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Balqis-Ali NZ, Ahmad N, Minhat HS, Fattah Azman AZ. Biopsychosocial factors of depression among community-dwelling geriatric population with low perceived social support; a population-based study. BMC Geriatr 2024; 24:685. [PMID: 39143517 PMCID: PMC11323693 DOI: 10.1186/s12877-024-05211-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] [Received: 04/19/2024] [Accepted: 07/08/2024] [Indexed: 08/16/2024] Open
Abstract
BACKGROUND Although significant and disabling consequences are presented due to geriatric population-related depression, an insufficient comprehension of various biological, psychological, and social factors affecting this issue has been observed. Notably, these factors can contribute to geriatric population-related depression with low social support. This study aimed to identify factors associated with depression among the community-dwelling geriatric population with low social support in Malaysia. METHODS This study used secondary data from a population-based health survey in Malaysia, namely the National Health Morbidity Survey (NHMS) 2018: Elderly Health. The analysis included 926 community-dwelling geriatric population aged 60 and above with low social support. The primary data collection was from August to October 2018, using face-to-face interviews. This paper reported the analysis of depression as the dependent variable, while various biological, psychological and social factors, guided by established biopsychosocial models, were the independent variables. Multiple logistic regression was applied to identify the factors. Analysis was performed using the complex sampling module in the IBM SPSS version 29. RESULTS The weighted prevalence of depression among the community-dwelling geriatric population aged 60 and above with low social support was 22.5% (95% CI: 17.3-28.7). This was significantly higher than depression among the general geriatric Malaysian population. The factors associated with depression were being single, as compared to those married (aOR 2.010, 95% CI: 1.063-3.803, p: 0.031), having dementia, as opposed to the absence of the disease (aOR 3.717, 95% CI: 1.544-8.888, p: 0.003), and having a visual disability, as compared to regular visions (aOR 3.462, 95% CI: 1.504-7.972, p: 0.004). The analysis also revealed that a one-unit increase in control in life and self-realisation scores were associated with a 32.6% (aOR: 0.674, 95% CI: 0.599-0.759, p < 0.001) and 24.7% (aOR: 0.753, 95% CI: 0.671-0.846, p < 0.001) decrease in the likelihood of developing depression, respectively. CONCLUSION This study suggested that conducting depression screenings for the geriatric population with low social support could potentially prevent or improve the management of depression. The outcome could be achieved by considering the identified risk factors while implementing social activities, which enhanced control and self-fulfilment.
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Affiliation(s)
- Nur Zahirah Balqis-Ali
- Institute for Health Systems Research, National Institutes of Health, Ministry of Health, Selangor, Malaysia
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Norliza Ahmad
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia.
| | - Halimatus Sakdiah Minhat
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Ahmad Zaid Fattah Azman
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
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Cholli PA, Buchacz KM, Harris NS, Crim SM, Yuan X, Tie Y, Koenig LJ, Beer L. Self-rated health and HIV outcomes among adults with diagnosed HIV - Medical Monitoring Project, United States. AIDS 2024; 38:1237-1247. [PMID: 38507582 DOI: 10.1097/qad.0000000000003890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2024]
Abstract
OBJECTIVES To evaluate associations between self-rated health (SRH) and care outcomes among United States adults with diagnosed HIV infection. DESIGN We analyzed interview and medical record data collected during June 2020-May 2021 from the Medical Monitoring Project, a complex, nationally representative sample of 3692 people with HIV (PWH). Respondents reported SRH on a 5-point Likert type scale (poor to excellent), which we dichotomized into "good or better" and "poor or fair". We computed weighted percentages with 95% confidence intervals (CIs) and age-adjusted prevalence ratios (aPRs) to investigate associations between SRH and HIV outcomes and demographic, psychosocial, and behavioral characteristics. RESULTS Nationally, 72% of PWH reported "good or better" SRH. PWH with the following characteristics had a lower prevalence of "good or better" SRH, compared with those without: any missed HIV care appointment in the last 12 months (aPR 0.86, 95% CI: 0.81-0.91), symptoms of moderate or severe depression (aPR 0.51, 95% CI: 0.43-0.59) and anxiety (aPR 0.60, 95% CI: 0.54-0.68), unstable housing or homelessness (aPR 0.77, 95% CI: 0.71-0.82), and hunger or food insecurity (aPR 0.74, 95% CI: 0.69-0.80), as well as having a mean CD4 count <200 cells/mm 3 vs. CD4 + >500 cells/mm 3 (aPR 0.70, 95% CI: 0.57-0.86). CONCLUSIONS Though SRH is a holistic measure reflective of HIV outcomes, integrated approaches addressing needs beyond physical health are necessary to improve SRH among PWH in the United States. Modifiable factors like mental health, unstable housing or homelessness, and food insecurity warrant further study as potential high-yield targets for clinical and policy interventions to improve SRH among PWH.
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Affiliation(s)
- Preetam A Cholli
- Division of HIV Prevention, Centers for Disease Control and Prevention
- Epidemic Intelligence Service, Centers for Disease Control and Prevention
| | - Kate M Buchacz
- Division of HIV Prevention, Centers for Disease Control and Prevention
| | - Norma S Harris
- Division of HIV Prevention, Centers for Disease Control and Prevention
| | - Stacy M Crim
- Division of HIV Prevention, Centers for Disease Control and Prevention
| | - Xin Yuan
- DLH Corporation, Atlanta, GA, USA
| | - Yunfeng Tie
- Division of HIV Prevention, Centers for Disease Control and Prevention
| | - Linda J Koenig
- Division of HIV Prevention, Centers for Disease Control and Prevention
| | - Linda Beer
- Division of HIV Prevention, Centers for Disease Control and Prevention
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Rambukwella R, Westbury LD, Cooper C, Harvey NC, Dennison EM. Lifecourse correlates of self-rated health and associations with subsequent mortality: findings from the Hertfordshire Cohort Study. JOURNAL OF MEDICINE, SURGERY, AND PUBLIC HEALTH 2024; 2:None. [PMID: 38666141 PMCID: PMC11039436 DOI: 10.1016/j.glmedi.2024.100085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 03/08/2024] [Accepted: 03/08/2024] [Indexed: 04/28/2024]
Abstract
Background Poor self-rated health (SRH) has been shown to predict adverse health outcomes among older people, however these associations have traditionally only been considered at one point in the lifecourse, usually midlife or later. Here we examined lifecourse correlates of SRH in early, mid and later life, relating these to subsequent risk of mortality in a community-dwelling cohort. Methods 2989 men and women from the Hertfordshire Cohort Study (HCS) were included in this study. The HCS was initially retrospective and linked contemporary health outcome data to early life data available from health ledgers but investigations from baseline (1998-2004, aged 59-73) onwards have been prospective. At baseline, participants completed an initial clinic visit, which included questionnaire assessment of SRH, reported as 'excellent', 'very good', 'good', 'fair', or 'poor'. Socioeconomic, lifestyle, mental health and demographic information was also collected. Deaths were recorded from baseline to 31/12/2018. Baseline characteristics in relation to SRH were examined using sex-stratified ordinal logistic regression; these factors were examined in relation to mortality using sex-stratified Cox regression. Statistically significant exposures were then included in sex-stratified mutually-adjusted models. Results In mutually-adjusted analysis, numerous contemporaneous correlates of poorer SRH in the seventh decade were identified and included obesity, lower physical activity, greater comorbidity and higher levels of depression among men and women. For example, odds ratios for being in a lower category of SRH were as follows: obese (BMI≥30) vs underweight/healthy (BMI<25) (men 1.60 (1.21, 2.11), women 1.65 (1.25, 2.17)) and per additional system medicated (men 1.62 (1.47, 1.77), women 1.53 (1.41, 1.66)). By contrast, factors earlier in the lifecourse (early growth, age left full-time education) were not associated with SRH in late adulthood. 36% of men and 26% of women died during follow-up. Hazard ratios (95% CI) for mortality per lower category of SRH were 1.22 (1.10,1.36) among men and 1.17 (1.01,1.35) among women after adjustment for age, BMI, smoking, physical activity, diet quality, education, home ownership status, comorbidity level and depression levels, suggesting residual confounding by other unrecorded factors that are related to SRH. Conclusions Poorer SRH in the seventh decade was a risk factor for mortality. Importantly modifiable adverse health behaviours in the seventh decade, such as low physical activity, were associated with poorer SRH and later mortality after adjustment for socioeconomic factors and comorbidity level. By contrast early growth and education were not related to later SRH. These data suggest that attention to lifestyle in late midlife may be associated with better SRH and subsequent health outcomes, highlighting the value of intervention at this stage of the lifecourse.
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Affiliation(s)
- Roshan Rambukwella
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, United Kingdom
| | - Leo D. Westbury
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, United Kingdom
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, United Kingdom
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
- NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, United Kingdom
| | - Nicholas C. Harvey
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, United Kingdom
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Elaine M. Dennison
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, United Kingdom
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
- Victoria University of Wellington, Wellington, New Zealand
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Jung EJ, Cho SS, Lee HE, Min J, Jang TW, Kang MY. Association between social jetlag and self-rated health: Evidence from Korean representative working population. Sleep Med 2024; 114:86-91. [PMID: 38160581 DOI: 10.1016/j.sleep.2023.12.019] [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: 10/31/2023] [Revised: 12/12/2023] [Accepted: 12/21/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND Social jetlag is a circadian misalignment that arises from a discrepancy between activity/sleep schedules on school/work days and free days. This study explored the correlation between social jetlag and self-rated health (SRH) in a representative sample of Korea. METHODS This study included 8259 working population in the Korea National Health and Nutrition Examination Survey, 2016-2018. Social jetlag was calculated as the difference between the midpoint of sleep time on work day and work-free day. Five-point Likert scale of SRH was used to assess subjective health perception on general health conditions. Multiple logistic regression analysis was performed to calculate the odds ratios (ORs) and 95 % confidence interval (CI) for poor SRH in the 1-2 h or longer than 2 h social jetlag groups compared to that in the reference group (less than 1 h), after adjusting for age, sex, marital status, occupation, household income, and weekly working hours. RESULTS The proportions of those with <1 h, 1-2 h, >2 h of social jetlag were 63.80 %, 25.67 %, and 10.53 %, respectively. The risk of poor SRH increased as social jetlag increased. Greater social jetlag was significantly associated with an increased likelihood of reporting poor SRH. The adjusted ORs for the groups with social jetlag between 1 and <2 h, and >2 h were 1.100 (95 % CI = 0.935-1.295), and 1.503 (95 % CI = 1.097-1.727), respectively. Moreover, the OR trend was statistically significant (p for trend = 0.008). CONCLUSION This study found that social jetlag and poor SRH were significantly related in the Korean working population.
