1
|
Xu YH, Wu F, Yu S, Guo YN, Zhao RR, Zhang RL. Therapeutic sleep deprivation for major depressive disorder: A randomized controlled trial. J Affect Disord 2024; 361:10-16. [PMID: 38844163 DOI: 10.1016/j.jad.2024.06.005] [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: 10/11/2023] [Revised: 04/01/2024] [Accepted: 06/02/2024] [Indexed: 06/10/2024]
Abstract
BACKGROUND Major depressive disorder (MDD) is treated primarily using antidepressant drugs, but clinical effects may be delayed for weeks to months. This study investigated the efficacy of brief therapeutic sleep deprivation (TSD) for inducing rapid improvements in MDD symptoms. METHODS From November 2020 to February 2023, 54 inpatients with MDD were randomly allocated to TSD and Control groups. The TSD group (23 cases) remained awake for 36 h, while the Control group (31 cases) maintained regular sleep patterns. All participants continued regular drug therapy. Mood was assessed using the 24-item Hamilton Depression Scale (HAMD-24) at baseline and post-intervention in both groups. In the TSD group, the Visual Analogue Scale (VAS) was utilized to evaluate subjective mood during and after the intervention. Cognitive function was assessed at baseline and post-intervention using the Montreal Cognitive Assessment (MoCA). Objective sleep parameters were recorded in the TSD group by polysomnography. The follow-up period spanned one week. RESULTS HAMD-24 scores did not differ between groups at baseline or post-intervention. However, the clinical response rate was 34.8 % higher in the TSD group on day 3 post-intervention compared to the Control group (3.2 %), but not sustained by day 7. Moreover, responders demonstrated a faster improvement in the VAS score during TSD than non-responders (p = 0.047). There were no significant differences in MoCA scores or objective sleep parameters between the groups. LIMITATIONS Small sample size and notable attrition rate. CONCLUSIONS Therapeutic sleep deprivation can rapidly improve MDD symptoms without influencing sleep parameters or cognitive functions. Assessment of longer-term effects and identification of factors predictive of TSD response are warranted.
Collapse
Affiliation(s)
- Ya-Hui Xu
- Department of Sleep Medicine, Second Affiliated Hospital of Xinxiang Medical University; Henan Collaborative Innovation Center for Prevention and Treatment of Mental Disorders; Brain Institute, Henan Academy of Innovations in Medical Science, Xinxiang, China.
| | - Fang Wu
- Department of Sleep Medicine, Second Affiliated Hospital of Xinxiang Medical University; Henan Collaborative Innovation Center for Prevention and Treatment of Mental Disorders; Brain Institute, Henan Academy of Innovations in Medical Science, Xinxiang, China
| | - Shuai Yu
- Department of Sleep Medicine, Second Affiliated Hospital of Xinxiang Medical University; Henan Collaborative Innovation Center for Prevention and Treatment of Mental Disorders; Brain Institute, Henan Academy of Innovations in Medical Science, Xinxiang, China
| | - Ya-Nan Guo
- Department of Sleep Medicine, Second Affiliated Hospital of Xinxiang Medical University; Henan Collaborative Innovation Center for Prevention and Treatment of Mental Disorders; Brain Institute, Henan Academy of Innovations in Medical Science, Xinxiang, China
| | - Rong-Rong Zhao
- Psychiatry Department, First Affiliated Hospital of Henan University of Science and Technology, Luoyang, China
| | - Rui-Ling Zhang
- Department of Sleep Medicine, Second Affiliated Hospital of Xinxiang Medical University; Henan Collaborative Innovation Center for Prevention and Treatment of Mental Disorders; Brain Institute, Henan Academy of Innovations in Medical Science, Xinxiang, China
| |
Collapse
|
2
|
Sakimoto M, Igusa T, Kobayashi T, Uchida H, Fukazawa A, Machida C, Fujii H, Sekine K, Kurosaki M, Tsuchiya K, Kikuchi S, Hirao K. Effects of a video-viewing intervention with positive word stimulation on the depressive symptoms of older patients with cardiac disease and subthreshold depression: a pilot randomized controlled trial protocol. Biopsychosoc Med 2024; 18:16. [PMID: 39014477 PMCID: PMC11251332 DOI: 10.1186/s13030-024-00312-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 07/11/2024] [Indexed: 07/18/2024] Open
Abstract
BACKGROUND Intervention for older patients with cardiac disease and subthreshold depression (StD) may be an effective strategy to prevent the development of major depressive disorder. The subliminal priming with supraliminal reward stimulation (SPSRS) website developed by us is an advanced intervention that can improve depressive symptoms in individuals with StD by presenting positive word stimuli in videos. However, its efficacy for treating depressive symptoms in older patients with cardiac disease and StD has not been investigated. Here, we present a pilot randomized controlled trial protocol to investigate the preliminary efficacy of an intervention for older patients with cardiac disease with StD. METHODS The study was designed as a single-center, open-label, pilot, randomized, parallel-group trial. The participants will include 30 older patients with cardiac disease and StD who are hospitalized in acute wards. The Experimental group received the SPSRS intervention (video viewing with positive word stimuli; n = 15) and the Control group will receive the YouTube intervention (video viewing without positive word stimuli; n = 15). In both groups, the intervention will be administered for 10 min per day, five times per week for 1 week. The primary outcome will be the change in the scores on the Japanese version of the Beck Depression Inventory-II at 1 week after the baseline assessment. The secondary outcomes will be the changes in the Specific Activity Scale, New York Heart Association functional classification, as well as grip strength at 1 week after the baseline assessment. DISCUSSION This pilot randomized controlled trial will be the first to evaluate the SPSRS intervention for depressive symptoms in older patients with cardiac disease and StD who are admitted to acute wards. The results will provide tentative indications regarding the impact of the intervention on depressive symptoms among older patients with cardiac disease and StD who are admitted to acute wards, and will contribute to the planning of a full-scale study. TRIAL REGISTRATION UMIN, UMIN000052155. Registered September 8, 2023, https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000059526 . This study was registered with the University Hospital Medical Information Network (UMIN) (UMIN000052155) in Japan.
Collapse
Affiliation(s)
- Masataka Sakimoto
- Graduate School of Health Sciences, Gunma University, 3-39-22 Showa, Maebashi, Gunma, 371-8514, Japan
- Department of Rehabilitation, Fujioka General Hospital, Fujioka, Japan
| | - Takumi Igusa
- Graduate School of Health Sciences, Gunma University, 3-39-22 Showa, Maebashi, Gunma, 371-8514, Japan
- Department of Rehabilitation, Medical Corporation Taiseikai, Uchida Hospital, Numata, Japan
| | - Takuya Kobayashi
- Graduate School of Health Sciences, Gunma University, 3-39-22 Showa, Maebashi, Gunma, 371-8514, Japan
- Department of Rehabilitation, Japan Community Healthcare Organization, Gunma Chuo Hospital, Maebashi, Japan
| | - Hiroyuki Uchida
- Graduate School of Health Sciences, Gunma University, 3-39-22 Showa, Maebashi, Gunma, 371-8514, Japan
- Department of Rehabilitation, Kurashiki Heisei Hospital, Kurashiki, Japan
| | - Aya Fukazawa
- Department of Rehabilitation, Fujioka General Hospital, Fujioka, Japan
| | - Chihaya Machida
- Department of Rehabilitation, Fujioka General Hospital, Fujioka, Japan
| | - Hirokuni Fujii
- Department of Rehabilitation, Fujioka General Hospital, Fujioka, Japan
| | - Keisuke Sekine
- Department of Rehabilitation, Fujioka General Hospital, Fujioka, Japan
| | - Minori Kurosaki
- Department of Rehabilitation, Fujioka General Hospital, Fujioka, Japan
| | - Kenji Tsuchiya
- Department of Rehabilitation, Faculty of Health Sciences, Nagano University of Health and Medicine, Nagano, Japan
| | - Senichiro Kikuchi
- Graduate School of Health Sciences, Gunma University, 3-39-22 Showa, Maebashi, Gunma, 371-8514, Japan
| | - Kazuki Hirao
- Graduate School of Health Sciences, Gunma University, 3-39-22 Showa, Maebashi, Gunma, 371-8514, Japan.
| |
Collapse
|
3
|
How EH, Chin SM, Teo CH, Parhar IS, Soga T. Accelerated biological brain aging in major depressive disorder. Rev Neurosci 2024; 0:revneuro-2024-0025. [PMID: 39002110 DOI: 10.1515/revneuro-2024-0025] [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: 02/07/2024] [Accepted: 06/26/2024] [Indexed: 07/15/2024]
Abstract
Major depressive disorder (MDD) patients commonly encounter multiple types of functional disabilities, such as social, physical, and role functioning. MDD is related to an accreted risk of brain atrophy, aging-associated brain diseases, and mortality. Based on recently available studies, there are correlations between notable biological brain aging and MDD in adulthood. Despite several clinical and epidemiological studies that associate MDD with aging phenotypes, the underlying mechanisms in the brain remain unknown. The key areas in the study of biological brain aging in MDD are structural brain aging, impairment in functional connectivity, and the impact on cognitive function and age-related disorders. Various measurements have been used to determine the severity of brain aging, such as the brain age gap estimate (BrainAGE) or brain-predicted age difference (BrainPAD). This review summarized the current results of brain imaging data on the similarities between the manifestation of brain structural changes and the age-associated processes in MDD. This review also provided recent evidence of BrainPAD or BrainAGE scores in MDD, brain structural abnormalities, and functional connectivity, which are commonly observed between MDD and age-associated processes. It serves as a basis of current reference for future research on the potential areas of investigation for diagnostic, preventive, and potentially therapeutic purposes for brain aging in MDD.
Collapse
Affiliation(s)
- Eng Han How
- 65210 Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia , Jalan Lagoon Selatan, Bandar Sunway, 47500, Selangor, Malaysia
| | - Shar-Maine Chin
- 65210 Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia , Jalan Lagoon Selatan, Bandar Sunway, 47500, Selangor, Malaysia
| | - Chuin Hau Teo
- 65210 Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia , Jalan Lagoon Selatan, Bandar Sunway, 47500, Selangor, Malaysia
| | - Ishwar S Parhar
- Center Initiatives for Training International Researchers (CiTIR), University of Toyama, Gofuku, 930-8555 Toyama, Japan
| | - Tomoko Soga
- 65210 Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia , Jalan Lagoon Selatan, Bandar Sunway, 47500, Selangor, Malaysia
| |
Collapse
|
4
|
Sowan W, Yagil D, Cohen M. Self-employed people with chronic health conditions: Business maintenance and well-being. Stress Health 2024:e3445. [PMID: 39003602 DOI: 10.1002/smi.3445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Revised: 05/18/2024] [Accepted: 07/05/2024] [Indexed: 07/15/2024]
Abstract
Chronic health conditions (CHCs) involve physical, psychological, and social challenges and can have a significant negative impact on work ability, which can then affect performance and job satisfaction. However, the various effects of CHCs on business operations and maintenance among self-employed workers are understudied. This study examined four common CHCs that are characterised by persistent symptoms and can prompt major life changes: respiratory disease, heart conditions, inflammatory bowel disease, and cancer survivorship. Groups were compared regarding the CHC's impact on business maintenance (declining in income and activity, and slowing business growth), and well-being. A sample of 294 self-employed workers with these CHCs completed questionnaires about how their conditions affect their businesses, physical symptoms, and well-being. The four CHCs had substantial negative effects on business maintenance. Differences were found in reported changes in income, activity, and growth between individuals with inflammatory bowel disease and cancer. No differences in well-being occurred among self-employed people with different CHCs. In the overall sample, work absences and slowing business growth were negatively associated with well-being. Although the groups differed in the severity of symptoms, threat to life, and treatment regimen, the CHCs had similar effects on most business maintenance factors and well-being. Moreover, the results indicate that the inability to maintain a business can negatively affect well-being.
Collapse
Affiliation(s)
- Wafaa Sowan
- School of Social Work, University of Haifa, Haifa, Israel
| | - Dana Yagil
- Department of Human Services, University of Haifa, Haifa, Israel
| | - Miri Cohen
- School of Social Work, University of Haifa, Haifa, Israel
| |
Collapse
|
5
|
Wang Q, Huang X, Liu M, Wang C, Sun Z, Huang C, Tang S. Prevalence and risk factors of depression among elderly people in nursing homes from 2012 to 2022: a systematic review and meta-analysis. Aging Ment Health 2024:1-12. [PMID: 38952191 DOI: 10.1080/13607863.2024.2367044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 02/20/2024] [Indexed: 07/03/2024]
Abstract
OBJECTIVES To determine a pooled prevalence of depression and its influencing factors among nursing home residents. METHOD PsycINFO, PubMed, Embase, and Web of Science were searched for studies investigating the prevalence and risk factors of late-life depression among nursing home residents between January 2012 and November 2022. Two reviewers independently completed the literature screening, data extraction and quality assessment. A random-effects model was utilized to pool the prevalence of depression and summarize the influencing factors. RESULTS This meta-analysis included 48 studies involving 28,501 participants. The pooled prevalence of depressive mood and major depressive disorder was 53% and 27%, respectively. The rate of depressive mood is higher in lower-middle-income countries (60.0%), compared with high- (53.0%) and upper-middle-income countries (44.0%). The rate of depressive mood (35.0%) is higher among females than male (19.0%). Depression was influenced by factors, including male (OR = 0.28), insufficient income (OR = 3.53), comorbidities (OR = 2.66), pain (OR = 2.67; r = 0.31), functional disability (r = 0.33), loneliness (r = 0.43), number of chronic health problems (r = 0.18), social support (r = -0.28), activities of daily living (r = -0.43), subjective health (r = -0.28), autonomy (r = -0.41), environment (r = -0.50) and physical (r = -0.57) and psychological health (r = -0.65). CONCLUSION The prevalence of depressive mood is high among nursing home residents, especially in lower-middle-income countries. It is influenced by factors including gender, income, social support, daily activities, environment, physical and psychological health and autonomy. Understanding those factors can provide evidence-based recommendations for improved awareness, prevention and better management of late-life depression.
Collapse
Affiliation(s)
- Qing Wang
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Xiaoting Huang
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Minhui Liu
- School of Nursing, Ningxia Medical University, Yinchuan, China
| | - Chunyu Wang
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Zaiqing Sun
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Chongmei Huang
- School of Nursing, Ningxia Medical University, Yinchuan, China
| | - Siyuan Tang
- Xiangya School of Nursing, Central South University, Changsha, China
| |
Collapse
|
6
|
Bai JJ, Ao M, Xing A, Yu LJ, Tong HY, Bao WY, Wang Y. Areca Thirteen Pill Improves Depression in Rat by Modulation of the Chemokine/Chemokine Receptor Axis. Mol Neurobiol 2024; 61:4633-4647. [PMID: 38110645 DOI: 10.1007/s12035-023-03855-1] [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: 08/31/2023] [Accepted: 11/27/2023] [Indexed: 12/20/2023]
Abstract
Depressive disorder is a severe and complex mental illness. There are a few anti-depressive medications that can reduce depressive symptoms, but with adverse or side effects. GaoYou-13 (GY-13), commonly known as Areca Thirteen Pill, is a traditional medicine for depression treatment with significant clinical impact. However, the molecular mechanism of GY-13 has not been fully elucidated. This study aimed to explore and explain the action and mechanism of GY-13 in treatment for depression. SD male rats were stimulated differently daily for 42 days to construct a depression rat model and divided into six groups: the control, CUMS model, GY-13L, GY-13 M, GY-13H, and FLUO. The body weight of was measured on day 7, 14, 21, 28, 35, and 42 or different days, and the behavioral tests (Open-field test, Sucrose preference test, Morris water maze) were made alongside. After the rats were decapitated, the rat brains were stained with Nissl or H&E dyes. The serums of TNF-α and IL-1β were tested. The protein of p-IKKα, p-IкBα, and p-NFкBp65 was traced. Then nano-LC-MS/MS analysis was made to detect the mechanism of GY-13. The active ingredients, drug targets, and key pathways of GY-13 in treating depression were analyzed through network pharmacology and molecular docking. With immunohistochemistry, quantitative RT-PCR, and western-blot techniques, the therapeutic mechanism of GY-13 was traced and analyzed. This study revealed that GY-13 significantly enhances autonomous and exploratory behavior, sucrose consumption, learning and memory ability, and hippocampal neuronal degeneration, which inhibits inflammation. In addition, omics analysis showed several proteins were altered in the hippocampus of rats following CUMS and GY-13 treatment. Bioinformatics analysis and network pharmacology revealed the antidepressant effects of GY-13 are related to the chemokine/chemokine receptor axis. Immunohistochemistry, western blotting and RT-PCR assay further support the findings of omics analysis. We highlighted the importance of the chemokine/chemokine receptor axis in the treatment of depression, as well as showed GY-13 can be used as a novel targeted therapy for depression treatment.
