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Wang Z, Chen C, Ruan H, He S. Association of increased participation in social activity in later life with risk of all-cause mortality and heart diseases in older people: results from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Front Public Health 2024; 12:1396184. [PMID: 38983252 PMCID: PMC11231370 DOI: 10.3389/fpubh.2024.1396184] [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: 03/05/2024] [Accepted: 06/14/2024] [Indexed: 07/11/2024] Open
Abstract
Background Previous studies have shown social activity is associated with reduced risk of health outcomes. However, among older people (≥65 years) who were socially inactive at baseline, limited study explored whether increased participation in social activity in later life was associated with reduced risk of health outcomes; therefore, using the data from the Chinese Longitudinal Healthy Longevity Survey, the study was performed. Methods The study outcomes were 10-year all-cause mortality (sample number = 9,984) and 10-year heart diseases (sample number = 7,496). The exposure was the change of social activity frequency. Cox regression analysis was used for data analysis. Results During the follow-up, there were 6,407 all-cause mortalities and 1,035 heart diseases, respectively. Kaplan-Meier analysis demonstrated that cumulative incidences of all-cause mortality were significantly lower in participants with changes into more frequent social activity (log-rank p < 0.001), while no significant difference was observed for heart diseases (log-rank p = 0.330). Compared with the subgroup who never participated in social activity at baseline, adjusted HRs of all-cause mortality were 0.79 (95% CI: 0.70-0.90, p < 0.001), 0.78 (95% CI: 0.63-0.96, p = 0.019), 0.74 (0.59-0.92, p = 0.006), and 0.70 (95% CI: 0.56-0.88, p = 0.002) for the subgroup of switching to sometimes, the subgroup of switching to once a month, the subgroup of switching to once a week, and the subgroup of switching to everyday, respectively. The corresponding HRs of heart diseases were 0.83 (95% CI: 0.65-1.08, p = 0.170), 0.82 (95% CI: 0.51-1.31, p = 0.412), 0.91 (0.58-1.42, p = 0.675) and 0.75 (95% CI: 0.47-1.20, p = 0.227), respectively. Stratified and sensitivity analyses revealed similar results. Conclusion Among older people who never participated in social activity, increased participation in social activity in later life was associated with reduced risk of all-cause mortality, but was not associated with reduced risk of heart diseases.
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Affiliation(s)
- Ziqiong Wang
- Department of Cardiology, West China Hospital of Sichuan University, Chengdu, China
| | - Changchun Chen
- Department of Cardiology, West China Hospital of Sichuan University, Chengdu, China
| | - Haiyan Ruan
- Department of Cardiology, West China Hospital of Sichuan University, Chengdu, China
- Department of Cardiology, Hospital of Traditional Chinese Medicine, Chengdu, China
| | - Sen He
- Department of Cardiology, West China Hospital of Sichuan University, Chengdu, China
- Karamay Hospital of Integrated Chinese and Western Medicine, Xinjiang, China
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Zhou Y, Li Z, Li J, Wang X, Qi K, Zhang S, Zhou C. Sex Difference in the Association Between Sedentary Behavior and Sleep Quality: A Longitudinal Study Among Older Adults in Rural China. J Am Med Dir Assoc 2023; 24:1520-1526.e2. [PMID: 37105235 DOI: 10.1016/j.jamda.2023.03.022] [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: 12/25/2022] [Revised: 03/15/2023] [Accepted: 03/15/2023] [Indexed: 04/29/2023]
Abstract
OBJECTIVES Sleep quality plays a vital role in maintaining health in older adults. Sedentary behavior may be a risk factor for poor sleep quality in older adults. This study aimed to explore the relationship between sedentary behavior and sleep quality among older adults in rural China and determine whether there is a sex difference in this association. DESIGN A longitudinal design. The data used in this study were obtained from the Shandong Rural Elderly Health Cohort (wave 1: 2019, wave 2: 2020). SETTING AND PARTICIPANTS Data were from 2731 individuals aged ≥60 years from rural areas in China. METHODS Sleep quality was assessed using the Pittsburgh Sleep Quality Index. Sedentary behavior and control variables were measured using self-reported questions. Multivariable logistic regression and generalized estimating equations were used to assess the associations. RESULTS After full adjustment, the association between sedentary behavior and poor sleep quality was statistically significant [odds ratio (OR) 1.49, 95% CI 1.20-1.85]. Specifically, a longer sedentary time was associated with worse subjective sleep quality, less sleep latency, and lower habitual sleep efficiency (OR 1.39-1.58). A significant association was observed in women but not men. CONCLUSIONS AND IMPLICATIONS Older adults who spend more time engaging in sedentary activities have poorer sleep quality and more sleep problems. Prolonged sedentary time is more detrimentally associated with poor sleep quality in women than men. There is a need for tailored exercise prescriptions and guidelines to stimulate older adults of different sexes to change their sedentary behavior, which may improve sleep quality in older adults.
