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Wang Y, Peng S, Wu J, Li X, Jiang P, Shen G. The role of depression between sleep disorders and frailty among elderly patients with chronic kidney disease (CKD) in China: a cross-sectional study. Int Urol Nephrol 2024; 56:2085-2092. [PMID: 38289547 DOI: 10.1007/s11255-023-03910-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 12/05/2023] [Indexed: 05/14/2024]
Abstract
OBJECTIVE To investigate the correlation among sleep disorders, physical frailty, and depression in elderly patients with chronic kidney disease (CKD), and to explore the mediating role of depression. METHODS This was a cross-sectional study, simple sampling was used to investigate the elderly CKD patients from one tertiary hospital in Shanghai. Those CKD patients who were diagnosed as CKD1-5 phase and were admitted to the Renal Medicine Ward from January to June 2022 and provided formal consent were considered for inclusion in our study. They were investigated with frailty phenotype (FP), Pittsburgh sleep quality index (PSQI), Center for Epidemiological Studies Depression Scale (CES-D), and self-made general information questionnaire. Linear regression was used to assess the associations between the variables, before this, PROCESS v4.1 was used to transform PSQI, CES-D and FP score to improve its normality, and conduct intermediary analysis. A difference of p < 0.05 was statistically significant. RESULTS A total of 504 elderly patients with CKD completed the questionnaire survey, aged 60-91. The incidence of sleep disorders among elderly patients with CKD was 60%, and the incidence of physical frailty was 18%. The depression was positively correlated with physical frailty (r = 0.418, p < 0.01) and sleep disorders (r = 0.541, p < 0.01). Physical frailty was positively correlated with sleep disorders (r = 0.320, p < 0.01). The depression plays a significant mediating role in the model, and the effect ratio of depression is 52%. CONCLUSION Depression is a mediating variable between sleep disorders and frailty. Improving depression in elderly patients with CKD accompanied by sleep disorders can help delay the occurrence of frailty.
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Affiliation(s)
- Yan Wang
- Huzhou Central Hospital, Affiliated Central Hospital Huzhou University, Huzhou, Zhejiang Province, China
- Graduate School of Nursing, Huzhou University, Huzhou, Zhejiang Province, China
| | - Shuzhi Peng
- Graduate School, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Graduate School, Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Jingwen Wu
- Huzhou Central Hospital, Affiliated Central Hospital Huzhou University, Huzhou, Zhejiang Province, China
- Graduate School of Nursing, Huzhou University, Huzhou, Zhejiang Province, China
| | - Xiang Li
- Huzhou Central Hospital, Affiliated Central Hospital Huzhou University, Huzhou, Zhejiang Province, China
- Graduate School of Nursing, Huzhou University, Huzhou, Zhejiang Province, China
| | - Peiyu Jiang
- Graduate School of Nursing, Huzhou University, Huzhou, Zhejiang Province, China.
| | - Guodi Shen
- Huzhou Central Hospital, Affiliated Central Hospital Huzhou University, Huzhou, Zhejiang Province, China.
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Yoshimaru N, Nanri A, Eguchi M, Kochi T, Kabe I, Mizoue T. Eating behaviors and depressive symptoms among Japanese workers: the Furukawa Nutrition and Health Study. Eur J Clin Nutr 2024; 78:307-313. [PMID: 38135709 DOI: 10.1038/s41430-023-01391-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 12/04/2023] [Accepted: 12/11/2023] [Indexed: 12/24/2023]
Abstract
BACKGROUND/OBJECTIVES In addition to the potential effects of nutrients on mood, eating behaviors have been suggested to be associated with depressive symptoms. We investigated the prospective association between the accumulation of unhealthy eating behaviors and depressive symptoms in a Japanese working population. METHODS Participants were 914 workers (aged 19-68 years) who did not have depressive symptoms at baseline (April 2012 and May 2013) and attended a 3-year follow-up survey (April 2015 and May 2016). Unhealthy eating behaviors (skipping breakfast, eating dinner just before bedtime, and snacking after dinner) were assessed at baseline. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression (CES-D) scale at follow-up. Multiple logistic regression was used to estimate the odds ratio of depressive symptoms (CES-D score ≥16) at follow-up according to the number of unhealthy eating behaviors. RESULTS In a model with adjustment of background factors, participants having 2-3 unhealthy eating behaviors at baseline had significantly higher risk of developing depressive symptoms (OR, 2.02; 95% CI, 1.21-3.38) compared with those having no such behaviors. After adjustment for occupational and lifestyle factors, the association was slightly attenuated but remained significant (OR, 1.87; 95% CI, 1.10-3.21). This association was further attenuated and became statistically non-significant after additional adjustment for nutritional factors (OR, 1.67; 95% CI, 0.96-2.90). CONCLUSIONS Our results suggest that the accumulation of unhealthy eating behaviors is associated with an increased risk of depressive symptoms and that this association may be partly ascribed to a lower intake of nutrients with mood-improving effects.
