items used to construct the composite cognitive measure are limited; selection bias due to missing data; and residual confounding. CONCLUSIONS Our study found a bidirectional association between depressive symptoms and MCI. High-risk depressive symptoms are related to a higher risk of subsequent MCI; and MCI predicts subsequent high-risk depression. Though neither gender nor education moderated the bidirectional association, public health interventions crafted to reduce the risk of depression and MCI should pivot attention to older women and those with less formal education.
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Affiliation(s)
- Yunyun Guo
- Ageing Epidemiology Research Unit, School of Public Health, Imperial College London, London, United Kingdom; Research Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Manacy Pai
- Department of Sociology, Kent State University, Kent, OH, United States of America
| | - Baowen Xue
- Research Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Wentian Lu
- Research Department of Epidemiology and Public Health, University College London, London, United Kingdom.
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26
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Hu F, Jing Y, Qin W, Han W, Xu L, Li Y. The mechanisms underlying the negative effect of socioeconomic status on depressive symptoms among older adults: The roles of social support and living arrangement. Int J Geriatr Psychiatry 2023; 38:e5991. [PMID: 37655502 DOI: 10.1002/gps.5991] [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: 10/31/2022] [Accepted: 08/12/2023] [Indexed: 09/02/2023]
Abstract
OBJECTIVES Previous studies have found an association between socioeconomic status (SES) and depressive symptoms among older adults, however the mechanisms underlying this association remained unclear. This study aimed to examine the mediating role of social support and the moderating role of living arrangement in the association between SES and depressive symptoms. METHODS Data was collected from the 2020 Household Health Interview Survey in Taian city, Shandong Province, China. A total of 3896 older adults aged 60 and above were included in this study. Depressive symptoms was measured by the Patient health Questionnaire-9 (PHQ-9), Social support by the Multidimensional Scale of Perceived Social Support (MSPSS), and other variables by related demographic scales. The moderated mediation model was examined using HAYES PROCESS 3.5. RESULTS SES negatively predicted depressive symptoms among older adults, and social support could mediate this association. Living arrangement played a moderating role in the relationship between social support and depressive symptoms (the second half of the mediating effect), and the effect was stronger among older adults who lived alone. CONCLUSIONS Social support partially mediated the relationship between SES and depressive symptoms among older adults, and living alone strengthened the effect of social support on depressive symptoms. Interventions that address older adults' social support and living arrangement may ameliorate depressive symptoms among older adults.
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Affiliation(s)
- Fangfang Hu
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, Shandong, China
- Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan, Shandong, China
| | - Yurong Jing
- School of Public Health, Fudan University, Shanghai, China
| | - Wenzhe Qin
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, Shandong, China
- Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan, Shandong, China
| | - Wantong Han
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, Shandong, China
- Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan, Shandong, China
| | - Lingzhong Xu
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, Shandong, China
- Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan, Shandong, China
| | - Yinlong Li
- School of Public Health, Jining Medical University, Jining, Shandong, China
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27
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Madigan A, Daly M. Socioeconomic status and depressive symptoms and suicidality: The role of subjective social status. J Affect Disord 2023; 326:36-43. [PMID: 36709827 DOI: 10.1016/j.jad.2023.01.078] [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: 08/16/2022] [Revised: 01/11/2023] [Accepted: 01/21/2023] [Indexed: 01/28/2023]
Abstract
BACKGROUND Low socioeconomic status (SES) confers access to material resources and social standing and is an established risk factor of both depressive symptoms and suicidality. Subjective social status (SSS) assesses how people perceive their position within the social hierarchy and has been proposed to impact mental health. This study examined the relationship between SES and depressive symptoms and suicidality and tested whether SSS mediated these associations. METHODS This study drew on publicly available survey data from the US National Longitudinal Study of Adolescent to Adult Health (Add Health). Participants were surveyed at baseline in 2008 (N = 4948; aged 28.8 years) and at followed up in 2016-2018 (N = 3509; aged 37.8 years). SES was gauged using personal and household income, assets, education, and job prestige. SSS was assessed using the MacArthur Scale. Depressive symptoms were assessed using four-items from the Centre for Epidemiological Studies Scale of Depression (CESD) and participants reported suicidal ideation and suicide attempts in the past year. RESULTS Both low SES and SSS were associated with elevated levels of depressive symptoms, suicidal ideation, and suicide attempts in cross-sectional and prospective analyses. SSS explained 27 % of the association between SES and depressive symptoms, 51 % of the relationship between SES and suicidal ideation, and 37 % of the link between SES and suicide attempts on average. CONCLUSIONS These findings contribute to understanding the long-term effects of SSS and suggest that perceptions of status may be a key mechanism through which low SES forecasts the development of depressive symptoms and suicidality.
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Affiliation(s)
- Anna Madigan
- Department of Psychology, Maynooth University, Co. Kildare, Ireland
| | - Michael Daly
- Department of Psychology, Maynooth University, Co. Kildare, Ireland.
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28
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Zhang C, Zhang J, Xiao S, Shi L, Xue Y, Zheng X, Benli X, Chen Y, Li X, Kai Y, Liu Y, Zhou G. Health-related quality of life and its association with socioeconomic status and diet diversity in Chinese older adults. Front Public Health 2023; 10:999178. [PMID: 36743155 PMCID: PMC9895932 DOI: 10.3389/fpubh.2022.999178] [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: 07/20/2022] [Accepted: 12/23/2022] [Indexed: 01/22/2023] Open
Abstract
Objectives The study aimed at examining the combined association of socioeconomic status (SES) and diet diversity (DD) with health-related quality of life (HRQoL) and exploring whether DD played a mediating role in the relationship between varied SES and HRQoL among Chinese older persons. Method A multi-stage random sampling method was conducted in Shanxi Province of China, with 3,250 older adults participating in this cross-sectional survey. SES was divided into groups by quartiles and DD by means, and these variable groups were combined in pairs to generate a total of eight combinations. The PROCESS macro developed by Hayes was employed for the simple mediation analysis. Results Compared with the reference group (those with both high SES and high DD), older adults who were classified to have lower SES or DD had elevated odds of having worse HRQoL: low SES/ low DD (OR = 1.65, 95% CI 1.41-2.92); low SES/ high DD (OR = 1.45, 95% CI 1.17-1.80); middle low SES/ low DD (OR = 1.43, 95% CI 1.24-1.65); middle low SES/ high DD (OR = 1.23, 95% CI 1.03-1.47); upper high SES/ low DD (OR = 1.41, 95% CI 1.21-1.65); and high SES/ low DD (OR = 1.30, 95%CI 1.10-1.53). The mediation analysis revealed that DD mediated the relationship between SES and HRQoL (B=0.011, 95% CI 0.008-0.013), with its indirect effects accounting for 39.29% of the total effects. Conclusions These findings highlighted the role of DD as a mediator of the relationship between SES and HRQoL. As DD could be protective, modifiable, and easy for older adults to understand and implement, village clinics and community health stations should work collaboratively to design proper DD intervention measures for better HRQoL.