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Affiliation(s)
- En-Joo Jung
- Department of Public Health Center, Seoul National University Hospital, Seoul, Republic of Korea; Department of Preventive Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea
| | - Seong-Sik Cho
- Department of Occupational and Environmental Medicine, College of Medicine, Dong-A University, Busan, Republic of Korea
| | - Hye-Eun Lee
- Department of Social and Preventive Medicine, Hallym University College of Medicine, Chuncheon, Republic of Korea
| | - Jeehee Min
- Department of Occupational and Environmental Medicine, Hanyang University Hospital, Seoul, Republic of Korea
| | - Tae-Won Jang
- Department of Occupational and Environmental Medicine, Hanyang University College of Medicine, Seoul, Republic of Korea
| | - Mo-Yeol Kang
- Department of Occupational and Environmental Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
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Zadworna M. Effects of Wisdom on Mental Health in Old Age: Exploring the Pathways Through Developmental Tasks Attainment and Self-Rated Health. Psychol Res Behav Manag 2023; 16:4541-4554. [PMID: 37942442 PMCID: PMC10629457 DOI: 10.2147/prbm.s429918] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 10/16/2023] [Indexed: 11/10/2023] Open
Abstract
Purpose A number of studies indicate a relationship between wisdom and mental health in older adults, which can be explained by different pathways. However, the role of developmental task accomplishment, and of self-rated health in the relationships between wisdom and mental health in later life remain unclear. The aim of the current study is to explore the structure of the relationships between wisdom, developmental task attainment, self-rated health, and positive and negative mental health outcomes (viz. wellbeing and depressive symptoms) in older adults. Methods The study included 381 Polish older adults aged 60-86 (M= 67.33; SD = 5.08). The respondents completed the Personal Wellbeing Index, Geriatric Depression Scale, Three-Dimensional Wisdom Scale, Developmental Tasks Attainment Questionnaire for Seniors, self-rated health scale and sociodemographic survey. Results Three-dimensional wisdom, developmental task attainment and self-rated health scores were positive predictors of personal wellbeing and negative predictors of depressive symptoms in older adults. Structural equation modelling revealed that developmental tasks attainment and self-rated health partially mediated the relations between wisdom and mental health in older adults. Conclusion It can be assumed that wise older adults implement developmental tasks more efficiently and assess their subjective health more favorably, which may strengthen their personal wellbeing and prevent depression. The findings suggest that wisdom plays an important role in healthy aging.
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Affiliation(s)
- Magdalena Zadworna
- Institute of Psychology, Faculty of Educational Sciences, University of Lodz, Lodz, Poland
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Zhang Y, Jiang X. The relationship between walking ability, self-rated health, and depressive symptoms in middle-aged and elderly people after controlling demographic, health status, and lifestyle variables. Medicine (Baltimore) 2023; 102:e34403. [PMID: 37478208 PMCID: PMC10662912 DOI: 10.1097/md.0000000000034403] [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: 03/01/2023] [Accepted: 06/28/2023] [Indexed: 07/23/2023] Open
Abstract
The global aging problem is very serious. With the increase of age, the risk of depression in the elderly is also increasing. It is necessary to find effective strategies to reduce the depressive symptoms of the elderly. This study investigated the relationship between depressive symptoms, walking ability, and self-evaluation health of middle-aged and elderly Chinese after controlling demographic variables, health status, and lifestyle. The data is from the China health and retirement longitudinal study database in 2018. Six thousand eight hundred thirty-five people over the age of 50 have complete information on walking ability, self-assessed health status, and depressive symptoms. SPSS 27.0 software was used to conduct Z-test, logistic regression and linear hierarchical regression analysis on the collected data. The results showed that poor walking ability and poor self-evaluation health status of middle-aged and elderly people were significantly related to depression. The study concluded that middle-aged and elderly people with good walking ability and self-rated health status had a lower risk of depression. This study can provide reference for formulating specific and effective intervention measures for senile depression.
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Affiliation(s)
- Yaqun Zhang
- School of Sports Science, Anshan Normal University, Anshan, China
| | - Xin Jiang
- School of Physical Education, Dalian University, Dalian, China
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Wu Y, Zhang X, Yu T, Sui X, Li Y, Xu H, Zeng T, Leng X, Zhao L, Li F. Effects of reminiscence therapy combined with memory specificity training (RT-MeST) on depressive symptoms in older adults: a randomized controlled trial protocol. BMC Geriatr 2023; 23:398. [PMID: 37386362 PMCID: PMC10308705 DOI: 10.1186/s12877-023-03967-2] [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: 12/15/2022] [Accepted: 04/12/2023] [Indexed: 07/01/2023] Open
Abstract
BACKGROUND Geriatric depression has become a serious public health problem, and reduced autobiographical memory and increased overgeneral memory, as the main cognitive markers of depression, are not only associated with current depressive symptoms but also associated with the onset and course of depression, which can lead to a range of harms. Economic and effective psychological interventions are urgently needed. The aim of this study is to confirm the effectiveness of reminiscence therapy combined with memory specificity training in improving autobiographical memory and depressive symptoms in older adults. METHODS In this multicentre, single-blind, three-arm parallel randomized controlled study, we aim to enrol 78 older adults aged 65 years or older with a score of ≥ 11 on the Geriatric Depression Scale, and participants will be randomly assigned to either a reminiscence therapy group, a reminiscence therapy with memory specificity training group or a usual care group. Assessments will be conducted at baseline (T0) as well as immediately post-intervention (T1) and 1 (T2), 3 (T3) and 6 (T4) months post-intervention. The primary outcome measure is self-reported depressive symptoms, measured using the GDS. Secondary outcome measures include measures of autobiographical memory, rumination, and social engagement. DISCUSSION We believe that the intervention will play a positive role in improving autobiographical memory and depressive symptoms in older adults. Poor autobiographical memory is a predictor of depression and a major cognitive marker, and improving autobiographical memory is of great significance in alleviating depressive symptoms in older people. If our program is effective, it will provide a convenient and feasible strategy for further promoting healthy ageing. TRIAL REGISTRATION ChiCTR2200065446.
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Affiliation(s)
- Yuejin Wu
- School of Nursing, Jilin University, 965 Xinjiang Street, Changchun, 130012, China
| | - Xin Zhang
- School of Nursing, Jilin University, 965 Xinjiang Street, Changchun, 130012, China
| | - Tianzhuo Yu
- School of Nursing, Jilin University, 965 Xinjiang Street, Changchun, 130012, China
| | - Xin Sui
- School of Nursing, Jilin University, 965 Xinjiang Street, Changchun, 130012, China
| | - Yuewei Li
- School of Nursing, Jilin University, 965 Xinjiang Street, Changchun, 130012, China
| | - Haiyan Xu
- School of Nursing, Jilin University, 965 Xinjiang Street, Changchun, 130012, China
| | - Ting Zeng
- School of Nursing, Jilin University, 965 Xinjiang Street, Changchun, 130012, China
| | - Xin Leng
- School of Nursing, Jilin University, 965 Xinjiang Street, Changchun, 130012, China
| | - Lijing Zhao
- School of Nursing, Jilin University, 965 Xinjiang Street, Changchun, 130012, China.
| | - Feng Li
- School of Nursing, Jilin University, 965 Xinjiang Street, Changchun, 130012, China.
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Mennig EF, Schäfer SK, Eschweiler GW, Rapp MA, Thomas C, Wurm S. The relationship between pre-surgery self-rated health and changes in functional and mental health in older adults: insights from a prospective observational study. BMC Geriatr 2023; 23:203. [PMID: 37003994 PMCID: PMC10064967 DOI: 10.1186/s12877-023-03861-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 02/27/2023] [Indexed: 04/03/2023] Open
Abstract
BACKGROUND Elective surgeries are among the most common health stressors in later life and put a significant risk at functional and mental health, making them an important target of research into healthy aging and physical resilience. Large-scale longitudinal research mostly conducted in non-clinical samples provided support of the predictive value of self-rated health (SRH) for both functional and mental health. Thus, SRH may have the potential to predict favorable adaptation processes after significant health stressors, that is, physical resilience. So far, a study examining the interplay between SRH, functional and mental health and their relative importance for health changes in the context of health stressors was missing. The present study aimed at addressing this gap. METHODS We used prospective data of 1,580 inpatients (794 complete cases) aged 70 years or older of the PAWEL study, collected between October 2017 and May 2019 in Germany. Our analyses were based on SRH, functional health (Barthel Index) and self-reported mental health problems (PHQ-4) before and 12 months after major elective surgery. To examine changes and interrelationships in these health indicators, bivariate latent change score (BLCS) models were applied. RESULTS Our analyses provided evidence for improvements of SRH, functional and mental health from pre-to-post surgery. BLCS models based on complete cases and the total sample pointed to a complex interplay of SRH, functional health and mental health with bidirectional coupling effects. Better pre-surgery SRH was associated with improvements in functional and mental health, and better pre-surgery functional health and mental health were associated with improvements in SRH from pre-to-post surgery. Effects of pre-surgery SRH on changes in functional health were smaller than those of functional health on changes in SRH. CONCLUSIONS Meaningful changes of SRH, functional and mental health and their interplay could be depicted for the first time in a clinical setting. Our findings provide preliminary support for SRH as a physical resilience factor being associated with improvements in other health indicators after health stressors. Longitudinal studies with more timepoints are needed to fully understand the predictive value of SRH for multidimensional health. TRIAL REGISTRATION PAWEL study, German Clinical Trials Register, number DRKS00013311. Registered 10 November 2017 - Retrospectively registered, https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00013311 .
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Affiliation(s)
- Eva F Mennig
- Department of Prevention Research and Social Medicine, Institute for Community Medicine, University Medicine Greifswald, Walther-Rathenau-Strasse 48, 17475, Greifswald, Germany
- Department of Geriatric Psychiatry and Psychotherapy, Klinikum Stuttgart, Priessnitzweg 24, 70374, Stuttgart, Germany
| | - Sarah K Schäfer
- Department of Prevention Research and Social Medicine, Institute for Community Medicine, University Medicine Greifswald, Walther-Rathenau-Strasse 48, 17475, Greifswald, Germany
- Leibniz Institute for Resilience Research, Wallstrasse 7, 55122, Mainz, Germany
| | - Gerhard W Eschweiler
- Geriatric Center at the University Hospital Tübingen, University Hospital of Psychiatry and Psychotherapy Tübingen, Calwerstrasse 14, 72076, Tübingen, Germany
- Department of Psychiatry and Psychotherapy, University Hospital of Tübingen, Calwerstrasse 14, 72076, Tübingen, Germany
| | - Michael A Rapp
- Department of Social and Preventive Medicine, University of Potsdam, Am Neuen Palais 10, 14469, Potsdam, Germany
| | - Christine Thomas
- Department of Geriatric Psychiatry and Psychotherapy, Klinikum Stuttgart, Priessnitzweg 24, 70374, Stuttgart, Germany
- Department of Psychiatry and Psychotherapy, University Hospital of Tübingen, Calwerstrasse 14, 72076, Tübingen, Germany
| | - Susanne Wurm
- Department of Prevention Research and Social Medicine, Institute for Community Medicine, University Medicine Greifswald, Walther-Rathenau-Strasse 48, 17475, Greifswald, Germany.