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Affiliation(s)
- Yanxin Zhou
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Zhixian Li
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Jie Li
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China; Key Lab of Health Economics and Policy Research, Shandong University, Jinan, Shandong, China
| | - Xiyuan Wang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Kaili Qi
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Shimin Zhang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Chengchao Zhou
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China; Key Lab of Health Economics and Policy Research, Shandong University, Jinan, Shandong, China; Institute of Health and Elderly Care, Shandong University, Jinan, Shandong, China.
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Fan S, Wang Q, Zheng F, Wu Y, Yu T, Wang Y, Zhang X, Zhang D. Depression as a Mediator and Social Participation as a Moderator in the Bidirectional Relationship Between Sleep Disorders and Pain: Dynamic Cohort Study. JMIR Public Health Surveill 2023; 9:e48032. [PMID: 37494109 PMCID: PMC10413249 DOI: 10.2196/48032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 06/07/2023] [Accepted: 06/20/2023] [Indexed: 07/27/2023] Open
Abstract
BACKGROUND Chronic pain, sleep disorders, and depression are major global health concerns. Recent studies have revealed a strong link between sleep disorders and pain, and each of them is bidirectionally correlated with depressive symptoms, suggesting a complex relationship between these conditions. Social participation has been identified as a potential moderator in this complex relationship, with implications for treatment. However, the complex interplay among sleep disorders, pain, depressive symptoms, and social participation in middle- and old-aged Asians remains unclear. OBJECTIVE This study aimed to examine the bidirectional relationship between sleep disorders and pain in middle- and old-aged Chinese and measure the role of depression as a mediator and social participation as a moderator in this bidirectional relationship through a dynamic cohort study. METHODS We used data from the China Health and Retirement Longitudinal Study across 5 years and included a total of 7998 middle- and old-aged people (≥45 years old) with complete data in 2011 (T1), 2015 (T2), and 2018 (T3). The cross-lag model was used to assess the interplay among sleep disorders, pain, depressive symptoms, and social participation. Depressive symptoms were assessed by the 10-item Centre for Epidemiological Studies Depression scale. Sleep disorders were assessed by a single-item sleep quality scale and nighttime sleep duration. The pain score was the sum of all pain locations reported. Social participation was measured using self-reported activity. RESULTS Our results showed significant cross-lagged effects of previous sleep disorders on subsequent pain at T2 (β=.141; P<.001) and T3 (β=.117; P<.001) and previous pain on subsequent poor sleep at T2 (β=.080; P<.001) and T3 (β=.093; P<.001). The indirect effects of previous sleep disorders on pain through depressive symptoms (β=.020; SE 0.004; P<.001; effect size 21.98%), as well as previous pain on sleep disorders through depressive symptoms (β=.012; SE 0.002; P<.001; effect size 20.69%), were significant across the 3 time intervals. Among participants with high levels of social participation, there were no statistically significant effects of previous sleep disorders on subsequent pain at T2 (β=.048; P=.15) and T3 (β=.085; P=.02), nor were there statistically significant effects of previous pain on subsequent sleep disorders at T2 (β=.037; P=.15) and T3 (β=.039; P=.24). Additionally, the mediating effects of depressive symptoms on the sleep disorders-to-pain pathway (P=.14) and the pain-to-sleep disorders pathway (P=.02) were no longer statistically significant. CONCLUSIONS There is a bidirectional relationship between sleep disorders and pain in middle- and old-aged Asians; depression plays a longitudinal mediating role in the bidirectional relationship between them; and social participation moderates the bidirectional relationship between them directly and indirectly by affecting depression. Future interventions may consider the complex relationship between these conditions and adopt a comprehensive treatment regime.