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Affiliation(s)
- Chichen Zhang
- Department of Health Management, Nanfang Hospital, Southern Medical University, Guangzhou, China,School of Health Management, Southern Medical University, Guangzhou, China,Institute of Health Management, Southern Medical University, Guangzhou, China,*Correspondence: Chichen Zhang ✉
| | - Jiachi Zhang
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Shujuan Xiao
- School of Health Management, Southern Medical University, Guangzhou, China,School of Public Health, Southern Medical University, Guangzhou, China
| | - Lei Shi
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Yaqing Xue
- School of Health Management, Southern Medical University, Guangzhou, China,School of Public Health, Southern Medical University, Guangzhou, China
| | - Xiao Zheng
- School of Health Management, Southern Medical University, Guangzhou, China,Shunde Hospital, Southern Medical University, Guangzhou, China
| | - Xue Benli
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Yiming Chen
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Xinru Li
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Yan Kai
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Yuxi Liu
- School of Humanities and Management, Institute for Health Law and Policy, Guangdong Medical University, Dongguan, China
| | - Guangqing Zhou
- Department of Health Management, Nanfang Hospital, Southern Medical University, Guangzhou, China
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Chen Y, Wang P, He Y, Jiang F, Liu H, Liu Y, Liu T, Tang YL, Zhu J. Gender differences in the association between lifestyle behaviors and mental health among psychiatrists in China. J Affect Disord 2022; 318:196-203. [PMID: 36041580 DOI: 10.1016/j.jad.2022.08.089] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 08/21/2022] [Accepted: 08/24/2022] [Indexed: 10/15/2022]
Abstract
INTRODUCTION Mental health symptoms are common among health professionals and the influence of lifestyle behaviors on psychiatrists' mental health is insufficiently understood. Based on a nationwide sample, we aimed to survey the lifestyle behaviors and mental health status among psychiatrists, and to identify the co-occurrence and gender differences in lifestyle behaviors. METHODS Data were collected through an anonymous questionnaire among psychiatrists in China. Depression, Anxiety and Stress Scale - 21 (DASS-21) was used to evaluate mental health symptoms. Latent class analysis (LCA) was used to explore the co-occurrence of lifestyle behaviors. The multivariate logistic regression model was used to examine the effects of demographic and lifestyle factors. RESULTS 4520 psychiatrists were included in the analysis with 11.5 % of them reporting smoking, 10 % reporting alcohol misuse, 35.2 % reporting physical inactivity, and 23.1 % reporting insomnia. The prevalence of depression, anxiety and stress symptoms were 29.2 %, 34.5 %, and 12.2 %, respectively. Significant gender differences were found in smoking (P < 0.001), alcohol misuse (P < 0.001), and physical inactivity (P < 0.001), but not in insomnia. Based on these four high-risk health behaviors above, three lifestyle behavior clusters with huge gender differences were identified through the LCA. Accordingly, the unhealthy lifestyle classes, though defined differently for males and females, were significantly associated with depression, anxiety, and stress. CONCLUSIONS The co-occurrence and significant gender differences in multiple lifestyle behaviors exist in this group, highlighting the need for gender-specific comprehensive interventions against mental health symptoms and the urgency of promoting their well-being.
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Affiliation(s)
- Yanhua Chen
- Vanke School of Public Health, Tsinghua University, Beijing, China; School of Medicine, Tsinghua University, Beijing, China
| | - Peicheng Wang
- Vanke School of Public Health, Tsinghua University, Beijing, China; School of Medicine, Tsinghua University, Beijing, China
| | - Yanrong He
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Feng Jiang
- Institute of Healthy Yangtze River Delta, Shanghai Jiao Tong University, Shanghai 200030, China
| | - Huanzhong Liu
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China; Anhui Psychiatric Center, Anhui Medical University, Hefei, China
| | - Yuanli Liu
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Tingfang Liu
- Institute for Hospital Management, Tsinghua University, Beijing, China
| | - Yi-Lang Tang
- Mental Health Service Line, Atlanta VA Medical Center, Decatur, USA; Addiction Psychiatry Fellowship Program, Department of Psychiatry and Behavioural Sciences, Emory University, Atlanta, USA.
| | - Jiming Zhu
- Vanke School of Public Health, Tsinghua University, Beijing, China.
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30
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Xu J, Zhang H, Zhang T, Sun J, Shi Q, Liu J, Tian G, Zhang B, Wang H, Wu Q, Kang Z. The "jolly fat" for the middle-aged and older adults in China, was education level considered? J Affect Disord 2022; 317:347-353. [PMID: 36057286 DOI: 10.1016/j.jad.2022.08.093] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 08/10/2022] [Accepted: 08/26/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Several studies have found a negative association between obesity and depression in Chinese middle-aged and elderly, suggesting the existence of "jolly fat". This study aims to investigate whether "jolly fat" is applicable among middle-aged and elderly with different education levels, and to provide a new perspective for depression screening and obesity interventions in middle-aged and older adults. METHODS 10,018 individuals aged 45 years and over in China Family Panel Study (2018) were selected for analysis. A short version of Center for Epidemiological Research Depression Scale was used to assess depression. Body mass index was applied to define obesity status. Subgroup analysis of multiple logistic regression was performed to explore whether the relationship between obesity and depression was influenced by education levels. RESULTS The prevalence of obesity and depression was 9.02 % and 22.96 % among participants. Obesity reduced the probability of depression in middle-aged and elderly with primary school education or below (OR = 0.71, 95 % CI = 0.56-0.91) while not affecting those with junior high school education or above (OR = 0.80, 95 % CI = 0.57-1.13). LIMITATIONS The results cannot be interpreted as causality due to the cross-sectional design. Besides, we cannot directly measure the body composition of the participants. CONCLUSIONS "Jolly fat" existed among middle-aged and elderly with low education, but not in those with junior high school education or above. Health care providers need to monitor the psychological status of low-educated middle-aged and older adults who are seen as needing to lose weight, while the underweight group should be the key target of depression screening.
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Affiliation(s)
- Jinpeng Xu
- School of Health Management, Harbin Medical University, Harbin, China
| | - Hongyu Zhang
- School of Health Management, Harbin Medical University, Harbin, China
| | - Ting Zhang
- School of Health Management, Harbin Medical University, Harbin, China
| | - Jiale Sun
- Xuzhou Center for Disease Control and Prevention, Xuzhou, China
| | - Qi Shi
- School of Health Management, Harbin Medical University, Harbin, China
| | - Jian Liu
- School of Health Management, Harbin Medical University, Harbin, China
| | - Guomei Tian
- Department of Nuclear Medicine, The Fourth Hospital of Harbin Medical University, Harbin, China
| | - Bokai Zhang
- School of Health Management, Harbin Medical University, Harbin, China
| | - Haixin Wang
- School of Health Management, Harbin Medical University, Harbin, China
| | - Qunhong Wu
- School of Health Management, Harbin Medical University, Harbin, China
| | - Zheng Kang
- School of Health Management, Harbin Medical University, Harbin, China.