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Hajek A, König HH, Buczak-Stec E, Blessmann M, Grupp K. Prevalence and Determinants of Depressive and Anxiety Symptoms among Transgender People: Results of a Survey. Healthcare (Basel) 2023; 11:healthcare11050705. [PMID: 36900710 PMCID: PMC10000997 DOI: 10.3390/healthcare11050705] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 02/23/2023] [Accepted: 02/24/2023] [Indexed: 03/06/2023] Open
Abstract
OBJECTIVES The aim was to investigate the prevalence of probable depression and probable anxiety and to investigate the determinants of depressive symptoms and anxiety symptoms among transgender people. METHODS In this "Transgender Survey" (n = 104) we included transgender people who had joined self-help groups to obtain and share information about the gender-affirming surgeries performed at the Division of Plastic, Reconstructive and Aesthetic Surgery at the University Medical Center Hamburg-Eppendorf. Data collection took place between April and October 2022. To measure probable depression, the patient health questionnaire-9 was used. The generalized anxiety disorder-7 was used to quantify probable anxiety. RESULTS The prevalence of probable depression was 33.3% and it was 29.6% for probable anxiety. Multiple linear regressions showed that both more depressive symptoms and anxiety symptoms were significantly associated with younger age (β = -0.16, p < 0.01; β = -0.14, p < 0.01), being unemployed (e.g., full-time employed compared to unemployment: β = -3.05, p < 0.05; β = -2.69, p < 0.05), worse self-rated health (β = -3.31, p < 0.001; β = -1.88, p < 0.05), and having at least one chronic disease (β = 3.71, p < 0.01; β = 2.61, p < 0.05). CONCLUSIONS Remarkably high prevalence rates were identified among transgender people. Furthermore, risk factors of poor mental health (e.g., unemployment or younger age) were identified-which can help to address transgender people at risk for poor mental health.
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Affiliation(s)
- André Hajek
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, 20246 Hamburg, Germany
- Correspondence:
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, 20246 Hamburg, Germany
| | - Elzbieta Buczak-Stec
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, 20246 Hamburg, Germany
| | - Marco Blessmann
- Division of Plastic, Reconstructive and Aesthetic Surgery, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Katharina Grupp
- Division of Plastic, Reconstructive and Aesthetic Surgery, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
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Milton-Cole R, Ayis S, O'Connell MDL, Smith T, Sheehan KJ. Trajectories of Depressive Symptoms Among Older Adults and in Adults With Hip Fracture: Analysis From the English Longitudinal Study of Ageing. J Gerontol A Biol Sci Med Sci 2022; 77:2453-2458. [PMID: 36073633 PMCID: PMC9799186 DOI: 10.1093/gerona/glac182] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND This study aimed to determine trajectories of depressive symptoms among older adults in England, overall and for those with hip fracture. The study aimed to explore the differential characteristics of each trajectory identified. METHODS Analysis of adults aged 60 years or more (n = 7 050), including a hip fracture subgroup (n = 384), from the English Longitudinal Study of Ageing. Latent class growth mixture modeling was completed. Depressive symptom prevalence was estimated at baseline. Chi-square tests were completed to compare baseline characteristics across trajectories. RESULTS Three trajectories of depressive symptoms (no, mild, and moderate-severe) were identified overall and for those with hip fracture. The moderate-severe trajectory comprised 13.7% and 7% of participants for overall and hip fracture populations, respectively. The proportion of participants with depressive symptoms in the moderate-severe trajectory was 65.4% and 85.2% for overall and hip fracture populations, respectively. Depressive symptoms were stable over time, with a weak trend toward increasing severity for the moderate-severe symptom trajectory. Participants in the moderate-severe symptom trajectory were older, more likely to be female, live alone, and had worse health measures than other trajectories (p < .001). CONCLUSIONS Older adults, and those with hip fracture, follow one of the 3 trajectories of depressive symptoms that are broadly stable over time. Depressive symptoms' prevalence was higher for those with hip fracture and, when present, the symptoms were more severe than the overall population. Results suggest a role of factors including age, gender, and marital status in depressive symptom trajectories.
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Affiliation(s)
- Rhian Milton-Cole
- Department of Population Health Sciences, School of Life Course and Population Sciences, King's College London, London, UK
| | - Salma Ayis
- Department of Population Health Sciences, School of Life Course and Population Sciences, King's College London, London, UK
| | - Matthew D L O'Connell
- Department of Population Health Sciences, School of Life Course and Population Sciences, King's College London, London, UK
| | - Toby Smith
- Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK
| | - Katie Jane Sheehan
- Department of Population Health Sciences, School of Life Course and Population Sciences, King's College London, London, UK
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11
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Rashmi R, Srivastava S, Muhammad T, Kumar M, Paul R. Indigenous population and major depressive disorder in later life: a study based on the data from Longitudinal Ageing Study in India. BMC Public Health 2022; 22:2258. [PMID: 36463131 PMCID: PMC9719225 DOI: 10.1186/s12889-022-14745-x] [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: 04/19/2022] [Accepted: 11/28/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Existing evidence suggests that the indigenous older population who live with their families and friends might experience lesser depressive symptoms due to better emotional support and well-being. The present study aimed to investigate the differentials in the prevalence of the major depressive disorder among tribal and non-tribal older populations in India and to explore the contribution of socio-demographic, health-related, and household factors in such disparities. METHODS A cross-sectional study was conducted using data from the Longitudinal Aging Study in India (2017-18). The analytical sample included 30,637 older adults, among whom 5,025 and 25,612 belonged to the Scheduled Tribe (ST) and non-Scheduled Tribe (non-ST) social groups, respectively. Major depressive disorder assessed by the Composite International Diagnostic Interview short-form (CIDI-SF) scale was the outcome variable. Descriptive statistics, bivariate and multivariable regression and, decomposition analyses were conducted. RESULTS About 4.8% and 8.9% of older adults from the ST and non-ST social groups had major depression. For both tribal and non-tribal groups, older adults who were unmarried, dissatisfied with living arrangements, and those who faced lifetime discrimination were at increased risk of major depression. Findings from differences due to characteristics (E) revealed that if the regional differences were minimized, it would decrease the ST-non-ST gap in major depression by about 19.6%. Similarly, equal self-rated health status and chronic conditions among ST and non-ST groups would decrease the gap in major depression by almost 9.6% and 7.9%, respectively. Additionally, an equal status of Instrumental Activities of Daily Living (IADL) and Activities of Daily Living (ADL) among older adults would decrease the gap in major depression by about 3.8% and 3% respectively. Also, findings from differences due to coefficients (C) revealed that if older adults from the ST group had the same status of ADL as of older adults from the non-ST group, it would decrease the gap in major depression by about 11.8%. CONCLUSION The findings revealed a greater prevalence of major depression in older adults belonging to the non-ST group than the ST group. For both tribal and non-tribal groups, older adults who were unmarried, dissatisfied with living arrangements, and those who faced lifetime discrimination were at increased risk of major depression and these factors along with health-related variables contributed to significant ST-non-ST gap in depression, advantageous to tribal population; suggesting further research on the coping mechanisms of mental illnesses among indigenous population in India.
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Affiliation(s)
- Rashmi Rashmi
- International Institute for Population Sciences, Mumbai, 400088 India
| | | | - T. Muhammad
- International Institute for Population Sciences, Mumbai, 400088 India
| | - Manish Kumar
- International Institute for Population Sciences, Mumbai, 400088 India
| | - Ronak Paul
- International Institute for Population Sciences, Mumbai, 400088 India
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12
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Yuan J, Wang Y, Liu Z. Chronic disease and depression among the elderly in China: the mediating role of instrumental activities of daily living and the moderating role of area of residence. CURRENT PSYCHOLOGY 2022; 42:1-8. [PMID: 36258891 PMCID: PMC9561327 DOI: 10.1007/s12144-022-03782-9] [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: 03/11/2022] [Revised: 09/08/2022] [Accepted: 09/15/2022] [Indexed: 12/02/2022]
Abstract
Chronic diseases are associated with depressive symptoms in older adults. However, the mechanism of this relation is not clear. In this study, we explored the mediating role of instrumental activities of daily living and the moderating role of area of residence in the relationship between chronic diseases and depression. The data was from the Chinese Longitudinal Healthy Longevity Study. Results showed that chronic diseases were positively correlated with depression, and negatively associated with instrumental activities of daily living (IADLs). Moreover, IADLs mediated the relationship between chronic diseases and depression. In addition, area of residence (rural/urban) moderated the relation between IADLs and depression, such that this negative relation was stronger for old adults lived in rural area than for urban area. These results have important significance for prevention and intervention of depression in the elderly.
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Affiliation(s)
- Jing Yuan
- School of Nursing, Hebei University, Baoding, Hebei China
| | - Yan Wang
- School of Nursing, Hebei University, Baoding, Hebei China
| | - Zejun Liu
- Department of Psychology, Educational College, Shanghai Normal University, Shanghai, China
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13
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Abdollahpour I, Golestannejad Z, Salimi Y, Nedjat S, Aguilar-Palacioc I, Mansournia MA, de Courten M. Joint Waterpipe and Cigarette Smoking as Key Correlate of History of Depression in Iranian Population: A Cross-Sectional Study. Tob Use Insights 2022; 15:1179173X221100402. [PMID: 35600561 PMCID: PMC9118885 DOI: 10.1177/1179173x221100402] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 04/25/2021] [Indexed: 11/15/2022] Open
Abstract
Research on the association between waterpipe smoking and depression is limited. This study aimed to explore the prevalence and adjusted associated correlates of depression among Iranian adult. We analyzed data from 974 participants of a population-based cross-sectional study enrolling 18-50-year-old residents of Tehran, Iran in 2015. Data on lifetime self-reported history of depression, smoking behaviors, socioeconomic status, self-rated health, physical activity, stressful life events as well as a number of relevant confounders was obtained. Logistic regression models were employed for estimating adjusted odds ratios (ORs) and their 95% confidence intervals (CI). The mean (SD) age of the study sample was 32.55 (8.58) years. Of 974 recruited adults, 52.36% were female. The lifetime prevalence of depression in the general population was 17.0%. In general, 21.77% and 24.79% of participant reported lifetime history of cigarette and waterpipe smoking, respectively. While only cigarette smoking (OR = 1.94, 95% CI: (1.04-3.61) and only waterpipe smoking (OR = 1.65, 95% CI: (.95-2.86) were significantly associated with depression, joint cigarette and waterpipe smoking (OR= 3.76, 95% CI: (1.99-6.08) was the strongest correlate of depression followed by female gender (OR = 3.28, 95% CI: (2.08-5.15) and poor self-rated health (OR = 2.47, 95% CI: (1.73-3.53). The prevalence of self-reported depression in general population of Tehran is considerably higher than its global mean. We reported joint cigarette and waterpipe smoking as a significant correlate with depression in the general population. Future health promotion interventions should highlight the disadvantages of joint cigarette and waterpipe smoking targeting adults and especially females.
