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Yang L, Xue B, Zheng X, Zhang X, Xiao S, Zhou C, Zhang C. The independent and combined effects of physical activity and depressive symptoms on frailty in community-dwelling older adults: A cross-sectional study. J Clin Nurs 2024. [PMID: 38987926 DOI: 10.1111/jocn.17331] [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: 03/13/2024] [Revised: 05/06/2024] [Accepted: 06/03/2024] [Indexed: 07/12/2024]
Abstract
AIMS To investigate the independent and combined effects of physical activity (PA) and depressive symptoms on the risk of frailty in community-dwelling older adults. BACKGROUND Older adults face a high risk of frailty which is commonly used to predict adverse health outcomes in older patients. Engaging in PA and without depressive symptoms are crucial factors to prevent frailty. It is essential to investigate the independent and combined effects of these two variables on the risk of frailty. METHODS We included 3392 community-dwelling older adults. The FRAIL Scale was used to assess older adults' frail status (robust, prefrail and frail). Multiple logistic regression was utilized to examine the independent and combined effects of PA and depressive symptoms on the risk of prefrailty and frailty. The combined effects were visualized by marginal plots. RESULTS The prevalence of prefrailty and frailty in older adults were 42.16% and 10.58%. Compared with the group of "Light physical activity and With depressive symptoms", "Vigorous physical activity and Without depressive symptoms" had the lowest risk of prefrailty and frailty. CONCLUSIONS Older adults who do not engage in PA or have depressive symptoms increased the risk of frailty, but older adults with depressive symptoms could lower the risk of frailty through PA. RELEVANCE TO CLINICAL PRACTICE It is effective to reduce the risk of frailty by directing older adults to do moderate physical activity, although they have depressive symptoms. The focus should also be on older adults with depressive symptoms, who have at least more than twice and fourfold risk of prefrailty and frailty compared to those without. IMPACT This study offers insights for future interventions aimed at preventing frailty in older adults. REPORTING METHOD This study adhered to the STROBE checklist. PATIENT OR PUBLIC CONTRIBUTIONS Older adults participated in this study and completed questionnaires.
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Affiliation(s)
- Lingli Yang
- Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
- School of Nursing, Southern Medical University, Guangzhou, Guangdong, China
- Key Laboratory of Philosophy and Social Sciences of Colleges and Universities in Guangdong Province for Collaborative Innovation of Health Management Policy and Precision Health Service, School of Health Management, Southern Medical University, Guangzhou, Guangdong, China
| | - Benli Xue
- Key Laboratory of Philosophy and Social Sciences of Colleges and Universities in Guangdong Province for Collaborative Innovation of Health Management Policy and Precision Health Service, School of Health Management, Southern Medical University, Guangzhou, Guangdong, China
- School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Xiao Zheng
- Key Laboratory of Philosophy and Social Sciences of Colleges and Universities in Guangdong Province for Collaborative Innovation of Health Management Policy and Precision Health Service, School of Health Management, Southern Medical University, Guangzhou, Guangdong, China
- Department of Health Management, Shunde Hospital, Southern Medical University (the First People's Hospital of Shunde, Foshan), Foshan, China
| | - Xinyi Zhang
- Key Laboratory of Philosophy and Social Sciences of Colleges and Universities in Guangdong Province for Collaborative Innovation of Health Management Policy and Precision Health Service, School of Health Management, Southern Medical University, Guangzhou, Guangdong, China
- School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Shujuan Xiao
- Key Laboratory of Philosophy and Social Sciences of Colleges and Universities in Guangdong Province for Collaborative Innovation of Health Management Policy and Precision Health Service, School of Health Management, Southern Medical University, Guangzhou, Guangdong, China
- School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Chunlan Zhou
- Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Chichen Zhang
- Key Laboratory of Philosophy and Social Sciences of Colleges and Universities in Guangdong Province for Collaborative Innovation of Health Management Policy and Precision Health Service, School of Health Management, Southern Medical University, Guangzhou, Guangdong, China
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Ainsworth NJ, Brender R, Gotlieb N, Zhao H, Blumberger DM, Karp JF, Lenze EJ, Nicol GE, Reynolds CF, Wang W, Mulsant BH. Association between lean muscle mass and treatment-resistant late-life depression in the IRL-GRey randomized controlled trial. Int Psychogeriatr 2023; 35:707-716. [PMID: 36594430 DOI: 10.1017/s1041610222000862] [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] [Indexed: 01/04/2023]
Abstract
OBJECTIVE To investigate the relationship between lean muscle mass and treatment response in treatment-resistant late-life depression (TR-LLD). We hypothesized that lower lean muscle mass would be associated with older age, higher physical comorbidities, higher depressive symptom severity, and poorer treatment response. DESIGN Secondary analysis of a randomized, placebo-controlled trial. SETTING Three academic hospitals in the United States and Canada. PARTICIPANTS Adults aged 60+ years with major depressive disorder who did not remit following open treatment with venlafaxine extended-release (XR) (n = 178). MEASUREMENTS We estimated lean muscle mass using dual-energy X-ray absorptiometry (DEXA) scans prior to and following randomized treatment with aripiprazole or placebo added to venlafaxine XR. Multivariate regressions estimated influence of demographic and clinical factors on baseline lean muscle mass, and whether baseline lean muscle mass was associated with treatment response, adjusted for treatment arm. RESULTS Low lean muscle mass was present in 22 (12.4%) participants. Older age and female sex, but not depressive symptom severity, were independently associated with lower lean muscle mass at baseline. Marital status, baseline depressive symptom severity, and treatment group were associated with improvement of depressive symptoms in the randomized treatment phase. Baseline lean muscle mass was not associated with improvement, regardless of treatment group. CONCLUSION As expected, older age and female sex were associated with lower lean muscle mass in TR-LLD. However, contrary to prior results in LLD, lean muscle mass was not associated with depression severity or outcome. This suggests that aripiprazole augmentation may be useful for TR-LLD, even in the presence of anomalous body composition.clinicaltrials.gov Identifier: NCT00892047.