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Xue B, Wu Y, Zheng X, Xue Y, Dong F, Xiao S, Yin M, Wang M, Liu Y, Zhang C. Effects of information sources on public preventive behaviors in health emergencies: Evidence from a digital epidemiologic study during the COVID-19 pandemic. Front Public Health 2022; 10:981649. [PMID: 36311572 PMCID: PMC9615916 DOI: 10.3389/fpubh.2022.981649] [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: 06/29/2022] [Accepted: 09/23/2022] [Indexed: 01/25/2023] Open
Abstract
Introduction It has been approved that information sources would affect public behaviors. However, due to the outbreak of COVID-19, this influence was enhanced and showed a distinctive pattern among different populations, which has been less noticed before. We aimed to investigate the potential roles of different information sources in COVID-19 preventive behaviors of different publics. Methods A cross-sectional online survey with 11,190 participants from 33 province-level regions in China was conducted during the COVID-19 pandemic. Sociodemographic characteristics, COVID-19 preventive behaviors, and information sources for COVID-19-related information were assessed. A mixed linear model was used to analyze risk factors of COVID-19 preventive behaviors. The effects of different information sources on COVID-19 prevention behaviors of different publics were analyzed. Results Generally, the Chinese public had good COVID-19 preventive behaviors, and the top three COVID-19 preventive behaviors with the higher action rate were avoiding eat bushmeat (76.1%), a healthy diet (74.8%), and avoiding contact with people with symptoms of respiratory diseases (73.0%). About information sources, 12320 telephone (National Public Health Hotline) (-0.62, 95% CI: -0.94 to -0.31) and acquaintances consulting (-1.00, 95% CI: -1.31 to -0.69) were negatively associated with COVID-19 preventive behaviors, while internet resources, family doctors, hospitals, and community health centers were positively associated with COVID-19 preventive behaviors (1.00 vs. 0.47 vs. 0.46 vs. 0.33, P < 0.05). For older adults, accessing to COVID-19-related information through family doctors and community health centers were positively associated with COVID-19 preventive behaviors. For the non-educated, family doctors and community health centers had positive effects on their COVID-19 preventive behaviors. Family doctors and internet resources were positively associated with COVID-19 preventive behaviors among those earning 5,000 yuans and above. The effects of family doctors, hospitals, and internet resources were higher for COVID-19 preventive behaviors of urban publics than for rural publics. Finally, the effect of internet resources on COVID-19 preventive behaviors of females was lower than males. Conclusions Obtaining COVID-19-related information through internet resources had the most significant effect on COVID-19 preventive behaviors, but was not significant among publics with old age, low education, low income, and living in rural area.
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Affiliation(s)
- Benli Xue
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Yibo Wu
- School of Public Health, Peking University, Beijing, China
| | - Xiao Zheng
- School of Health Management, Southern Medical University, Guangzhou, China,Department of Health Management, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde, Foshan), Guangdong, China
| | - Yaqing Xue
- School of Health Management, Southern Medical University, Guangzhou, China,School of Public Health, Southern Medical University, Guangzhou, China
| | - Fang Dong
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Shujuan Xiao
- School of Health Management, Southern Medical University, Guangzhou, China,School of Public Health, Southern Medical University, Guangzhou, China
| | - Mei Yin
- School of Humanities and Social Sciences, Harbin Medical University, Harbin, China
| | - Mingxu Wang
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China,Health Culture Research Center of Shaanxi, Xi'an, China
| | - Yuxi Liu
- School of Humanities and Management, Guangdong Medical University, Dongguan, China,Yuxi Liu
| | - Chichen Zhang
- School of Health Management, Southern Medical University, Guangzhou, China,Department of Health Management, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde, Foshan), Guangdong, China,Department of Health Management, Nanfang Hospital, Southern Medical University, Guangzhou, China,*Correspondence: Chichen Zhang
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The Relationship between Physical Activity and Health-Related Quality of Life (HINT-Eight) in Middle-Aged Korean Women. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2022; 2022:4555547. [PMID: 36238823 PMCID: PMC9553406 DOI: 10.1155/2022/4555547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 06/15/2022] [Accepted: 09/22/2022] [Indexed: 11/17/2022]
Abstract
The purpose of this study was to provide basic data on health by examining the effect of HINT-eight on the physical activity of middle-aged Korean women using secondary data from the 2019 KNHANES. The subjects were 1,428 middle-aged women aged 45-64. Multiple regression was performed to verify the relationship between physical activity and HINT-eight. Following confirmation of the association between HINT-eight and physical activity, it was found that the subdomains of QOL, such as stair climbing, vitality, work, sleeping, and happiness, were connected to physical activity. Stair climbing positively affected physical activity, education level, and grip strength and negatively affected age. Pain positively affected education level and grip strength and negatively affected age. Vitality positively affected physical activity, monthly household income, and grip strength. Working positively affected education level, monthly household income, and grip strength and negatively affected age. Depression positively affected monthly household income. Memory and sleep positively affected education level and negative effect on age. Happiness positively affected physical activity and monthly household income. In this study, physical activity was found to have an effect on various factors of QOL. Physical activity in middle age is an important influencing factor on the QOL in old age; to improve the QOL in older adult, it is necessary to make efforts to improve physical activity in middle age.
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Díaz-García O, Herranz Aguayo I, Fernández de Castro P, Ramos JLG. Lifestyles of Spanish elders from supervened SARS-CoV-2 variant onwards: A correlational research on life satisfaction and social-relational praxes. Front Psychol 2022; 13:948745. [PMID: 36248522 PMCID: PMC9555211 DOI: 10.3389/fpsyg.2022.948745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 08/24/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectiveThis study aimed to analyze the influence and measurement of the relationship and interaction between the elderly lifestyles after the appearance of the SARS-CoV-2 variant and the factors analyzed comprised life satisfaction levels, social relationships, and daily-life activities.MethodsThe study population was ≥ 65 in Castile-La Mancha (N = 390,221). The research design was quantitative and arose from primary data collected via an ad hoc survey carried out through the Computer Assisted Telephone Interview system by randomly stratified sampling. The sample size was made up of 1,065 cases, and the participants were selected through a random sampling stratified by gender quotas (55.40% women; 44.60% men), age (x¯ = 76.56), province, and habitat size.ResultsThe results obtained revealed two main lifestyles, from which a notable behavioral change in personal relationships led to infer toward alternative lifestyles.ConclusionNotwithstanding the variation in lifestyles of the elderly after the pandemic, certain relationships remained unaltered. Thus, from the analyzed variables, relatives and friends relationships were scarcely influenced by the supervened incident.
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Affiliation(s)
- Orlanda Díaz-García
- Department of Labour Law and Social Work, Faculty of Social Sciences of Talavera de la Reina, University of Castilla-La Mancha, Ciudad Real, Spain
| | - Inmaculada Herranz Aguayo
- Department of Philosophy, Anthropology and Sociology, Faculty of Social Sciences of Talavera de la Reina, University of Castilla-La Mancha, Ciudad Real, Spain
- *Correspondence: Inmaculada Herranz Aguayo
| | - Patricia Fernández de Castro
- Department of Labour Law and Social Work, Faculty of Social Sciences of Talavera de la Reina, University of Castilla-La Mancha, Ciudad Real, Spain
| | - José Luis Gómez Ramos
- Pedagogy Department, Faculty of Education at Albacete, University of Castilla-La Mancha, Ciudad Real, Spain
- José Luis Gómez Ramos
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Xue B, Xue Y, Dong F, Zheng X, Shi L, Xiao S, Zhang J, Ou W, Wang Q, Zhang C. The impact of socioeconomic status and sleep quality on the prevalence of multimorbidity in older adults. Front Public Health 2022; 10:959700. [PMID: 36225792 PMCID: PMC9548700 DOI: 10.3389/fpubh.2022.959700] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 08/29/2022] [Indexed: 01/24/2023] Open
Abstract
Introduction Multimorbidity has become a global public health concern that can cause serious damage to the health status of older adults. This study aimed to investigate the impact of socioeconomic status (SES) and sleep quality on the prevalence of multimorbidity in older adults, thus providing a reference for reducing the risk of the prevalence of multimorbidity and improving the health of older adults. Methods A multi-stage random sampling method was used to conduct a questionnaire survey on 3,250 older adults aged 60 years and above in Shanxi Province, China. The chi-square test and multiple logistic regression models were used to analyze the association of SES and sleep quality with the prevalence of multimorbidity of older adults. Results The prevalence of multimorbidity was 30.31% in older adults aged 60 years and above in Shanxi Province, China. After adjusting for confounders, very low SES (OR = 1.440, 95% CI: 1.083-1.913) and poor sleep quality (OR = 2.445, 95% CI: 2.043-2.927) were associated with the prevalence of multimorbidity. Older adults with low SES and poor sleep quality had the highest risk of the prevalence of multimorbidity (OR = 3.139, 95% CI: 2.288-4.307). Conclusions SES and sleep quality are associated with the prevalence of multimorbidity in older adults, and older adults with lower SES and poorer sleep quality are at higher risk for the prevalence of multimorbidity.