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Affiliation(s)
- Ibrahim Abdollahpour
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Golestannejad
- Dental Research Center, Department of Oral and Maxillofacial Medicine, Dental Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Yahya Salimi
- Social Development and Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Department of Epidemiology, School of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Saharnaz Nedjat
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- Knowledge Utilization Research Center, Tehran University of Medical Science, Tehran, Iran
| | | | - Mohammad Ali Mansournia
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Maximilian de Courten
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
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14
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Wicke FS, Dinh TS, Riedel-Heller S, Weyerer S, König HH, Gensichen J, Schön G, Wegscheider K, Bickel H, Fuchs A, Schäfer I, van den Bussche H, Scherer M, Mergenthal K. Predictors of change in depressive symptoms in older and multimorbid patients: a longitudinal analysis of the multicare cohort. Aging Ment Health 2022; 26:818-827. [PMID: 33764211 DOI: 10.1080/13607863.2021.1902470] [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: 10/21/2022]
Abstract
BACKGROUND Depression in older adults is becoming an increasing concern. As depressive symptoms change over time, it is important to understand the determinants of change in depressive symptoms. The aim of our study is to use a longitudinal study design to explore the predictors of change, remission and incident depression in older patients with multimorbidity. METHODS Data from the MultiCare cohort study were used. The cohort studied 3,189 multimorbid general practice patients aged 65-85. Data were collected during personal interviews. Depressive symptoms were assessed using the Geriatric Depression Scale (GDS-15). Predictors of change in depressive symptoms were determined using multivariate linear regression, while multivariate logistic regression was used to analyze predictors of remission and incident depression. Models included depressive symptoms at baseline and follow-up, socio-demographics and data on health status and social support. RESULTS Overall, 2,746 participants with complete follow-up data were analyzed. Mean age was 74.2 years, 59.2% were female, and 11.3% were classified as depressed at baseline. Burden of multimorbidity and social support were statistically significant predictors in all regression analyses. Further predictors of change in depressive symptoms were: income, pain, nursing grade, self-rated health and self-efficacy. LIMITATIONS The sample size for prediction of remission limited statistical certainty. Assessment of depressive symptoms using GDS-15 differs from routine clinical diagnoses of depression. CONCLUSIONS Predictors of change in depressive symptoms in older multimorbid patients are similar to those predicting remission and incident depression, and do not seem to differ significantly from other older patient populations with depressive symptoms.
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Affiliation(s)
- Felix Sebastian Wicke
- Institute of General Practice, Goethe-University Frankfurt, Frankfurt am Main, Germany
| | - Truc Sophia Dinh
- Institute of General Practice, Goethe-University Frankfurt, Frankfurt am Main, Germany
| | - Steffi Riedel-Heller
- Institute for Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
| | - Siegfried Weyerer
- Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jochen Gensichen
- Institute of General Practice/Family Medicine, University Hospital of LMU Munich, Munich, Germany
| | - Gerhard Schön
- Department of Medical Biometry and Epidemiology, Center for Experimental Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Karl Wegscheider
- Department of Medical Biometry and Epidemiology, Center for Experimental Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Horst Bickel
- Department of Psychiatry, Technical University of Munich, Munich, Germany
| | - Angela Fuchs
- Institute of General Practice, Medical Faculty of the Heinrich Heine University Duesseldorf, Duesseldorf, Germany
| | - Ingmar Schäfer
- Department of Primary Medical Care, Center of Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hendrik van den Bussche
- Department of Primary Medical Care, Center of Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Martin Scherer
- Department of Primary Medical Care, Center of Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Karola Mergenthal
- Institute of General Practice, Goethe-University Frankfurt, Frankfurt am Main, Germany
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15
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Huang G, Guo F, Luo Y. Associations of depressive symptoms with disability-free life expectancy and self-assessed healthy life expectancy in middle-aged and older adults: results from a longitudinal population-based study in China. Arch Gerontol Geriatr 2022; 101:104670. [DOI: 10.1016/j.archger.2022.104670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 02/21/2022] [Accepted: 03/01/2022] [Indexed: 11/02/2022]
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16
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Tiilikainen E, Lisko I, Kekkonen E, Solomon A, Ngandu T, Kivipelto M, Kulmala J. Everyday Life Meaningfulness for the Community-Dwelling Oldest Old During the COVID-19 Pandemic. Front Psychol 2021; 12:716428. [PMID: 34566798 PMCID: PMC8459014 DOI: 10.3389/fpsyg.2021.716428] [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] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 08/16/2021] [Indexed: 11/13/2022] Open
Abstract
In many countries, the COVID-19 pandemic has led to strong restrictions and changed the everyday lives of older people. In Finland, people aged 70 and over were instructed to stay at home under quarantine-like conditions. Existing studies from other countries have reported increases in negative experiences and symptoms as a result of such restrictions, including psychosocial stress. However, little focus has been given to older people's experiences of meaningfulness during the pandemic. Using survey and interview data, we ask to what extent have community-dwelling oldest old (80+) experienced meaningfulness during the pandemic, what background factors are associated with meaningfulness and what factors have contributed to everyday life meaningfulness during the pandemic. The data was collected as part of the COVID-19 sub-study of the third follow-up of the Cardiovascular Risk Factors, Aging and Dementia (CAIDE85+) study, a Finnish population-based cohort study carried out in the eastern part of the country. In the quantitative analyses, meaningfulness was assessed as part of the Experiences of Social Inclusion Scale. The association of meaningfulness with different background factors (gender, age, living alone, self-chosen quarantine or physical isolation, self-rated health, physical functioning, and cognitive capacity) was explored with the Chi-square test. The quantitative findings indicate that the majority of the participants experienced meaningfulness during the pandemic. Participants who did not practice any physical isolation measures and participants with higher self-rated health experienced more meaningfulness. There was no evidence for difference in the prevalence of meaningfulness and other background factors. The qualitative data was analyzed using thematic analysis. The findings indicated that factors contributing to meaningfulness in everyday life were social contacts, daily chores and activities, familiar places and seasonal changes. The small sample size does not provide possibilities for generalizing the results into the wider population of older adults. However, the results provide new understanding of the oldest old's experiences of meaningfulness in everyday life during the global pandemic. The findings may help find ways to support older people's meaningfulness in challenging times.
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Affiliation(s)
- Elisa Tiilikainen
- Department of Social Sciences, University of Eastern Finland, Kuopio, Finland
| | - Inna Lisko
- Faculty of Sport and Health Sciences and Gerontology Research Center (GEREC), University of Jyväskylä, Jyväskylä, Finland.,Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Eija Kekkonen
- Institute of Clinical Medicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Alina Solomon
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Institute of Clinical Medicine, School of Medicine, University of Eastern Finland, Kuopio, Finland.,Ageing Epidemiology Research Unit, School of Public Health, Imperial College London, London, United Kingdom
| | - Tiia Ngandu
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Miia Kivipelto
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Ageing Epidemiology Research Unit, School of Public Health, Imperial College London, London, United Kingdom.,Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Helsinki, Finland
| | - Jenni Kulmala
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland.,Faculty of Social Sciences (Health Sciences) and Gerontology Research Center (GEREC), Tampere University, Tampere, Finland
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17
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Kang G, Hajduk A, Marottoli R, Nunez-Smith M. Older immigrants perceived health after migration to the United States: Influence of age and level of acculturation. J Am Geriatr Soc 2021; 69:2625-2637. [PMID: 34252200 PMCID: PMC8440395 DOI: 10.1111/jgs.17363] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 06/03/2021] [Accepted: 06/12/2021] [Indexed: 01/23/2023]
Abstract
OBJECTIVES To determine the age-related differences in the association between level of acculturation and perceptions about change in health status after migration in mid- to late-life immigrants. DESIGN Cross-sectional study. SETTING Nationally representative cohort of legal U.S. immigrants. PARTICIPANTS Legal immigrants ≥50 years of age. MEASUREMENTS The outcome was perceived change in health status, determined by the survey question, "compared with your health right before you most recently came to the United States to live, would you say that your health is better now, about the same or worse?" The main predictor included age group (50-64, 65-74, and ≥75 years) and secondary variable of interest was level of acculturation. Analyses were adjusted for demographic characteristics, medical, and functional comorbidities. RESULTS Immigrants age ≥75 years were more likely to report worse health after migration [RRR 1.93, 95% CI (1.17, 3.17), p < 0.01] compared with immigrants of 50-64 years, but this difference was not statistically significant in the adjusted model. Acculturation level was associated with increased likelihood of reporting worse health status, [RRR 2.10, (1.02, 4.35), p < 0.05] for somewhat acculturated and [RRR 2.55, (1.10, 5.88), p < 0.05] for most acculturated, compared with participants who were not acculturated. CONCLUSION The oldest immigrant group (≥75 years) was more likely to report worse health after migration, but this association was no longer significant after accounting for acculturation level and other covariates. Future work should be undertaken to identify specific health needs across older immigrant age groups and identify acculturative stressors that negatively impact health.
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Affiliation(s)
- Gina Kang
- University of Washington School of Medicine, Seattle, Washington
| | - Alexandra Hajduk
- Section of Geriatrics, Yale University School of Medicine, New Haven, Connecticut
| | - Richard Marottoli
- Section of Geriatrics, Yale University School of Medicine, New Haven, Connecticut
| | - Marcella Nunez-Smith
- Section of General Internal Medicine, Yale University School of Medicine, New Haven, Connecticut
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18
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Moss JL, Roy S, Clebak KT, Radico J, Sell J, Scartozzi C, Zhou S, Chi G, Oser T. Area- and Individual-Level Correlates of Self-Rated Health: Implications for Geographic Health Disparities. J Prim Care Community Health 2021; 12:21501327211039715. [PMID: 34412529 PMCID: PMC8381451 DOI: 10.1177/21501327211039715] [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] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Self-rated health (SRH) is a common measure of overall health. However, little is known about multilevel correlates of physical and mental SRH. METHODS Patients attending primary care clinics completed a survey before their appointment, which we linked to community data from American Community Survey and other sources (n = 455). We conducted multilevel logistic regression to assess correlates of excellent/very good versus good/fair/poor physical and mental SRH. RESULTS 43.9% of participants had excellent/very good physical SRH, and 55.2% had excellent/very good mental SRH. Physical SRH was associated with age (odds ratio[OR] = 0.82 per 10 years; 95% confidence interval[CI] = 0.72-0.93) and community correlates, including retail establishment density (OR = 0.94, 95% CI = 0.90-0.99) and percent of students eligible for free/reduced lunch (OR = 1.60, 95% CI = 1.08-2.38) (all P < .05). Mental SRH was not associated with any characteristics. CONCLUSIONS Practitioners in public health, social work, and medicine could use zip codes to intervene in patients and communities to improve physical SRH.