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Affiliation(s)
- Nicholas J Ainsworth
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Ram Brender
- Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada
| | - Neta Gotlieb
- Department of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Haoyu Zhao
- Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Daniel M Blumberger
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Jordan F Karp
- Department of Psychiatry, College of Medicine Tuscon, University of Arizona, Tuscon, AZ, USA
| | - Eric J Lenze
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Ginger E Nicol
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Charles F Reynolds
- Department of Psychiatry, University of Pittsburgh Medical Centre, Pittsburgh, PA, USA
| | - Wei Wang
- Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Benoit H Mulsant
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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Tomás JM, Sentandreu-Mañó T, Martínez-Gregorio S. Does depression mediate the pain-frailty relationship? Latent variables approach. Geriatr Nurs 2023; 51:388-393. [PMID: 37127015 DOI: 10.1016/j.gerinurse.2023.04.006] [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: 03/09/2023] [Revised: 04/09/2023] [Accepted: 04/11/2023] [Indexed: 05/03/2023]
Abstract
Frailty is highly prevalent among older adults. This study aims to add evidence to the mediational role of depression in the pain-frailty relationship. Data came from a sample of 2578 Spanish older adults recruited from the Survey of Health, Aging, and Retirement in Europe (SHARE). A set of competing structural equation models were performed: (a) independent prediction, (b) full mediation, and (c) partial mediation. Results showed a better fit for the partial mediation model. This model was extended including covariates. The effects of pain and depression remained relevant in the final model, which explained 91% of the frailty variance. These findings support the relevance of the pain-depression dyad in frailty development. Although the pain shows a direct impact on frailty, this association is partially mediated by depression. The interplay of these conditions could be crucial for treatment effectiveness.
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Affiliation(s)
- José M Tomás
- Department of Methodology for the Behavioral Sciences, University of Valencia, Valencia, Spain
| | | | - Sara Martínez-Gregorio
- Department of Methodology for the Behavioral Sciences, University of Valencia, Valencia, Spain
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Hsieh PI, Chen YC, Chen TF, Chiou JM, Chen JH. Multimorbid Patterns and Cognitive Performance in the Presence of Informative Dropout Among Community-Dwelling Taiwanese Older Adults. Innov Aging 2023; 7:igad012. [PMID: 37007640 PMCID: PMC10053640 DOI: 10.1093/geroni/igad012] [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: 08/26/2022] [Indexed: 02/10/2023] Open
Abstract
Background and Objectives Longitudinal studies among older adults often feature elevated dropout rates and multiple chronic conditions. How Taiwanese multimorbid patterns relate to different cognitive domains remains unclear. This study aims to identify sex-specific multimorbid patterns and associate them with cognitive performance while modeling the risk for dropout. Research Design and Methods A prospective cohort study (2011-19) in Taiwan recruited 449 Taiwanese older adults without dementia. Global and domain-specific cognition were assessed biennially. We used exploratory factor analysis to identify baseline sex-specific multimorbid patterns of 19 self-reported chronic conditions. We utilized a joint model incorporating longitudinal and time-to-dropout data to examine the association between multimorbid patterns and cognitive performance accounting for the informative dropout via the shared random effect. Results At the end of the study, 324 participants (72.1%) remained in the cohort, with an average annual attrition rate of 5.5%. We found that advanced age, low levels of physical activities, and poor cognition at baseline were associated with increased dropout risks. Besides, 6 multimorbid patterns were identified, labeled Mental, Renal-vascular, and Cancer-urinary patterns in men, and Mental, Cardiometabolic, and Cancer-endocrine patterns in women. For men, as the follow-up time increased, the Mental pattern was associated with poor global cognition and attention; the Renal-vascular pattern was associated with poor executive function. For women, the Mental pattern was associated with poor memory; as follow-up time increased, and Cardiometabolic patterns were related to poor memory. Discussion and Implications Sex-specific multimorbid patterns identified in the Taiwanese older population showed differences (notably Renal-vascular pattern in men) from patterns found in Western countries and were differentially associated with cognitive impairment over time. When informative dropout is suspected, appropriate statistical methods should be applied.