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Affiliation(s)
- Si Fan
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Qianning Wang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Feiyang Zheng
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yuanyang Wu
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Tiantian Yu
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yanting Wang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xinping Zhang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Dexing Zhang
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong
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Wang Y, Fu P, Li J, Gao T, Jing Z, Wang Q, Zhao D, Zhou C. Community-Level Social Support to Mitigate the Impact of Combined Frailty and Multimorbidity on Psychological Distress Among Rural Chinese Older Adults During the COVID-19 Pandemic: Multilevel Modeling Study. JMIR Public Health Surveill 2023; 9:e43762. [PMID: 36811848 PMCID: PMC10037180 DOI: 10.2196/43762] [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: 10/23/2022] [Revised: 02/07/2023] [Accepted: 02/14/2023] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND Accumulating research provides evidence that the psychological health of older people deteriorated from before to during the COVID-19 pandemic. Unlike robust individuals, coexisting frailty and multimorbidity expose older adults to more complicated and wide-ranging stressors. Community-level social support (CSS) is also an important impetus for age-friendly interventions, and it is 1 of the components of social capital that is seen as an ecological-level property. To date, we have not found research that examines whether CSS buffered the adverse impacts of combined frailty and multimorbidity on psychological distress in a rural setting during COVID-19 in China. OBJECTIVE This study explores the combined effect of frailty and multimorbidity on psychological distress in rural Chinese older adults during the COVID-19 pandemic and examines whether CSS would buffer the aforementioned association. METHODS Data used in this study were extracted from 2 waves of the Shandong Rural Elderly Health Cohort (SREHC), and the final analytic sample included 2785 respondents who participated in both baseline and follow-up surveys. Multilevel linear mixed effects models were used to quantify the strength of the longitudinal association between frailty and multimorbidity combinations and psychological distress using 2 waves of data for each participant, and then, cross-level interactions between CSS and combined frailty and multimorbidity were included to test whether CSS would buffer the adverse impact of coexisting frailty and multimorbidity on psychological distress. RESULTS Frail older adults with multimorbidity reported the most psychological distress compared to individuals with only 1 or none of the conditions (β=.68, 95% CI 0.60-0.77, P<.001), and baseline coexisting frailty and multimorbidity predicted the most psychological distress during the COVID-19 pandemic (β=.32, 95% CI 0.22-0.43, P<.001). Further, CSS moderated the aforementioned association (β=-.16, 95% CI -0.23 to -0.09, P<.001), and increased CSS buffered the adverse effect of coexisting frailty and multimorbidity on psychological distress during the COVID-19 pandemic (β=-.11, 95% CI -0.22 to -0.01, P=.035). CONCLUSIONS Our findings suggest that more public health and clinical attention should be paid to psychological distress among multimorbid older adults with frailty when facing public health emergencies. This research also suggests that community-level interventions prioritizing social support mechanisms, specifically improving the average levels of social support within communities, may be an effective approach to alleviate psychological distress for rural older adults who concurrently manifest frailty and multimorbidity.
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Affiliation(s)
- Yi Wang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Peipei Fu
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Jie Li
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Tingting Gao
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Zhengyue Jing
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Qiong Wang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Dan Zhao
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Chengchao Zhou
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- National Health Commission Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
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Xu J, Xu J, Chen Y, Wang Y, Qin G, Gao J. Associations between trajectories of social participation and functional ability among older adults: Results from the China Health and Retirement Longitudinal Study. Front Public Health 2022; 10:1047105. [PMID: 36530681 PMCID: PMC9751478 DOI: 10.3389/fpubh.2022.1047105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Accepted: 11/15/2022] [Indexed: 12/03/2022] Open
Abstract
Introduction Functional ability (FA) and social participation (SP) are important indicators of healthy aging, both their trajectories are heterogeneous. It is little known about how the SP trajectories affects FA trajectories. Methods FA was assessed by 20 items covering the ability of meeting basic needs and mobility. SP was assessed by frequency of participating in 10 social activities. Group-based trajectory modeling (GBTM) was used to identify the trajectories of FA and SP of the participants. Results Two FA trajectories were identified: low baseline-decline tendency (16.1%) and high baseline-stable tendency (83.9%) trajectories. Two SP trajectories were also identified: low baseline-stable tendency (58.5%) and high baseline-increase tendency (41.5%) trajectories. After controlling for the potential covariates, participants among the high baseline-increase tendency SP trajectory group also had significantly higher odds ratios to be belonged in high baseline-stable tendency FA trajectory group (ORs = 2.64, 95%CI = 1.98-3.05). Conclusions High-increasing social participation had a protective effect to maintain high baseline-stable tendency functional ability among older adults. These findings suggest social participation appears to have great benefits on promoting healthy aging in China.