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Affiliation(s)
- Norika Yoshimaru
- Department of Food and Health Sciences, International College of Arts and Sciences, Fukuoka Women's University, Fukuoka, Japan
| | - Akiko Nanri
- Department of Food and Health Sciences, International College of Arts and Sciences, Fukuoka Women's University, Fukuoka, Japan.
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan.
| | - Masafumi Eguchi
- Department of Health Administration, Furukawa Electric Corporation, Tokyo, Japan
| | - Takeshi Kochi
- Department of Health Administration, Furukawa Electric Corporation, Tokyo, Japan
| | | | - Tetsuya Mizoue
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
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Bala J, Newson JJ, Thiagarajan TC. Hierarchy of demographic and social determinants of mental health: analysis of cross-sectional survey data from the Global Mind Project. BMJ Open 2024; 14:e075095. [PMID: 38490653 PMCID: PMC10946366 DOI: 10.1136/bmjopen-2023-075095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 02/16/2024] [Indexed: 03/17/2024] Open
Abstract
OBJECTIVES To understand the extent to which various demographic and social determinants predict mental health status and their relative hierarchy of predictive power in order to prioritise and develop population-based preventative approaches. DESIGN Cross-sectional analysis of survey data. SETTING Internet-based survey from 32 countries across North America, Europe, Latin America, Middle East and North Africa, Sub-Saharan Africa, South Asia and Australia, collected between April 2020 and December 2021. PARTICIPANTS 270 000 adults aged 18-85+ years who participated in the Global Mind Project. OUTCOME MEASURES We used 120+ demographic and social determinants to predict aggregate mental health status and scores of individuals (mental health quotient (MHQ)) and determine their relative predictive influence using various machine learning models including gradient boosting and random forest classification for various demographic stratifications by age, gender, geographical region and language. Outcomes reported include model performance metrics of accuracy, precision, recall, F1 scores and importance of individual factors determined by reduction in the squared error attributable to that factor. RESULTS Across all demographic classification models, 80% of those with negative MHQs were correctly identified, while regression models predicted specific MHQ scores within ±15% of the position on the scale. Predictions were higher for older ages (0.9+ accuracy, 0.9+ F1 Score; 65+ years) and poorer for younger ages (0.68 accuracy, 0.68 F1 Score; 18-24 years). Across all age groups, genders, regions and language groups, lack of social interaction and sufficient sleep were several times more important than all other factors. For younger ages (18-24 years), other highly predictive factors included cyberbullying and sexual abuse while not being able to work was high for ages 45-54 years. CONCLUSION Social determinants of traumas, adversities and lifestyle can account for 60%-90% of mental health challenges. However, additional factors are at play, particularly for younger ages, that are not included in these data and need further investigation.
