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Wang H, Liu H, Wu B, Hai L. The Association Between Trajectories of Perceived Unmet Needs for Home and Community-Based Services and Life Satisfaction Among Chinese Older Adults: The Moderating Effect of Psychological Resilience. Res Aging 2024; 46:139-152. [PMID: 37768843 DOI: 10.1177/01640275231203608] [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] [Indexed: 09/30/2023]
Abstract
This study examined whether trajectories of perceived unmet needs for Home and Community-Based Services (HCBS) were associated with life satisfaction among Chinese older adults and whether the association was moderated by psychological resilience. Data came from five waves (2005-2018) of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Latent class growth analysis revealed three distinct trajectories of perceived unmet HCBS needs: "increasing" (n = 977, 36.24%), "persistent" (n = 570, 21.14%), and "decreasing" (n = 1149, 42.62%). Multiple regression estimates showed that the increasing group was associated with lower life satisfaction, and the association was moderated by psychological resilience, especially for older adults who were male, living in rural, and oldest-old. Results indicate that inequalities in cumulative exposure to perceived unmet HCBS needs may further lead to increasing inequalities in life satisfaction. Interventions focused on minimizing the provision-need gap of HCBS and enhancing personal resilience should be considered to improve the life satisfaction of older adults.
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Affiliation(s)
- Hui Wang
- Institute for Population and Development Studies, School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China
| | - Huijun Liu
- Institute for Population and Development Studies, School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China
| | - Bei Wu
- Rory Meyers College of Nursing, New York University, New York, NY, USA
| | - Lun Hai
- Institute for Population and Development Studies, School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China
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Komalasari R, Thiamwong L, Wangi K, Ng BP. Subjective Functional Difficulties Were Associated With Subjective Cognitive Decline Among U.S. Older Adults: Mentally Unhealthy Days Mediation and Income Level Moderation Effects. SAGE Open Nurs 2024; 10:23779608231226065. [PMID: 38268951 PMCID: PMC10807341 DOI: 10.1177/23779608231226065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 12/20/2023] [Accepted: 12/26/2023] [Indexed: 01/26/2024] Open
Abstract
Introduction Subjective cognitive decline (SCD) is a self-perceived decline in cognition that may progress to mild cognitive impairment or Alzheimer's disease. SCD may be associated with difficulties in daily functioning and psychological distress. Previous research has shown the association between functional difficulties and SCD via mentally unhealthy days (MUDs). However, whether income levels influence the mediation effect of MUDs is less understood. Objectives This study examined the association between subjective functional difficulties and the odds of SCD through MUDs, and whether the mediation effect was moderated by income levels. Methods Cross-sectional data were obtained from the 2019 Behavioral Risk Factor Surveillance System (N = 13,160 older adults aged 65+; 7,370 women). SCD was assessed by more frequent or worse memory loss and confusion in the past 12 months. Subjective functional difficulties represented difficulties with daily activities. MUDs denoted the days that a person felt mentally unwell within the past 30 days. We used path analysis with 5,000 bootstrapped confidence intervals and logistic regression to classify the risks of SCD based on subjective functional difficulties and MUDs. Results Subjective functional difficulties were positively associated with SCD through mediation by MUDs (b = 0.119, 95% CI 0.102, 0.137). After accounting for covariates, we found that greater subjective functional difficulties were associated with 2.50 times the odds of SCD (AOR = 2.50; 95% CI: 2.14, 2.91); MUDs were related to 1.06 times the odds of SCD reporting (AOR = 1.06; 95% CI: 1.05, 1.07). Income levels moderated the indirect effect of MUDs in the subjective functional difficulties-SCD relationship, with an income of <$15,000 showing the most prominent effect. Those earning ≥$50,000 self-reported a lower SCD than those earning <$15,000. Conclusions Our study extends previous findings by demonstrating that greater subjective functional difficulties are associated with higher odds of SCD through more frequent MUDs, with higher income levels being associated with more SCD reporting.
