Association between chronic disease and depression among older adults in China: the moderating role of social participation

Trajectories of depressive symptoms in Korean adults with diabetes: Individual differences and associations with life satisfaction and mortality

OBJECTIVE

We examined trajectories of depressive symptoms and their predictors in adults with diabetes. We assessed whether these trajectories were related to life satisfaction and mortality.

DESIGN

Longitudinal, prospective observational study.

METHODS

We analysed data from 1217 adults with diabetes (aged ≥45 years) in the Korean Longitudinal Study of Aging (2006-2018).

RESULTS

Three trajectories of depressive symptomology were identified in growth mixture models: low/stable (i.e., low and stable levels of symptoms; 85.56%), high/decreasing (i.e., high levels of symptoms with a decreasing trajectory; 7.47%), and moderate/increasing (i.e., moderate levels of symptoms with an increasing trajectory; 6.98%). Participants with poor perceived health status at baseline were more likely to be in the moderate/increasing or high/decreasing classes than in the low/stable class. The moderate/increasing class had the lowest satisfaction with quality of life, followed by the high/decreasing and low/stable classes. The moderate/increasing and the high/decreasing classes had lower satisfaction with relationships with spouse and children than the low/stable class. The high/decreasing class had a higher mortality risk than the low/stable class.

CONCLUSIONS

Long-term monitoring of depressive symptoms in adults with diabetes is warranted given their potential adverse impact on life satisfaction and mortality.

Relationship between social participation and depressive symptoms in patients with multimorbidity: the chained mediating role of cognitive function and activities of daily living

OBJECTIVE

The potential mechanisms linking social participation and depressive symptoms in Chinese individuals with multimorbidity are not yet fully understood. This study aims to explore how cognitive function and activities of daily living (ADLs) mediate the relationship between social participation and depressive symptoms in individuals with multimorbidity.

METHODS

We selected 3782 participants with multimorbidity from the 2018 China Health and Retirement Longitudinal Study. Data related to social participation, cognitive function, ADLs, and depressive symptoms were extracted. Regression and Bootstrap analyses were used to explore the sequential mediating effects of social participation, cognitive function, ADLs, and depressive symptoms.

RESULTS

(1) There was a significant correlation between social participation, cognitive function, activities of daily living, and depressive symptoms (p < 0.01). (2) Social participation directly affected depressive symptoms (β = -0.205, p < 0.05). (3) Cognitive function (β = -0.070, p < 0.01) and activities of daily living (β = -0.058, p < 0.01) played separate mediating roles in the effect of social participation on depressive symptoms. (4) Cognitive function and activities of daily living had a chain-mediated role in the relationship between social participation and depressive symptoms in patients with multimorbidity (β = -0.020, p < 0.01).

CONCLUSION

A chained mediating effect was found between cognitive function, ADLs, social participation, and depressive symptoms in patients with multimorbidity. Social participation was found to improve the cognitive function of patients with multimorbidity, which in turn enhanced their daily life activities and ultimately alleviated their depressive symptoms.

Age, Education and Depression Among Older Adults: The Mediating Role of Physical Activity

OBJECTIVES

Past geriatric studies related to the mediating role of physical activity in depression are scarce. This is perhaps the first study to examine the mediating effects of physical activity on the associations between depression and age, and education among older adults.

METHODS

Statistical analyses of cross-sectional data from a nationally representative survey on Malaysian older adult health were conducted. Structural equation modeling was used to assess the extent to which physical activity mediated the relationships between depression and age, and education. Associations between variables were explored using multivariable logistic regressions.

RESULTS

Analyses were based on a sample of 3974 older adults (aged ≥60 years). Only 12.2% of older adults had depression. Age was positively associated with the odds of depression. Better educated older adults were less likely to experience depression than less educated older adults. Physical activity fully mediated the association between depression and age, whereas it partially explained the depression-education relationship.

CONCLUSIONS

Older age and low educational levels were risk factors for depression, and physical activity was identified as a mediator.

CLINICAL IMPLICATIONS

Older and less-educated older adults should be encouraged to participate in physical activity, and those at risk of depression should be given special attention.