Collapse
Affiliation(s)
- Jing-Jing Bai
- Key Laboratory of Basic Pharmacology of Ministry of Education, Joint International Research Laboratory of Ethnomedicine of Ministry of Education, Zunyi Medical University, Zunyi, Guizhou, 563006, People's Republic of China
- Tongliao Institute of agriculture and animal husbandry, Tongliao, Inner Mongolia, People's Republic of China
| | - Min Ao
- Affiliated Hospital of Inner Mongolia Minzu University, Tongliao, Inner Mongolia, People's Republic of China
| | - An Xing
- Affiliated Hospital of Inner Mongolia Minzu University, Tongliao, Inner Mongolia, People's Republic of China
| | - Li-Jun Yu
- Inner Mongolia Minzu University, Tongliao, Inner Mongolia, People's Republic of China
| | - Hai-Ying Tong
- Affiliated Hospital of Inner Mongolia Minzu University, Tongliao, Inner Mongolia, People's Republic of China
| | - Wu-Ye Bao
- Affiliated Hospital of Inner Mongolia Minzu University, Tongliao, Inner Mongolia, People's Republic of China.
| | - Yu Wang
- Key Laboratory of Basic Pharmacology of Ministry of Education, Joint International Research Laboratory of Ethnomedicine of Ministry of Education, Zunyi Medical University, Zunyi, Guizhou, 563006, People's Republic of China.
| |
Collapse
|
7
|
Shu C, Zheng C, Du X, Luo D. Exploring the role of vitamin D in cognitive function: mediation by depression with diabetes modulation in older U.S. adults, a NHANES weighted analysis. Front Nutr 2024; 11:1356071. [PMID: 38895660 PMCID: PMC11183290 DOI: 10.3389/fnut.2024.1356071] [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: 12/18/2023] [Accepted: 05/24/2024] [Indexed: 06/21/2024] Open
Abstract
Background The relationship between vitamin D levels, depressive symptoms, and cognitive function has yet to be definitively understood in the elderly, particularly when considering the impact of chronic diseases. This study focuses on how depression mediates the impact of 25-hydroxyvitamin D3 (25(OH)D3) on cognitive performance in older U.S. adults. Methods We analyzed data from 2,745 elderly individuals extracted from the NHANES 2011-2014 cycles, applying weighted processing to account for the complex multi-stage sampling design characteristic of NHANES data. Utilizing weighted data for covariate and model selection, we conducted mediation analyses on both the overall population and subgroup data. Significant mediation pathways were validated using a stratified weighted bootstrap approach. For significant subgroup pathways, we explored interactive mechanisms through interactive mediation analysis. Results Mediation analyses, thoroughly accounting for the impact of chronic conditions, revealed significant pathways in both the weighted overall population and the weighted diabetes subgroup. After 1,000 stratified weighted bootstrap replications, the proportion of mediation effects were 10.6% [0.040, 0.268] and 20.9% [0.075, 0.663], respectively. Interactive mediation analysis for diabetes indicated that the interaction between diabetes and depression was not significant in the direct pathway (estimates = 0.050, p = 0.113) but was significant in the mediation pathway, yielding the largest effect size compared to other covariates (estimates = 0.981, p < 0.001). Conclusion This study highlights the mediating role of depression in the relationship between vitamin D levels and cognitive function in the elderly, particularly emphasizing diabetes as a key moderator. Our findings suggest targeted interventions addressing both vitamin D sufficiency and depression could significantly benefit cognitive health, especially in diabetic individuals.
Collapse
Affiliation(s)
- Chang Shu
- Tianjin Key Laboratory of Cerebral Vascular and Neurodegenerative Diseases, Tianjin Neurosurgical Institute, Tianjin Huanhu Hospital, Tianjin, China
| | - Chenguang Zheng
- Tianjin Key Laboratory of Brain Science and Neural Engineering, Tianjin University, Tianjin, China
| | - Xin Du
- Tianjin Huanhu Hospital, Tianjin, China
| | - Da Luo
- Tianjin Huanhu Hospital, Tianjin, China
| |
Collapse
|
8
|
Jin W, Felix MS, Paek SC, Lamy FR. Social Activities and Depressive Symptoms Among Elderly Based on Rural and Urban Differences in China: a National Cross-Sectional Study. Psychol Res Behav Manag 2024; 17:2243-2254. [PMID: 38855479 PMCID: PMC11162184 DOI: 10.2147/prbm.s460453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 05/28/2024] [Indexed: 06/11/2024] Open
Abstract
Objective Depression has become an important global public health problem. Despite the government's efforts, the outlook regarding the health issue of elderly depression in China is still not optimistic. This study explored the association between social activities and depressive symptoms among Chinese urban and rural elderly. Methods Data were collected from the 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS). The study sample included 5101 Chinese adults aged ≥ 65 years. Depressive symptoms were assessed using the 10-item Center for Epidemiologic Studies Depression Scale. Binary logistic regression analyses were used to explore the relationship between social activities and depressive symptoms. Results The prevalence rate of depressive symptoms in rural elderly is 1.37 times higher than that in urban elderly. The proportion of elderly persons participating in a social activity less than once monthly, or never having participated in social activities is higher in rural areas than in urban areas. The results from the logistic regression model analysis show that among rural elderly, visiting others' homes or interacting with friends at least once a month or once a week is positively associated with depressive symptoms. Playing cards or mahjong at least once a week or almost daily is negatively associated with depressive symptoms. Participating in organized social activities once a month is negatively associated with depressive symptoms. None of these five activities significantly correlate with depressive symptoms among urban older adults. Conclusion This study explored the differences in depressive symptoms among elderly populations in urban and rural China, as well as the impact of social activity participation on depressive symptoms. This study underscores the necessity of targeted social interventions in rural areas to enhance social participation among the elderly and reduce depressive symptoms.
Collapse
Affiliation(s)
- Weiyun Jin
- Department of Society and Health, Faculty of Social Sciences and Humanities, Mahidol University, Salaya, Thailand
- College of Humanities Education, Inner Mongolia Medical University, Hohhot, People’s Republic of China
| | - Mark Stephan Felix
- Department of Society and Health, Faculty of Social Sciences and Humanities, Mahidol University, Salaya, Thailand
| | - Seung Chun Paek
- Department of Society and Health, Faculty of Social Sciences and Humanities, Mahidol University, Salaya, Thailand
| | - François Rene Lamy
- Department of Society and Health, Faculty of Social Sciences and Humanities, Mahidol University, Salaya, Thailand
| |
Collapse
|
9
|
Wang Y, Zhang Y, Zhao C, Yang H, Ai C, Zhao W, Xu J. Genetic link between depression and musculoskeletal disorders: insights from Mendelian randomization analysis. Front Med (Lausanne) 2024; 11:1398203. [PMID: 38882662 PMCID: PMC11177873 DOI: 10.3389/fmed.2024.1398203] [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: 03/09/2024] [Accepted: 05/15/2024] [Indexed: 06/18/2024] Open
Abstract
Background The association between depression and musculoskeletal diseases has long been a subject of contentious debate. However, the causal relationship between the two remains uncertain. This study employs a two-sample Mendelian randomization (MR) analysis to investigate the causality between depression and six musculoskeletal diseases. Methods In this study, we performed MR analysis to systematically explore the causal relationship between depression and six musculoskeletal disorders. Single nucleotide polymorphisms (SNPs) that are linked to depression were employed as instrumental variables. To ensure robust and reliable conclusions, multiple analytical approaches were utilized, including inverse variance weighting(IVW), weighted median, and MR-Egger regression. Additionally, sensitivity analysis methods such as the MR-Egger intercept test, Cochran's Q test, leave-one-out analysis, and funnel plot were employed. Results Our MR analysis revealed a significant association between depression and cervical spondylosis (depression: OR 1.003, 95% CI 1.002-1.005, P = 8.32E-05; major depressive disorder: OR 1.003, 95% CI 1.001-1.005, P = 0.0052). Furthermore, a strong correlation was noted between major depressive disorder (MDD) and knee osteoarthritis (KOA) (OR 1.299, 95% CI 1.154-1.463, P = 1.50E-5). Sensitivity analysis confirmed the robustness of these findings. Our independent validation study also corroborated these results. Conclusion The MR analysis conducted in this study provides evidence supporting a genetic link between depression and cervical spondylosis, as well as KOA. Targeted interventions to manage depression in susceptible populations may contribute to lowering the risk of cervical spondylosis and KOA in these cohorts.
Collapse
Affiliation(s)
- Yanpeng Wang
- Department of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, China
| | - Yinzhen Zhang
- Department of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, China
| | - Changwei Zhao
- Department of Orthopedics, Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, China
| | - Hao Yang
- Department of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, China
| | - Chenglong Ai
- Department of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, China
| | - Wenhai Zhao
- Department of Orthopedics, Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, China
| | - Ji Xu
- Department of Spinal Orthopedics, Weifang Hospital of Traditional Chinese Medicine, Shandong Second Medical University, Weifang, China
| |
Collapse
|
10
|
Pietrabissa G, Marchesi G, Gondoni LA, Castelnuovo G. Exploring the Relationship of Anxiety and Depressive Symptoms and Impulsiveness with the Quality of Life of Older Patients with Cardiovascular Disease: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:646. [PMID: 38791860 PMCID: PMC11121691 DOI: 10.3390/ijerph21050646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2024] [Revised: 05/09/2024] [Accepted: 05/16/2024] [Indexed: 05/26/2024]
Abstract
BACKGROUND This study aimed to evaluate the relationship of selected clinical (i.e., body mass index, BMI) and psychological factors (i.e., anxiety, depression, and impulsiveness) with the quality of life (QoL) of elderly patients with cardiovascular disease (CVD) in a single clinical center in Italy. METHODS A total of 238 patients of older age (≥65 years) with CVD who voluntarily attended a single clinical center for weight loss and cardiac rehabilitation were sequentially recruited and tested upon admission to the hospital based on pre-established inclusion criteria. RESULTS The findings indicated that anxiety and depressive symptoms were moderately associated with lower QoL. Additionally, there were noteworthy but minor negative connections between impulsivity and QoL. Furthermore, BMI was inversely associated with the perceived QoL of the participants, and when incorporated into the regression analysis, BMI alone significantly accounted for 11.8% of the variability in QoL. This percentage increased to 18.4% with the inclusion of impulsiveness in the model and further to 34.3% with the addition of anxiety and depressive symptoms. However, after introducing anxiety and depression, the association between impulsivity and QoL ceased to be statistically significant. CONCLUSIONS Integrating the routine assessment and treatment of psychological factors into the care of older patients with CVD is important for optimizing their overall health outcomes and improving their QoL.
Collapse
Affiliation(s)
- Giada Pietrabissa
- Department of Psychology, Catholic University of Milan, 20123 Milan, Italy; (G.M.); (G.C.)
- Clinical Psychology Research Laboratory, IRCCS Istituto Auxologico Italiano, Ospedale San Giuseppe, 28824 Oggebbio, Italy
| | - Gloria Marchesi
- Department of Psychology, Catholic University of Milan, 20123 Milan, Italy; (G.M.); (G.C.)
| | - Luca Alessandro Gondoni
- Division of Cardiological Rehabilitation, IRCCS Istituto Auxologico Italiano, Ospedale San Giuseppe, 28824 Oggebbio, Italy;
| | - Gianluca Castelnuovo
- Department of Psychology, Catholic University of Milan, 20123 Milan, Italy; (G.M.); (G.C.)
- Clinical Psychology Research Laboratory, IRCCS Istituto Auxologico Italiano, Ospedale San Giuseppe, 28824 Oggebbio, Italy
| |
Collapse
|
11
|
Li A, Sun Y, Li M, Wang D, Ma X. Effects of elastic band resistance training on the physical and mental health of elderly individuals: A mixed methods systematic review. PLoS One 2024; 19:e0303372. [PMID: 38739588 PMCID: PMC11090353 DOI: 10.1371/journal.pone.0303372] [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: 10/17/2023] [Accepted: 04/24/2024] [Indexed: 05/16/2024] Open
Abstract
OBJECTIVES Elastic band resistance training in elderly individuals can improve physical fitness and promote mental health in addition to other benefits. This systematic review aimed to review, summarize, and evaluate quantitative, qualitative, and mixed methodological studies on the use of elastic band resistance training in elderly individuals, and to investigate the influence of elastic band resistance training on the physical and mental health of elderly individuals, as well as their preferences and obstacles in training. METHODS A convergent separation approach was used to synthesize and integrate the results, specifically the mixed systematic review approach recommended by the Joanna Briggs Institute. The extensive search strategy included electronic database searches in the Cochrane Library, PubMed, Embase, Web of Science, Google Scholar, MEDLINE, and CINAHL. The researchers rigorously screened the literature, extracted and analyzed the data, and evaluated the quality of the included studies using the Mixed Methods Appraisal Tool (MMAT). RESULTS Twenty-eight studies were included, of which 25 were quantitative studies, 2 were qualitative studies, and 1 was a mixed-methods study. A total of 1,697 subjects were investigated across all studies. Quantitative evidence supports the notion that elastic band resistance training can improve upper and lower limb flexibility, endurance, upper strength, physical balance, and cardiopulmonary function and enhance the mental health of elderly individuals. Participants in the qualitative study reported some preferences and obstacles with band resistance training, but most participants reported physical benefits. CONCLUSIONS Despite the heterogeneity between studies, this review is the first systematic review to comprehensively evaluate the effectiveness of elastic band resistance training in older adults. It not only shows the influence of elastic band resistance training on the physical and mental health of the elderly, but also emphasizes the preference and obstacles of elderly individuals face.
Collapse
Affiliation(s)
- Aiying Li
- Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital, Chengdu, Sichuan, China
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Yan Sun
- Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital, Chengdu, Sichuan, China
- The Philippines Women’s University, Manila, Metro Manila, Philippines
| | - Meng Li
- The Philippines Women’s University, Manila, Metro Manila, Philippines
- The Third People’s Hospital of Hanan Provinnce, Zhengzhou, Henan, China
| | - Dongyang Wang
- Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital, Chengdu, Sichuan, China
- Binzhou Medical University, Binzhou, Shangdong, China
| | - Xiaofeng Ma
- Henan University of Chinese Medicine, Zhengzhou, Henan, China
| |
Collapse
|
12
|
Ye C, Wang T, Wang H, Lian G, Xie L. Causal relationship between genetic proxies for calcium channel blockers and the risk of depression: a drug-target Mendelian randomization study. Front Psychiatry 2024; 15:1377705. [PMID: 38800057 PMCID: PMC11117141 DOI: 10.3389/fpsyt.2024.1377705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Accepted: 04/17/2024] [Indexed: 05/29/2024] Open
Abstract
Background Calcium channel blockers (CCBs) are widely used in the clinical management of hypertension. Depression, a common comorbidity of hypertension, is an important issue in the management of hypertension. However, the impact of CCBs on depression risk remains controversial. We aim to investigate the causal effect of CCBs on depression through drug-target Mendelian randomization (MR) analysis. Methods To proxy CCBs, we utilized the genetic variations located in or around drug target genes that were related to systolic blood pressure (SBP). Coronary artery disease (CAD) served as the positive control outcome. Genetic summary data of SBP, CAD, and depression were obtained from genome-wide association studies (GWAS) based on European population. Inverse variance weighted (IVW) method was applied as the main analysis to estimate the causal effect. Cochran's Q test, MR-Egger intercept, MR pleiotropy residual sum and outlier (MR-PRESSO) and leave-one-out sensitivity analysis were used to test the robustness of the results. Meta-analysis was applied to further confirm whether causal relationships existed between CCBs and depression. Results The IVW results failed to reveal any causal relationship between genetic proxies for CCBs and depression (P > 0.05). Cochran's Q test showed no evidence of heterogeneity (P > 0.05). The MR-Egger intercept test suggested no evidence of directional pleiotropy, and the MR pleiotropy residual sum and outlier (MR-PRESSO) global test for horizontal pleiotropy was also not significant (P > 0.05). Leave-one-out analysis did not reveal any genetic variant that influenced the results. In addition, the meta-analysis further confirmed the absence of a causal relationship. Conclusion The present study indicates no association of genetic proxies for CCBs with depression. Further studies are necessary to provide definitive evidence.