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Affiliation(s)
| | | | | | - Julie Radico
- Penn State College of Medicine, Hershey, PA, USA
| | - Jarrett Sell
- Penn State College of Medicine, Hershey, PA, USA
| | | | - Shuai Zhou
- The Pennsylvania State University, State College, PA, USA
| | - Guangqing Chi
- The Pennsylvania State University, State College, PA, USA
| | - Tamara Oser
- University of Colorado School of Medicine, Aurora, CO, USA
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19
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Peleg S, Nudelman G. Associations between self-rated health and depressive symptoms among older adults: Does age matter? Soc Sci Med 2021; 280:114024. [PMID: 34049050 DOI: 10.1016/j.socscimed.2021.114024] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 03/03/2021] [Accepted: 05/07/2021] [Indexed: 12/20/2022]
Abstract
OBJECTIVE It has been suggested that self-rated health (SRH), a construct of overall subjective health, is predicted by depressive symptoms. However, depressive symptoms were also found to predict SRH. The present study aimed to simultaneously examine these alternatives as well as test the potential moderating role of age. METHODS Data concerning self-reported measures from two consecutive waves of the Survey of Health, Aging and Retirement in Europe (SHARE) were examined by using a longitudinal cross-lagged panel analysis. RESULTS The model that included the effects of both paths, i.e. from SRH to depressive symptoms and from depressive symptoms to SRH, demonstrated better fit than models including one or no cross-lagged paths. However, the longitudinal effect of SRH on depressive symptoms was stronger than the longitudinal effect of depressive symptoms on SRH, particularly among adults aged 65-79. The longitudinal effect of depressive symptoms on SRH was stronger among individuals aged 80 and older, compared with younger ages. CONCLUSIONS Bidirectional effects may exist between SRH and depressive symptoms among adults aged 50 and older. Special attention should be paid to the unique effects of SRH on depressive symptoms in the years following retirement and also to depressive symptoms on SRH among the old-old.
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Affiliation(s)
- Shira Peleg
- The Israel Gerontological Data Center, The Hebrew University of Jerusalem, Jerusalem, Israel.
| | - Gabriel Nudelman
- Department of Psychology, The Academic College of Tel Aviv-Yaffo, Rabenu Yeruham St., P.O.B 8401 Yaffo, 6818211, Israel.
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20
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Liu S, Qiao Y, Wu Y, Shen Y, Ke C. The longitudinal relation between depressive symptoms and change in self-rated health: A nationwide cohort study. J Psychiatr Res 2021; 136:217-223. [PMID: 33618063 DOI: 10.1016/j.jpsychires.2021.02.039] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 02/04/2021] [Accepted: 02/12/2021] [Indexed: 10/22/2022]
Abstract
OBJECTIVE This study aimed to prospectively assess the relationship between depressive symptoms and change in self-rated health (SRH) in middle-aged and elderly Chinese adults. METHODS We used data from the China Health and Retirement Longitudinal Study (CHARLS). The final analysis included 8169 participants (≥45 years old) and a multinomial logistic regression model was used to assess the association between baseline depression and follow-up change in SRH. RESULTS Taking no change in SRH as the reference, depressive symptoms at baseline were positively associated with a 2-year decline in SRH (OR: 1.38, 95% CI: 1.15-1.65) and negatively associated with a 2-year improvement in SRH (OR: 0.74, 95% CI: 0.63-0.85). Over a 4-year period, the OR (95% CI) values increased to 1.41 (1.19-1.67) and decreased to 0.69 (0.59-0.80) for decline and improvement in SRH, respectively. In stratified analyses, the association between depression and 2- or 4-year decline/improvement in SRH persisted in all sex and age subgroups. CONCLUSIONS Baseline depression is an independent predictor of change in SRH among Chinese people aged 45 and above. Early monitoring and management of depressive symptoms may be worthwhile to maintain and improve SRH in the middle-aged and elderly population.
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Affiliation(s)
- Siyuan Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou, 215123, China
| | - Yanan Qiao
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou, 215123, China
| | - Ying Wu
- Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, 510515, China
| | - Yueping Shen
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou, 215123, China.
| | - Chaofu Ke
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou, 215123, China.
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Perceived Health among Adolescent and Young Adult Survivors of Childhood Cancer. ACTA ACUST UNITED AC 2021; 28:825-836. [PMID: 33562251 PMCID: PMC7985790 DOI: 10.3390/curroncol28010080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 01/29/2021] [Accepted: 02/03/2021] [Indexed: 11/27/2022]
Abstract
Survivors of childhood cancer (SCCs) are at increased risk of late effects, which are cancer- and treatment-related side-effects that are experienced months to years post-treatment and encapsulate a range of physical, cognitive and emotional problems including secondary malignancies. Perceived health can serve as an indicator of overall health. This study aims to (1) understand how a patient reported outcome (PRO) of perceived health of SCCs compares to controls who have not had a cancer diagnosis and (2) examine the relationships between perceived health and demographic and clinical variables, and health behavior. A total of 209 SCCs (n = 113 (54.10%) males; median age at diagnosis = 6.50 years; median time off treatment = 11.10 years; mean age at study = 19.00 years) were included. SCCs completed annual assessments as part of Long-Term Survivor Clinic appointments, including a question on perceived health answered on a five-point Likert scale. Data were collected retrospectively from medical charts. Perceived health of SCCs was compared to a control group (n = 836) using data from the 2014 Canadian Community Health Survey. Most SCCs (67%) reported excellent or very good health. The mean perceived health of SCCs (2.15 ± 0.91) was not statistically different from population controls (2.10 ± 0.87). Pain (B = 0.35; p < 0.001), physical activity (B = −0.39; p = 0.013) and concerns related to health resources (B = 0.59; p = 0.002) were significant predictors of perceived health. Factors shown to influence SCCs’ perceived health may inform interventions. Exploration into how SCCs develop their conception of health may be warranted.
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22
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Bamonti PM, Fiske A. Engaging in pleasant events explains the relation between physical disability and mental health outcomes in older adults. Aging Ment Health 2021; 25:225-233. [PMID: 31684753 DOI: 10.1080/13607863.2019.1683811] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVES This study expands the body of research examining mediators of the association between physical disability and mental health outcomes. Based on the behavioral model of depression, frequency of pleasant events were examined as a mediator between physical disability and mental health outcomes including depressive symptoms, meaning in life, and positive affect. We predicted that physical disability would have a significant indirect effect on mental health outcomes through the lower frequency of pleasant events. METHODS Cross-sectional study of 82 community-dwelling adults, Mage = 77.6, SD = 8.0, 64.6% female, was conducted. Self-report instruments measured frequency of pleasant events, physical disability, and mental health outcomes (depression symptoms, positive affect, and meaning in life). RESULTS Simple mediation analyses demonstrated a significant indirect effect of physical disability on depressive symptoms (unstandardized coefficient = 0.16, 95% bias-corrected CI 0.03, 0.41), positive affect (unstandardized coefficient = -2.65, 95% bias-corrected CI -5.38, -0.88), and meaning in life (unstandardized coefficient = -1.58, 95% bias-corrected CI -3.19, -0.47) through engagement in pleasant events. CONCLUSION Physical disability was associated with greater depressive symptoms and lower positive affect and meaning in life through reduced frequency of pleasant events. These findings are consistent with the behavioral model of depression and support several applied recommendations for reducing the burden of physical disability on mental health outcomes.
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Affiliation(s)
| | - Amy Fiske
- Department of Psychology, West Virginia University, Morgantown, WV, USA
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Abstract
OBJECTIVES Self-rated health is one of the most widely used measures in gerontology, but it has not been evaluated systematically in older adults with schizophrenia (OAS). Therefore, the aim of this study was to determine the utility of self-rated health in OAS by examining its influencing factors and contrasting these findings with a community comparison (CC) group. METHOD We compared 249 community-dwelling persons aged 55 years and older having a Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, diagnosis of schizophrenia arising before age 45 years with a demographically similar group of 113 older adults in the general community. Using a modified version of Ocampo's model of self-rated health, we identified 12 predictor variables within 5 dimensions. RESULTS There were no significant differences in self-health ratings between the OAS and the CC groups. Six of the 12 variables in the model significantly correlated with self-rated health in both groups. In linear regression analysis, three variables were significantly associated with self-rated health in both groups: Center for Epidemiological Studies-Depression score, number of physical disorders, and perception of self-health versus others. Self-rated health assessment was not associated with positive or negative symptoms or lack of awareness of mental illness. CONCLUSION There was a striking similarity in the factors influencing self-rated health in the two groups. The findings were consistent with results of previous gerontological studies that self-rated health reflects elements of psychiatric and physical well-being, as well as perceptions of their age peers. Our results support the use of self-rated health as a legitimate clinical and research measure in OAS.
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Tóth‐Király I, Morin AJ, Salmela‐Aro K. Reciprocal Associations between Burnout and Depression: An 8‐Year Longitudinal Study. APPLIED PSYCHOLOGY-AN INTERNATIONAL REVIEW-PSYCHOLOGIE APPLIQUEE-REVUE INTERNATIONALE 2021. [DOI: 10.1111/apps.12295] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Bu F, Steptoe A, Fancourt D. Relationship between loneliness, social isolation and modifiable risk factors for cardiovascular disease: a latent class analysis. J Epidemiol Community Health 2021; 75:749-754. [PMID: 33408162 PMCID: PMC8292586 DOI: 10.1136/jech-2020-215539] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Revised: 11/13/2020] [Accepted: 12/16/2020] [Indexed: 01/15/2023]
Abstract
Background There is growing research into the effects of psychological and social factors such as loneliness and isolation on cardiovascular disease (CVD). However, it is unclear whether individuals with particular clusters of CVD risk factors are more strongly affected by loneliness and isolation. This study aimed to identify latent clustering of modifiable risk factors among adults aged 50+ and explore the relationship between loneliness, social isolation and risk factor patterns. Methods Data from 8218 adults of English Longitudinal Study of Ageing were used in latent class analyses to identify latent classes of cardiovascular risk factors and predictors of class membership. Results There were four latent classes: low-risk (30.2%), high-risk (15.0%), clinical-risk (42.6%) and lifestyle-risk (12.2%) classes. Loneliness was associated with a greater risk of being in the high-risk class (relative risk ratio (RRR) 2.40, 95% CI 2.40 to 1.96) and lifestyle-risk class (RRR 1.36, 95% CI 1.10 to 1.67) and a lower risk of being in the clinical-risk class (RRR 0.84, 95% CI 0.72 to 0.98) relative to the low-risk class. Social disengagement, living alone and low social contact were also differentially associated with latent class memberships. Conclusion These findings supplement our existing knowledge of modifiable risk factors for CVD by showing how risk factors cluster together and how the risk patterns are related to social factors, offering important implications for clinical practice and preventive interventions.