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Zeng G, Lin Y, Lin J, He Y, Wei J. Association of cardiovascular health using Life's Essential 8 with depression: Findings from NHANES 2007-2018. Gen Hosp Psychiatry 2024; 87:60-67. [PMID: 38306947 DOI: 10.1016/j.genhosppsych.2024.01.011] [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: 10/14/2023] [Revised: 01/28/2024] [Accepted: 01/29/2024] [Indexed: 02/04/2024]
Abstract
OBJECTIVE Few studies have explored the correlation between cardiovascular health (CVH) and depression. We aimed to investigate the relationship between CVH using Life's Essential 8 (LE8) and depression among US adults. METHODS 16,362 individuals from the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2018 were included. The patient Health Questionnaire (PHQ-9) was utilized to recognized depression (PHQ-9 ≥ 10). LE8 was scored by four health behaviors (sleep, tobacco/nicotine exposure, physical activity and diet) and four health factors (body mass index, non-high-density lipoprotein cholesterol, blood glucose and blood pressure) and classified into low, moderate and high CVH groups. Weighted logistic regressions, restricted cubic splines and sensitivity analyses were utilized to investigate the correlation between LE8 and depression. RESULTS 1306 subjects had depression (7.98% of the participants), of which 860 (7.42%), 305 (17.24%) and 141 (3.01%) had low, moderate and high CVH, separately. In the fully adjusted model, LE8 was negatively correlated with depression (OR: 5.50, 95% CI 3.92-7.71, P < 0.001). Furthermore, there were inversely dose-response relationships between LE8 and depression (overall P < 0.001). CONCLUSIONS Adhering to a high CVH, estimated by the LE8 score, was correlated with lower odds of depression.
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Affiliation(s)
- Guixing Zeng
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yujie Lin
- The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jiarong Lin
- Second Affiliated Hospital, Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou, China
| | - Yaxing He
- School of Instrumentation and Optoelectronic Engineering, Beihang University, Beijing, China
| | - Junping Wei
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
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Cui L, Li S, Wang S, Wu X, Liu Y, Yu W, Wang Y, Tang Y, Xia M, Li B. Major depressive disorder: hypothesis, mechanism, prevention and treatment. Signal Transduct Target Ther 2024; 9:30. [PMID: 38331979 PMCID: PMC10853571 DOI: 10.1038/s41392-024-01738-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 12/24/2023] [Accepted: 12/28/2023] [Indexed: 02/10/2024] Open
Abstract
Worldwide, the incidence of major depressive disorder (MDD) is increasing annually, resulting in greater economic and social burdens. Moreover, the pathological mechanisms of MDD and the mechanisms underlying the effects of pharmacological treatments for MDD are complex and unclear, and additional diagnostic and therapeutic strategies for MDD still are needed. The currently widely accepted theories of MDD pathogenesis include the neurotransmitter and receptor hypothesis, hypothalamic-pituitary-adrenal (HPA) axis hypothesis, cytokine hypothesis, neuroplasticity hypothesis and systemic influence hypothesis, but these hypothesis cannot completely explain the pathological mechanism of MDD. Even it is still hard to adopt only one hypothesis to completely reveal the pathogenesis of MDD, thus in recent years, great progress has been made in elucidating the roles of multiple organ interactions in the pathogenesis MDD and identifying novel therapeutic approaches and multitarget modulatory strategies, further revealing the disease features of MDD. Furthermore, some newly discovered potential pharmacological targets and newly studied antidepressants have attracted widespread attention, some reagents have even been approved for clinical treatment and some novel therapeutic methods such as phototherapy and acupuncture have been discovered to have effective improvement for the depressive symptoms. In this work, we comprehensively summarize the latest research on the pathogenesis and diagnosis of MDD, preventive approaches and therapeutic medicines, as well as the related clinical trials.