Collapse
Affiliation(s)
- Chaoyi Ye
- Department of Geriatrics, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
- Fujian Hypertension Research Institute, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
- Department of Cardiology, Xiamen Cardiovascular Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
- Branch of National Clinical Research Center for Aging and Medicine, Fujian Province, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
- Fujian Provincial Clinical Research Center for Geriatric Hypertension Disease, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
- Department of Geriatrics, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Tingjun Wang
- Department of Geriatrics, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
- Fujian Hypertension Research Institute, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
- Branch of National Clinical Research Center for Aging and Medicine, Fujian Province, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
- Fujian Provincial Clinical Research Center for Geriatric Hypertension Disease, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
- Department of Geriatrics, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Huajun Wang
- Department of Geriatrics, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
- Fujian Hypertension Research Institute, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
- Branch of National Clinical Research Center for Aging and Medicine, Fujian Province, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
- Fujian Provincial Clinical Research Center for Geriatric Hypertension Disease, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
- Department of Geriatrics, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Guili Lian
- Department of Geriatrics, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
- Fujian Hypertension Research Institute, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
- Branch of National Clinical Research Center for Aging and Medicine, Fujian Province, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
- Fujian Provincial Clinical Research Center for Geriatric Hypertension Disease, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
- Department of Geriatrics, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Liangdi Xie
- Department of Geriatrics, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
- Fujian Hypertension Research Institute, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
- Branch of National Clinical Research Center for Aging and Medicine, Fujian Province, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
- Fujian Provincial Clinical Research Center for Geriatric Hypertension Disease, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
- Department of Geriatrics, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| |
Collapse
|
13
|
Nazari T, Moodi M, Fakhrzadeh H, Khodabakhshi H, Khorashadizadeh M, Arzaghi SM, Shoaee S, Varmaghani M, Ejtahed HS, Sharifi F. The association of depressive symptoms with handgrip strength and gait speed in community-dwelling older adults: data from the baseline phase of Birjand Longitudinal Aging Study. BMC Geriatr 2024; 24:393. [PMID: 38702602 PMCID: PMC11069203 DOI: 10.1186/s12877-024-04944-z] [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: 10/05/2023] [Accepted: 04/03/2024] [Indexed: 05/06/2024] Open
Abstract
BACKGROUND Depression is a multifaceted condition with a high prevalence and burden to society. Handgrip strength (HGS) and gait speed (GS) are indices of physical health, which is linked to mental health. Previous studies have shown heterogeneity among countries in the association of physical parameters and depression. In this study, we aimed to investigate the association of HGS and GS with depressive symptoms in older adults. METHODS This is a cross-sectional study analyzing data from the Birjand Longitudinal Aging Study, a cohort of community-dwelling older adults (≥ 60 years old). Depressive symptoms were assessed by the nine-item Patient Health Questionnaire. HGS was measured with a hand dynamometer in a sitting position, and GS was estimated by a 15-foot walk test at usual pace. RESULTS Compared to participants in the first quartile, those in the second quartile of HGS had significantly lower odds of suffering from depressive symptoms, while GS was not significantly associated with depressive symptoms. A higher HGS was associated with a lower risk of moderate depressive symptoms, while a higher GS was related to a lower risk of moderately severe and severe symptoms. CONCLUSIONS Our findings suggest that older people residing in Birjand, Iran with a moderate HGS are less likely to suffer from depressive symptoms than those with lower HGS.
Collapse
Affiliation(s)
- Tina Nazari
- Department of Medical Geriatrics, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mitra Moodi
- Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran
- School of Health, Birjand University of Medical Sciences, Birjand, Iran
| | - Hossein Fakhrzadeh
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Huriye Khodabakhshi
- Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Masoumeh Khorashadizadeh
- Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Seyed Masoud Arzaghi
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Shervan Shoaee
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Varmaghani
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hanieh-Sadat Ejtahed
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Farshad Sharifi
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
14
|
Ai F, Li E, Ji Q, Zhang H. Construction of a machine learning-based risk prediction model for depression in middle-aged and elderly hypertensive people in China: a longitudinal study. Front Psychiatry 2024; 15:1398596. [PMID: 38764471 PMCID: PMC11099225 DOI: 10.3389/fpsyt.2024.1398596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Accepted: 04/22/2024] [Indexed: 05/21/2024] Open
Abstract
Background Hypertension is a common chronic disease that can trigger symptoms such as anxiety and depression. Therefore, it is essential to predict their risk of depression. The aim of this study is to find the best prediction model and provide effective intervention strategies for health professionals. Methods The study subjects were 2733 middle-aged and older adults who participated in the China Health and Retirement Longitudinal Study (CHARLS) between 2018 and 2020. R software was used for Lasso regression analysis to screen the best predictor variables, and logistic regression, random forest and XGBoost models were constructed. Finally, the prediction efficiency of the three models was compared. Results In this study, 18 variables were included, and LASSO regression screened out 10 variables that were important for the establishment of the model. Among the three models, Logistic Regression model showed the best performance in various evaluation indicators. Conclusion The prediction model based on machine learning can accurately assess the likelihood of depression in middle-aged and elderly patients with hypertension in the next three years. And by combining Logistic regression and nomograms, we were able to provide a clear interpretation of personalized risk predictions.
Collapse
Affiliation(s)
| | | | | | - Huijun Zhang
- Department of Nursing, Jinzhou Medical University, Jinzhou, China
| |
Collapse
|
15
|
Aggarwal RA, Fields CD, van Zuilen MH. Mental Health for LGBTQIA+ Older Adults. Clin Geriatr Med 2024; 40:299-308. [PMID: 38521600 DOI: 10.1016/j.cger.2023.10.003] [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] [Indexed: 03/25/2024]
Abstract
LGBTQIA+ older adults share a unique set of risk factors that impact mental health. This article provides an overview of the minority stress and allostatic load models and how they can lead to worse physical and mental health outcomes. The article also describes unique epidemiologic and psychosocial context for various aspects of mental health among LGBTQIA+ older adults. Within each section are suggestions for health care providers when addressing these mental health issues and caring for LGBTQIA+ older adults in all settings.
Collapse
Affiliation(s)
- Rohin A Aggarwal
- Department of Medicine, Johns Hopkins University School of Medicine, 1800 Orleans Street, Baltimore, MD 21287, USA.
| | - Cynthia D Fields
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Meyer 235, Baltimore, MD 21287, USA
| | - Maria H van Zuilen
- Department of Medical Education, University of Miami Miller School of Medicine (R53), 1600 NW 19th Avenue, Miami, FL 33136, USA
| |
Collapse
|
16
|
Wu SH, Shi WQ, Li YH, Liu RH, Hu DY, Zheng LQ, Ma WL. Effect of Guanxin Danshen Dripping Pills on Coronary Heart Disease Comorbid with Depression or Anxiety: The ADECODE-Real World Study. Chin J Integr Med 2024; 30:443-448. [PMID: 37947990 DOI: 10.1007/s11655-023-3628-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] [Accepted: 10/12/2022] [Indexed: 11/12/2023]
Abstract
OBJECTIVE To evaluate the efficacy of Guanxin Danshen Dripping Pill (GXDSDP) in treating anxiety and depression in patients with coronary heart disease (CHD). METHODS A total of 1,428 patients diagnosed with CHD screened for anxiety, depression, and quality of life (QOL) at baseline received 0.4 g of GXDSDP treatment 3 times per day and returned for monthly reassessment. Patients were recruited after stable treatment for CHD and received assessment of General Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), and Seattle Angina Questionnaire (SAQ) for evaluating anxiety, depression, and QOL. Patients were followed up 3 times, once every 4 weeks, during outpatient visits for 12 weeks. RESULTS At the third follow-up (F3), the anxiety symptom of 63.79% (673/1,055) of the patients improved to sub-clinical level, and the GAD-7 score improved significantly (8.11 vs. 3.87, P<0.01); 57.52% (585/1,017) patients' depressive symptoms improved to sub-clinical level, with a significant improvement in PHQ-9 score (8.69 vs. 4.41, P<0.01) at F3. All aspects of QOL significantly improved at the end of treatment compared to those at baseline (all P<0.01) as assessed by SAQ: physical limitation (31.17 vs. 34.14), anginal stability (2.74 vs. 4.14), anginal frequency (8.16 vs. 9.10), treatment satisfaction (13.43 vs. 16.29), and disease perception (8.69 vs. 11.02). CONCLUSIONS A fixed dosage of GXDSDP may be a potential treatment option for CHD patients comorbid with anxiety or depression. (Registration No. ChiCTR2100051523).
Collapse
Affiliation(s)
- Shi-Hao Wu
- Department of Geriatric Medicine, Tongji Hospital, School of Medicine, Tongji University, Shanghai, 200065, China
| | - Wei-Qi Shi
- Department of Geriatric Medicine, Tongji Hospital, School of Medicine, Tongji University, Shanghai, 200065, China
| | - Yu-Hang Li
- Department of Geriatric Medicine, Tongji Hospital, School of Medicine, Tongji University, Shanghai, 200065, China
| | - Ru-Hui Liu
- Department of Cardiology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, 200065, China
| | - Da-Yi Hu
- Department of Cardiology, Peking University People's Hospital, Beijing, 100044, China
| | - Li-Qiang Zheng
- School of Public Health, Shanghai Jiao Tong University, Shanghai, 200030, China.
| | - Wen-Lin Ma
- Department of Geriatric Medicine, Tongji Hospital, School of Medicine, Tongji University, Shanghai, 200065, China.
| |
Collapse
|
17
|
Ma LL, Chen N, Zhang Y, Feng XM, Gong M, Yan YX. Association of phenotypic frailty and frailty index with type 2 diabetes and dyslipidemia in middle-aged and elderly Chinese: A longitudinal cohort study. Arch Gerontol Geriatr 2024; 119:105311. [PMID: 38101111 DOI: 10.1016/j.archger.2023.105311] [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: 10/30/2023] [Revised: 11/29/2023] [Accepted: 12/10/2023] [Indexed: 12/17/2023]
Abstract
PURPOSE Frailty, type 2 diabetes (T2D) and dyslipidemia are highly prevalent in middle-aged and elderly populations. However, evidence on the longitudinal association of frailty with T2D and dyslipidemia is limited. The aim of our study was to explore the cross-sectional and longitudinal effects of frailty levels on T2D and dyslipidemia in combination with phenotypic frailty and frailty index (FI). MATERIALS AND METHODS Multivariate logistic regression model was used to explore the association of frailty status with T2D and dyslipidemia. Area under curve (AUC) of the receiver operating characteristic curve (ROC) to estimate the predictive values of phenotypic frailty and frailty index for T2D and dyslipidemia. In addition, depressive symptom was used as a mediating variable to examine whether it mediates the association between frailty and T2D or dyslipidemia. RESULTS 10,203 and 9587 participants were chosen for the longitudinal association analysis of frailty with T2D and dyslipidemia. Frailty was associated with T2D (phenotypic frailty: OR=1.50, 95 %CI=1.03, 2.17; FI: OR=1.17, 95 %CI=1.08, 1.26) and dyslipidemia (phenotypic frailty: OR=1.56, 95 %CI=1.16, 2.10; FI: OR=1.17, 95 %CI=1.10, 1.25). Phenotypic frailty and frailty index significantly improved the risk discrimination of T2D and dyslipidemia (p<0.05). Depressive symptoms played a mediating role in the association between frailty and long-term T2D or dyslipidemia (p<0.05). CONCLUSION Frailty had adverse effects on type 2 diabetes and dyslipidemia, with depressive symptoms acting as the mediator.
Collapse
Affiliation(s)
- Lin-Lin Ma
- Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, No.10 Xitoutiao, You'anmenWai, Fengtai District, Beijing 100069, China
| | - Ning Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, No.10 Xitoutiao, You'anmenWai, Fengtai District, Beijing 100069, China
| | - Yu Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, No.10 Xitoutiao, You'anmenWai, Fengtai District, Beijing 100069, China
| | - Xu-Man Feng
- Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, No.10 Xitoutiao, You'anmenWai, Fengtai District, Beijing 100069, China
| | - Miao Gong
- Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, No.10 Xitoutiao, You'anmenWai, Fengtai District, Beijing 100069, China
| | - Yu-Xiang Yan
- Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, No.10 Xitoutiao, You'anmenWai, Fengtai District, Beijing 100069, China; Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China.
| |
Collapse
|
18
|
Turhon M, Maimaiti A, Abulaiti A, Dilixiati Y, Zhang F, AXiEr AX, Kadeer K, Wang Z, Yang X, Aisha M. Appraising the causal association among depression, anxiety and intracranial aneurysms: Evidence from genetic studies. J Affect Disord 2024; 350:909-915. [PMID: 38278329 DOI: 10.1016/j.jad.2024.01.166] [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: 08/10/2023] [Revised: 12/24/2023] [Accepted: 01/16/2024] [Indexed: 01/28/2024]
Abstract
BACKGROUND The risk of intracranial aneurysms (IAs) is increased in individuals with depression and anxiety. This indicates that depression and anxiety may contribute to the development of physical disorders. Herein, to investigate the association between genetic variants related to depression and anxiety and the risk of IA, two-sample Mendelian randomization was performed. METHODS The genome-wide association study (GWAS) comprised genome-wide genotype data of 2248 clinically well-characterized patients with anxiety and 7992 ethnically matched controls from four European countries. Sex-specific summary-level outcome data were obtained from the GWAS of IA, including 23 cohorts with a total of 10,754 cases and 306,882 controls of European and East Asian ancestry. To improve validity, five varying Mendelian randomization techniques were used in the analysis, namely Mendelian randomization-Egger, weighted median, inverse variance weighted, simple mode, and weighted mode. RESULTS The inverse variance weighted results indicated the causal effect of depression on IA (P = 0.03, OR = 1.32 [95 % CI, 1.03-1.70]) and unruptured IA (UIA) (P = 0.02, OR = 1.68 [95 % CI, 1.08-2.61]). However, the causal relationship between depression and subarachnoid hemorrhage (SAH) was not found (P = 0.16). We identified 43 anxiety-associated single-nucleotide polymorphisms as genetic instruments and found no causal relationship between anxiety and IA, UIA, and SAH. LIMITATIONS Potential pleiotropy, possible weak instruments, and low statistical power limited our findings. CONCLUSION Our MR study suggested a possible causal effect of depression on the increased risk of UIAs. Future research is required to investigate whether rational intervention in depression treatment can help to decrease the societal burden of IAs.