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Affiliation(s)
- Feifei Bu
- Department of Behavioural Science and Health, University College London, London, UK
| | - Andrew Steptoe
- Department of Behavioural Science and Health, University College London, London, UK
| | - Daisy Fancourt
- Department of Behavioural Science and Health, University College London, London, UK
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Vaughan B, Fitzgerald K, Flesichmann M, Mulcahy J. The short-form Orebro Musculoskeletal Pain Questionnaire (OMPQ-10): Associations with determinants of health and demographics in a musculoskeletal pain cohort. INT J OSTEOPATH MED 2020. [DOI: 10.1016/j.ijosm.2020.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Attitudes toward aging, social support and depression among older adults: Difference by urban and rural areas in China. J Affect Disord 2020; 274:85-92. [PMID: 32469837 DOI: 10.1016/j.jad.2020.05.052] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2019] [Revised: 04/10/2020] [Accepted: 05/10/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND The specific impacts of attitudes toward aging on depressive symptoms have not been widely reported in previous studies in China. OBJECTIVES The aim is to examine the associations between attitudes toward aging, perceived social support, and depressive symptoms among older adults stratified by rural and urban dwelling. METHODS This study used a cross-sectional data including 7209 participants, among which 64.6% were urban adults and 35.4% were rural adults. Several multiple liner regression models were used to analysis the data. Three social support types were analyzed as moderators of the relationship between the attitudes toward aging and depressive symptoms. RESULTS Positive attitudes toward aging (β=-0.139, P<0.001), negative attitudes toward aging (β=0.284, P<0.001) were significantly associated with lower depressive symptoms among older Chinese adults. Support from family (β=-0.087, P<0.001), friends (β=-0.047, P<0.01) and the government (β=-0.035, P<0.01) were all significantly associated with urban older adults' levels of depressive symptoms. Only family support (β=-0.109, P<0.001) was associated with lower depressive symptoms among rural older adults'. In addition, family support buffered the effect of negative attitudes toward aging on depressive symptoms for all the older adults, while the moderation effects of support from friends and government only worked for urban elderly. LIMITATIONS A cross-sectional design is limited to establish causal associations. CONCLUSIONS Addressing depression among older adults should focus on improving attitudes toward aging and expanding the availability of social support. Moreover, deeper reforms are needed to address inequalities between urban and rural areas in China.
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Harris ML, Titler MG, Hoffman GJ. Associations Between Alzheimer's Disease and Related Dementias and Depressive Symptoms of Partner Caregivers. J Appl Gerontol 2020; 40:772-780. [PMID: 32865109 DOI: 10.1177/0733464820952252] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Family members-mainly spouses and partners-are the primary caregivers for individuals with Alzheimer's disease and related dementias (ADRDs), chronic progressive illnesses requiring increasing levels of care. We performed a retrospective observational analysis comparing depressive symptoms of 16,650 older individuals with partners without ADRDs, and those recently (within 2 years) or less recently diagnosed (≥2 years prior), controlling for lagged sociodemographic and health characteristics. The mean number of reported depressive symptoms was 1.2 (SD = 1.8). Compared with respondents with partners with no ADRD, having a partner with any ADRD was associated with a 0.35 increase (95% confidence interval [CI] = [0.30, 0.41]), or 30% increase, in depressive symptoms. A less recent partner diagnosis was associated with a 33% increase, while a recent diagnosis was associated with a 27% increase. Clinically meaningful and longitudinally worsening depressive symptoms amplify the need to prioritize partner health and family-centered care following an ADRD diagnosis.
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Mannion C, Hughes J, Moriarty F, Bennett K, Cahir C. Agreement between self-reported morbidity and pharmacy claims data for prescribed medications in an older community based population. BMC Geriatr 2020; 20:283. [PMID: 32778067 PMCID: PMC7419222 DOI: 10.1186/s12877-020-01684-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 07/29/2020] [Indexed: 11/21/2022] Open
Abstract
Background Studies have indicated variability around prevalence estimates of multimorbidity due to poor consensus regarding its definition and measurement. Medication-based measures of morbidity may be valuable resources in the primary-care setting where access to medical data can be limited. We compare the agreement between patient self-reported and medication-based morbidity; and examine potential patient-level predictors of discordance between these two measures of morbidity in an older (≥ 50 years) community-based population. Methods A retrospective cohort study was performed using national pharmacy claims data linked to The Irish LongituDinal study on Ageing (TILDA). Morbidity was measured by patient self-report (TILDA) and two medication-based measures, the Rx-Risk (< 65 years) and Rx-Risk-V (≥65 years), which classify drug claims into chronic disease classes. The kappa statistic measured agreement between self-reported and medication-based morbidity at the individual patient-level. Multivariate logistic regression was used to examine patient-level characteristics associated with discordance between measures of morbidity. Results Two thousand nine hundred twenty-five patients were included (< 65 years: N = 1095, 37.44%; and ≥ 65 years: N = 1830 62.56%). Hypertension and high cholesterol were the most prevalent self-reported morbidities in both age cohorts. Agreement was good or very good (κ = 0.61–0.81) for diabetes, osteoporosis and glaucoma; and moderate for high cholesterol, asthma, Parkinson’s and angina (κ = 0.44–0.56). All other conditions had fair or poor agreement. Age, gender, marital status, education, poor-delayed recall, depression and polypharmacy were significantly associated with discordance between morbidity measures. Conclusions Most conditions achieved only moderate or fair agreement between self-reported and medication-based morbidity. In order to improve the accuracy in prevalence estimates of multimorbidity, multiple measures of multimorbidity may be necessary. Future research should update the current Rx-Risk algorithms in-line with current treatment guidelines, and re-assess the feasibility of using these indices alone, or in combination with other methods, to yield more accurate estimates of multimorbidity.
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Affiliation(s)
- Clionadh Mannion
- Department of Pharmacology and Therapeutics, University of Dublin, Trinity College Dublin, Dublin, Ireland
| | - John Hughes
- Division of Population Health Sciences, Royal College of Surgeons in Ireland, Dublin 2, Ireland
| | - Frank Moriarty
- Health Research Board Centre for Primary Care Research, Royal College of Surgeons in Ireland, Dublin, Ireland.,The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland
| | - Kathleen Bennett
- Department of Pharmacology and Therapeutics, University of Dublin, Trinity College Dublin, Dublin, Ireland.,Division of Population Health Sciences, Royal College of Surgeons in Ireland, Dublin 2, Ireland
| | - Caitriona Cahir
- Division of Population Health Sciences, Royal College of Surgeons in Ireland, Dublin 2, Ireland.
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Abstract
Depression in old age deserves special attention in view of the fact of progressive population ageing, because of the way in which depression and risk factors interact in this period of life and the particularly negative impact of late-life depression on health and quality of life. This editorial aims to provide some insight into longitudinal aspects of depression in old age. Depression may follow varying trajectories (e.g. episode emergence, recurrence) across the lifespan. Late-life depression is not an exception. A symptom-based approach is presented as an appropriate research method to study the predictors and course of affective syndromes in old age. Findings from our studies on depressive symptom trajectories in old age revealed that participants with a course of unremitting elevated symptoms showed the highest levels of loneliness across the trajectory groups and that participants with subclinical symptoms also showed higher levels of loneliness than their counterparts with a minimal-symptom course trajectory. This highlights the need to address loneliness as a way of dealing with depression in old age.
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Bentur N, Heymann AD. Depressive symptoms and use of health services among older adults in Israel. Isr J Health Policy Res 2020; 9:15. [PMID: 32482166 PMCID: PMC7265633 DOI: 10.1186/s13584-020-00374-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 03/27/2020] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVES Depressive symptoms are often undetected, particularly among older adults. The purpose of this study is to provide information on the prevalence, characteristics, and patterns of depressive symptoms among older adults residing in the community in Israel, and their health-care utilization. METHODS A cross-sectional survey was conducted among a random sample of 2502 members of one HMO in Israel, aged 65+. They were interviewed by telephone with the GDS-15 scale, which serves as the gold standard for depressive symptoms. Data from the computerized medical records of the HMO were added to the interview file, including the diagnosis of depression, purchase of antidepressant medication and use of services. RESULTS The average age of respondents was 73; 54% were women. They tended to be older, living alone, suffering from falls and from sleep disorders, and to have poor subjective health status. 24% scored 6+ on the GDS scale. A significant association was found between a GDS score of 6+ and increased hospitalizations, visits to the emergency room and/or to family physicians and specialists. CONCLUSION We found a high prevalence of depression. Its negative effects on the individual and increased costs to the health system, supports the screening and treatment of the disease in the older population. This problem should be a national priority, with screening and treatment becoming part of the national quality of care indicators which would then be implemented by the HMOs as part of an integrated disease management program for the elderly.
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Affiliation(s)
- Netta Bentur
- Stanley Steyer School for Health Professionals, Tel-Aviv University, Tel Aviv, Israel
| | - Anthony David Heymann
- The Department of Family Medicine, The Sackler School of Medicine, University of Tel Aviv, Tel Aviv, Israel
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Kühn M, Díaz-Venegas C, Jasilionis D, Oksuzyan A. Gender differences in health in Havana versus in Mexico City and in the US Hispanic population. Eur J Ageing 2020; 18:217-226. [PMID: 34220403 PMCID: PMC8217427 DOI: 10.1007/s10433-020-00563-w] [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] [Indexed: 11/29/2022] Open
Abstract
Health progress in the 1960s and 1970s placed Cuba at the vanguard of longevity in Latin America and the Caribbean. This success has often been attributed to equity of access to the health care system and its cost-effectiveness in the country. Cuba also has a small gender gap in life expectancy. In this study, we examined how this pattern is reflected in the gender differences in health among the population aged 60+ in Havana. We compared gender differences in health in samples drawn from Havana, Mexico City, and the US Hispanic population: three geographic settings with very different political, health care, and social systems. The data come from the Survey on Health, Well-Being, and Aging in Latin America and the Caribbean and the 2000 Health and Retirement Study. Age-adjusted prevalence and logistic regressions were estimated for poor self-rated health, limitations on activities of daily living, depression, and mobility limitations. While an absolute female disadvantage in health was apparent in all three populations, the relative gender differences were inconsistent across all four health domains. Gender differences were most pronounced in Havana, even after adjusting for age, socio-economic status, family characteristics, and smoking behaviour. Despite having higher overall life expectancy and more equitable and universal access to primary care and preventive medicine, women in Havana appear to have a larger burden of ill health than women in less equitable societies. The study provides indirect evidence that Cuba faces challenges in combating the health threats posed by chronic diseases and other diseases and conditions common among the population aged 60+.
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Affiliation(s)
- Mine Kühn
- Max Planck Institute for Demographic Research, Konrad-Zuse Straße 1, 18057 Rostock, Germany
| | - Carlos Díaz-Venegas
- Max Planck Institute for Demographic Research, Konrad-Zuse Straße 1, 18057 Rostock, Germany
| | - Domantas Jasilionis
- Max Planck Institute for Demographic Research, Konrad-Zuse Straße 1, 18057 Rostock, Germany.,Demographic Research Centre, Vytautas Magnus University, Jonavos Str. 66-212, 44191 Kaunas, Lithuania
| | - Anna Oksuzyan
- Max Planck Institute for Demographic Research, Konrad-Zuse Straße 1, 18057 Rostock, Germany
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Chang Y, Noh JW, Cheon JY, Kim Y, Kwon YD, Ryu S. Self-rated health and risk of incident non-alcoholic fatty liver disease: A cohort study. Sci Rep 2020; 10:3826. [PMID: 32123241 PMCID: PMC7052149 DOI: 10.1038/s41598-020-60823-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 02/18/2020] [Indexed: 11/28/2022] Open
Abstract
Although self-rated health (SRH), a subjective measure of overall health status, associates with metabolic abnormalities, studies on the relationship between SRH and non-alcoholic fatty liver disease (NAFLD), a hepatic manifestation of metabolic syndrome, are limited. In this study, we evaluated whether or not SRH predicts the risk of incident NAFLD. This cohort study was performed in a sample of 148,313 Korean adults free of ultrasound-diagnosed NAFLD at baseline with annual or biennial follow-up for a median of 3.7 years. SRH and NAFLD were measured at baseline and follow-up visits. NAFLD was determined based on the ultrasound-diagnosed fatty liver without excessive alcohol consumption or any other cause. Hazard ratios with 95% confidence intervals were estimated via a parametric proportional hazards model. During 522,696.1 person-years of follow-up, 23,855 individuals with new-onset NAFLD were identified (incidence rate, 45.6 per 1,000 person-years). After adjustments for possible confounders including total calorie intake, sleep duration, and depressive symptoms, the multivariate-adjusted hazard ratios (95% confidence intervals) for incident NAFLD comparing good, fair, and poor or very poor SRH to very good SRH were 1.06 (0.97-1.14), 1.18 (1.09-1.27), and 1.24 (1.13-1.37), respectively. This association of SRH with incident NAFLD remained significant after accounting for changes in SRH and confounders during follow-up and was similar across clinically relevant subgroups. In a large-scale cohort study of apparently healthy Korean adults, poor SRH was independently and positively associated with incident NAFLD risk, indicating a predictive role of SRH as a health measure in NAFLD.