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Affiliation(s)
- Jiaqin Xu
- School of Public Health, Fudan University, Shanghai, China
| | - Jixiang Xu
- School of Public Health, Fudan University, Shanghai, China
| | - Yingwei Chen
- School of Public Health, Fudan University, Shanghai, China
| | - Yujie Wang
- School of Public Health, Fudan University, Shanghai, China
| | - Guoyou Qin
- School of Public Health, Fudan University, Shanghai, China
| | - Junling Gao
- School of Public Health, Fudan University, Shanghai, China
- Collaborative Innovation Cooperative Unit of National Clinical Research Center for Geriatric Diseases, Shanghai, China
- Core Unit of Shanghai Clinical Research Center for Geriatric Diseases, Shanghai, China
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Li J, Okoye S, Dwivedi P, Sciarratta L, Li M, Taylor J, Szanton SL. Promoting sleep in low-income older adults with disabilities: Comparing CAPABLE with a social engagement control. Geriatr Nurs 2022; 47:220-225. [PMID: 35944382 PMCID: PMC10167677 DOI: 10.1016/j.gerinurse.2022.07.016] [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: 05/31/2022] [Revised: 07/20/2022] [Accepted: 07/21/2022] [Indexed: 11/16/2022]
Abstract
Sleep plays a vital role in older adults' health. The Community Aging in Place-Advancing Better Living for Elders (CAPABLE) trial, conducted in Maryland between 2012 and 2016, is a 5-month biobehavioral environmental intervention study to reduce functional disabilities in 300 low-income older adults. Individual and environmental factors impacting sleep were addressed in CAPABLE. This secondary data analysis was to test the preliminary effect of CAPABLE on actigraph-measured sleep, compared with a social engagement control in 73 CAPABLE participants with pretest-posttest actigraph data. Participants in this analysis were aged 75.8±7.5 years; 86.3% of them were females and 84.9% were Black/African Americans. Both CAPABLE intervention and social engagement control improved sleep efficiency and reduced sleep onset latency. The effect of CAPABLE on sleep was comparable to social engagement. These findings underline the importance of promoting physical function and maintaining social activity for sleep in low-income older adults with disabilities.
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Affiliation(s)
- Junxin Li
- Johns Hopkins University School of Nursing, Baltimore, United States.
| | - Safiyyah Okoye
- Johns Hopkins University School of Nursing, Baltimore, United States
| | - Pallavi Dwivedi
- Johns Hopkins University School of Nursing, Baltimore, United States
| | - Lena Sciarratta
- Johns Hopkins University School of Nursing, Baltimore, United States
| | - Mengchi Li
- Johns Hopkins University School of Nursing, Baltimore, United States
| | - Janiece Taylor
- Johns Hopkins University School of Nursing, Baltimore, United States
| | - Sarah L Szanton
- Johns Hopkins University School of Nursing, Baltimore, United States
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Zhang S, Wang Q, Wang X, Qi K, Zhou Y, Zhou C. Pet ownership and cognitive frailty among Chinese rural older adults who experienced a social loss: Is there a sex difference? Soc Sci Med 2022; 305:115100. [PMID: 35690032 DOI: 10.1016/j.socscimed.2022.115100] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 05/04/2022] [Accepted: 05/30/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND The loss of a spouse (widowed or divorced) is one of the most common forms of social loss in older adults. However, evidence is limited regarding whether social loss is associated with cognitive frailty. Maintaining pets has become increasingly popular. Despite its health benefits, little is known about whether pet ownership can buffer cognitive frailty in older adults facing social loss. Here, we examined the role of pet ownership in the relationship between social loss and cognitive frailty among males and females older adults living in rural China. METHODS A total of 2638 rural older adults were analysed. Binary logistic regression analyses were conducted to explore risk or protective factors associated with cognitive frailty. Participants were categorised into four groups according to social loss and pet ownership assessment: (i) no social loss + own pet, (ii) no social loss + no pet, (iii) social loss + own pet, and (iv) social loss + no pet. Binary logistic regression was also performed to examine the interaction effects of social loss and pet ownership on cognitive frailty stratified by sex. RESULTS Regardless of pet ownership, spousal loss was associated with cognitive frailty for men and women. Female participants who experienced loss without a pet had a significantly higher risk of cognitive frailty. However, we did not observe a significant association between pet ownership and cognitive frailty among men who experienced loss. CONCLUSIONS Our findings highlight the buffering effect of pet ownership on cognitive frailty in older women experiencing social loss. This implies that targeted support for older adults of different sexes who experienced social losses may be effective in preventing cognitive frailty in rural China.