Collapse
Affiliation(s)
- Mirzat Turhon
- Department of Interventional Neuroradiology, Beijing Neurosurgical Institute, Capital Medical University, Beijing, People's Republic of China; Department of Interventional Neuroradiology, Beijing TianTan Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Aierpati Maimaiti
- Department of Neurosurgery, Xinjiang Medical University Affiliated First Hospital, Urumqi, Xinjiang, People's Republic of China
| | - Aimitaji Abulaiti
- Department of Neurosurgery, Xinjiang Medical University Affiliated First Hospital, Urumqi, Xinjiang, People's Republic of China
| | | | - Fujunhui Zhang
- Department of Interventional Neuroradiology, Beijing Neurosurgical Institute, Capital Medical University, Beijing, People's Republic of China; Department of Interventional Neuroradiology, Beijing TianTan Hospital, Capital Medical University, Beijing, People's Republic of China
| | - AXiMuJiang AXiEr
- Department of Neurosurgery, Xinjiang Medical University Affiliated First Hospital, Urumqi, Xinjiang, People's Republic of China
| | - Kaheerman Kadeer
- Department of Neurosurgery, Xinjiang Medical University Affiliated First Hospital, Urumqi, Xinjiang, People's Republic of China
| | - Zengliang Wang
- Department of Neurosurgery, Xinjiang Medical University Affiliated First Hospital, Urumqi, Xinjiang, People's Republic of China
| | - Xinjian Yang
- Department of Interventional Neuroradiology, Beijing Neurosurgical Institute, Capital Medical University, Beijing, People's Republic of China; Department of Interventional Neuroradiology, Beijing TianTan Hospital, Capital Medical University, Beijing, People's Republic of China.
| | - Maimaitili Aisha
- Department of Neurosurgery, Xinjiang Medical University Affiliated First Hospital, Urumqi, Xinjiang, People's Republic of China.
| |
Collapse
|
19
|
Ren Z, Wang S, He M, Shi H, Zhao H, Cui L, Zhao J, Li W, Wei Y, Zhang W, Chen Z, Liu H, Zhang X. The effects of living arrangements and leisure activities on depressive symptoms of Chinese older adults: Evidence from panel data analysis. J Affect Disord 2024; 349:226-233. [PMID: 38211742 DOI: 10.1016/j.jad.2024.01.077] [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: 10/09/2022] [Revised: 12/25/2023] [Accepted: 01/04/2024] [Indexed: 01/13/2024]
Abstract
BACKGROUND Livable environment and ways, as the necessary conditions for the elderly to enjoy their old age, have a significant impact on their mental health and happiness. It's crucial to understand how living arrangements affect depressive symptoms in China. Studies on how various leisure activities modify this association are yet limited. METHODS This study relies on panel data derived from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), collected during waves spanning 2008/2009, 2011/2012, 2014, and 2018. The primary objective is to examine the relationship between living arrangements, leisure activities, and depressive symptoms of elderly individuals. Linear mixed-effects models were used to analyze the data. RESULTS A total of 26,342 observations aged 65 and over were included in this paper. Older adults living alone (β = 0.66, 95 % CI: 0.55, 0.76) or living in institutions (β = 0.69, 95 % CI: 0.40, 0.98) had more depressive symptoms than those living with family. Leisure activities were negatively associated with depressive symptoms (β = -0.16, 95 % CI: -0.18, -0.15). Moreover, there was significant interactions between living arrangements and leisure activities. No matter which kind of living arrangements, participating in physical, productive or social activity was associated with a lower risk of depressive symptoms. LIMITATIONS Study design might introduce bias, and it cannot establish causality between the tested variables. CONCLUSIONS Older adults living alone or in institutions have more possibility to develop depressive symptoms than those living with family, and such a relationship among Chinese older adults can be moderated by participating in leisure activities.
Collapse
Affiliation(s)
- Zheng Ren
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China; School of Politics and Public Administration, Guangxi Normal University, Guilin 541006, Guangxi, China
| | - Shixun Wang
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Minfu He
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Hong Shi
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Hanfang Zhao
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Li Cui
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Jieyu Zhao
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Wenjun Li
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Yachen Wei
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Wenjing Zhang
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Ziqiang Chen
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Hongjian Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Xiumin Zhang
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China.
| |
Collapse
|
20
|
Mansour M, Ehrenberg S, Mahroum N, Tsur AM, Fisher L, Amital H. The existence of a bidirectional link between ischemic heart disease and fibromyalgia. Coron Artery Dis 2024; 35:99-104. [PMID: 38206805 DOI: 10.1097/mca.0000000000001329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2024]
Abstract
STUDY OBJECTIVES Fibromyalgia (FM) is one of the most common causes of chronic widespread musculoskeletal pain, but also sleep disturbances, cognitive and psychological disorders. It has been suggested that FM may have a correlation with cardiovascular events. In this study, we aimed to assess the association between FM and ischemic heart disease (IHD). METHODS A population-based cross-sectional study was conducted utilizing data retrieved from the largest medical records database in Israel, Clalit Health Services. Patients were defined as having FM or IHD when there were at least two such documented diagnoses in their medical records. The occurrence of IHD was compared between FM and age- and sex-frequency-matched healthy controls. A logistic regression model was used to estimate this association following an adjustment for conventional cardiovascular risk factors and depression. RESULTS An overall population of 18 598 FM patients and 36 985 age- and gender-matched controls were included in the study. The proportion of IHD amongst FM patients was increased in comparison to controls (9.2% and 6.2%, respectively; P < 0.001). Furthermore, FM demonstrated an independent association with IHD on multivariate analysis (odds ratio [OR], 1.43; 95% confidence intervals [CI], 1.33-1.54; P < 0.0001). Finally, IHD was also found to be independently associated with the diagnosis of FM (OR, 1.40; CI, 1.31-1.51; P < 0.0001). CONCLUSION Our data suggest a bidirectional link between FM and IHD even after the adjustment for conventional cardiovascular risk factors. These findings should be considered when treating patients with either FM or IHD, and their routine interactional screening may be of clinical importance.
Collapse
Affiliation(s)
- Mahmoud Mansour
- Department of Medicine 'B', Sheba Medical Center, Tel-Hashomer
- Faculty of Medicine, Tel-Aviv University, Israel
| | - Scott Ehrenberg
- Department of Medicine 'B', Sheba Medical Center, Tel-Hashomer
- Faculty of Medicine, Tel-Aviv University, Israel
| | - Naim Mahroum
- Department of Medicine 'B', Sheba Medical Center, Tel-Hashomer
- Faculty of Medicine, Tel-Aviv University, Israel
| | - Avishai M Tsur
- Department of Medicine 'B', Sheba Medical Center, Tel-Hashomer
- Faculty of Medicine, Tel-Aviv University, Israel
- Israel Defense Forces, Medical Corps, Tel-Hashomer, Ramat-Gan, Israel
| | - Lior Fisher
- Department of Medicine 'B', Sheba Medical Center, Tel-Hashomer
- Faculty of Medicine, Tel-Aviv University, Israel
| | - Howard Amital
- Department of Medicine 'B', Sheba Medical Center, Tel-Hashomer
- Faculty of Medicine, Tel-Aviv University, Israel
| |
Collapse
|
21
|
Ha SC, Nam E, Lee SY. Perceived Risk of Solitary Death and Depressive Symptoms Among Older Adults Living Alone in Seoul: Can Structural and Functional Social Support Buffer the Impact? J Appl Gerontol 2024; 43:251-260. [PMID: 37990529 DOI: 10.1177/07334648231211452] [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] [Indexed: 11/23/2023] Open
Abstract
Although older adults living alone are at a greater risk of solitary death, there is a dearth of literature in this area. Using the 2018 Seoul Elderly Survey, we investigated the extent to which older adults living alone in Seoul perceive the risk of solitary death and examined the association between the perceived risk of solitary death and depressive symptoms. Additionally, we explored the role of structural and functional support in that association as a buffering factor. Results showed that more than half of the older adults living alone in Seoul perceived that they could be victims of solitary death. The perceived risk of solitary death among older adults living alone was independently associated with depressive symptoms. Additionally, the structural aspect of social support moderated the impact of the perceived risk of solitary death on depressive symptoms. Interventions that enhance the structural aspect of social support should be primarily considered.
Collapse
Affiliation(s)
- Seok Cheol Ha
- Policy Research Department, Seoul Welfare Foundation, Mapo-Gu, Seoul, Korea
| | - Eunji Nam
- Department of Social Welfare, Incheon National University, Yeonsu-Gu, Inchoen, Korea
| | - Sun Young Lee
- Department of Social Welfare, Gangneung-Wonju National University, Wonju-Si, Kangwon, Korea
| |
Collapse
|
22
|
Wang X, Gao D, Zhang X. Association of Depressive and Anxiety Symptoms With Risk of Cardiovascular Disease in Middle-Aged and Older Chinese Women. Asia Pac J Public Health 2024; 36:184-191. [PMID: 38462854 DOI: 10.1177/10105395241237664] [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] [Indexed: 03/12/2024]
Abstract
The objective of this study was to estimate the association of depressive and anxiety symptoms with the risk of cardiovascular disease (CVD) in middle-aged and older Chinese women and to further evaluate whether the association was influenced by sociodemographic factors. This cross-sectional study included 9544 women aged 40 to 70 years from the eastern, central, and western regions of China in 2018. Logistic regression models were utilized to examine odds ratios (ORs) and their 95% confidence intervals (CIs) for depressive and anxiety symptoms with CVD risk. Depressive (OR = 1.89) and anxiety symptoms (OR = 1.55) were independently associated with an increased risk of CVD after adjusting for potential confounders. Stratified analyses found that depressive symptoms were only significantly associated with higher risk of CVD in women aged over 50 years and with lower levels of education and household income, whereas anxiety symptoms were only significantly associated with an elevated risk of CVD in women aged 60 to 70 years, and living in rural areas, and with lower levels of education and household income. Our findings emphasize the improvement of recognizing and managing depressive and anxiety symptoms to reduce the risk of CVD in middle-aged and older women, particularly in older women of low socioeconomic status.
Collapse
Affiliation(s)
- Xueyin Wang
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China
| | - Di Gao
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China
| | - Xiaosong Zhang
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China
| |
Collapse
|
23
|
Wang F, Sun M, Wang X, Wu Z, Guo R, Yang Y, Wang Y, Liu Y, Dong Y, Wang S, Li B. The mediating role of dietary inflammatory index on the association between eating breakfast and depression: Based on NHANES 2007-2018. J Affect Disord 2024; 348:1-7. [PMID: 38070746 DOI: 10.1016/j.jad.2023.12.015] [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: 05/30/2023] [Revised: 11/07/2023] [Accepted: 12/02/2023] [Indexed: 12/18/2023]
Abstract
BACKGROUND Depression is a significant, pervasive, global public health problem, associated with many factors, such as diet, social factors, and lifestyle habits. We aimed to evaluate the association between eating breakfast, dietary inflammatory index (DII) and depression, and to verify the mediating role of DII on the effect of eating breakfast on depression. METHODS 21,865 participants from the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2018 were included in this study. Binary logistic regression and mediated effect analysis were conducted to analyze the associations between eating breakfast, DII and depression. Dietary inflammation was divided into pro-inflammatory diet and anti-inflammatory diet according to the DII. RESULTS Both pro-inflammatory diet and skipping breakfast were risk factors for depression. After adjusting for covariables, compared with participants reporting breakfast in both recalls, reporting breakfast in one recall had a higher OR 95%CI (1.54(1.20, 1.98)) of depression. These associations in stratified analysis and sensitivity analysis without cardiovascular diseases (CVD) and diabetes were robust. DII mediated the association between eating breakfast and depression, the proportion of participants who reported breakfast in one recall and no recall was 26.15 % and 26.67 %, respectively. LIMITATIONS This was a cross-sectional study that couldn't argue for the cause-effect relationship. Moreover, the confounding factor regarding medication use was not accounted for due to limited data. CONCLUSIONS Skipping breakfast may increase the risk of depression by raising DII. And our study supported the essential role of regular breakfast and the anti-inflammatory diet in reducing the risk of depression.
Collapse
Affiliation(s)
- Fengdan Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun 130021, China
| | - Mengzi Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun 130021, China
| | - Xuhan Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun 130021, China
| | - Zibo Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun 130021, China
| | - Ruirui Guo
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun 130021, China
| | - Yixue Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun 130021, China
| | - Yuxiang Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun 130021, China
| | - Yan Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun 130021, China
| | - Yibo Dong
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun 130021, China
| | - Sizhe Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun 130021, China
| | - Bo Li
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun 130021, China.
| |
Collapse
|
24
|
Wilhoite SR, Zaheed AB, Palms JD, Morris EP, Sol K, Martino A, Zahodne LB. Mechanisms underlying the association between adverse childhood experiences and racial disparities in later-life cognition. J Int Neuropsychol Soc 2024; 30:253-263. [PMID: 37622423 PMCID: PMC11008525 DOI: 10.1017/s1355617723000474] [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] [Indexed: 08/26/2023]
Abstract
OBJECTIVE Adverse childhood experiences (ACEs) may be a risk factor for later-life cognitive disorders such as dementia; however, few studies have investigated underlying mechanisms, such as cardiovascular health and depressive symptoms, in a health disparities framework. METHOD 418 community-dwelling adults (50% nonHispanic Black, 50% nonHispanic White) aged 55+ from the Michigan Cognitive Aging Project retrospectively reported on nine ACEs. Baseline global cognition was a z-score composite of five factor scores from a comprehensive neuropsychological battery. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale. Cardiovascular health was operationalized through systolic blood pressure. A mediation model controlling for sociodemographics, childhood health, and childhood socioeconomic status estimated indirect effects of ACEs on global cognition via depressive symptoms and blood pressure. Racial differences were probed via t-tests and stratified models. RESULTS A negative indirect effect of ACEs on cognition was observed through depressive symptoms [β = -.040, 95% CI (-.067, -.017)], but not blood pressure, for the whole sample. Black participants reported more ACEs (Cohen's d = .21), reported more depressive symptoms (Cohen's d = .35), higher blood pressure (Cohen's d = .41), and lower cognitive scores (Cohen's d = 1.35) compared to White participants. In stratified models, there was a negative indirect effect through depressive symptoms for Black participants [β = -.074, 95% CI (-.128, -.029)] but not for White participants. CONCLUSIONS These results highlight the need to consider racially patterned contextual factors across the life course. Such factors could exacerbate the negative impact of ACEs and related mental health consequences and contribute to racial disparities in cognitive aging.
Collapse
|
25
|
Zhang F, Yang W. Interaction between activities of daily living and cognitive function on risk of depression. Front Public Health 2024; 12:1309401. [PMID: 38384887 PMCID: PMC10880188 DOI: 10.3389/fpubh.2024.1309401] [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: 10/08/2023] [Accepted: 01/04/2024] [Indexed: 02/23/2024] Open
Abstract
Objective There is a lack of literature about the joint effects of activities of daily living (ADL) limitation and cognitive impairment on depression. This study aimed to estimate the association of ADL limitation and cognitive impairment with depression among Chinese older adults aged 65 and above and to test their interaction on both additive and multiplicative scales. Methods Data was drawn from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), including 11,025 eligible participants. Logistic regression models were fitted, and both multiplicative and additive interactions for ADL limitation and cognitive impairment were tested. Results A total of 3,019(27.4%) participants reported depressive symptoms. After controlling for potential confounding factors, ADL limitation and cognitive impairment were both positively associated with depression. The adjusted additive interaction of basic and instrumental activities of daily living limitation were 2.47 (95%CI:1.92-3.19) and 3.67 (95%CI:2.88-4.66), respectively, but the multiplicative interaction items were both insignificant. Conclusion ADL limitation and cognitive impairment were both risk factors for depression among Chinese older adults. Moreover, the significant interaction of ADL limitation and cognitive impairment was found in the additive model, suggesting that improving ADL may be helpful in reducing the risk of depression among older people with cognitive impairment.