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Affiliation(s)
- Yoosoo Chang
- Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine Seoul, Seoul, Republic of Korea
- Department of Clinical Research Design & Evaluation, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea
| | - Jin-Won Noh
- Department of Health Administration, College of Health Science, Dankook University, Cheonan, Republic of Korea
- Institute of Health Promotion and Policy, Dankook University, Cheonan, Republic of Korea
- Global Health Unit, Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Joo Young Cheon
- Department of Nursing Science, Sungshin University, Seoul, Republic of Korea
| | - Yejin Kim
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine Seoul, Seoul, Republic of Korea
| | - Young Dae Kwon
- Department of Humanities and Social Medicine, College of Medicine and Catholic Institute for Healthcare Management, The Catholic University of Korea, Seoul, Republic of Korea
| | - Seungho Ryu
- Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine Seoul, Seoul, Republic of Korea.
- Department of Clinical Research Design & Evaluation, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea.
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Feenstra M, van Munster BC, MacNeil Vroomen JL, de Rooij SE, Smidt N. Trajectories of self-rated health in an older general population and their determinants: the Lifelines Cohort Study. BMJ Open 2020; 10:e035012. [PMID: 32075843 PMCID: PMC7045095 DOI: 10.1136/bmjopen-2019-035012] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 12/23/2019] [Accepted: 01/06/2020] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVES Poor self-rated health (SRH) is a strong predictor of premature mortality in older adults. Trajectories of poor SRH are associated with multimorbidity and unhealthy behaviours. Whether trajectories of SRH are associated with deviating physiological markers is unclear. This study identified trajectories of SRH and investigated the associations of trajectory membership with chronic diseases, health risk behaviours and physiological markers in community-dwelling older adults. STUDY DESIGN AND SETTING Prospective general population cohort. PARTICIPANTS Trajectories of SRH over 5 years were identified using data of 11 600 participants aged 65 years and older of the Lifelines Cohort Study. OUTCOME MEASURES Trajectories of SRH were the main outcome. Covariates included demographics (age, gender, education), chronic diseases, health-risk behaviour (physical activity, smoking, drinking) and physiological markers (body mass index, cardiovascular function, lung function, glucose metabolism, haematological condition, endocrine function, renal function, liver function and cognitive function). RESULTS Four stable trajectories were identified, including excellent (n=607, 6%), good (n=2111, 19%), moderate (n=7677, 65%) and poor SRH (n=1205, 10%). Being women (OR: 1.4; 95% CI: 1.0 to 1.9), low education (OR: 2.1; 95% CI: 1.5 to 3.0), one (OR: 10.4; 95% CI: 7.4 to 14.7) or multiple chronic diseases (OR: 37.8; 95% CI: 22.4 to 71.8), smoking (OR: 1.8; 95% CI: 1.0 to 3.2), physical inactivity (OR: 3.1; 95% CI: 1.8 to 5.2), alcohol abstinence (OR: 2.2; 95% CI: 1.4 to 3.2) and deviating physiological markers (OR: 1.5; 95% CI: 1.1 to 2.0) increase the odds for a higher probability of poor SRH trajectory membership compared with excellent SRH trajectory membership. CONCLUSION SRH of community-dwelling older adults is stable over time with the majority (65%) having moderate SRH. Older adults with higher probabilities of poor SRH often have unfavourable health status.
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Affiliation(s)
- Marlies Feenstra
- Department of Internal Medicine and Geriatrics, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Barbara C van Munster
- Department of Internal Medicine and Geriatrics, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Geriatrics, Gelre Hospitals, Apeldoorn, Gelderland, Netherlands
| | - Janet L MacNeil Vroomen
- Department of Internal Medicine, Section of Geriatric Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
- Section of Geriatrics, Department of Internal Medicine, School of Medicine, Yale University, New Haven, Connecticut, USA
| | - Sophia E de Rooij
- Department of Internal Medicine and Geriatrics, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Nynke Smidt
- Department of Internal Medicine and Geriatrics, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Determinants of self-rated health in older adults before and 3 months after an emergency department visit: a prospective study. Eur J Emerg Med 2020; 26:255-260. [PMID: 29384753 DOI: 10.1097/mej.0000000000000538] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Self-rated health (SRH) is an important patient-reported outcome, but little is known about SRH after a visit to the emergency department (ED). We investigated the determinants of decline in SRH during 3 months after an ED visit in older patients. DESIGN This was a multicenter prospective cohort study including acutely presenting older ( ≥ 70 years) patients in the ED (the Netherlands). Patients were asked to self-rate their health between 0 and 10. The main outcome was a decline in SRH defined as a transition of a SRH of at least 6 to a SRH of less than 6, 3 months after the patient's visit to the ED. RESULTS Three months after the ED visit, 870 (71.4%) patients had a stable SRH and 209 (11.5%) patients declined in SRH. Independent predictors with a decline in SRH were: male gender (OR 1.83) living alone (OR 1.56), living in residential care or nursing home (OR 2.75), number of different medications (OR 1.08), using a walking device (OR 1.70), and the Katz-ADL score (OR 1.22). Patients with functional decline 3 months after an ED visit show a steeper decline in the mean SRH (0.68 points) than patients with no functional decline (0.12 points, P < 0.001). CONCLUSION Decline in SRH after an ED visit in older patients is at least partly dependent on factors of functional capacity and functional decline. Preventive interventions to maintain functional status may be the solution to maintain SRH, but more research is needed to further improve and firmly establish the clinical usability of these findings.
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Lau YW, Vaingankar JA, Abdin E, Shafie S, Jeyagurunathan A, Zhang Y, Magadi H, Ng LL, Chong SA, Subramaniam M. Social support network typologies and their association with dementia and depression among older adults in Singapore: a cross-sectional analysis. BMJ Open 2019; 9:e025303. [PMID: 31154300 PMCID: PMC6549623 DOI: 10.1136/bmjopen-2018-025303] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES To examine the social support network type and its associations with depression and dementia among older adults in Singapore. DESIGN This study is a cross-sectional analysis of data from the Well-being of the Singapore Elderly study. The Practitioner Assessment of Network Type was used to identify five social support network types. Odds Ratios (OR) of dementia and depression were estimated with logistic regression and multinomial logistic regression, respectively, adjusted for sociodemographic variables. SETTING Singapore. OUTCOME MEASURES 10/66 criteria and Automated Geriatric Examination for Computer Assisted Taxonomy computer algorithm. PARTICIPANTS 2421 older adults aged 60 years and above, and their informants. RESULTS Logistic regression revealed that as compared with participants in the family dependent social support network type, those in the locally integrated social support network type were negatively associated with dementia. It was observed that it is the older adults' perception of the quality of social interaction that influences the likelihood of depression. CONCLUSION The social support network typology presents knowledge about the older adults' social network profile and their cognitive functioning-ability which would help stakeholders better identify older adults who might be at risk of cognitive decline or experiencing delay in diagnosis of dementia.
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Affiliation(s)
- Ying Wen Lau
- Research Division, Institute of Mental Health, Singapore, Singapore
| | | | - Edimansyah Abdin
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Saleha Shafie
- Research Division, Institute of Mental Health, Singapore, Singapore
| | | | - Yunjue Zhang
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Harish Magadi
- Department of Geriatric Psychiatry, Institute of Mental Health, Singapore, Singapore
| | - Li Ling Ng
- Psychological Medicine, Changi General Hospital, Singapore, Singapore
| | - Siow Ann Chong
- Research Division, Institute of Mental Health, Singapore, Singapore
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Abrams LR, Mehta NK. Changes in depressive symptoms over age among older Americans: Differences by gender, race/ethnicity, education, and birth cohort. SSM Popul Health 2019; 7:100399. [PMID: 31024986 PMCID: PMC6476127 DOI: 10.1016/j.ssmph.2019.100399] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 02/25/2019] [Accepted: 04/07/2019] [Indexed: 01/17/2023] Open
Abstract
Despite concerns about recent trends in the health and functioning of older Americans, little is known about dynamics of depression among recent cohorts of U.S. older adults and how these dynamics differ across sociodemographic groups. This study examined sociodemographic differences in mid- and late-life depressive symptoms over age, as well as changes over time. Using nationally representative data from the Health and Retirement Study (1994–2014), we estimated mixed effects models to generate depressive symptoms over age by gender, race/ethnicity, education, and birth cohort in 33,280 adults ages 51–90 years. Depressive symptoms were measured using the 8-item Center for Epidemiological Studies Depression scale. Women compared to men, low compared to high education groups, and racial/ethnic minorities compared to whites exhibited higher depressive symptoms. The largest disparity resulted from education, with those without high school degrees exhibiting over two more predicted depressive symptoms in midlife compared to those with college degrees. Importantly, war babies and baby boomers (born 1942–1959) exhibited slightly higher depressive symptoms with more decreasing symptoms over age than their predecessors (born 1931–1941) at ages 51–65. We additionally observed an age-as-leveler pattern by gender, whereby females compared to males had higher depressive symptomology from ages 51–85, but not at ages 86–90. Our findings have implication for gauging the aging population's overall well-being, for public health policies aimed at reducing health disparities, and for anticipating demand on an array of health and social services. Depressive symptoms in mid- and late-life are higher among socially disadvantaged groups. Education levels generated the largest sociodemographic disparity, especially in mid-life. Recent birth cohorts had higher symptoms with more declining curves than predecessors ages 51-65. Trajectories of depressive symptoms in sociodemographic subgroups converged at higher ages. Depressed mood and somatic complaints both rose in late life but men reported lower depressed mood.