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Affiliation(s)
- Renata Komalasari
- Ross and Carol Nese College of Nursing, Pennsylvania State University, University Park, PA, USA
| | - Ladda Thiamwong
- Disability, Aging and Technology Cluster, University of Central Florida, Orlando, FL, USA
| | - Karolus Wangi
- Ross and Carol Nese College of Nursing, Pennsylvania State University, University Park, PA, USA
| | - Boon Peng Ng
- Disability, Aging and Technology Cluster, University of Central Florida, Orlando, FL, USA
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Hu X, Ruan J, Zhang W, Chen J, Bao Z, Ruan Q, Yu Z. The overall and domain-specific quality of life of Chinese community-dwelling older adults: the role of intrinsic capacity and disease burden. Front Psychol 2023; 14:1190800. [PMID: 37691818 PMCID: PMC10485271 DOI: 10.3389/fpsyg.2023.1190800] [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: 03/21/2023] [Accepted: 08/01/2023] [Indexed: 09/12/2023] Open
Abstract
Objective This study aimed to investigate the impact of the different domains of intrinsic capacity (IC) and chronic disease burden on health-related quality of life (HRQoL) and domain-specific HRQoL in Chinese community-dwelling older adults. Design A cross-sectional observational study of a community-based cohort. Participants We evaluated Chinese older adults (n = 429, mean age, 72.91 ± 7.014 years; female proportion, 57.30%). Measurements IC contains five domains, namely locomotion, vitality, cognition, psychological, and sensory capacity. Locomotion dysfunction was defined as grip and/or gait decline. Vitality decline was defined if two of the following three parameters were present: fatigue, physical inactivity, and weight loss or overweight. Cognition was classified into normal cognition, pre-mild cognitive impairment (pre-MCI), and MCI according to the normative z-scores of the neuropsychological test battery. Psychological dysfunction was diagnosed based on depressive symptoms. Sensory dysfunction was defined as hearing and/or vision impairment. HRQoL was assessed using the AQoL-8D scale, which comprised physical (including independent living, senses, and pain) and psychosocial (including mental health, happiness, self-worth, coping, and relationships) dimensions. Low HRQoL (HRQoL score or subscores in the highest quintile) was used as a dependent variable in logistic regression analyses adjusted for demographic, health-related, and psychological confounders. Results Sensory impairment was an independent determinant of senses, and locomotion impairment was significantly associated with overall HRQoL, independent living, and pain in the physical dimension of HRQoL. Cognition was an independent determinant of the senses. Vitality was independently associated with overall HRQoL, senses, and pain in the physical dimension and mental health and relationships in the psychological dimension of HRQoL. The psychological domain of IC was independently associated with overall and domain-specific HRQoL apart from senses after adjustment for all confounders. The number of multimorbidities mainly had a significant impact on independent living after adjustment for all confounders. Conclusion IC domains and chronic disease burden had heterogeneous influences on overall and domain-specific HRQoL. The impairment of sensory and locomotion domains had a synergistic impact on the overall and physical dimensions of HRQoL. The vitality and psychological domains of IC had more profound effects on HRQoL. Older people with high morbidity might have a higher risk of poor independent living.