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Affiliation(s)
- Benli Xue
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Yaqing Xue
- School of Health Management, Southern Medical University, Guangzhou, China,School of Public Health, Southern Medical University, Guangzhou, China
| | - Fang Dong
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Xiao Zheng
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Lei Shi
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Shujuan Xiao
- School of Health Management, Southern Medical University, Guangzhou, China,School of Public Health, Southern Medical University, Guangzhou, China
| | - Jiachi Zhang
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Weiyan Ou
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Qi Wang
- Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, China
| | - Chichen Zhang
- School of Health Management, Southern Medical University, Guangzhou, China,Department of Health Management, Nanfang Hospital, Southern Medical University, Guangzhou, China,Institute of Health Management, Southern Medical University, Guangzhou, China,*Correspondence: Chichen Zhang
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35
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How Late-Life Working Affects Depression Among Retirement-Aged Workers? An Examination of the Influence Paths of Job-Related (Non–Job-Related) Physical Activity and Social Contact. J Occup Environ Med 2022; 64:e435-e442. [DOI: 10.1097/jom.0000000000002572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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36
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Eimontas J, Gegieckaitė G, Zamalijeva O, Pakalniškienė V. Unmet Healthcare Needs Predict Depression Symptoms among Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19158892. [PMID: 35897261 PMCID: PMC9330083 DOI: 10.3390/ijerph19158892] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 07/09/2022] [Accepted: 07/19/2022] [Indexed: 02/04/2023]
Abstract
Risk factors for depression in older adults include significant interpersonal losses, increasing social isolation, and deteriorating physical abilities and health that require healthcare. The effects of unmet healthcare needs on depression in older adults are understudied. This study aimed to analyze the association between unmet healthcare needs and symptoms of depression, sleep, and antidepressant medication while controlling for other significant factors among older adults. For this study, we used a multinational database from The Survey of Health, Ageing and Retirement in Europe (SHARE), containing data of individuals aged 50 and older. The final sample used in this research consisted of 39,484 individuals from 50 to 100 years (mean − 71.15, SD ± 9.19), 42.0 percent of whom were male. Three path models exploring relationships between symptoms of depression at an older age and unmet healthcare needs were produced and had a good model fit. We found that unmet healthcare needs were directly related to depression, activity limitations were related to depression directly and through unmet healthcare needs, whereas financial situation mostly indirectly through unmet healthcare needs. We discuss how depression itself could increase unmet healthcare needs.
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Li H, Liu X, Zheng Q, Zeng S, Luo X. Gender differences and determinants of late-life depression in China: A cross-sectional study based on CHARLS. J Affect Disord 2022; 309:178-185. [PMID: 35472476 DOI: 10.1016/j.jad.2022.04.059] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 01/06/2022] [Accepted: 04/10/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Literature related to within-gender differences in depression among older individuals in China is sparse, and often limited to specific provinces. METHODS We analyzed data on 8104 participants from the fourth waves of the China Health and Retirement Longitudinal Study (CHARLS). Using logistic regressions, we identified the correlates of depressive symptoms among older individuals, both in the aggregate and along gender lines. Additionally, we examined the interaction between other covariates and gender. RESULTS The prevalence of late-life depression symptoms among females was 45.79%, which was higher than among males (31.13%, P < 0.01). Living in a rural area, earned income, education level, tobacco use and number of chronic diseases were correlated with depression in both genders (P < 0.05), with no interaction (Pint > 0.050). Social activities were correlated with depression in males but not in females (Pint = 0.373), inverse in their 70s (Pint = 0.020) group. The correlation between daily sleep duration and depression is stronger in females than in males (Pint ≤ 0.020). Female who drunk <1 per month decreased their prevalence of depression, but it increased in males (Pint = 0.001). Taking part in LTPA and being a religious believer were correlated with depression in females (P < 0.05), but not in males (P(LTPA)int = 0.009; P(religious believers)int = 0.033). LIMITATIONS Since only analyzed one wave of data, we could not conclude that there was causation. CONCLUSIONS Geriatric depression is a serious mental health issue in China. There is, an urgent need for prevention and intervention activities for older individuals, and these needs diverge along gender lines.
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Affiliation(s)
- Huijun Li
- School of Public Health, Lanzhou University, Lanzhou, China
| | - Xiaoling Liu
- School of Public Health, Lanzhou University, Lanzhou, China
| | - Qingyong Zheng
- School of Nursing, Evidence-based Nursing Center, Lanzhou University, Lanzhou, China
| | - Siyuan Zeng
- The First School of Clinical Medicine, Lanzhou University, Lanzhou, China
| | - Xiaofeng Luo
- School of Public Health, Lanzhou University, Lanzhou, China.
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Zhang J, Xiao S, Shi L, Xue Y, Zheng X, Dong F, Xue B, Zhang C. Differences in Health-Related Quality of Life and Its Associated Factors Among Older Adults in Urban and Rural Areas. Risk Manag Healthc Policy 2022; 15:1447-1457. [PMID: 35923554 PMCID: PMC9342693 DOI: 10.2147/rmhp.s373077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 07/14/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose Urban-rural health disparity is one of the most prominent challenges in China today. The goal of this study is to find differences in health-related quality of life (HRQoL) and its associated factors among older people in urban and rural areas. Methods A multi-stage stratified sampling method was conducted in Shanxi Province, with a total of 3250 older adults participated in this cross-sectional survey. HRQoL was assessed using the Chinese version of the EQ-5D-5L. Tobit regression models were employed to identify associated factors for HRQoL. Results The mean EQ-5D utility score of the total sample was 0.87± 0.23, with a statistically significant difference observed between urban (0.89 ± 0.22) and rural areas (0.86 ± 0.23). Obesity (Coe=−0.10, p=0.021) and nutrition awareness (Coe=−0.14, p=0.009) were two unique associated factors to rural older adults’ HRQoL. While, age (Urban: Coe=0.13, p=0.001; Rural: Coe=−0.019, p<0.001), socioeconomic status (Urban: Coe=0.13, p<0.001; Rural: Coe=0.14, p<0.001), number of chronic non-communicable diseases (Urban: Coe=−0.20, p<0.001; Rural: Coe=−0.15, p<0.001), sleep quality (Urban: Coe=−0.22, p<0.001; Rural: Coe=0.15, p<0.001) and daytime sleepiness (Urban: Coe=−0.13, p<0.001; Rural: Coe=−0.13, p<0.001) were found to be associated with HRQoL regardless of the residential area. Conclusion This study suggested that rural older adults are facing HRQoL disadvantages compared to those in urban area. Accordingly, more attention should be devoted to rural older adults’ HRQoL, particularly to the unique factors like body weight and nutrition awareness. Targeted policies and interventions should be implemented to improve HRQoL and bridge the urban-rural HRQoL gap.