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Affiliation(s)
- Lulu Cui
- Department of Forensic Analytical Toxicology, School of Forensic Medicine, China Medical University, Shenyang, China
- Liaoning Province Key Laboratory of Forensic Bio-evidence Sciences, Shenyang, China
- China Medical University Centre of Forensic Investigation, Shenyang, China
| | - Shu Li
- Department of Forensic Analytical Toxicology, School of Forensic Medicine, China Medical University, Shenyang, China
- Liaoning Province Key Laboratory of Forensic Bio-evidence Sciences, Shenyang, China
- China Medical University Centre of Forensic Investigation, Shenyang, China
| | - Siman Wang
- Department of Forensic Analytical Toxicology, School of Forensic Medicine, China Medical University, Shenyang, China
- Liaoning Province Key Laboratory of Forensic Bio-evidence Sciences, Shenyang, China
- China Medical University Centre of Forensic Investigation, Shenyang, China
| | - Xiafang Wu
- Department of Forensic Analytical Toxicology, School of Forensic Medicine, China Medical University, Shenyang, China
- Liaoning Province Key Laboratory of Forensic Bio-evidence Sciences, Shenyang, China
- China Medical University Centre of Forensic Investigation, Shenyang, China
| | - Yingyu Liu
- Department of Forensic Analytical Toxicology, School of Forensic Medicine, China Medical University, Shenyang, China
- Liaoning Province Key Laboratory of Forensic Bio-evidence Sciences, Shenyang, China
- China Medical University Centre of Forensic Investigation, Shenyang, China
| | - Weiyang Yu
- Department of Forensic Analytical Toxicology, School of Forensic Medicine, China Medical University, Shenyang, China
- Liaoning Province Key Laboratory of Forensic Bio-evidence Sciences, Shenyang, China
- China Medical University Centre of Forensic Investigation, Shenyang, China
| | - Yijun Wang
- Department of Forensic Analytical Toxicology, School of Forensic Medicine, China Medical University, Shenyang, China
- Liaoning Province Key Laboratory of Forensic Bio-evidence Sciences, Shenyang, China
- China Medical University Centre of Forensic Investigation, Shenyang, China
| | - Yong Tang
- International Joint Research Centre on Purinergic Signalling/Key Laboratory of Acupuncture for Senile Disease (Chengdu University of TCM), Ministry of Education/School of Health and Rehabilitation, Chengdu University of Traditional Chinese Medicine/Acupuncture and Chronobiology Key Laboratory of Sichuan Province, Chengdu, China
| | - Maosheng Xia
- Department of Orthopaedics, The First Hospital, China Medical University, Shenyang, China.
| | - Baoman Li
- Department of Forensic Analytical Toxicology, School of Forensic Medicine, China Medical University, Shenyang, China.
- Liaoning Province Key Laboratory of Forensic Bio-evidence Sciences, Shenyang, China.
- China Medical University Centre of Forensic Investigation, Shenyang, China.
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Menassa M, Wesenhagen K, Stronks K, Franco OH, Verschuren W, Picavet H. Individual mental health patterns and the role of lifestyle among ageing adults over 20 years - the Doetinchem Cohort Study. Arch Gerontol Geriatr 2023; 115:105222. [PMID: 37839196 DOI: 10.1016/j.archger.2023.105222] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 10/03/2023] [Accepted: 10/05/2023] [Indexed: 10/17/2023]
Abstract
OBJECTIVE We explored the prevalence of individual mental health patterns and the role of lifestyle factors over 20 years. STUDY DESIGN We used data from the Doetinchem Cohort Study (1995-2019), a population-based study amongst adults (26-90 years) examined every five years in the Netherlands. Participants were classified in five pre-defined mental health patterns (persistent good, persistent poor, worsening, improving, varying) over 20 years (five rounds) using the MHI-5 questionnaire. BMI, sleep, smoking, alcohol consumption, and physical activity were dichotomised as healthy/unhealthy based on guidelines. The role of lifestyle at baseline (t1), 20 years later (t5), and longitudinally over 20 years (using pre-defined patterns) was explored using logistic regression. RESULTS Most participants had good mental health at t1 (85 %) and t5 (88 %). Over 20 years, 67 % followed a persistent good mental health pattern, 30 % a changing pattern, and 3 % a persistent poor pattern. Persistent poor and changing patterns were associated with unhealthy sleep and smoking at t1, t5, and with the 20-year unhealthy patterns. Persistent poor mental health was associated with stable unhealthy and changing sleep (OR=5.58(2.48-12.54) and OR=2.07(1.14-3.74), respectively), and with stable unhealthy and changing smoking (OR=3.35(1.58-7.11) and OR=2.53(1.40-4.57), respectively). Changing mental health was associated with changing (OR=1.54(1.26-1.88) and OR=1.64(1.30-2.07), respectively) and stable unhealthy (OR=1.80(1.23-2.64) and OR=2.24(1.60-3.14), respectively) sleep and smoking, respectively. CONCLUSIONS Persistent good and changing mental health patterns were more common than poor mental health in adults and were associated with smoking and sleep. Clarifying the underlying mechanisms and directionality between mental health and lifestyle could improve interventions.