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Affiliation(s)
- Shimin Zhang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China; NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China
| | - Qiong Wang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China; NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China
| | - Xiyuan Wang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China; NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China
| | - Kaili Qi
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China; NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China
| | - Yanxin Zhou
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China; NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China
| | - Chengchao Zhou
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China; NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China.
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Lin H, Xiao S, Shi L, Zheng X, Xue Y, Yun Q, Ouyang P, Wang D, Zhu H, Zhang C. Impact of Multimorbidity on Symptoms of Depression, Anxiety, and Stress in Older Adults: Is There a Sex Difference? Front Psychol 2022; 12:762310. [PMID: 34992564 PMCID: PMC8724032 DOI: 10.3389/fpsyg.2021.762310] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 11/22/2021] [Indexed: 12/25/2022] Open
Abstract
Introduction: Multimorbidity has become a key issue in the health care sector globally, and it can also lead to psychological distress in older adults. This study aimed to assess the impact of multimorbidity on depression, anxiety, and stress symptoms and identify whether there is a sex difference in these associations. Methods: A cross-sectional study using a multistage random sampling method was conducted among 3,266 older adults in China. Multiple linear regression models were used to estimate the independent associations between multimorbidity and depression, anxiety, and stress symptoms. Furthermore, interaction analysis was employed to investigate the interaction effect of multimorbidity and sex on depression, anxiety, and stress symptoms. Results: A total of 3,250 participants aged 60 years and older were included in this study. Our findings suggest that multimorbidity is strongly positively associated with depression, anxiety, and stress symptoms. In addition, the positive relations between multimorbidity and depression, anxiety, and stress symptoms are stronger for older female than male adults. Conclusion: Old adults with multimorbidity are more likely have depression, anxiety, and stress symptoms. This study offers new insight for the mental health from the perspective of multimorbidity among older people, implies that encouraging the accessibility of treatment for multimorbidity in older people with different sex may be effective in promoting mental health in China.
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Affiliation(s)
- Huang Lin
- Shool of Public Health, Southern Medical University, Guangzhou, China.,School of Health Management, Southern Medical University, Guangzhou, China.,The First School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Shujuan Xiao
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Lei Shi
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Xiao Zheng
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Yaqing Xue
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Qilong Yun
- Tandon School of Engineering, New York University, New York, NY, United States
| | - Ping Ouyang
- Department of Health Management, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Dong Wang
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Hong Zhu
- The First School of Clinical Medicine, 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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Yang L, Wang H, Cheng J. Association between social capital and sleep duration among rural older adults in China. BMC Public Health 2022; 22:12. [PMID: 34986811 PMCID: PMC8734274 DOI: 10.1186/s12889-021-12441-w] [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: 05/10/2021] [Accepted: 12/17/2021] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE Sleep disturbances are great challenges to older adults' health promotion. The study tested gender differences in the association between different dimensions of social capital and self-reported sleep duration of Chinese rural older adults. DESIGN The data of rural older adults were extracted from a national cross-sectional survey of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) and analyzed in this study. SETTING CLHLS covered 23 provinces in China. PARTICIPANTS The 6552 rural respondents aged ≥65 years old were involved. MAIN OUTCOME MEASURES Generalized trust, informal social participation, formal social participation and social support were used to assess social capital. Self-reported sleep duration was measured as health outcome. RESULTS Low level of generalized trust had harmful effect on insufficient sleep (AOR 1.110, 95% CI 1.018-1.324), and having no formal or informal social participation was significantly positively associated with long sleep (AORformal 1.424, 95% CI 1.007-2.013; AORinformal 1.241, 95% CI 1.016-1.516). Rural older female adults with no emotional social support had higher odds of insufficient sleep (AOR 1.502, 95% CI 1.258-1.978). Meanwhile, both informal and formal social participation showed inverse association with long sleep for females. CONCLUSIONS This study found the relationship between social capital, sleep duration and the gender differences in Chinese rural older adults. More targeted sleep disturbance interventions could be taken in social capital of rural older adults, and gender differences should be considered when making social capital-embedded health promotion policies and interventions.
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Affiliation(s)
- Le Yang
- School of Management, Shanxi Medical University, 56 Xinjian South Road, Taiyuan, Shanxi Province, China.
| | - Hongman Wang
- School of Health Humanities, Peking University, 38 Xueyuan Road, Haidian, Beijing, China
| | - Jingmin Cheng
- School of Management, Shanxi Medical University, 56 Xinjian South Road, Taiyuan, Shanxi Province, China
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10
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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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