Collapse
Affiliation(s)
- Fenghao Zhang
- Department of Neonatology, Xiangtan Central Hospital, Xiangtan, Hunan, China
| | - Wenyan Yang
- Department of Epidemiology and Medical Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| |
Collapse
|
26
|
Hafızoğlu M, Odacı Cömertoğlu E, Öztürk Y, Kahyaoğlu Z, Çavuşoglu Ç, Balcı C, Halil MG, Erden Aki Ö, Cankurtaran M, Doğu BB. Which comorbidity index is more appropriate for geriatric patients from the frailty perspective? Eur Geriatr Med 2024; 15:115-125. [PMID: 37607996 DOI: 10.1007/s41999-023-00851-5] [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: 05/09/2023] [Accepted: 08/01/2023] [Indexed: 08/24/2023]
Abstract
OBJECTIVES This study examined the relationship between comorbidity indices and physical, psychologic and social frailty and 1-year mortality. METHODS A cross-sectional analysis was conducted with 136 community-dwelling older adults. The relationship of 4 comorbidity indices (CIRS-G, ACCI, GIC, ICED) with 3 different frailty scales (FRAIL, CFS, TFI) was examined. RESULTS The participants' median age was 72 years (65-90); 62% of the participants were female. Overall, 15.4% of the participants were living with frailty according to the FRAIL scale, 27.9% of them according to the CFS, 58.8% of them according to the TFI, 47.7% of them living with psychological frailty, and 28.6% of them living with social frailty. There were significant and moderate correlations between CIRS-G and FRAIL, CFS and TFI total scores, TFI-Psychological scores and TFI-Social scores (respectively; p < 0.001, r = 0.530; p < 0.001, r = 0.471; p < 0.001, r = 0.535; p < 0.001, r = 0.402; p = 0.016 r = 0.206). AUC for CIRS-G was calculated as 0.716 among comorbidity indices in predicting the presence of frailty according to the FRAIL scale (p = 0.002, 95%CI [0.60-0.82]), 0.765 according to the CFS (p < 0.001, 95%CI [0.66-0.86]), 0.746 according to the TFI (p < 0.001, 95%CI [0.66-0.82]). CONCLUSION The CIRS-G index was found to be superior to other indices in predicting the presence of frailty of comorbidity indices, and only GIC scores showed significant results in predicting mortality. However, it would not be the right approach to recommend a single comorbidity index when evaluating older adults.
Collapse
Affiliation(s)
- Merve Hafızoğlu
- Department of Internal Medicine, Division of Geriatrics Medicine, Faculty of Medicine, Hacettepe University Medical School, Altındag, Ankara, Turkey.
| | - Ezgi Odacı Cömertoğlu
- Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Yelda Öztürk
- Department of Geriatrics, Eskisehir City Hospital, Health Sciences University, Eskisehir, Turkey
| | - Zeynep Kahyaoğlu
- Department of Internal Medicine, Division of Geriatrics Medicine, Faculty of Medicine, Hacettepe University Medical School, Altındag, Ankara, Turkey
| | - Çağatay Çavuşoglu
- Department of Geriatrics Mehmet, Akif Inan Training and Research Hospital, Health Sciences University, Sanliurfa, Turkey
| | - Cafer Balcı
- Department of Internal Medicine, Division of Geriatrics Medicine, Faculty of Medicine, Hacettepe University Medical School, Altındag, Ankara, Turkey
| | - Meltem Gülhan Halil
- Department of Internal Medicine, Division of Geriatrics Medicine, Faculty of Medicine, Hacettepe University Medical School, Altındag, Ankara, Turkey
| | - Özlem Erden Aki
- Departments of Psychiatry, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Mustafa Cankurtaran
- Department of Internal Medicine, Division of Geriatrics Medicine, Faculty of Medicine, Hacettepe University Medical School, Altındag, Ankara, Turkey
| | - Burcu Balam Doğu
- Department of Internal Medicine, Division of Geriatrics Medicine, Faculty of Medicine, Hacettepe University Medical School, Altındag, Ankara, Turkey
| |
Collapse
|
27
|
Shukla M, Pandey R. Emotional dampening in hypertension: Impaired recognition of implicit emotional content in auditory and cross-modal stimuli. Psych J 2024; 13:124-138. [PMID: 37942991 PMCID: PMC10917100 DOI: 10.1002/pchj.704] [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: 01/28/2023] [Accepted: 09/04/2023] [Indexed: 11/10/2023]
Abstract
Research shows a reduced responsivity to implicit as well as explicit facial emotion recognition (emotional dampening) in prehypertensives and hypertensives. This study explored auditory and audiovisual emotion recognition in prehypertensives and hypertensives. Participants (N = 175) who were normotensives, prehypertensives, and hypertensives (n = 57, 58, and 60, respectively) completed an auditory implicit task (matching auditory target with auditory distractors) and two cross-modal implicit tasks (matching visual target with auditory distractors, and vice-versa), and an auditory explicit task (labelling emotions in audio-clips). Findings showed an aberrant speed-accuracy trade-off, where prehypertensives focused more on accuracy at the cost of speed while hypertensives showed the opposite. Discriminant function analysis revealed that blood pressure (BP)-associated emotional dampening is a highly specific but moderately sensitive correlate of hypertension. Our study highlights that prehypertensives and hypertensives demonstrate emotional dampening in implicit (but not explicit) auditory emotion recognition and a greater deficit for auditory than visual recognition of implicit emotions. Findings show emotional dampening as an observable correlate of elevated BP and hypertension.
Collapse
Affiliation(s)
- Meenakshi Shukla
- Department of PsychologyBanaras Hindu UniversityVaranasiIndia
- Present address:
Department of PsychologyUniversity of AllahabadPrayagrajIndia
| | - Rakesh Pandey
- Department of PsychologyBanaras Hindu UniversityVaranasiIndia
| |
Collapse
|
28
|
Lu Y, Li Z, Qin K, Chen J, Zeng N, Yan B, Liu D. Association between perceived neighborhood environment and depression among residents living in mega-communities in Guiyang, China: a cross-sectional study. BMC Public Health 2024; 24:343. [PMID: 38302930 PMCID: PMC10836001 DOI: 10.1186/s12889-024-17844-z] [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: 08/24/2023] [Accepted: 01/22/2024] [Indexed: 02/03/2024] Open
Abstract
BACKGROUND Little was known about the relationship between perceived neighborhood environment and depression among residents living in mega-communities. Furthermore, the mediating effects of physical activity (PA) and anxiety in this relationship have not been investigated. Thus, this study aimed to comprehensively examine the association between perceived neighborhood environment and depression among residents living in mega-communities, and test whether PA and anxiety mediated the association. METHODS A cross-sectional study on perceived neighborhood environment and depression was conducted among individuals who lived in mega-communities (n = 665) in Guiyang, China from July to August 2022. Perceived neighborhood environment was assessed from the following six aspects: traffic, building quality, accessibility, neighborhood, indoor, and pollution. Depression was measured by the Patients Health Questionnaire-9. Structural equation model was used to evaluate the association between perceived neighborhood environment and depression, and test the mediating effect of PA and anxiety in this association. RESULTS We found that neighborhood (β = -0.144, p = 0.002) and PA (β = -0.074, p < 0.001) were both negatively associated with depression, while anxiety was positively associated with depression (β = 0.447, p < 0.001). Married residents were less likely to experience depression than residents of other marital status. PA played a mediator role in the relationship between accessibility and depression (β = 0.014, p = 0.033). PA mediated the relationship between neighborhood and depression (β = -0.032, p = 0.015). The mediating effect of anxiety in the relationship between perceived neighborhood environment and depression was not significant. CONCLUSIONS This study demonstrated that neighborhood, which was assessed by satisfaction with safety, hygiene, parking, greening, lighting, and building shape, was negatively associated with depression, and PA mediated the relationship.
Collapse
Affiliation(s)
- Yong Lu
- School of Public Health, the Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, China
| | - Zenglin Li
- School of Public Health, the Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, China
| | - Kai Qin
- School of Public Health, the Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, China
| | - Jiao Chen
- School of Public Health, the Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, China
| | - Nana Zeng
- School of Public Health, the Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, China
| | - Bo Yan
- Guangzhou Medical University Library, Guangzhou, China.
| | - Di Liu
- School of Public Health, Guangzhou Medical University, Guangzhou, China.
| |
Collapse
|
29
|
Kim J, Kim Y, Li Y. Trends in forgone medical care and unmet needs among Medicare beneficiaries with a history of depression during the COVID-19 pandemic: a national, repeated cross-sectional study. BMJ Open 2024; 14:e078223. [PMID: 38262646 PMCID: PMC10806608 DOI: 10.1136/bmjopen-2023-078223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 01/04/2024] [Indexed: 01/25/2024] Open
Abstract
OBJECTIVES To investigate trends in forgone medical care, basic needs disruption, financial and mental health disruption, engagement of preventive behaviours guidelines, and perceived severity of COVID-19 among community-living Medicare beneficiaries in the USA with and without a self-reported history of depression from Summer 2020 to Winter 2021. DESIGN/SETTING A repeated cross-sectional study using a nationally representative sample of Medicare beneficiaries of three rounds of survey data from the Medicare Current Beneficiary Survey COVID-19 Supplement Public Use Files: Summer 2020, Fall 2020 and Winter 2021. PARTICIPANTS A total of 28 480 community-dwelling Medicare beneficiaries. MAIN OUTCOME MEASURES Forgone medical care, basic needs disruption, financial and mental health disruption, engagement of preventive behaviours guidelines, and perceived severity of COVID-19. RESULTS In the study sample, 7629 (27%) had a history of depression. After adjusting for potential confounders, weighted multivariable logistic regression models showed that Medicare beneficiaries with a history of depression had higher odds of foregone medical care (OR: 1.29, 95% CI 1.16 to 1.42, p<0.001), of basic need disruption (OR: 1.49, 95% CI 1.33 to 1.67, p<0.001), and of financial and mental health disruption (OR: 1.75, 95% CI 1.60 to 1.91, p<0.001) during the COVID-19 pandemic when compared with those without a history of depression. No statistically significant differences were observed in engagement of essential preventive behaviours or perception of COVID-19 severity. CONCLUSIONS COVID-19 pandemic may exacerbate existing barriers to healthcare access and financial and social needs, possibly leading to persistent unmet needs among Medicare beneficiaries with a history of depression beyond the pandemic.
Collapse
Affiliation(s)
- Jihye Kim
- University of Nevada Las Vegas, Las Vegas, Nevada, USA
| | - Yeunkyung Kim
- University of Nevada Las Vegas, Las Vegas, Nevada, USA
| | - Yue Li
- University of Rochester Medical Center, Rochester, New York, USA
| |
Collapse
|
30
|
Hou W, Huang L, Huang H, Liu S, Dai W, Tang J, Chen X, Lu X, Zheng Q, Zhou Z, Zhang Z, Lan J. Bioactivities and Mechanisms of Action of Sinomenine and Its Derivatives: A Comprehensive Review. Molecules 2024; 29:540. [PMID: 38276618 PMCID: PMC10818773 DOI: 10.3390/molecules29020540] [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: 12/14/2023] [Revised: 01/13/2024] [Accepted: 01/18/2024] [Indexed: 01/27/2024] Open
Abstract
Sinomenine, an isoquinoline alkaloid extracted from the roots and stems of Sinomenium acutum, has been extensively studied for its derivatives as bioactive agents. This review concentrates on the research advancements in the biological activities and action mechanisms of sinomenine-related compounds until November 2023. The findings indicate a broad spectrum of pharmacological effects, including antitumor, anti-inflammation, neuroprotection, and immunosuppressive properties. These compounds are notably effective against breast, lung, liver, and prostate cancers, exhibiting IC50 values of approximately 121.4 nM against PC-3 and DU-145 cells, primarily through the PI3K/Akt/mTOR, NF-κB, MAPK, and JAK/STAT signaling pathways. Additionally, they manifest anti-inflammatory and analgesic effects predominantly via the NF-κB, MAPK, and Nrf2 signaling pathways. Utilized in treating rheumatic arthritis, these alkaloids also play a significant role in cardiovascular and cerebrovascular protection, as well as organ protection through the NF-κB, Nrf2, MAPK, and PI3K/Akt/mTOR signaling pathways. This review concludes with perspectives and insights on this topic, highlighting the potential of sinomenine-related compounds in clinical applications and the development of medications derived from natural products.
Collapse
Affiliation(s)
- Wen Hou
- College of Pharmacy, Gannan Medical University, Ganzhou 341000, China; (W.H.); (H.H.); (S.L.); (W.D.); (X.C.); (X.L.); (Q.Z.); (Z.Z.); (Z.Z.)
| | - Lejun Huang
- College of Rehabilitation, Gannan Medical University, Ganzhou 341000, China;
| | - Hao Huang
- College of Pharmacy, Gannan Medical University, Ganzhou 341000, China; (W.H.); (H.H.); (S.L.); (W.D.); (X.C.); (X.L.); (Q.Z.); (Z.Z.); (Z.Z.)
| | - Shenglan Liu
- College of Pharmacy, Gannan Medical University, Ganzhou 341000, China; (W.H.); (H.H.); (S.L.); (W.D.); (X.C.); (X.L.); (Q.Z.); (Z.Z.); (Z.Z.)
| | - Wei Dai
- College of Pharmacy, Gannan Medical University, Ganzhou 341000, China; (W.H.); (H.H.); (S.L.); (W.D.); (X.C.); (X.L.); (Q.Z.); (Z.Z.); (Z.Z.)
| | - Jianhong Tang
- Laboratory Animal Engineering Research Center of Ganzhou, Gannan Medical University, Ganzhou 341000, China;
| | - Xiangzhao Chen
- College of Pharmacy, Gannan Medical University, Ganzhou 341000, China; (W.H.); (H.H.); (S.L.); (W.D.); (X.C.); (X.L.); (Q.Z.); (Z.Z.); (Z.Z.)
| | - Xiaolu Lu
- College of Pharmacy, Gannan Medical University, Ganzhou 341000, China; (W.H.); (H.H.); (S.L.); (W.D.); (X.C.); (X.L.); (Q.Z.); (Z.Z.); (Z.Z.)
| | - Qisheng Zheng
- College of Pharmacy, Gannan Medical University, Ganzhou 341000, China; (W.H.); (H.H.); (S.L.); (W.D.); (X.C.); (X.L.); (Q.Z.); (Z.Z.); (Z.Z.)
| | - Zhinuo Zhou
- College of Pharmacy, Gannan Medical University, Ganzhou 341000, China; (W.H.); (H.H.); (S.L.); (W.D.); (X.C.); (X.L.); (Q.Z.); (Z.Z.); (Z.Z.)
| | - Ziyun Zhang
- College of Pharmacy, Gannan Medical University, Ganzhou 341000, China; (W.H.); (H.H.); (S.L.); (W.D.); (X.C.); (X.L.); (Q.Z.); (Z.Z.); (Z.Z.)
| | - Jinxia Lan
- College of Public Health and Health Management, Gannan Medical University, Ganzhou 341000, China
| |
Collapse
|
31
|
Zhang XM, Huang J, Ni XY, Zhu HR, Huang ZX, Ding S, Yang XY, Tan YD, Chen JF, Cai JH. Current progression in application of extracellular vesicles in central nervous system diseases. Eur J Med Res 2024; 29:15. [PMID: 38173021 PMCID: PMC10763486 DOI: 10.1186/s40001-023-01606-5] [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] [Accepted: 12/20/2023] [Indexed: 01/05/2024] Open
Abstract
Early diagnosis and pharmacological treatment of central nervous system (CNS) diseases has been a long-standing challenge for clinical research due to the presence of the blood-brain barrier. Specific proteins and RNAs in brain-derived extracellular vesicles (EVs) usually reflect the corresponding state of brain disease, and therefore, EVs can be used as diagnostic biomarkers for CNS diseases. In addition, EVs can be engineered and fused to target cells for delivery of cargo, demonstrating the great potential of EVs as a nanocarrier platform. We review the progress of EVs as markers and drug carriers in the diagnosis and treatment of neurological diseases. The main areas include visual imaging, biomarker diagnosis and drug loading therapy for different types of CNS diseases. It is hoped that increased knowledge of EVs will facilitate their clinical translation in CNS diseases.