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Affiliation(s)
- M Menassa
- Institute of Social and Preventive Medicine, University of Bern, Mittelstrasse 43, Bern 3012, Switzerland; Graduate School for Health Sciences, University of Bern, Bern, Switzerland; Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, the Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands.
| | - Kej Wesenhagen
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, the Netherlands
| | - K Stronks
- Department of Public and Occupational Health, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands
| | - O H Franco
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Wmm Verschuren
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, the Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Hsj Picavet
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, the Netherlands
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Nanri A, Yamamoto S, Suetsugu M, Kochi T, Kabe I, Mizoue T. Isoflavone intake and depressive symptoms among workers. Clin Nutr ESPEN 2023; 58:416-420. [PMID: 38057034 DOI: 10.1016/j.clnesp.2023.11.005] [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: 05/11/2023] [Revised: 10/22/2023] [Accepted: 11/06/2023] [Indexed: 12/08/2023]
Abstract
BACKGROUND & AIM High intake of isoflavones has been reported to be associated with decreased prevalence of depressive symptoms. However, no prospective study has examined this association. We prospectively investigated the association between isoflavone intake and depressive symptoms in a Japanese working population. METHODS Participants were 1162 workers (1033 men and 129 women aged 18-68 years) without depressive symptoms at baseline. Dietary intake was assessed using a validated self-administered diet history questionnaire. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression (CES-D) scale. Cox proportional hazards regression for interval-censored data was used to estimate the hazard ratio of depressive symptoms (CES-D ≥16) according to the tertile of isoflavone intake with adjustment for covariates. RESULTS During 5065 person-years of follow-up, 276 (23.8 %) workers were newly identified as having depressive symptoms. Isoflavone intake was not associated with risk of depressive symptoms. After adjustment for lifestyle and dietary factors and baseline CES-D score, the multivariable-adjusted hazard ratios (95 % confidence interval) for the lowest through highest tertile of isoflavone intake were 1.00 (reference), 0.93 (0.66-1.31), and 0.93 (0.62-1.38) (P for trend = 0.70). CONCLUSIONS Our findings suggest that higher isoflavone intake is not associated with decreased risk of depressive symptoms among Japanese.
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Affiliation(s)
- Akiko Nanri
- Department of Food and Health Sciences, International College of Arts and Sciences, Fukuoka Women's University, Fukuoka, Japan; Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan.
| | - Shohei Yamamoto
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Masana Suetsugu
- Department of Food and Health Sciences, International College of Arts and Sciences, Fukuoka Women's University, Fukuoka, Japan
| | - Takeshi Kochi
- Department of Health Administration, Furukawa Electric Corporation, Tokyo, Japan
| | | | - Tetsuya Mizoue
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
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Nielson SA, Kay DB, Dzierzewski JM. Sleep and Depression in Older Adults: A Narrative Review. Curr Psychiatry Rep 2023; 25:643-658. [PMID: 37740851 DOI: 10.1007/s11920-023-01455-3] [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] [Accepted: 09/06/2023] [Indexed: 09/25/2023]
Abstract
PURPOSE OF REVIEW The sleep-depression association has been recognized for decades. Efforts to clarify this association continue at an increasing pace. This review summarizes recent research on the sleep-depression association in older adults. RECENT FINDINGS Research over the past 4 years has utilized cross-sectional, longitudinal, cohort, and intervention designs to examine these associations. Short (< 7 h) and long (> 8-9 h) sleep durations and insomnia symptoms are risk factors for depression in older adults. Similarly, short sleep, long sleep, insomnia symptoms, and depression are all risk factors for poorer health in late life, including increased risk of cognitive decline, falls, and poorer quality-of-life. Intervention studies have produced mixed findings, with some studies suggesting that sleep interventions may be potentially effective in improving both insomnia and mood symptoms. Intervention studies incorporating both behavioral and physiological measures of sleep, and larger and diverse samples may enhance the field's understanding of the complex interplay between sleep and mood in older adults.
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Affiliation(s)
- Spencer A Nielson
- Department of Psychology, Virginia Commonwealth University, Richmond, USA
| | - Daniel B Kay
- Department of Psychology, Brigham Young University, Provo, UT, USA
| | - Joseph M Dzierzewski
- National Sleep Foundation, 2001 Massachusetts Ave NW, Washington, DC, 20036, USA.