Inter- and intrapopulation differences in the association between physical multimorbidity and depressive symptoms

BACKGROUND

The association between physical multimorbidity and depression differs by populations. However, no direct inter- or intrapopulation comparison of the association has been conducted. Thus, this study aims to estimate the association in China and the United States and reveal inter- and intrapopulation differences in the association.

METHODS

Middle-aged and older adults from the China Health and Retirement Longitudinal Study and the Health and Retirement Study were included. Physical multimorbidity was defined as the simultaneous presence of two or more chronic physical conditions and depressive symptoms was measured by the Center for Epidemiologic Studies Depression Scale. Generalized estimating equation model and stratification multilevel method were the main statistical models.

RESULTS

The presence of physical multimorbidity was associated with a higher risk of depression in both China (RR = 1.360 [95 % CI: 1.325-1.395]) and the US (RR = 1.613 [95 % CI: 1.529-1.701]). For individuals at a low risk of multimorbidity, multimorbidity was associated with 47.4 % (95 % CI: 1.377-1.579) and 71.1 % (95 % CI: 1.412-2.074) increases in the likelihood of depression in China and the US. The effect size was smaller for individuals at a moderate or high risk. However, the cross-national differences were greater for those with a high risk of multimorbidity.

LIMITATIONS

The self-report measures, attribution bias.

CONCLUSIONS

Compared to Chinese adults, the presence of physical multimorbidity led to an additional increase in depressive symptoms for American counterparts. The association was stronger for individuals at a low risk of multimorbidity, but cross-national differences were observed mostly among individuals at a high risk.

Urban-rural disparities in depressive symptoms and related factors among offspring of advanced maternal mothers: A national cross-sectional study in China

BACKGROUND

Urbanization remains an important factor affecting the mental health of people. Currently, there is insufficient research on depression among the offspring of women who have children at an advanced maternal age (AMA). The objective of this study is to investigate the urban and rural disparities in depressive symptoms among the offspring of AMA and related influencing factors.

METHODS

In this study, a total of 1273 offspring born to AMA were selected from the fourth wave of the China Health and Retirement Longitudinal Study (CHARLS) database. The questionnaire used in the study included demographic information and the Center for Epidemiologic Studies Depression Scale (CESD). Chi-square tests and logistic regression analysis were employed to examine the urban-rural differences.

RESULTS

The likelihood of developing depressive symptoms of the offspring of AMA in rural areas was 1.633 times higher (AOR = 1.633; 95%CI: 1.211-2.202) compared to their urban counterparts. Several factors including gender, education, marital status, disability, chronic diseases, and sleep duration showed a linkage with depression among rural based offspring of AMA. For the urban offspring of AMA, only disability and sleep duration exhibited a significant association with depressive symptoms.

LIMITATIONS

This study cannot establish a causal relationship between depressive symptoms and the influencing factors for the offspring of AMA. Age range and variables of the respondents needs further consideration.

CONCLUSIONS

This study has brought to light the elevated risk of depressive symptoms among rural-based offspring of AMA. Thus, emphasizing the urgent need for targeted interventions and measures to address the negative impact.

Effect of long-term care insurance policy on depression in non-disabled people: evidence from China

BACKGROUND

Policy effect might be multidimensional and spill over to non-recipients. It is unclear how the implementation of Long-Term Care Insurance (LTCI) policy affects depression in non-disabled people and how this effect differs in different non-disabled groups.

METHODS

Using time-varying differences-in-differences method and nationally representative health survey data in wave 2011, wave 2013, wave 2015 and wave 2018 from the China Health and Retirement Longitudinal Study, we assessed the effect of LTCI policy on depression in non-disabled people aged 45 years and older, and discussed the heterogeneity of effect across different population characteristics: retirement, financial support and social participation status.

RESULTS

We found LTCI policy statistically significant reduced depression by 0.76 units in non-disabled people compared to non-pilot cities. Depression in non-disabled people who unretired, with financial support and without social participation was reduced by 0.8267, 0.7079 and 1.2161 units, respectively.

CONCLUSIONS

Depression in non-disabled people was statistically significant reduced because of LTCI policy in China, and non-disabled people who unretired, with financial support and without social participation benefited more from LTCI policy. Our findings highlight the depression-reducing effect of LTCI policy in non-recipients and suggest that non-disabled people who unretired, with financial support and without social participation should be concerned during LTCI policy progress.