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Affiliation(s)
- Jiachi Zhang
- School of Health Management, Southern Medical University, Guangzhou, People’s Republic of China
| | - Shujuan Xiao
- School of Health Management, Southern Medical University, Guangzhou, People’s Republic of China
- School of Public Health, Southern Medical University, Guangzhou, People’s Republic of China
| | - Lei Shi
- School of Health Management, Southern Medical University, Guangzhou, People’s Republic of China
| | - Yaqing Xue
- School of Health Management, Southern Medical University, Guangzhou, People’s Republic of China
- School of Public Health, Southern Medical University, Guangzhou, People’s Republic of China
| | - Xiao Zheng
- School of Health Management, Southern Medical University, Guangzhou, People’s Republic of China
- School of Public Health, Southern Medical University, Guangzhou, People’s Republic of China
| | - Fang Dong
- School of Health Management, Southern Medical University, Guangzhou, People’s Republic of China
| | - Benli Xue
- School of Health Management, Southern Medical University, Guangzhou, People’s Republic of China
| | - Chichen Zhang
- School of Health Management, Southern Medical University, Guangzhou, People’s Republic of China
- Department of Health Management, Nanfang Hospital, Southern Medical University, Guangzhou, People’s Republic of China
- Institute of Health Management, Southern Medical University, Guangzhou, People’s Republic of China
- Correspondence: Chichen Zhang, School of Health Management, Southern Medical University, No. 1023 Shatai South Road, Baiyun District, Guangzhou, 510515, People’s Republic of China, Tel +86-20-61648756, Email
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Xiong Y, Xue Y, Jiao G, Xie J, Cheng J. Comparative Analysis of the Status and Influencing Factors of Immunization Among Children Between Registered and Floating Population. Front Public Health 2022; 10:872342. [PMID: 35757635 PMCID: PMC9218952 DOI: 10.3389/fpubh.2022.872342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 05/02/2022] [Indexed: 11/13/2022] Open
Abstract
Background A vaccine is an effective tool to reduce the gap between the rich and the poor and improve health equity, through which a number of serious childhood diseases can be successfully prevented or eradicated. This study is aimed to compare the current situation of vaccination and related factors among children in China's registered residents and floating population, to provide a reference for achieving the 100% vaccination rate in China. Methods The data used for this study are from the 2017 National Migrants Dynamic Monitoring Special Survey data. A self-designed questionnaire was used to collect information, such as socio-demographics, vaccination status of children, and so on, on the registered population and floating population. Descriptive statistics and a chi-square independence test were used to describe the information and to compare the vaccination status of children under different sociodemographic characteristics. Binary logistic regression was employed to analyze influencing factors associated with vaccination of children. Results The findings showed that 94.39% of children in registered residence were completely vaccinated, which was significantly higher than that of the floating children (91.68%, p < 0.001). The region, parents' education level, and marital status were found to be significant risk factors for complete vaccination of children regardless of the registered or floating population. In addition, ethnicity and length of time to the nearest medical institution were unique risk factors for complete vaccination of children in registered residence. And, health record was an independent influencing factor for vaccination of children of floating population. Conclusion Compared with registered population, floating population was at a disadvantage in using basic public health services, especially in children's vaccination. To achieve 100% vaccination for children, particular interventions should be taken for different populations.
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Affiliation(s)
- Yan Xiong
- School of Public Health, Shanxi Medical University, Taiyuan, China.,School of Management, Shanxi Medical University, Taiyuan, China
| | - Yaqing Xue
- School of Public Health, Southern Medical University, Guangzhou, China.,School of Health Management, Southern Medical University, Guangzhou, China
| | - Guojin Jiao
- School of Management, Shanxi Medical University, Taiyuan, China
| | - Jun Xie
- School of Basic Medicine, Shanxi Medical University, Taiyuan, China
| | - Jingmin Cheng
- School of Management, Shanxi Medical University, Taiyuan, China
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Kim SA, Song Y, Kwon M. Do Adults Who Practice Aerobic Physical Activities Have Different Influencing Factors for Depression: A Secondary Data Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19106142. [PMID: 35627678 PMCID: PMC9141176 DOI: 10.3390/ijerph19106142] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 05/15/2022] [Accepted: 05/17/2022] [Indexed: 02/06/2023]
Abstract
Practice in aerobic activities can positively impact depression. This study aimed to identify differences between adults who do and do not practice aerobic activities in terms of general, physical, and psychological factors that influence depression. This study comprised a secondary analysis of data from the 6th (year 2) and 7th (years 1, 3) editions of the Korea National Health and Nutrition Examination Survey. Data from 12,891 adults were analyzed, of whom 7148 reported no practice in aerobic physical activities and 5743 reported practicing such activities. Data were analyzed using SPSS 25. Among those who did not perform aerobic activities, gender, family income, marital status, obesity, frequency of drinking, subjective health, subjective body weight, and stress were found to influence the level of depression. For those who practiced aerobic activities, gender, age, family income, education level, marital status, blood pressure, hypercholesterolemia status, frequency of drinking, subjective health, subjective body weight, and stress influenced the level of depression. This study found that the factors affecting depressive symptoms differ depending on whether individuals practice aerobic activities. Thus, to reduce depressive symptoms among adults, it is necessary to consider their level of physical activity and target the influencing factors associated with this level.
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Affiliation(s)
- Sun Ae Kim
- Department of Nursing, Korea National University of Transportation, Jeungpyeong-gun 27909, Korea;
| | - Youngshin Song
- College of Nursing, Chungnam National University, Daejeon 35015, Korea
- Correspondence: (Y.S.); (M.K.)
| | - Myoungjin Kwon
- Department of Nursing, Daejeon University, Daejeon 34520, Korea
- Correspondence: (Y.S.); (M.K.)