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Paterson J, Trevenen M, Hill K, Almeida OP, Yeap BB, Golledge J, Hankey GJ, Flicker L. Balance and Strength Measures are Associated With Mortality in Older Men. J Am Med Dir Assoc 2023; 24:1527-1532.e2. [PMID: 37187326 DOI: 10.1016/j.jamda.2023.03.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 03/30/2023] [Accepted: 03/30/2023] [Indexed: 05/17/2023]
Abstract
OBJECTIVES As people age, rates of morbidity and mortality are heterogenous. Balance and strength performance may contribute to this, offering modifiable risk factors for mortality. We aimed to compare relationships of balance and strength performance with all-cause and cause-specific mortality. DESIGN The Health in Men Study, a cohort study, using wave 4 as baseline for analyses (2011-2013). SETTING AND PARTICIPANTS 1335 older men (>65 years old), initially recruited April 1996-January 1999 in Western Australia, were included. METHODS Physical tests included a strength (knee extension test) and balance measure (modified Balance Outcome Measure for Elder Rehabilitation (mBOOMER) Score), derived from baseline physical assessments. Outcome measures included all-cause, cardiovascular, and cancer mortality, ascertained via the WADLS death registry. Data were analyzed using Cox proportional hazards regression models (age as analysis time, adjusted for sociodemographic data, health behaviors, and conditions). RESULTS Four hundred seventy-three participants died before the end of follow-up (December 17, 2017). Better performance on both the mBOOMER score and knee extension test was associated with lower likelihood of all-cause [hazard ratio (HR) 0.83, 95% CI 0.80-0.87, and HR 0.96, 95% CI 0.95-0.98, respectively] and cardiovascular mortality (HR 0.82, 95% CI 0.77-0.87, and HR 0.96, 95% CI 0.94-0.98, respectively). Better mBOOMER score performance was associated with lower likelihood of cancer mortality (HR 0.90, 95% CI 0.83-0.98) only when including participants with prior cancer. CONCLUSIONS AND IMPLICATIONS In summary, this study demonstrates an association of poorer performance in both strength and balance with future all-cause and cardiovascular mortality. Notably, these results clarify the relationship of balance with cause-specific mortality, with balance equaling strength as a modifiable risk factor for mortality.
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Affiliation(s)
- Jack Paterson
- Medical School, University of Western Australia, Perth, Western Australia, Australia
| | - Michelle Trevenen
- Western Australian Centre for Health & Ageing, Medical School, University of Western Australia, Perth, Western Australia, Australia
| | - Keith Hill
- Rehabilitation Ageing and Independent Living (RAIL) Research Centre, Monash University, School of Primary and Allied Health Care, Peninsula Campus, Frankston, Victoria, Australia
| | - Osvaldo P Almeida
- Western Australian Centre for Health & Ageing, Medical School, University of Western Australia, Perth, Western Australia, Australia
| | - Bu B Yeap
- Medical School, University of Western Australia, Perth, Western Australia, Australia; Department of Endocrinology and Diabetes, Fiona Stanley Hospital, Perth, Western Australia, Australia
| | - Jonathan Golledge
- Queensland Research Centre for Peripheral Vascular Disease, James Cook University, Townsville, Queensland, Australia; Department of Vascular and Endovascular Surgery, Townsville University Hospital, Townsville, Queensland, Australia
| | - Graeme J Hankey
- Medical School, University of Western Australia, Nedlands, Western Australia, Australia; Perron Institute for Neurological and Translational Science, Nedlands, Western Australia, Australia
| | - Leon Flicker
- Western Australian Centre for Health & Ageing, Medical School, University of Western Australia, Perth, Western Australia, Australia.