Collapse
Affiliation(s)
- Xiang-Min Zhang
- Department of Radiology Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, No. 136, Zhongshan Second Road, Chongqing, 400014, China
- Chongqing Engineering Research Center of Stem Cell Therapy, No. 136, Zhongshan Second Road, Chongqing, 400014, China
| | - Jie Huang
- Department of Radiology Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, No. 136, Zhongshan Second Road, Chongqing, 400014, China
- Chongqing Engineering Research Center of Stem Cell Therapy, No. 136, Zhongshan Second Road, Chongqing, 400014, China
| | - Xiao-Ying Ni
- Department of Radiology Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, No. 136, Zhongshan Second Road, Chongqing, 400014, China
- Chongqing Engineering Research Center of Stem Cell Therapy, No. 136, Zhongshan Second Road, Chongqing, 400014, China
| | - Hui-Ru Zhu
- Department of Radiology Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, No. 136, Zhongshan Second Road, Chongqing, 400014, China
- Chongqing Engineering Research Center of Stem Cell Therapy, No. 136, Zhongshan Second Road, Chongqing, 400014, China
| | - Zhong-Xin Huang
- Department of Radiology Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, No. 136, Zhongshan Second Road, Chongqing, 400014, China
- Chongqing Engineering Research Center of Stem Cell Therapy, No. 136, Zhongshan Second Road, Chongqing, 400014, China
| | - Shuang Ding
- Department of Radiology Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, No. 136, Zhongshan Second Road, Chongqing, 400014, China
- Chongqing Engineering Research Center of Stem Cell Therapy, No. 136, Zhongshan Second Road, Chongqing, 400014, China
| | - Xin-Yi Yang
- Department of Radiology Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, No. 136, Zhongshan Second Road, Chongqing, 400014, China
- Chongqing Engineering Research Center of Stem Cell Therapy, No. 136, Zhongshan Second Road, Chongqing, 400014, China
| | - Yan-Di Tan
- Department of Ultrasound the Third Affiliated Hospital of Chongqing Medical University, No. 1, Shuanghu Branch Road, Huixing Street, Chongqing, 401120, China
| | - Jian-Fu Chen
- Department of Ultrasound, The Second People's Hospital of Yunnan Province, No. 176, Qingnian Road, Kunming, 650021, China
| | - Jin-Hua Cai
- Department of Radiology Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, No. 136, Zhongshan Second Road, Chongqing, 400014, China.
| |
Collapse
|
32
|
Sun X, Yang X, Zhang Y, Liu Y, Xiao F, Guo H, Liu X. Correlation analysis between per-fluoroalkyl and poly-fluoroalkyl substances exposure and depressive symptoms in adults: NHANES 2005-2018. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 906:167639. [PMID: 37813256 DOI: 10.1016/j.scitotenv.2023.167639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 09/27/2023] [Accepted: 10/05/2023] [Indexed: 10/11/2023]
Abstract
BACKGROUND Excessive exposure to per and poly-fluoroalkyl compounds (PFAS) can lead to various negative health effects. However, there's a lack of research studying the link between PFAS exposure and depression in adults, and the existing findings are inconsistent. OBJECTIVES Utilizing data collected from the National Health and Nutrition Examination Survey (NHANES) database spanning 2005 to 2018, this study aimed to examine the potential connection between PFAS exposure and depressive symptoms in adults. METHODS The correlation between individual PFAS exposure and depressive symptoms was examined through the establishment of weighted logistic regression models (crude model, model 1, model 2) and restricted cubic spline models. To verify the stability of the model, receiver operating characteristic (ROC) curves of the logistic regression model were generated, and a ten-fold cross-validation model was employed. Additionally, the relationship between adult depressive symptoms and mixed PFAS exposure was tested through the utilization of quantile g-computation (qgcomp). RESULTS The findings revealed that heightened exposure levels to PFOA, PFHxS, and PFUnDA, were connected with a diminished risk of depressive symptoms in adults (ORPFOA: 0.67, 95 % confidence interval (CI): 0.47, 0.95; ORPFHxS: 0.66, 95 %CI: 0.49, 0.89; ORPFUnDA: 0.65, 95 %CI: 0.45, 0.96). PFOS, PFHxS, and PFDA demonstrated a dose-response relationship with the risk of depressive symptoms. The ROC curve indicated model stability, with recognition accuracy exceeding 90 % in the cross-validation model. The outcomes of qgcomp demonstrated that an increase in serum PFAS concentration was linked to a decreased risk of depressive symptoms in adults (OR: 0.85, 95 %CI: 0.75, 0.96). DISCUSSION Due to the cross-sectional design of this study, it's important to acknowledge the potential for reverse causality between PFAS exposure and depressive symptoms. As a result, the outcomes should not be oversimplified to interpret PFAS exposure as a protective factor against adult depressive symptoms.
Collapse
Affiliation(s)
- Xiaoyi Sun
- Department of Occupational and Environmental Health, School of Public Health, Hebei Medical University, Hebei Key Laboratory of Environment and Human Health, Zhongshan East Road 361, Shijiazhuang 050017, Hebei, PR China
| | - Xupu Yang
- Department of Occupational and Environmental Health, School of Public Health, Hebei Medical University, Hebei Key Laboratory of Environment and Human Health, Zhongshan East Road 361, Shijiazhuang 050017, Hebei, PR China
| | - Yizhe Zhang
- Department of Preventive Medicine, School of Public Health, Hebei Medical University, Zhongshan East Road 361, Shijiazhuang 050017, Hebei, PR China
| | - Yi Liu
- Department of Toxicology, School of Public Health, Hebei Medical University, Hebei Key Laboratory of Environment and Human Health, Zhongshan East Road 361, Shijiazhuang 050017, Hebei, PR China
| | - Fang Xiao
- Department of Toxicology, School of Public Health, Hebei Medical University, Hebei Key Laboratory of Environment and Human Health, Zhongshan East Road 361, Shijiazhuang 050017, Hebei, PR China
| | - Huicai Guo
- Department of Toxicology, School of Public Health, Hebei Medical University, Hebei Key Laboratory of Environment and Human Health, Zhongshan East Road 361, Shijiazhuang 050017, Hebei, PR China
| | - Xuehui Liu
- Department of Occupational and Environmental Health, School of Public Health, Hebei Medical University, Hebei Key Laboratory of Environment and Human Health, Zhongshan East Road 361, Shijiazhuang 050017, Hebei, PR China.
| |
Collapse
|
33
|
Kim AJ, Stewart SH, Sherry SB, McGrath DS, Mushquash CJ, Olthuis JV, Mushquash AR. Clarifying the pathway from anxiety sensitivity to binge eating: The mediating role of depressive symptoms in a 3-week, 3-wave longitudinal study of undergraduates. Eat Behav 2024; 52:101843. [PMID: 38217932 DOI: 10.1016/j.eatbeh.2024.101843] [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: 08/15/2023] [Revised: 01/02/2024] [Accepted: 01/04/2024] [Indexed: 01/15/2024]
Abstract
Anxiety sensitivity (AS) - characterized by a persistent fear that arousal-related bodily sensations will lead to serious cognitive, physical, and/or social consequences - is associated with various psychopathologies, including depressive symptoms and binge eating. This 3-week, 3-wave longitudinal study examined the relation between AS (including its global AS factor and lower-order AS cognitive, physical, and social concern dimensions), depressive symptoms, and binge eating among 410 undergraduates from two universities. Using generalized estimating equation models, we found that global AS, AS social concerns, and depressive symptoms predicted binge eating during any given week. Mediation analyses showed that global AS (as a latent variable with its lower-order AS dimensions as indicators), AS cognitive concerns, and AS physical concerns at Wave 1 predicted subsequent increases in depressive symptoms at Wave 2, which, in turn, led to increases in binge eating at Wave 3. Findings contribute to a better understanding of the interplay between AS, depressive symptoms, and binge eating, highlighting the role of binge eating as a potential coping mechanism for individuals with high AS, particularly in managing depressive symptoms. This study underscores the importance of AS-targeted intervention and prevention efforts in addressing depressive symptoms and binge eating.
Collapse
Affiliation(s)
- Andy J Kim
- Department of Psychology and Neuroscience, Dalhousie University, B3H4R2, Canada.
| | - Sherry H Stewart
- Department of Psychology and Neuroscience, Dalhousie University, B3H4R2, Canada; Department of Psychiatry, Dalhousie University, B3H2E2, Canada.
| | - Simon B Sherry
- Department of Psychology and Neuroscience, Dalhousie University, B3H4R2, Canada; Department of Psychiatry, Dalhousie University, B3H2E2, Canada.
| | - Daniel S McGrath
- Department of Psychology, University of Calgary, T2N1N4, Canada.
| | | | - Janine V Olthuis
- Department of Psychology, University of New Brunswick, E3B5A3, Canada.
| | | |
Collapse
|
34
|
Bhanu C, Petersen I, Orlu M, Davis D, Sofat R, Bazo-Alvarez JC, Walters K. Drug-induced orthostatic hypotension: Cluster analysis of co-prescription patterns in older people in UK primary care. Pharmacoepidemiol Drug Saf 2024; 33:e5730. [PMID: 37974394 DOI: 10.1002/pds.5730] [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: 04/13/2023] [Revised: 11/06/2023] [Accepted: 11/09/2023] [Indexed: 11/19/2023]
Abstract
PURPOSE Over 250 medications are reported to cause orthostatic hypotension, associated with serious adverse outcomes in older adults. Studies suggest a harmful cumulative risk of orthostatic hypotension with multiple medication use. However, there is limited evidence on the potential for harm in practice, particularly which drugs is co-prescribed and may increase risk of orthostatic hypotension. METHODS Retrospective cohort study and cluster analysis using general practice data from IQVIA Medical Research Data (IMRD) in patients aged ≥50 contributing data between 1 January 2018 and 31 December 2018. Thirteen drug groups known to be associated with orthostatic hypotension by mechanism, were analyzed and clusters generated by sex and age-band. RESULTS A total of 602 713 individuals aged ≥50 with 283 912 (47%) men and 318 801 (53%) women were included. The most prevalent prescriptions that might contribute to orthostatic hypotension were ACE inhibitors, calcium-channel blockers, beta-blockers, selective serotonin reuptake inhibitors and uroselective alpha-blockers. We identified distinct clusters of cardiovascular system (cardiovascular system) drugs in men and women at all ages. cardiovascular system plus psychoactive drug clusters were common in women at all ages, and in men aged ≤70. cardiovascular system plus uroselective alpha-blockers were identified in men aged ≥70. CONCLUSIONS Distinct clusters of drugs associated with orthostatic hypotension exist in practice, which change over the life course. Our findings highlight potentially harmful drug combinations that may cause cumulative risk of orthostatic hypotension in older people. This may guide clinicians about the potential of synergistic harm and to monitor for orthostatic hypotension if using combinations of cardiovascular system drugs, cardiovascular system plus psychoactive drugs and/or alpha-blockers-particularly in patients aged ≥70 or at high-risk due to comorbidity. Future research should consider quantifying the risk of drug-induced orthostatic hypotension with such drug combinations.
Collapse
Affiliation(s)
- Cini Bhanu
- Research Department of Primary Care and Population Health, University College London, London, UK
| | - Irene Petersen
- Research Department of Primary Care and Population Health, University College London, London, UK
| | - Mine Orlu
- University College London (UCL) School of Pharmacy, UK
| | - Daniel Davis
- MRC Unit for Lifelong Health & Ageing, University College London, London, UK
| | - Reecha Sofat
- Department of Pharmacology and Therapeutics, University of Liverpool, Liverpool, UK
- British Heart Foundation, Data Science Centre, UK
| | - Juan Carlos Bazo-Alvarez
- Research Department of Primary Care and Population Health, University College London, London, UK
| | - Kate Walters
- Research Department of Primary Care and Population Health, University College London, London, UK
| |
Collapse
|
35
|
Wang X, Gao D, Wang X, Zhang X, Song B. Hypertension, socioeconomic status and depressive and anxiety disorders: a cross-sectional study of middle-aged and older Chinese women. BMJ Open 2023; 13:e077598. [PMID: 38154906 PMCID: PMC10759086 DOI: 10.1136/bmjopen-2023-077598] [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: 07/10/2023] [Accepted: 11/29/2023] [Indexed: 12/30/2023] Open
Abstract
OBJECTIVES To investigate the association of hypertension with depressive and anxiety disorders in middle-aged and older Chinese women, and to further assess whether the association was influenced by socioeconomic status (SES). DESIGN Nationwide cross-sectional study. SETTING Six provinces of the eastern, central and western regions of China. PARTICIPANTS Women aged 40-70 years were included by a multistage stratified random cluster sampling in 2018 (N=9900). PRIMARY OUTCOME MEASURES Depressive and anxiety disorders were measured by the Patient Health Questionnaire-9 and the Generalized Anxiety Disorder-7, respectively. Logistic regression models were used to evaluate the OR and 95% CI for hypertension and the odds of depressive and anxiety disorders. RESULTS 18.5% of participants reported having hypertension; 20.9% and 15.3% of women experienced depressive and anxiety disorders, respectively. After adjusting for potential confounders, women diagnosed with hypertension were more likely to have depressive (OR=1.27, 95% CI 1.11 to 1.45) and anxiety disorders (OR=1.48, 95% CI 1.28 to 1.71) than those without hypertension. Stratified analyses demonstrated that hypertension was significantly associated with higher odds of depressive disorders in women living in rural areas (OR=1.34, 95% CI 1.13 to 1.59), with lower levels of education (OR=1.28, 95% CI 1.12 to 1.46) and with average monthly household income <¥3000 (OR=1.33, 95% CI 1.12 to 1.59), while hypertension was significantly correlated with increased odds of anxiety disorders in women living in urban (OR=1.41, 95% CI 1.12 to 1.79) and rural areas (OR=1.53, 95% CI 1.27 to 1.84), with lower levels of education (OR=1.47, 95% CI 1.27 to 1.70), and with average monthly household income <¥3000 (OR=1.45, 95% CI 1.20 to 1.75) and ≥¥3000 (OR=1.49, 95% CI 1.18 to 1.86). CONCLUSIONS Hypertension was associated with increased odds of depressive and anxiety disorders among middle-aged and older women, especially in those with low SES. Effective strategies and actions for identification and management of hypertension and depressive and anxiety disorders are needed.
Collapse
Affiliation(s)
- Xueyin Wang
- Peking University First Hospital, Beijing, China
| | - Di Gao
- Peking University First Hospital, Beijing, China
| | - Xu Wang
- Peking University First Hospital, Beijing, China
| | | | - Bo Song
- Chinese Center for Disease Control and Prevention, Beijing, China
| |
Collapse
|
36
|
Zhou Y, Li C, Wang W, Ding L. Large-scale data reveal disparate associations between leisure time physical activity patterns and mental health. COMMUNICATIONS MEDICINE 2023; 3:175. [PMID: 38129660 PMCID: PMC10739930 DOI: 10.1038/s43856-023-00399-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 11/03/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Leisure time physical activity (LTPA) is known to be associated with a lower risk for mental health burden, while whether the underlying mechanisms vary across populations is unknown. We aimed to explore the disparate associations between LTPA and mental health based on large-scale data. METHODS In this study, we analyzed data including 711,759 individuals aged 15 years or above from the latest four rounds (2003, 2008, 2013, and 2018) of the National Health Service Survey (NHSS) in China. We used multiple logistic regression models adjusted for potential confounders to investigate associations between LTPA and mental health in the total population and subgroups by measuring a diverse set of activity frequencies, intensities, and types. To examine the dose-response associations between total activity volume and mental health, we conducted restricted cubic splines to investigate possible nonlinearity. RESULTS LTPA was associated with remarkably lower self-reported mental health burden (OR 0.56, 95% CI 0.54-0.58). The dose-response relationship between total activity volume and mental health was highly nonlinear (p < 0.001), presenting L-shaped with first 1200 metabolic equivalents of task (METs)-min/week for significant risk reduction (OR 0.58, 95% CI 0.56-0.60). Notably, merely exercising 3-5 times per week with moderate swimming was significantly associated with lower mental health burden among younger people, while the association was strongly large in older adults aged 60 years or above doing 55-min moderate apparatus exercise at least six times a week. CONCLUSIONS In a large Chinese sample, LTPA was meaningfully and disparately associated with mental health burden across different people. Policy targeted at prompting activity may be effective for reducing mental health burden, but importantly, tailored strategies are needed based on population contexts.
Collapse
Affiliation(s)
- Ying Zhou
- Center for Smart and Healthy Buildings, Huazhong University of Science and Technology, 430074, Wuhan, Hubei, China
| | - Chenshuang Li
- Center for Smart and Healthy Buildings, Huazhong University of Science and Technology, 430074, Wuhan, Hubei, China
| | - Wei Wang
- Center for Smart and Healthy Buildings, Huazhong University of Science and Technology, 430074, Wuhan, Hubei, China.