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Zheng X, Xue Y, Dong F, Shi L, Xiao S, Zhang J, Xue B, Qian Y, Zhu H, Man Q, Zhang C. The association between health-promoting-lifestyles, and socioeconomic, family relationships, social support, health-related quality of life among older adults in china: a cross sectional study. Health Qual Life Outcomes 2022; 20:64. [PMID: 35443689 PMCID: PMC9022255 DOI: 10.1186/s12955-022-01968-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 03/29/2022] [Indexed: 12/30/2022] Open
Abstract
Objectives Lifestyles, accounting for 53% in determining death, play a vital role in improving the health of older adults. Thus, this study aimed to explore the influencing factors of the health-promoting-lifestyles and interaction mechanisms among older adults. Methods A total of 8526 elders were selected by a three-stage stratified random cluster sampling method. Socioeconomic status, family relationships, social support, health-related quality of life (QOL), and health-promoting-lifestyles (HPLP) of older adults were assessed with the Social Support Rating Scale, the short form 36 health survey (SF-36) and Health-Promoting Lifestyle Profile. A structural equation model (SEM) was conducted to test the direct and indirect association between influencing factors with HPLP. Results In this study, there were 4901 older adults who were empty nesters, and 3625 were non-empty nesters. Of all respondents, the average QOL score of older adults was 62.28 ± 16.51, average social support score was 78.06 ± 7.50. The HPLP score of older adults was 105.9 ± 19.6, and the average score of subscales was 2.5 ± 0.5, which was at the medium level. Social support had a positive and direct effect on HPLP of older adults (total effect, 0.34). Meanwhile, social support mediated the relationship between socioeconomic (total effect, 0.17), QOL (total effect, 0.33) and HPLP. Family relationships had a small indirect effect on HPLP via social support (0.01). Conclusions Social support is the strongest influencing factor in the health-promoting-lifestyles among older adults, followed by socioeconomic, health-related quality of life and family support. Thus, maintaining higher social support was important to improve the HPLP of older adults.
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Affiliation(s)
- Xiao Zheng
- School of Public Health, Southern Medical University, Guangzhou, Guangdong, China.,School of Health Management, Southern Medical University, No. 1023, South Shatai Road, Baiyun District, Guangzhou, Guangdong, China
| | - Yaqing Xue
- School of Public Health, Southern Medical University, Guangzhou, Guangdong, China.,School of Health Management, Southern Medical University, No. 1023, South Shatai Road, Baiyun District, Guangzhou, Guangdong, China
| | - Fang Dong
- School of Health Management, Southern Medical University, No. 1023, South Shatai Road, Baiyun District, Guangzhou, Guangdong, China
| | - Lei Shi
- School of Health Management, Southern Medical University, No. 1023, South Shatai Road, Baiyun District, Guangzhou, Guangdong, China
| | - Shujuan Xiao
- School of Health Management, Southern Medical University, No. 1023, South Shatai Road, Baiyun District, Guangzhou, Guangdong, China
| | - Jiachi Zhang
- School of Health Management, Southern Medical University, No. 1023, South Shatai Road, Baiyun District, Guangzhou, Guangdong, China
| | - Benli Xue
- School of Health Management, Southern Medical University, No. 1023, South Shatai Road, Baiyun District, Guangzhou, Guangdong, China
| | - Yi Qian
- School of Health Management, Southern Medical University, No. 1023, South Shatai Road, Baiyun District, Guangzhou, Guangdong, China
| | - Hong Zhu
- Institute of Health Management Southern Medical University, Guangzhou, Guangdong, China
| | - Qiang Man
- School of International Education, Southern Medical University, Guangzhou, Guangdong, China.
| | - Chichen Zhang
- School of Health Management, Southern Medical University, No. 1023, South Shatai Road, Baiyun District, Guangzhou, Guangdong, China. .,Institute of Health Management Southern Medical University, Guangzhou, Guangdong, China. .,Department of Health Management, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
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Zheng X, Cui Y, Xue Y, Shi L, Guo Y, Dong F, Zhang C. Adverse childhood experiences in depression and the mediating role of multimorbidity in mid-late life: A nationwide longitudinal study. J Affect Disord 2022; 301:217-224. [PMID: 35031336 DOI: 10.1016/j.jad.2022.01.040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 12/07/2021] [Accepted: 01/10/2022] [Indexed: 12/17/2022]
Abstract
BACKGROUNDS Adverse childhood experiences are co-occurring factors of multimorbidity and depression in mid-late life, but the combined effect of ACEs and multimorbidity on depression over life has not been fully studied. METHODS We used data from the China Health and Retirement Longitudinal Study which includes 4,440 middle-aged and older adults. Different types of ACEs experienced up to the age of 17 were assessed based on self-reports. We used parallel process Latent Growth Curve modelling to evaluate the longitudinal mediation role of ACEs, multimorbidity and depression. RESULTS People who had more ACEs were found to have a higher level of multimorbidity (intercept: 0.057, 95% CI: 0.031 to 0.079) and depression (intercept: 0.047, 95% CI: 0.013 to 0.076) at the baseline and a faster increase in multimorbidity (slope: 0.107, 95%CI: 0.078 to 0.136) and depression (slope: 0.074, 95%CI: 0.035 to 0.153). The mediation analysis indicated that there was a positive indirect association of ACEs via the multimorbidity intercept with the intercept of depression (0.028, 95%CI: 0.012 to 0.043), and a small negative association with the slope of depression (-0.002, 95%CI: -0.003 to -0.001). We also found a positive indirect association of ACEs via the multimorbidity slope with the intercept (0.035, 95%CI: 0.021 to 0.049) and slope (0.008, 95%CI: 0.004 to 0.011) of depression. CONCLUSIONS ACEs were related to higher depression partly via elevated multimorbidity. Public health services and behavioural interventions to prevent and reduce the occurrence of ACEs might help to lower the risk of multimorbidity and depression in later life.
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Affiliation(s)
- Xiao Zheng
- School of Public Health, Southern Medical University, Guangzhou, Guangdong, China; School of Health Management, Southern Medical University, Guangzhou, China
| | - Yuehua Cui
- Department of Statistics & Probability, Michigan State University, China
| | - Yaqing Xue
- School of Public Health, Southern Medical University, Guangzhou, Guangdong, China; School of Health Management, Southern Medical University, Guangzhou, China
| | - Lei Shi
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Yi Guo
- School of Public Health, Southern Medical University, Guangzhou, Guangdong, China; Department of Health Management, Nafang Hospital, Guangzhou, China
| | - Fang Dong
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Chichen Zhang
- School of Health Management, Southern Medical University, Guangzhou, China; Department of Health Management, Nafang Hospital, Guangzhou, China; Institute of Health Management, Southern Medical University, Guangzhou, China.
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Xiao S, Shi L, Xue Y, Zheng X, Zhang J, Chang J, Lin H, Zhang R, Zhang C. The relationship between activities of daily living and psychological distress among Chinese older adults: A serial multiple mediation model. J Affect Disord 2022; 300:462-468. [PMID: 34954333 DOI: 10.1016/j.jad.2021.12.069] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 11/20/2021] [Accepted: 12/19/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Few studies have shed light on the mechanisms underlying the link between activities of daily living (ADL) and psychological distress. This study aimed to explore the multiple mediating roles of loneliness and sleep quality in this relationship among Chinese older adults. METHODS A total of 3250 older adults completed the Barthel Index, UCLA 20-item Loneliness Scale, Pittsburgh Sleep Quality Index, and Depression, Anxiety, and Stress Scale Questionnaire. Serial multiple mediation analysis was conducted using Hayes' PROCESS macro. RESULTS ADL was found to directly impact psychological distress through three significant mediation pathways: (1) loneliness (B=-0.124, 95% CI=-0.140, -0.109), which accounted for 23.98% of the total effect, (2) sleep quality (B=-0.050, 95% CI=-0.063, -0.039), which accounted for 9.67% of the total effect, and (3) loneliness and sleep quality (B=-0.015, 95% CI=-0.020, -0.012), accounting for 2.91% of the total effect. The total mediating effect was 36.56%. LIMITATIONS The cross-sectional design we used limited causal interpretations. Future studies could examine longitudinal changes in outcome measures. CONCLUSIONS These findings highlight the role of loneliness and sleep quality as serial mediators of the relationship between ADL and psychological distress. Thus, for the early detection and prevention of psychological distress, it is necessary to conduct loneliness and sleep quality interventions for older adults with ADL limitations.