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Aguilar-Latorre A, Oliván-Blázquez B, Algorta GP, Serrano-Ripoll MJ, Escobar-Olszewski L, Turón-Lanuza A. One-year follow-up of the effectiveness of a lifestyle modification programme as an adjuvant treatment of depression in primary care: A randomised clinical trial. J Affect Disord 2023; 332:231-237. [PMID: 37054898 DOI: 10.1016/j.jad.2023.04.007] [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: 06/13/2022] [Revised: 03/20/2023] [Accepted: 04/07/2023] [Indexed: 04/15/2023]
Abstract
BACKGROUND An estimated 280 million individuals suffer from depression. Brief group interventions in Primary Healthcare Centres (PHCs) are recommended. One goal of these interventions is to educate people about healthy lifestyle habits, as they prevent the development of depression. This study aims to analyse the one-year follow-up results about the effectiveness of a Lifestyle Modification Programme (LMP) and an LMP plus Information and Communication Technologies (LMP + ICTs) when compared to Treatment as Usual (TAU). METHODS We conducted an open-label, multicentre, pragmatic, randomised clinical trial. A total of 188 individuals that visited a general practitioner and met the inclusion criteria were randomised. LMP consisted of six weekly 90-minute group sessions focusing on lifestyle improvement. LMP + ICTs was a hybrid of the LMP format with the inclusion of a wearable smartwatch. We used linear mixed models (with a random intercept and an unstructured covariance) to evaluate the effectiveness of the interventions, and an intention-to-treat analysis and Multiple Imputation technique for handling missing data. RESULTS LMP + ICTs showed a statistically significant reduction on depressive symptoms (b = -2.68, 95 % CI = [-4.239, -1.133] p = .001) and sedentarism (b = -37.38, 95 % CI [-62.930, -11.833], p = .004) compared to TAU. LIMITATIONS Most of the dropouts were due to time restrictions. CONCLUSIONS In long-term, LMPs plus ICTs administered in PHCs to people suffering from depression were effective in reducing depressive symptomatology and sedentarism comparing to TAU. More research is needed to enhance adherence to lifestyle recommendations. These promising programmes could be easily implemented in PHCs. TRIAL REGISTRATION NUMBER ClinicalTrials.gov Registry (NCT03951350).
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Affiliation(s)
- Alejandra Aguilar-Latorre
- Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain; Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain
| | - Bárbara Oliván-Blázquez
- Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain; Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain.
| | - Guillermo Pérez Algorta
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, United Kingdom
| | - Maria J Serrano-Ripoll
- Balearic Islands Health Services, Primary Care Research Unit of Mallorca, Palma, Balearic Islands, Spain; Research in Preventive Activities and Promotion and in Cancer Illes Balears (GRAPP-CAIB), Health Research Institute of the Balearic Islands (IdISBa), Palma, Balearic Islands, Spain; Research Netork in Preventive Activities and Health Promotion (RedIAPP), Barcelona, Spain
| | - Linda Escobar-Olszewski
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, United States of America
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Associations between Sleep, Depression, and Cognitive Performance in Adolescence. Eur J Investig Health Psychol Educ 2023; 13:501-511. [PMID: 36826222 PMCID: PMC9955842 DOI: 10.3390/ejihpe13020038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 02/09/2023] [Accepted: 02/16/2023] [Indexed: 02/22/2023] Open
Abstract
The relevance of cognitive performance during adolescence requires further studies that analyze potential associated factors. This study aimed to analyze inductive reasoning, reading comprehension, and mathematical thinking (problem-solving and number and calculation) in relation to sleep and depression in 244 students aged 12-17 years (47.6% boys and 52.4% girls). Daytime sleepiness, sleep quality, dysthymia, and euthymia (state and trait) were assessed by self-reported questionnaires. Moreover, correlations between these variables and cognitive performance, and differences depending on sociodemographic variables (sex, age, or academic year) were analyzed using non-parametric tests. Robust regression models were also conducted to evaluate the predictive role of significant variables on cognitive performance. The results showed significant bidirectional relationships between sleep- and depression-related variables, and between the latter ones and cognitive performance. Depression-trait was more related to cognitive performance than depression-state, and euthymia more than dysthymia, but neither daytime sleepiness nor sleep quality significantly correlated with it. As for sociodemographic variables, girls reported worse sleep and more depressive symptoms than boys did, and younger students reported better sleep but performed worse than the older ones. Although these findings should be further explored in forthcoming studies adding other promising variables, they highlight the importance of promoting euthymia to improve cognitive performance in adolescents.