- Department of Neurology, Tongji Hospital, Huazhong University of Science and Technology, 430030, Wuhan, Hubei, China.
| | - Lieyun Ding
- Center for Smart and Healthy Buildings, Huazhong University of Science and Technology, 430074, Wuhan, Hubei, China.
| |
Collapse
|
37
|
Wu Q, Miao X, Cao Y, Chi A, Xiao T. Heart rate variability status at rest in adult depressed patients: a systematic review and meta-analysis. Front Public Health 2023; 11:1243213. [PMID: 38169979 PMCID: PMC10760642 DOI: 10.3389/fpubh.2023.1243213] [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: 06/27/2023] [Accepted: 11/30/2023] [Indexed: 01/05/2024] Open
Abstract
Purposes A meta-analysis was conducted to examine the differences in heart rate variability (HRV) between depressed patients and healthy individuals, with the purpose of providing a theoretical basis for the diagnosis of depression and the prevention of cardiovascular diseases. Methods To search China National Knowledge Infrastructure (CNKI), WanFang, VIP, PubMed, Web of Science, Science Direct, and Cochrane Library databases to collect case-control studies on HRV in depressed patients, the retrieval date is from the establishment of the database to December 2022. Effective Public Health Practice Project (EPHPP) scale was used to evaluate literature quality, and Stata14.0 software was used for meta-analysis. Results This study comprised of 43 papers, 22 written in Chinese and 21 in English, that included 2,359 subjects in the depression group and 3,547 in the healthy control group. Meta-analysis results showed that compared with the healthy control group, patients with depression had lower SDNN [Hedges' g = -0.87, 95% CI (-1.14, -0.60), Z = -6.254, p < 0.01], RMSSD [Hedges' g = -0.51, 95% CI (-0.69,-0.33), Z = -5.525, p < 0.01], PNN50 [Hedges' g = -0.43, 95% CI (-0.59, -0.27), Z = -5.245, p < 0.01], LF [Hedges' g = -0.34, 95% CI (-0.55, - 0.13), Z = -3.104, p < 0.01], and HF [Hedges' g = -0.51, 95% CI (-0.69, -0.33), Z = -5.669 p < 0.01], and LF/HF [Hedges' g = -0.05, 95% CI (-0.27, 0.18), Z = -0.410, p = 0.682] showed no significant difference. Conclusion This research revealed that HRV measures of depressed individuals were lower than those of the healthy population, except for LF/HF, suggesting that people with depression may be more at risk of cardiovascular diseases than the healthy population.
Collapse
Affiliation(s)
- Qianqian Wu
- School of Physical Education, Shaanxi Normal University, Xi’an, China
| | | | - Yingying Cao
- School of Physical Education, Shaanxi Normal University, Xi’an, China
| | - Aiping Chi
- School of Physical Education, Shaanxi Normal University, Xi’an, China
| | - Tao Xiao
- School of Physical Education, Shaanxi Normal University, Xi’an, China
| |
Collapse
|
38
|
Mr V, P RP. The Validation of Beck's Depression Inventory in Patients With Systemic Diseases: A Psychometric Study at a Dental Institute. Cureus 2023; 15:e49830. [PMID: 38164320 PMCID: PMC10758205 DOI: 10.7759/cureus.49830] [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: 08/28/2023] [Accepted: 12/02/2023] [Indexed: 01/03/2024] Open
Abstract
Background Depression seriously threatens the world's public health, manifesting symptoms like loss of interest, fatigue, guilt, and impaired focus. Major depressive disorder is a common problem for those with chronic systemic illnesses. Since this illness has an impact on psychosocial well-being and interacts with anxiety and stress, it is crucial to assess psychological functioning. Depression-related issue has a negative impact on oral health and can cause cognitive dysfunction, social interaction problems, and low self-esteem. For the purpose of identifying and effectively managing depression in patients with systemic illnesses undergoing dental procedures, screening tools like the Beck's Depression Inventory (BDI) were used. The BDI's benefits include its strong internal consistency, sensitivity to change, broad concept validity, adaptable criteria validity for separating depressed and nondepressed people, and global dissemination. Materials and methods A cross-sectional prospective study was carried out after receiving the necessary institutional ethical approvals, and the participant's agreement was also obtained. The questionnaire was explained to the patients. The entire participation was voluntary. Results In the current study patient's ages ranged from 34 years to maximum age of 83 years with a mean age of 59.70±13.16 years, with 40% of the population falling into the 51-65 years age group. According to the results, participants who had multiple systemic disorders were more likely to experience depression than people who had one systemic illness. The chi-square test showed no statistically significant results between the depression scores and the number of systemic diseases (p-0.574). Seventy-five per cent of individuals with depression required tooth extractions. Conclusion Those with systemic disorders who were receiving dental care in the current study showed elevated levels of depression. An important finding was the correlation between depression and tooth extraction, highlighting the need for proactive mental health assessments in dental care. Tailored interventions can mitigate the impact, enhancing the holistic well-being of patients suffering from systemic diseases and depression.
Collapse
Affiliation(s)
- Visalachi Mr
- Department of Oral Medicine and Radiology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Roland Prethipa P
- Department of Oral Medicine and Radiology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| |
Collapse
|
39
|
You R, Li W, Ni L, Peng B. Study on the trajectory of depression among middle-aged and elderly disabled people in China: Based on group-based trajectory model. SSM Popul Health 2023; 24:101510. [PMID: 37736259 PMCID: PMC10509349 DOI: 10.1016/j.ssmph.2023.101510] [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: 06/12/2023] [Revised: 08/09/2023] [Accepted: 09/03/2023] [Indexed: 09/23/2023] Open
Abstract
Background Previous studies have shown that middle-aged and elderly adults with disabilities are at higher risk for depressive symptoms. However, there are few studies on the long-term trajectories of depressive symptoms in the Chinese middle-aged and elderly disabled population. Objective This study aimed to identify the different development trajectories of depressive symptoms and their influencing factors in middle-aged and elderly people with disabilities in China. Methods Using data from the China Health and Retirement Longitudinal Study (CHARLS) in 2011, 2013, 2015, and 2018, a longitudinal cohort was formed for the study. A total of 2053 participants underwent at least two measures of depressive symptoms, assessed using the Center for Epidemiological Studies Depression Scale (CES-D10), a depression symptom assessment scale. We constructed a Group-Based Trajectory Model (GBTM) to identify the development trajectory of depressive symptoms in 2053 middle-aged and elderly disabled individuals, screened the potential predictors using lasso regression, and analyzed the factors affecting the development trajectory of depression through multivariate logistic regression. Results We identified four depression symptom trajectories throughout the follow-up process: "low depressive symptom group", "worsening depressive symptom group", "relieved depressive symptom group", and "high depressive symptom group". We found that there were differences in basic characteristics among different subgroups of depression trajectory. However, middle-aged and elderly disabled women living in rural areas, with limited ADL or IADL, physical pain, poor self-reported health and self-reported memory, short sleep time, and no relatives and friends to take care of them were the key groups for the prevention and treatment of depressive symptoms. Conclusion There is heterogeneity in the trajectories of depressive symptoms in the Chinese middle-aged and elderly disabled population, it is necessary to focus on the characteristics of the trajectories of different subgroups.
Collapse
Affiliation(s)
| | | | - Linghao Ni
- School of Public Health, Chongqing Medical University, Chongqing, 400016, China
| | - Bin Peng
- School of Public Health, Chongqing Medical University, Chongqing, 400016, China
| |
Collapse
|
40
|
Muhammad T, Pai M, Ansari S. Gender differences in the association between cardiovascular diseases and major depressive disorder among older adults in India. DIALOGUES IN HEALTH 2023; 2:100107. [PMID: 38515472 PMCID: PMC10953934 DOI: 10.1016/j.dialog.2023.100107] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 01/24/2023] [Accepted: 01/28/2023] [Indexed: 03/23/2024]
Abstract
Background Despite the global disease burden associated with the co-occurrence of cardiovascular diseases (CVDs) and depression, depression remains underdiagnosed and undertreated in the CVD population, especially among older adults in India. As such, this study examines (1) the association between single and multiple CVDs and major depressive disorder among older Indians; (2) whether this association is mediated by older adults' self-rated health and functional limitations; and (3) whether these associations vary for older men and women. Methods Data come from the 2017-18 wave 1 of the Longitudinal Ageing Study in India. Multivariable logistic regression is used to explore the association between CVDs and major depressive disorder among older men and women. The Karlson-Holm-Breen (KHB) method is used to examine the mediation effects of self-rated health and functional difficulties in the observed associations. Results Overall, 5.08% of the older adults had multiple CVDs. Older women (9.71%) had a higher prevalence of major depressive disorder compared to men (7.50%). Multiple CVDs were associated with greater odds of major depressive disorder after adjusting the potential covariates (adjusted odds ratio [AOR]: 1.49; 95% confidence interval [CI]: 1.10-2.00). Older men with multiple CVDs had a greater risk of major depressive disorder (AOR: 1.64; 95% CI: 1.05-2.57) relative to women with CVDs (AOR: 1.39; 95% CI: 0.93-2.08). The association between multiple CVDs and depression was mediated by self-rated health (34.03% for men vs. 34.55% for women), ADL difficulty (22.25% vs. 15.42%), and IADL difficulty (22.90% vs. 19.10%). Conclusions One in five older Indians with multiple CVDs reports major depressive disorder, which is three times more common than the prevalence of depressive disorder in older adults without CVDs. This association is attenuated by self-rated health and functional limitations. Moreover, these associations are more pronounced in older men relative to older women. These findings depart from prior inferences that men with CVDs are less psychologically distressed than their female counterparts. Moreover, the findings underscore the importance of gender-specific approaches to interventions and therapeutics for CVD-related mental health.
Collapse
Affiliation(s)
- T. Muhammad
- Department of Family & Generations, International Institute for Population Sciences, Mumbai, India
| | - Manacy Pai
- Department of Sociology, Kent State University, Kent, OH 44242, USA
| | - Salmaan Ansari
- Department of Biostatistics & Epidemiology, International Institute for Population Sciences, Mumbai, India
| |
Collapse
|
41
|
Leconte CE, Ng JW, Manzardo AM, Douglass MM. A Pediatric Patient with Severe Obstructive Sleep Apnea and Comorbid Depression and Substance Abuse. Case Rep Psychiatry 2023; 2023:9985503. [PMID: 38028754 PMCID: PMC10656197 DOI: 10.1155/2023/9985503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 10/16/2023] [Accepted: 10/18/2023] [Indexed: 12/01/2023] Open
Abstract
Obstructive sleep apnea (OSA), depression, and substance abuse problems share similar symptomatology and have significant interplay. An underlying diagnosis of OSA can often be overlooked in patients with significant psychiatric illness and polysubstance use. Pediatric OSA is often associated with adenotonsillar hypertrophy and frequently requires surgical intervention for resolution of symptoms. Untreated OSA can worsen mental status and encourage polysubstance abuse as a form of self-medication. Proper identification and management of OSA plays an important role in treating psychiatric conditions. We report a 16-year-old with major depressive disorder (MDD), suicide attempts, polysubstance use disorder, and severe OSA admitted to an inpatient psychiatric facility. History included sleep and mood disturbances started at age 12. Patient presented with apnea-hypopnea index greater than 50 and started on bilevel-positive airway pressure (BiPAP) prior to admission. Management of OSA led to significant improvement of MDD, insomnia, and polysubstance abuse. OSA can often be overlooked in patients with MDD or substance abuse. Among adolescent patients with poorly managed psychiatric conditions, significant sleep disturbances, and polysubstance abuse, providers should maintain a high degree of suspicion for OSA, as its proper management will aid in the management of the other conditions.
Collapse
Affiliation(s)
- Caitlin E. Leconte
- University of Kansas School of Medicine, 2060 W 39th Avenue, Kansas City, KS 66103, USA
| | - Joshua W. Ng
- University of Kansas School of Medicine-Wichita, 1010 N Kansas Street, Wichita, KS 67214, USA
| | - Ann M. Manzardo
- Department of Psychiatry and Behavioral Sciences, University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS 66103, USA
| | - Mitchell M. Douglass
- Department of Psychiatry and Behavioral Sciences, University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS 66103, USA
| |
Collapse
|
42
|
Poudineh M, Mansoori A, Sadooghi Rad E, Hosseini ZS, Salmani Izadi F, Hoseinpour M, Mahmoudi Zo M, Ghoflchi S, Tanbakuchi D, Nazar E, Ferns G, Effati S, Esmaily H, Ghayour-Mobarhan M. Platelet distribution widths and white blood cell are associated with cardiovascular diseases: data mining approaches. Acta Cardiol 2023; 78:1033-1044. [PMID: 37694924 DOI: 10.1080/00015385.2023.2246199] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 06/12/2023] [Accepted: 08/03/2023] [Indexed: 09/12/2023]
Abstract
OBJECTIVE To investigate the association between cardiovascular diseases (CVDs) and haematologic factors in a cohort of Iranian adults. METHOD For a total population of 9,704 aged 35 to 65, a prospective study was designed. Haematologic factors and demographic characteristics (such as gender, age, and smoking status) were completed for all participants. The association between haematologic factors and CVDs was assessed through logistic regression (LR) analysis, decision tree (DT), and bootstrap forest (BF). RESULTS Almost all of the included factors were significantly associated with CVD (p<.001). Among the included factors, were: age, white blood cell (WBC), and platelet distribution width (PDW) had the strongest correlation with the development of CVD. For unit OR interpretation, WBC has been represented as the most remarkable risk factor for CVD (OR: 1.22 (CI 95% (1.18, 1.27))). Also, age is associated with an increase in the odds of CVD + occurrence (OR: 1.12 (CI 95% (1.11, 1.13))). Moreover, males are times more likely to develop CVD than females (OR: 1.39 (CI 95% (1.22, 1.58))). In DT model, age is the best classifier factor in CVD development, followed by WBC and PDW. Furthermore, based on the BF algorithm, the most crucial factors correlated with CVD are age, WBC, PDW, sex, and smoking status. CONCLUSION The obtained result from LR, DT, and BF models confirmed that age, WBC, and PDW are the most crucial factors for the development of CVD.
Collapse
Affiliation(s)
- Mohadeseh Poudineh
- Student Research Committee, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Amin Mansoori
- International UNESCO center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Elias Sadooghi Rad
- Student Research Committee, School of Medicine, Birjand University of Medical Sciences, Birjand, Iran
| | | | - Faezeh Salmani Izadi
- Student Research Committee, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahdieh Hoseinpour
- Student Research Committee, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mostafa Mahmoudi Zo
- Student Research Committee, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Sahar Ghoflchi
- International UNESCO center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Davoud Tanbakuchi
- Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Eisa Nazar
- International UNESCO center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Applied Mathematics, Ferdowsi University of Mashhad, Mashhad, Iran
| | - Gordon Ferns
- Brighton and Sussex Medical School, Division of Medical Education, Brighton, United Kingdom
| | - Sohrab Effati
- Department of Applied Mathematics, Ferdowsi University of Mashhad, Mashhad, Iran
| | - Habibollah Esmaily
- Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Majid Ghayour-Mobarhan
- International UNESCO center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
| |
Collapse
|
43
|
Wang M, Wu J, Yan H. Effect of music therapy on older adults with depression: A systematic review and meta-analysis. Complement Ther Clin Pract 2023; 53:101809. [PMID: 37952258 DOI: 10.1016/j.ctcp.2023.101809] [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: 12/31/2022] [Revised: 10/26/2023] [Accepted: 10/26/2023] [Indexed: 11/14/2023]
Abstract
BACKGROUND AND PURPOSE Depression is becoming more prevalent in older adults. Music therapy appears to have a positive effect on older adults with depression, but the effects of specific interventions (such as active music therapy and passive music therapy) are not fully known. This review aims to evaluate the therapeutic effects of music therapy and the effects of specific interventions on older adults with depression. METHODS A systematic search was conducted from inception to June 2022, and an updated search was conducted in July 2023 on PubMed, Web of Science, Cochrane Library, Embase, VIP, Wanfang Data, CNKI, and CBM. This review solely targeted randomized controlled trials. Two reviewers independently reviewed the retrieved studies. The risk of bias was evaluated using the Cochrane risk of bias assessment tool 2.0, and statistical analysis was made using the RevMan 5.4 software. RESULTS Twenty-one studies with a total of 1777 participants were included. Music therapy was beneficial in reducing depression, anxiety, and blood pressure and increasing cognitive ability (p < 0.05). Subgroup analysis showed that passive music therapy, single intervention for 60 min, individual intervention format, and total duration of 20 h had a more significant effect on depressive symptoms in older adults. CONCLUSION Music therapy reduces symptoms of depression and anxiety, improves blood pressure, and enhances cognitive ability in older adults with depression. Further rigorously designed studies are warranted to confirm the effects of music therapy on older adults with depression.