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Affiliation(s)
- Xiuhua Hu
- Laboratory of Aging, Anti-aging and Cognitive Performance, Shanghai Institute of Geriatrics and Gerontology, Huadong Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Jian Ruan
- Department of Otolaryngology, Huadong Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Weibin Zhang
- Laboratory of Aging, Anti-aging and Cognitive Performance, Shanghai Institute of Geriatrics and Gerontology, Huadong Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Jie Chen
- Shanghai Key Laboratory of Clinical Geriatrics, Huadong Hospital, and Research Center of Aging and Medicine, Huadong Hospital, Shanghai Medical College, Fudan University, Shanghai, China
- Department of Geriatrics, Huadong Hospital, Fudan University, Shanghai, China
| | - Zhijun Bao
- Shanghai Key Laboratory of Clinical Geriatrics, Huadong Hospital, and Research Center of Aging and Medicine, Huadong Hospital, Shanghai Medical College, Fudan University, Shanghai, China
- Department of Geriatrics, Huadong Hospital, Fudan University, Shanghai, China
| | - Qingwei Ruan
- Laboratory of Aging, Anti-aging and Cognitive Performance, Shanghai Institute of Geriatrics and Gerontology, Huadong Hospital, Shanghai Medical College, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Clinical Geriatrics, Huadong Hospital, and Research Center of Aging and Medicine, Huadong Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Zhuowei Yu
- Laboratory of Aging, Anti-aging and Cognitive Performance, Shanghai Institute of Geriatrics and Gerontology, Huadong Hospital, Shanghai Medical College, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Clinical Geriatrics, Huadong Hospital, and Research Center of Aging and Medicine, Huadong Hospital, Shanghai Medical College, Fudan University, Shanghai, China
- Department of Geriatrics, Huadong Hospital, Fudan University, Shanghai, China
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Toyoshima K, Ichiki M, Inoue T, Masuya J, Fujimura Y, Higashi S, Kusumi I. The Role of Cognitive Complaints in the Relationship Between Trait Anxiety, Depressive Symptoms, and Subjective Well-Being and Ill-Being in Adult Community Volunteers. Neuropsychiatr Dis Treat 2021; 17:1299-1309. [PMID: 33958871 PMCID: PMC8096453 DOI: 10.2147/ndt.s303751] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 04/14/2021] [Indexed: 01/10/2023] Open
Abstract
PURPOSE Trait anxiety, depressive symptoms, and cognitive complaints affect mental health. The mediating role of cognitive complaints has been reported recently. However, the mediating effects of cognitive complaints in the relationships between trait anxiety, depressive symptoms, and subjective well-being (SWB) and ill-being (SIB) remain unknown. Therefore, we used path analyses to investigate these mediating effects. MATERIALS AND METHODS A total of 554 adult community volunteers in Japan were studied using the State-Trait Anxiety Inventory (Form Y), Patient Health Questionnaire-9, Cognitive Complaints in Bipolar Disorder Rating Assessment, and Subjective Well-Being Inventory. These assessment tools evaluated trait anxiety, depressive symptoms, cognitive complaints, SWB, and SIB. Path analyses were performed in this study. RESULTS Path analyses revealed that there were significant indirect effects, via cognitive complaints, of trait anxiety and depressive symptoms on SIB. However, there were no significant indirect effects of trait anxiety and depressive symptoms on SWB. There were significant indirect effects, via depressive symptoms, of trait anxiety on cognitive complaints, SWB, and SIB. CONCLUSION The role of cognitive complaints may be different between SWB and SIB associated with trait anxiety and depressive symptoms. Evaluating the mediating effect of cognitive complaints may be more useful on SIB than SWB associated with trait anxiety and depressive symptoms. These findings may be useful when considering intervention targets in mental health.
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Affiliation(s)
- Kuniyoshi Toyoshima
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, 060-8638, Japan
| | - Masahiko Ichiki
- Department of Psychiatry, Tokyo Medical University, Tokyo, 160-0023, Japan
| | - Takeshi Inoue
- Department of Psychiatry, Tokyo Medical University, Tokyo, 160-0023, Japan
| | - Jiro Masuya
- Department of Psychiatry, Tokyo Medical University, Tokyo, 160-0023, Japan
| | - Yota Fujimura
- Department of Psychiatry, Tokyo Medical University, Tokyo, 160-0023, Japan.,Department of Psychiatry, Tokyo Medical University Hachioji Medical Center, Tokyo, 193-0998, Japan
| | - Shinji Higashi
- Department of Psychiatry, Tokyo Medical University Hachioji Medical Center, Tokyo, 193-0998, Japan.,Department of Psychiatry, Ibaraki Medical Center, Tokyo Medical University, Ibaraki, 300-0395, Japan
| | - Ichiro Kusumi
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, 060-8638, Japan
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