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Samper-Pardo M, León-Herrera S, Oliván-Blázquez B, Benedé-Azagra B, Magallón-Botaya R, Gómez-Soria I, Calatayud E, Aguilar-Latorre A, Méndez-López F, Pérez-Palomares S, Cobos-Rincón A, Valero-Errazu D, Sagarra-Romero L, Sánchez-Recio R. Development and Validation of a Mobile Application as an Adjuvant Treatment for People Diagnosed with Long COVID-19: Protocol for a Co-Creation Study of a Health Asset and an Analysis of Its Effectiveness and Cost-Effectiveness. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:ijerph20010462. [PMID: 36612782 PMCID: PMC9819090 DOI: 10.3390/ijerph20010462] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 12/20/2022] [Accepted: 12/21/2022] [Indexed: 05/29/2023]
Abstract
OBJECTIVE To analyse the overall effectiveness and cost-efficiency of a mobile application (APP) as a community health asset (HA) with recommendations and recovery exercises created bearing in mind the main symptoms presented by patients in order to improve their quality of life, as well as other secondary variables, such as the number and severity of ongoing symptoms, physical and cognitive functions, affective state, and sleep quality. METHODS The first step was to design and develop the technologic community resource, the APP, following the steps involved in the process of recommending health assets (RHA). After this, a protocol of a randomised clinical trial for analysing its effectiveness and cost-efficiency as a HA was developed. The participants will be assigned to: (1st) usual treatment by the primary care practitioner (TAU), as a control group; and (2nd) TAU + use of the APP as a HA and adjuvant treatment in their recovery + three motivational interviews (MI), as an interventional group. An evaluation will be carried out at baseline with further assessments three and six months following the end of the intervention. DISCUSSION Although research and care for these patients are still in their initial stages, it is necessary to equip patients and health care practitioners with tools to assist in their recovery. Furthermore, enhanced motivation can be achieved through telerehabilitation (TR).
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Affiliation(s)
| | | | - Bárbara Oliván-Blázquez
- Department of Psychology and Sociology, University of Zaragoza, 50009 Zaragoza, Spain
- Institute for Health Research Aragon (IISAragon), 50009 Zaragoza, Spain
- Department of Physiatry and Nursing, University of Zaragoza, 50009 Zaragoza, Spain
| | - Belén Benedé-Azagra
- Institute for Health Research Aragon (IISAragon), 50009 Zaragoza, Spain
- Aragones Group of Research in Primary Health Care (GAIAP), 50009 Zaragoza, Spain
| | - Rosa Magallón-Botaya
- Department of Medicine, University of Zaragoza, 50009 Zaragoza, Spain
- Institute for Health Research Aragon (IISAragon), 50009 Zaragoza, Spain
- Aragones Group of Research in Primary Health Care (GAIAP), 50009 Zaragoza, Spain
| | - Isabel Gómez-Soria
- Institute for Health Research Aragon (IISAragon), 50009 Zaragoza, Spain
- Department of Physiatry and Nursing, University of Zaragoza, 50009 Zaragoza, Spain
| | - Estela Calatayud
- Institute for Health Research Aragon (IISAragon), 50009 Zaragoza, Spain
- Department of Physiatry and Nursing, University of Zaragoza, 50009 Zaragoza, Spain
| | - Alejandra Aguilar-Latorre
- Institute for Health Research Aragon (IISAragon), 50009 Zaragoza, Spain
- Aragones Group of Research in Primary Health Care (GAIAP), 50009 Zaragoza, Spain
| | - Fátima Méndez-López
- Institute for Health Research Aragon (IISAragon), 50009 Zaragoza, Spain
- Aragones Group of Research in Primary Health Care (GAIAP), 50009 Zaragoza, Spain
| | - Sara Pérez-Palomares
- Institute for Health Research Aragon (IISAragon), 50009 Zaragoza, Spain
- Department of Physiatry and Nursing, University of Zaragoza, 50009 Zaragoza, Spain
- Aragones Group of Research in Primary Health Care (GAIAP), 50009 Zaragoza, Spain
| | - Ana Cobos-Rincón
- Department of Nursing, University of La Rioja, 26004 Logroño, Spain
| | - Diana Valero-Errazu
- Department of Psychology and Sociology, University of Zaragoza, 50009 Zaragoza, Spain
| | - Lucia Sagarra-Romero
- GAIAS Research Group, Faculty of Health Sciences, University San Jorge, 50830 Zaragoza, Spain
| | - Raquel Sánchez-Recio
- Institute for Health Research Aragon (IISAragon), 50009 Zaragoza, Spain
- Department of Preventive Medicine and Public Health, University of Zaragoza, 50009 Zaragoza, Spain
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