Collapse
Affiliation(s)
- Min Wang
- Chengdu University of Traditional Chinese Medicine, China
| | - Jingwen Wu
- Chengdu University of Traditional Chinese Medicine, China
| | - Hong Yan
- Chengdu University of Traditional Chinese Medicine, China.
| |
Collapse
|
44
|
Zhang L, Yin J, Sun H, Yang J, Liu Y. Association between atherogenic coefficient and depression in US adults: a cross-sectional study with data from National Health and Nutrition Examination Survey 2005-2018. BMJ Open 2023; 13:e074001. [PMID: 37899167 PMCID: PMC10619029 DOI: 10.1136/bmjopen-2023-074001] [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: 03/24/2023] [Accepted: 10/11/2023] [Indexed: 10/31/2023] Open
Abstract
OBJECTIVE The pathogenesis of depression is related to immune inflammatory response. Atherogenic coefficient (AC) is an important indicator of lipid abnormalities, which can lead to immune inflammatory responses. However, no study has investigated the relationship between AC and depression in adult Americans. Therefore, we investigated this relationship. DESIGN This study used a cross-sectional design. SETTING The National Health and Nutrition Examination Survey (2005-2018) data were used for this study. PARTICIPANTS A total of 32 502 participants aged 20 years or older who had complete information for AC and depression were included in this study. PRIMARY AND SECONDARY OUTCOME MEASURES Depressive symptoms were assessed using the nine-item version of the Patient Health Questionnaire (PHQ-9), with a cut-off point of 9/10 indicating likely depression cases. Weighted logistic regression analyses and the smooth curve fittings were performed to explore the association between AC and depression. RESULTS After adjusting for potential confounders, a single unit increase in AC was associated with a 3% increase in the prevalence of depression (HR=1.03, 95% CI=1.00 to 1.06, p=0.039). The relationship between AC and depression was more obvious in females. CONCLUSIONS The AC is positively associated with depression.
Collapse
Affiliation(s)
- Lu Zhang
- The First Clinical College, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Jiahui Yin
- College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Haiyang Sun
- The Second Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Jiguo Yang
- College of Acupuncture and Massage, Shandong University of Traditional Chinese Medicine, Shandong, China
| | - Yuanxiang Liu
- Department of Neurology, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| |
Collapse
|
45
|
Feng F, Chen Q, Zheng C, Zhang H. Intercultural adaptation and influencing factors analysis of the Chinese version of the anxiety scale for the older adults in a long-term care population. Front Public Health 2023; 11:1270284. [PMID: 37920589 PMCID: PMC10619850 DOI: 10.3389/fpubh.2023.1270284] [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: 08/01/2023] [Accepted: 10/04/2023] [Indexed: 11/04/2023] Open
Abstract
Objective The purpose of this study was to translate the Geriatric Anxiety Scale-Long-Term Care into Chinese and to assess its reliability and validity in a long-term care population, as well as to explore factors contributing to anxiety in older adults requiring long-term care. Methods The study recruited 399 older adults residents requiring long-term care and used the Brislin double translation-back-translation method to create the initial Chinese version of the Geriatric Anxiety Scale-Long-Term Care. The study used internal consistency and split-half reliability to assess the reliability of the scale, as well as exploratory factor analysis, validation factor analysis, and content validity to assess the validity of the scale. Linear regression was used to analyze the relationship between the independent variables and anxiety levels in the long-term care population. Results The Cronbach's coefficient value of the Chinese version of the Geriatric Anxiety Scale-Long-Term Care was 0.81, and the split-half reliability was 0.80. The results of exploratory factor analysis showed support for a one-dimensional factor structure. The results of the validation factor analysis indicated a good fit for the one-factor model. Gender (β = 0.190, 95% CI:0.540 ~ 1.546, p < 0.001), self-rated health (β = 0.220, 95% CI:0.379 ~ 0.953, p < 0.001), life satisfaction (β = -0.315, 95% CI: -1.355 ~ -0.734, p < 0.001) and participation in activities (β = -0.106, 95% CI: -1.122 ~ -0.084, p < 0.05) were significant predictors of anxiety levels in the long-term care population. Conclusion The Chinese version of the Geriatric Anxiety Scale-Long-Term Care has good reliability and validity in the long-term care population. The Geriatric Anxiety Scale-Long-Term Care is effective in assessing the anxiety level of the Chinese long-term care older adults population and provides an opportunity to detect and observe anxiety disorders in the long-term care population.
Collapse
Affiliation(s)
| | | | | | - Huijun Zhang
- Department of Nursing, Jinzhou Medical University, Jinzhou, China
| |
Collapse
|
46
|
Liu W, Zheng R, Zhang Y, Zhang W. Differences in the influence of daily behavior on health among older adults in urban and rural areas: evidence from China. Front Public Health 2023; 11:1259204. [PMID: 37869199 PMCID: PMC10587611 DOI: 10.3389/fpubh.2023.1259204] [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: 07/15/2023] [Accepted: 09/19/2023] [Indexed: 10/24/2023] Open
Abstract
Background As the population of older adult in China keeps growing, the degree of aging is becoming increasingly serious and the health of older adults is a growing concern. Comparing the personal characteristics and health levels of urban and rural older adults and determining the relationship between these factors are of great significance in maintaining their health. In addition, exploring how these relationships differ between urban and rural areas is important. Method This study conducted a literature review to examine the impact of various factors on the physical and mental health of older adults in urban and rural areas in China. Moreover, based on cross-sectional data from the 2017 Chinese General Social Survey (CGSS), urban-rural differences in the factors' degree of influence on the perceived health of older adults were studied using multiple logistic regression. Results Regular physical exercise had a powerful protective effect on urban older adults' physical and mental health, whereas regular participation in social activities had a positive impact on rural older adults' health. Low income, low educational level, low social trust, lack of a partner, and having more than one child negatively affected the physical health of rural older people. Low socioeconomic status had a negative impact on rural people's health both in mind and body. Overall, the rural adults' health status was found to be relatively low and deserves more attention. Conclusion This study demonstrated that older people's physical and mental health levels can be significantly affected by the frequency of daily activities and individual and family characteristics. Furthermore, urban-rural differences were observed. These findings could provide feasible suggestions for governments, communities, and older adults' family members to help alleviate health inequality.
Collapse
Affiliation(s)
- Weizhong Liu
- Business School, Yangzhou University, Yangzhou, China
- Research Center for Government Governance and Public Policy of Yangzhou University, Yangzhou University, Yangzhou, China
| | - Renjie Zheng
- Business School, Yangzhou University, Yangzhou, China
- Research Center for Government Governance and Public Policy of Yangzhou University, Yangzhou University, Yangzhou, China
| | - Yu Zhang
- Business School, Yangzhou University, Yangzhou, China
- Research Center for Government Governance and Public Policy of Yangzhou University, Yangzhou University, Yangzhou, China
| | - Wang Zhang
- Business School, Yangzhou University, Yangzhou, China
- Research Center for Government Governance and Public Policy of Yangzhou University, Yangzhou University, Yangzhou, China
| |
Collapse
|
47
|
Paula da Silva Ramos A, Fernandes de Souza Ribeiro J, Lima Trajano ET, Aurélio Dos Santos Silva M, Alexsandra da Silva Neto Trajano L. Hospitalized Women Have Anxiety and Worse Mental Health Scores than Men. Psychol Rep 2023; 126:2266-2279. [PMID: 35465784 DOI: 10.1177/00332941221088967] [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] [Indexed: 09/23/2023]
Abstract
This study aimed to assess the levels of anxiety, depression, and quality of life in hospitalized men and women using the Hospital Anxiety and Depression Scale (HADS), Beck's Anxiety Inventory (BAI), and Short Form-36 Health Survey Questionnaire (SF-36). 60 patients of both sexes were recruited from at the outpatient department of the Hospital Universitário de Vassouras (HUV). The HADS-Anxiety (HADS-A) and BAI questionnaires were used to assess anxiety; the HADS-Depression (HADS-D) questionnaire to assess levels of depression, and the SF-36 to assess the quality of life. The results indicated that hospitalized women had higher levels of anxiety when compared to men. No difference was observed in the levels of depression between men and women. Regarding quality of life, women showed more deterioration in general and mental health compared to men. Thus, the findings suggest that hospitalized women have higher levels of anxiety when compared to men and that this increase can lead to worse general and mental health. Professionals should be aware of possible psychological changes in hospitalized women as they can affect the overall quality of life.
Collapse
|
48
|
Huang X, Yang C, Huang M. Protective mechanism of the EZH2/microRNA-15a-5p/CXCL10 axis in rats with depressive-like behaviors. J Chem Neuroanat 2023; 132:102283. [PMID: 37146769 DOI: 10.1016/j.jchemneu.2023.102283] [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: 12/20/2022] [Revised: 04/19/2023] [Accepted: 05/02/2023] [Indexed: 05/07/2023]
Abstract
OBJECTIVE Enhancer of zeste homolog 2 (EZH2), microRNA-15a-5p (miR-15a-5p), and chemokine C-X-C ligand 10 (CXCL10) have been studied in many diseases. However, the investigation of the EZH2/miR-15a-5p/CXCL10 axis in depression is not sufficient. Our study aimed to investigate the regulatory functions of the EZH2/miR-15a-5p/CXCL10 axis in rats with depressive-like behaviors. METHODS The rat model of depression-like behaviors was established by chronic unpredictable mild stress (CUMS), and EZH2, miR-15a-5p, and CXCL10 expression levels in rats with depression-like behaviors were detected. The silenced EZH2 or enhanced miR-15a-5p recombinant lentivirus was injected into the rats with depression-like behaviors to assess the changes in behavioral tests, hippocampal pathological structure, levels of inflammatory cytokines in the hippocampus, and hippocampal neuron apoptosis. The regulatory relationships among EZH2, miR-15a-5p, and CXCL10 were measured. RESULTS miR-15a-5p expression was reduced, and EZH2 and CXCL10 expression levels were elevated in rats with depressive-like behaviors. Downregulation of EZH2 or elevation of miR-15a-5p improved depressive behavior, and inhibited hippocampal inflammatory response and hippocampal neuron apoptosis. EZH2 promoted histone methylation at the promoter of miR-15a-5p, and miR-15a-5p bound to CXCL10 to inhibit its expression. CONCLUSION Our study summarizes that EZH2 promotes the hypermethylation of the miR-15a-5p promoter, thereby promoting CXCL10 expression. Upregulation of miR-15a-5p or inhibition of EZH2 can improve the symptoms in rats with depressive-like behaviors.
Collapse
Affiliation(s)
- Xuezhu Huang
- Mental Health Center, West China Hospital, Sichuan University, Chengdu 610000, Sichuan, China; Mental Medicine College, The Medical University of Wenzhou, Wenzhou 325000 Zhejiang, China; Clinical Psychology Department, Nanchong Centre Hospital Affiliated to the Medical College of North Sichuan, Nanchong 637000, Sichuan, China.
| | - Chuang Yang
- Department of Psychiatry, the No. 1 Hospital Affiliated to The Medical University of Wenzhou, Wenzhou 325000 Zhejiang, China
| | - Min Huang
- Clinical Psychology Department, Nanchong Centre Hospital Affiliated to The Medical College of North Sichuan, Nanchong 637000, Sichuan, China
| |
Collapse
|
49
|
Coaston A, Lee SJ, Johnson JK, Weiss S, Hoffmann T, Stephens C. Factors associated with mobile medical clinic use: a retrospective cohort study. Int J Equity Health 2023; 22:195. [PMID: 37749529 PMCID: PMC10521435 DOI: 10.1186/s12939-023-02004-3] [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: 07/15/2022] [Accepted: 09/05/2023] [Indexed: 09/27/2023] Open
Abstract
BACKGROUND Mobile medical clinics have been used for decades to provide primary and preventive care to underserved populations. While several studies have examined their return on investment and impact on chronic disease management outcomes in the Mid-Atlantic and East Coast regions of the United States, little is known about the characteristics and clinical outcomes of adults who receive care aboard mobile clinics on the West Coast region. Guided by the Anderson Behavioral Model, this study describes the predisposing, enabling, and need factors associated with mobile medical clinic use among mobile medical clinic patients in Southern California and examines the relationship between mobile clinic utilization and presence and control of diabetes and hypertension. METHODS We conducted a retrospective cohort study of 411 adults who received care in four mobile clinic locations in Southern California from January 1, 2018, to December 31, 2019. Data were collected from patient charts on predisposing (e.g., sex, race, age), enabling (e.g., insurance and housing status), and need (e.g., chronic illness) factors based on Andersen's Behavioral Model. Zero-truncated negative binomial regression was used to examine the association of chronic illness (hypertension and diabetes) with number of clinic visits, accounting for potential confounding factors. RESULTS Over the course of the 2-year study period, 411 patients made 1790 visits to the mobile medical clinic. The majority of patients were female (68%), Hispanic (78%), married (47%), with a mean age of 50 (SD = 11). Forty-four percent had hypertension and 29% had diabetes. Frequency of mobile clinic utilization was significantly associated with chronic illness. Patients with hypertension and diabetes had 1.22 and 1.61 times the rate of mobile medical clinic visit than those without those conditions, respectively (IRR = 1.61, 95% CI, 1.36-1.92; 1.22, 95% CI, 1.02-1.45). CONCLUSIONS Mobile clinics serve as an important system of health care delivery, especially for adults with uncontrolled diabetes and hypertension.
Collapse
Affiliation(s)
- Angela Coaston
- California Baptist University, College of Nursing, 8432 Magnolia Ave, Riverside, Ca, 92504, USA.
| | - Soo-Jeong Lee
- University of California, San Francisco, CA, 94143, USA
| | | | - Sandra Weiss
- University of California, San Francisco, CA, 94143, USA
| | | | | |
Collapse
|
50
|
Kim JH, Yang HM. Moderating Effect of Self-Esteem on the Relationship between Depression and Family Conflict Coping Strategies in the Elderly with Chronic Diseases in Korea. Healthcare (Basel) 2023; 11:2569. [PMID: 37761766 PMCID: PMC10531067 DOI: 10.3390/healthcare11182569] [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: 08/21/2023] [Revised: 09/09/2023] [Accepted: 09/16/2023] [Indexed: 09/29/2023] Open
Abstract
(1) Background: The elderly with chronic diseases often experience high levels of depression, which can negatively affect their family conflict coping strategies. Additionally, as the level of depression increases, self-esteem tends to decrease. This study aims to investigate whether self-esteem plays a moderating role in the relationship between depression and family conflict coping strategies among the elderly with chronic diseases. (2) Method: The subjects were 2501 older adults with chronic diseases included in the 16th Korean Welfare Panel Study. The CES-D scale, Rosenberg Self-Esteem Scale, and the tool of Family Conflict Coping Strategies were used. (3) Results: Depression was negatively correlated with self-esteem and coping strategies for family conflict, while self-esteem was positively correlated with coping strategies for family conflict. In the multiple regression model, self-esteem had a moderating effect (F = 43.20, p < 0.001). This result indicated that as self-esteem increases, the negative influence of depression on family conflict coping strategies becomes weaker (β = -0.08, t = -3.04, p = 0.002). (4) Conclusions: When addressing family conflict coping strategies in the elderly with chronic diseases, it is crucial to focus on enhancing self-esteem. Additionally, it may be beneficial to classify the elderly into groups based on their level of self-esteem.
Collapse
Affiliation(s)
| | - Hwa-Mi Yang
- Department of Nursing, Daejin University, Pocheon-si 11159, Republic of Korea;
| |
Collapse
|