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Affiliation(s)
- Shujuan Xiao
- School of Health Management, Southern Medical University, Guangzhou, Guangdong, China
| | - Lei Shi
- School of Health Management, Southern Medical University, Guangzhou, Guangdong, China
| | - Yaqing Xue
- School of Health Management, Southern Medical University, Guangzhou, Guangdong, China; School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Xiao Zheng
- School of Health Management, Southern Medical University, Guangzhou, Guangdong, China; School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Jiachi Zhang
- School of Health Management, Southern Medical University, Guangzhou, Guangdong, China
| | - Jinghui Chang
- School of Health Management, Southern Medical University, Guangzhou, Guangdong, China
| | - Huang Lin
- School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Ruibin Zhang
- School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Chichen Zhang
- School of Health Management, Southern Medical University, Guangzhou, Guangdong, China; Department of Health Management, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China; Institute of Health Management, Southern Medical University, Guangzhou, Guangdong, China.
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The Impact of Family Socioeconomic Status on Elderly Health in China: Based on the Frailty Index. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19020968. [PMID: 35055790 PMCID: PMC8775784 DOI: 10.3390/ijerph19020968] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 01/08/2022] [Accepted: 01/13/2022] [Indexed: 01/27/2023]
Abstract
China is about to enter a moderate aging society. In the process of social and economic development, the family socioeconomic status and health status of the elderly have also changed significantly. Learning the impact of family socioeconomic status on elderly health can help them improve family socioeconomic status and better achieve healthy and active aging. Using the data of the Chinese Longitudinal Healthy Longevity Survey in 2018, this study firstly analyzed the impact of family socioeconomic status on elderly health using the multivariate linear regression model and quantile regression model, the heterogeneity of different elderly groups using subsample regression, and the mediation effects of three conditions associated with the family socioeconomic status of the elderly. The results show that family socioeconomic status has a negative effect on the frailty index, that is, it has a positive impact on elderly health. Family socioeconomic status has a higher positive impact on the health status of the middle and lower age elderly and rural elderly. Overall living status and leisure and recreation status both have mediation effects, while health-care status has no mediation effect.
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Sun G, Liu Z, Ma Z, Lew B, Jia C. The Relationship Between Negative Focused Disposition and Suicidal Ideation Among College Students: The Mediating Effects of Somatic Anxiety, General Distress, and Depression. Front Psychiatry 2022; 13:928666. [PMID: 35836665 PMCID: PMC9275592 DOI: 10.3389/fpsyt.2022.928666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 06/06/2022] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE Suicide among college students is a major public health problem. Research has confirmed that negative focused disposition had a significant effect on suicidal ideation. This study aims to evaluate somatic anxiety, general distress and depression as mediators of the relationship between negative focused disposition and suicidal ideation. METHODS A total of 1798 college students (942 males) were recruited to complete measures of negative focused disposition, somatic anxiety, general distress, positive affect and suicidal ideation. The mediation models were conducted to assess the mediating effects of somatic anxiety, general distress and depression. RESULTS There was a significant and positive correlation between negative focused disposition and suicidal ideation in Chinese college students. On mediation analysis, somatic anxiety, general distress and depression mediated the relationship between negative focused disposition and suicidal ideation. CONCLUSIONS Negative focused disposition appears to directedly associate with suicidal ideation and can indirectly relate to suicidal ideation through the relation with somatic anxiety, general distress and depression. College students with few positive expectations of the future may benefit from interventions focusing on somatic anxiety, general distress and depression.
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Affiliation(s)
- Guoxiao Sun
- School of Physical Education, Shandong University, Jinan, China
| | - Zongyu Liu
- School of Physical Education, Shandong University, Jinan, China
| | - Zhiyao Ma
- School of Physical Education, Shandong University, Jinan, China
| | - Bob Lew
- Griffith University, School of Applied Psychology, Australian Inst Suicide Res & Prevent, Brisbane, QLD, Australia
| | - Cunxian Jia
- School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
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Yang G, D'Arcy C. The changing relationship between health risk behaviors and depression among birth cohorts of Canadians 65+, 1994-2014. Front Psychiatry 2022; 13:1078161. [PMID: 36620694 PMCID: PMC9810750 DOI: 10.3389/fpsyt.2022.1078161] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 11/28/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVE The older adult residents of Canada form an increasingly larger proportion of the population and are becoming better educated and have more income. Depression is a common mental disorder, particularly among seniors. Several health risk behaviors-physical inactivity, tobacco use, and alcohol consumption-are linked to mental health problems. This study examines whether these health risk behaviors and their association with depression among Canadians 65+ born in eight cohorts between 1910-1914 and 1945-1949, have changed. METHODS Pooled data drawn from 11 nationally representative health surveys conducted by Statistics Canada between 1994 and 2014 are analyzed-88,675 survey participants met inclusion criteria. Depression was assessed by the Composite International Diagnostic Interview-Short Form. Health risk behaviors examined were physical activity/inactivity, smoking, and alcohol use. A Cochran Armitage trend test for categorical outcomes and a log-binomial modeling for binary outcomes were used to estimate the risk ratios across cohorts. RESULTS The proportions of Canadians 65+ who are physically active, regular drinkers, and regular smokers have increased; however, depression prevalence fluctuated non-significantly. Depression increased among all health risk behaviors, particularly in recent birth cohorts. Depression among physically inactive seniors, current smokers, and non-drinkers was significantly higher than among active, non-smokers, and regular drinkers (all P < 0.05). Physical inactivity and smoking-attributable depression risk showed an increasing linear trend across birth cohorts (RR = 1.67, P < 0.001; RR = 1.79, P < 0.001). For seniors born between 1915 and 1944, regular drinking was associated with a significant decrease in depression (all P < 0.001), but the protective effects of regular drinking became non-existent in the most recent 1945-1949 birth cohort (RR = 1.09, P < 0.05, after adjusting for covariates). CONCLUSION Inactivity and smoking were consistently associated with a significantly increased risk of depression among Canadian residents 65+, with smoking becoming more firmly connected to depression risk in more recent birth cohorts. In contrast, moderate alcohol use was associated with a decreased risk of depression, but that protective effect ceased in most recent birth cohort. Identifying the changing relationships between health risk behaviors and depression is meaningful for developing prevention strategies for depression and other emotional and mental health problems.