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Affiliation(s)
- Pei-Iun Hsieh
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Yen-Ching Chen
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
- Department of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Ta-Fu Chen
- Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan
| | - Jeng-Min Chiou
- Institute of Statistical Science, Academia Sinica, Nankang District, Taipei, Taiwan
- Institute of Statistics and Data Science, National Taiwan University, Taipei, Taiwan
| | - Jen-Hau Chen
- Department of Geriatrics and Gerontology, National Taiwan University Hospital, Taipei, Taiwan
- Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
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Lesmana MHS, Le NQK, Chiu WC, Chung KH, Wang CY, Irham LM, Chung MH. Genomic-Analysis-Oriented Drug Repurposing in the Search for Novel Antidepressants. Biomedicines 2022; 10:biomedicines10081947. [PMID: 36009493 PMCID: PMC9405592 DOI: 10.3390/biomedicines10081947] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 08/07/2022] [Accepted: 08/08/2022] [Indexed: 12/02/2022] Open
Abstract
From inadequate prior antidepressants that targeted monoamine neurotransmitter systems emerged the discovery of alternative drugs for depression. For instance, drugs targeted interleukin 6 receptor (IL6R) in inflammatory system. Genomic analysis-based drug repurposing using single nucleotide polymorphism (SNP) inclined a promising method for several diseases. However, none of the diseases was depression. Thus, we aimed to identify drug repurposing candidates for depression treatment by adopting a genomic-analysis-based approach. The 5885 SNPs obtained from the machine learning approach were annotated using HaploReg v4.1. Five sets of functional annotations were applied to determine the depression risk genes. The STRING database was used to expand the target genes and identify drug candidates from the DrugBank database. We validated the findings using the ClinicalTrial.gov and PubMed databases. Seven genes were observed to be strongly associated with depression (functional annotation score = 4). Interestingly, IL6R was auspicious as a target gene according to the validation outcome. We identified 20 drugs that were undergoing preclinical studies or clinical trials for depression. In addition, we identified sarilumab and satralizumab as drugs that exhibit strong potential for use in the treatment of depression. Our findings indicate that a genomic-analysis-based approach can facilitate the discovery of drugs that can be repurposed for treating depression.
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Affiliation(s)
| | - Nguyen Quoc Khanh Le
- Professional Master Program in Artificial Intelligence in Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
- Research Center for Artificial Intelligence in Medicine, Taipei Medical University, Taipei 11031, Taiwan
- Translational Imaging Research Center, Taipei Medical University Hospital, Taipei 11031, Taiwan
| | - Wei-Che Chiu
- Department of Psychiatry, Cathay General Hospital, Taipei 10630, Taiwan
- School of Medicine, Fu Jen Catholic University, New Taipei City 242062, Taiwan
| | - Kuo-Hsuan Chung
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
- Department of Psychiatry and Psychiatric Research Center, Taipei Medical University Hospital, Taipei Medical University, Taipei 11031, Taiwan
| | - Chih-Yang Wang
- Ph.D. Program for Cancer Molecular Biology and Drug Discovery, College of Medical Science and Technology, Taipei Medical University and Academia Sinica, Taipei 11031, Taiwan
- Graduate Institute of Cancer Biology and Drug Discovery, College of Medical Science and Technology, Taipei Medical University, Taipei 11031, Taiwan
| | - Lalu Muhammad Irham
- Faculty of Pharmacy, University of Ahmad Dahlan, Yogyakarta 55164, Indonesia
- Correspondence: (L.M.I.); (M.-H.C.); Tel.: +62-851-322-55-414 (L.M.I.); +886-02-2736-1661 (M.-H.C.)
| | - Min-Huey Chung
- School of Nursing, College of Nursing, Taipei Medical University, Taipei 11031, Taiwan
- Department of Nursing, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan
- Correspondence: (L.M.I.); (M.-H.C.); Tel.: +62-851-322-55-414 (L.M.I.); +886-02-2736-1661 (M.-H.C.)
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Social capital and geriatric depression in the Asian context. Int Psychogeriatr 2022; 34:671-673. [PMID: 35918184 DOI: 10.1017/s1041610222000576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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