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Affiliation(s)
- Guang Yang
- School of Public Health, University of Saskatchewan, Saskatoon, SK, Canada
| | - Carl D'Arcy
- School of Public Health, University of Saskatchewan, Saskatoon, SK, Canada.,Department of Psychiatry, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
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The Impact of Leisure Activities on the Mental Health of Older Adults: The Mediating Effect of Social Support and Perceived Stress. JOURNAL OF HEALTHCARE ENGINEERING 2021; 2021:6264447. [PMID: 34790344 PMCID: PMC8592769 DOI: 10.1155/2021/6264447] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 09/14/2021] [Accepted: 10/27/2021] [Indexed: 01/18/2023]
Abstract
As the aging continues, China has become the country with the largest older population. In order to ensure the well-being of older adults in their later years, the whole society is increasingly concerned about the mental health of older adults. In 2019, we conduct a questionnaire survey in Shaanxi Province. Stratified random sampling is used to select three representative cities, and 677 samples are selected from the survey results for research. By using the structural equation model, we aim to reveal the mechanism of leisure activities' influence on mental health of the older adults and verify whether social support and perceived stress play a mediating role. The study finds that the older adults' leisure activities have no significant direct impact on mental health. Social support has a significant mediating effect between leisure activities and mental health of the older adults. Leisure activities indirectly affect the mental health of the older adults through social support, and participation in leisure activities can improve the social support of the older adults, thus improving the mental health level of the older adults. Perceived stress plays a significant mediating role between leisure activities and mental health of the older adults. By participating in leisure activities, the perceived stress of the older adults will be reduced, thus improving their mental health. Social support and perceived stress play a sufficient mediating role in the influence of leisure activities on mental health.
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Hinata A, Kabasawa K, Watanabe Y, Kitamura K, Ito Y, Takachi R, Tsugane S, Tanaka J, Sasaki A, Narita I, Nakamura K. Education, household income, and depressive symptoms in middle-aged and older Japanese adults. BMC Public Health 2021; 21:2120. [PMID: 34794416 PMCID: PMC8600755 DOI: 10.1186/s12889-021-12168-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 11/03/2021] [Indexed: 11/10/2022] Open
Abstract
Background Income inequality has dramatically increased worldwide, and there is a need to re-evaluate the association between socio-economic status (SES) and depression. Relative contributions of household income and education to depression, as well as their interactions, have not been fully evaluated. This study aimed to examine the association between SES and depressive symptoms in Japanese adults, focusing on interactions between education and household income levels. Methods This cross-sectional study used data from baseline surveys of two cohort studies. Participants were 38,499 community-dwelling people aged 40–74 years who participated in baseline surveys of the Murakami cohort study (2011–2012) and Uonuma cohort study (2012–2015) conducted in Niigata Prefecture, Japan. Information regarding marital status, education level, household income, occupation, activities of daily living (ADL), and history of cancer, myocardial infarction, stroke, and diabetes was obtained using a self-administered questionnaire. Depressive symptoms were examined using the Center for Epidemiologic Studies Depression Scale (CES-D). Logistic regression analysis was used to obtain odds ratios (ORs). Covariates included age, sex, marital status, education, household income, occupation, ADL, and disease history. Results Individuals with higher education levels had lower ORs (adjusted P for trend = 0.0007) for depressive symptoms, independently of household income level. The OR of the university-or-higher group was significantly lower than that of the junior high school group (adjusted OR = 0.79). Individuals with lower household income levels had higher ORs (adjusted P for trend< 0.0001) for depressive symptoms, independently of education level. The type of occupation was not associated with depressive symptoms. In subgroup analyses according to household income level, individuals with higher education levels had significantly lower ORs in the lowest- and lower-income groups (adjusted P for trend = 0.0275 and 0.0123, respectively), but not in higher- and highest-income groups (0.5214 and 0.0915, respectively). Conclusions Both education and household income levels are independently associated with the prevalence of depressive symptoms, with household income levels showing a more robust association with depressive symptoms than education levels. This suggests that a high household income level may offset the risk of depressive symptoms from having a low education level. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-12168-8.
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Affiliation(s)
- Aya Hinata
- Division of Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Keiko Kabasawa
- Department of Health Promotion Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
| | - Yumi Watanabe
- Division of Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Kaori Kitamura
- Division of Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Yumi Ito
- Department of Health Promotion Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Ribeka Takachi
- Department of Food Science and Nutrition, Nara Women's University Graduate School of Humanities and Sciences, Nara, Japan
| | - Shoichiro Tsugane
- Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Junta Tanaka
- Department of Health Promotion Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | | | - Ichiei Narita
- Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Kazutoshi Nakamura
- Division of Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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The Practice of Vigorous Physical Activity Is Related to a Higher Educational Level and Income in Older Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010815. [PMID: 34682560 PMCID: PMC8536035 DOI: 10.3390/ijerph182010815] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 10/11/2021] [Accepted: 10/11/2021] [Indexed: 12/25/2022]
Abstract
Few studies have shown evidence about the factors that can determine physical practice in women over 60 years of age due to educational, economic, social, or health inequalities. Its knowledge could help to understand the determinants that encourage the practice of physical activity and the improvement of health in women over 60. Therefore, the aim of this research was to evaluate the level of studies, income, and the usefulness of social and health services in physically active older women according to the level of activity they practice. The IPAQ (International Physical Activity Questionnaire) and CUBRECAVI (subjective health scale) scales have been applied to a sample of 257 women between 61 and 93 years old (M = 69.44, SD = 4.61). The results have shown that those with vigorous physical activity are related to higher levels of education (p < 0.001) and income (p = 0.004). Furthermore, being dissatisfied with social and health services is associated with low levels of physical activity (p = 0.005). Older women who perform physical activity regularly are associated with high levels in some of the socio-environmental aspects of quality of life. High physical activity is related to a higher educational level and income. Socio-environmental factors generate social inequalities and modulate the lifestyles of older women.
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Xiao S, Lin H, Zhao C, Zheng X, Shi L, Zhang J, Xue B, Chang J, Chen J, Zhang C. Impact of Different Type and Frequency of Social Participation on Depressive Symptoms Among Older Chinese Adults: Is There a Gender Difference? Front Psychiatry 2021; 12:758105. [PMID: 34658980 PMCID: PMC8515849 DOI: 10.3389/fpsyt.2021.758105] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 09/13/2021] [Indexed: 12/03/2022] Open
Abstract
Objectives: Social participation may prevent depressive symptoms in older adults. But research to date ignores gender differences in the associations between social participation and depressive symptoms. The purpose of this study was to determine the effect of different type and frequency of social participation on depressive symptoms, as well as if there is a gender difference in these correlations among older Chinese adults. Methods: Data was obtained from adults aged 60 years or above in the 2018 China Health and Retirement Longitudinal Survey, a nationally representative sample of older adults in China. Depressive symptoms were measured using CESD-10. Social participation included participation in social groups, hobby groups, sports groups, and community-related organizations. The independent relationships between each type of social participation and depressive symptoms were assessed using multiple linear regression models. Results: A total of 6,287 older adults were included in this analysis, of whom 49.69% were women. Participating in social groups, sports groups, and community-related organizations with a frequency of one or more per week was all linked to better mental health. Furthermore, our findings suggest that the positive relationship between participation in social groups, hobby groups, and community-related organizations and depressive symptoms is more flexible for older men than for women. Conclusions: Older individuals who participate in social participation at a high frequency may have better mental health. The findings provide novel insights into mental health from the standpoint of social participation in older adults. Gender differences in the associations between social participation and depressive symptoms need to be considered when formulating interventions to prevent depression.
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Affiliation(s)
- Shujuan Xiao
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Huang Lin
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Chongbang Zhao
- Department of Psychiatry, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Xiao Zheng
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Lei Shi
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Jiachi Zhang
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Benli Xue
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Jinghui Chang
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Jiangyun Chen
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Chichen Zhang
- School of Health Management, Southern Medical University, Guangzhou, China.,Department of Health Management, Nanfang Hospital, Southern Medical University, Guangzhou, China.,Institute of Health Management, Southern Medical University, Guangzhou, China
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