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Affiliation(s)
- Leah R Abrams
- University of Michigan School of Public Health, Department of Health Management and Policy, 1415 Washington Heights, Ann Arbor, MI, 48109-2029, USA
| | - Neil K Mehta
- University of Michigan School of Public Health, Department of Health Management and Policy, 1415 Washington Heights, Ann Arbor, MI, 48109-2029, USA
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Lys R, Belanger E, Phillips SP. Improved mood despite worsening physical health in older adults: Findings from the International Mobility in Aging Study (IMIAS). PLoS One 2019; 14:e0214988. [PMID: 30958861 PMCID: PMC6453471 DOI: 10.1371/journal.pone.0214988] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 03/25/2019] [Indexed: 11/24/2022] Open
Abstract
Objectives Older adults experience increasing physical illness with age, but paradoxically, they frequently describe improvements in mood and self-rated health. The role of declining physical health as a risk for depression in elderly men and women remains unclear. We assessed whether declining physical health predicted changes in depression over time among seniors using data from the International Mobility in Aging Study (IMIAS). Methods IMIAS is a longitudinal population-based study of older adults in Canada, Colombia, and Brazil. We assessed change in depression by comparing Center for Epidemiology–Depression (CES-D) scores for 1161 men and women between 2012 and 2016, and used multiple regression to identify whether changes in chronic health conditions, grip strength and self-rated health predicted change in depression over time. Results Despite worsening physical health measured as chronic health conditions and grip strength, mean CES-D scores decreased from 8.15 (95% CI 7.70–8.60) in 2012 to 7.15 (95% CI 6.75 to 7.56) in 2016. Counterintuitively, women reported increased self-rated health despite having declining physical health, p = 0.004. Decreases in depressive symptoms were aligned with higher CES-D in 2012 and with increases in self-rated health among women and overall, and with high CES-D 2012 and increases in chronic health conditions in men, ps < 0.05. Conclusions Mental health appears to be a fundamentally different construct than physical health in older adults, allowing seniors to experience improved mood despite declining physical health. Clinicians should not consider depression in elderly populations as an inevitability of aging.
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Affiliation(s)
- Rebecca Lys
- School of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Emmanuelle Belanger
- Center for Gerontology and Healthcare Research, Department of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, Rhode Island, United States of America
| | - Susan P Phillips
- Family Medicine and Public Health Sciences, Queen's University, Kingston, Ontario, Canada
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Self-rated health and the risk of incident type 2 diabetes mellitus: A cohort study. Sci Rep 2019; 9:3697. [PMID: 30842537 PMCID: PMC6403398 DOI: 10.1038/s41598-019-40090-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 02/08/2019] [Indexed: 12/15/2022] Open
Abstract
We aimed to evaluate the association between self-rated health (SRH) and the risk of incident type 2 diabetes mellitus (T2D). This cohort study consisted of 250,805 Korean men and women without T2D at baseline. SRH was assessed at baseline with a self-administered structured questionnaire. Incident T2D was defined as fasting serum glucose ≥126 mg/dL, HbA1C ≥6.5%, or use of medication for T2D during follow-up. After adjustment for possible confounders including age, center, year of screening exam, smoking status, alcohol intake, physical activity, education level, total calorie intake, body mass index, sleep duration, depressive symptoms, family history of diabetes, history of hypertension, and history of cardiovascular disease, the multivariable-adjusted hazard ratios (95% confidence intervals) for incident T2D comparing good, fair, and poor or very poor SRH to very good SRH were 1.20 (0.98-1.48), 1.63 (1.33-1.98), and 1.83 (1.47-2.27), respectively. These associations were consistently observed in clinically relevant subgroups. Fair or poorer SRH was independently and positively associated with the development of T2D in a large-scale cohort study of apparently healthy Korean adults, indicating that SRH is a predictor of metabolic health. Physicians involved in diabetes screening and management should routinely consider SRH when evaluating T2D risk as well as overall health.
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Prevalence, clinical and psychosocial variables of depression, anxiety and suicidality in geriatric tertiary care settings. Asian J Psychiatr 2019; 41:38-44. [PMID: 30348596 DOI: 10.1016/j.ajp.2018.10.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2018] [Accepted: 10/01/2018] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The study investigated the prevalence of depressive and anxiety disorders and suicide risk in geriatric outpatients in tertiary care hospitals. MATERIALS AND METHODS An observational, cross-sectional study was conducted with 803 participants aged 60 and above attending geriatric outpatient clinics in tertiary care hospitals in Thailand. Participants were assessed using DSM-IV-TR criteria to calculate the prevalence of deressive and anxiety disorders, and their suicide risk. Montreal Cognitive Assessment (MoCA), Perceived Stress Scale (PSS), Multidimensional Scale of Perceived Social Support, Core Symptom Index (CSI), 15-item Geriatric Depression Scale (GDS-15), Neuroticism Inventory (NI) and the Revised Experience of Close Relationships Questionnaire (ECR-R) were administered. Quality of life was assessed using the EuroQoL (EQ-5D). RESULTS The prevalence rate for depressive disorders was 23.7%, anxiety disorders was 6.4%, and current suicide risk was 20.4%. PSS, MSPSS, GDS, CSI, and NI scores were significantly higher in all clinical disorders and a suicide group compared with nonclinical subjects. MoCA and ECR-R did not differentiate between clinical disorder and nonclinical samples. Comparing all four outcomes, the EQ-5D differed most in the mixed depressive-anxiety disorder and nonclinical groups (t = 12.20, p < .001). CONCLUSION The present findings revealed a high prevalence of depression, anxiety and suicidality among elderly patients attending tertiary care hospitals. Perceived stress, perceived social support, and neuroticism scores were significantly higher in this group. Role of sociodemographic, clinical and psychosocial variables as risk factors for these clinical disorders should be further examined.
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Han KM, Ko YH, Yoon HK, Han C, Ham BJ, Kim YK. Relationship of depression, chronic disease, self-rated health, and gender with health care utilization among community-living elderly. J Affect Disord 2018; 241:402-410. [PMID: 30145510 DOI: 10.1016/j.jad.2018.08.044] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 07/17/2018] [Accepted: 08/12/2018] [Indexed: 11/15/2022]
Abstract
BACKGROUND We investigated the interactive effects of depressive symptoms and chronic diseases on health care utilization among elderly people and explored the potential moderating effect of gender and the mediating effect of self-rated health (SRH) on the association between depressive symptoms and health care utilization. METHOD We analyzed data from 5223 people aged 60 years or older living in the community from the Korea Welfare Panel Study in 2015. Depressive symptoms were measured using an 11-item version of the Center for Epidemiologic Studies Depression (CES-D-11) Scale and morbidity within 28 disease categories was assessed. Health care utilization was evaluated as the number of outpatient visits (OV), number of hospitalizations (NH), and number of days spent in the hospital (DH) during past year. Hierarchical moderated regression analyses were applied to investigate the interactive effects. We also adopted the mediation analysis method by Hayes and Preacher. RESULTS A significant interactive effect of CES-D-11 score and chronic disease on OV was found. A positive correlation between CES-D-11 score and OV was only observed in those with chronic disease. Gender had a moderating effect on the association of depression symptoms with OV, NH, and DH among elderly people with chronic disease. SRH had mediating effects on the association of CES-D-11 with OV, NH, and DH only among those with chronic disease. LIMITATIONS The severity or multimorbidity of chronic diseases, which could affect health care utilization among elderly were not considered. CONCLUSIONS We elucidated the complex aspects of the relationship between depressive symptoms and chronic disease and their interactive effects on health care utilization among elderly people, and identified important roles of gender and SRH.
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Affiliation(s)
- Kyu-Man Han
- Department of Psychiatry, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Young-Hoon Ko
- Department of Psychiatry, Korea University Ansan Hospital, Korea University College of Medicine, 123 Jeokgeum-ro, Danwon-gu, Ansan, Republic of Korea.
| | - Ho-Kyoung Yoon
- Department of Psychiatry, Korea University Ansan Hospital, Korea University College of Medicine, 123 Jeokgeum-ro, Danwon-gu, Ansan, Republic of Korea
| | - Changsu Han
- Department of Psychiatry, Korea University Ansan Hospital, Korea University College of Medicine, 123 Jeokgeum-ro, Danwon-gu, Ansan, Republic of Korea
| | - Byung-Joo Ham
- Department of Psychiatry, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Yong-Ku Kim
- Department of Psychiatry, Korea University Ansan Hospital, Korea University College of Medicine, 123 Jeokgeum-ro, Danwon-gu, Ansan, Republic of Korea
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Jones JW, Ledermann T, Fauth EB. Self-rated health and depressive symptoms in older adults: A growth mixture modeling approach. Arch Gerontol Geriatr 2018; 79:137-144. [PMID: 30216775 DOI: 10.1016/j.archger.2018.08.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Revised: 07/16/2018] [Accepted: 08/28/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVE Self-Rated Health (SRH) and depressive symptoms are important indicators of global quality of life in older adults. Prior research suggests associations between SRH and depressive symptoms. The current study assessed latent groups in levels and trajectories of these two subjective health indicators and how the latent groups relate to each other. METHODS Participants from the Australian Longitudinal Study of Aging (N = 2,087, ages 65+) were assessed over six waves of data collection, spanning eight years. RESULTS Growth Mixture Models were run for SRH and depressive symptoms, each yielded three latent groups with similar patterns: for both SRH and depressive symptoms two groups differing in their level with worsening status over time, and a third stable, but poorer functioning group. Analysis of the assignment of the latent groups revealed a consistent pattern for the majority, but some people were high in depression and high in SRH and some were low in depression and low in SRH. CONCLUSIONS SRH and depressive symptoms yielded both three latent groups whose combination supported the expected assignment for the majority and an unexpected assignment for some people. This may be a result of a protective factor existing for one variable but not the other.
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Affiliation(s)
- Joseph W Jones
- Department of Psychology, Utah State University, United States.
| | - Thomas Ledermann
- Department of Family and Child Sciences, Florida State University, United States
| | - Elizabeth B Fauth
- Department of Human Development and Family Sciences, Utah State University, United States
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Walsh SE, LaJoie AS. Influence of Built Environment Quality and Social Capital on Mental Health of Residents of Assisted Living Communities in Louisville, Kentucky. Gerontol Geriatr Med 2018; 4:2333721418795900. [PMID: 30159360 PMCID: PMC6109847 DOI: 10.1177/2333721418795900] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 07/30/2018] [Accepted: 07/30/2018] [Indexed: 11/17/2022] Open
Abstract
Objectives: Prior research has shown social capital and built environment quality are associated with overall health status and the incidence of mental illness. This study explores the relationship between social capital, built environment, and quality of life specifically for assisted living residents, currently a gap in the literature. Method: A total of 76 assisted living residents were interviewed for the study using researcher-administered questionnaires. In addition, site audits were conducted to quantitatively evaluate the built environment surrounding 12 assisted living communities in the Louisville Metro region. Results: There was a moderate, positive correlation between social capital and mental health, r = .473, p < .001. Built environment quality for the neighborhood immediately surrounding the assisted living community was not significantly correlated with quality of life for assisted living residents. Other population characteristics, including demographic characteristics, self-rated health status, and instrumental activities of daily living were not significantly predictive of mental health scores. Conclusion: This study demonstrates that social capital is associated with happiness and self-rated quality of life. Specifically, increased social capital is associated with increased mental well-being for older adults residing in assisted living communities, with social capital explaining about 20% of the variation in quality of life scores.
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Peleg S, Drori E, Banai S, Finkelstein A, Shiloh S. The Dynamic Nature of Self-Assessed Health (SAH) as a Function of Negative and Positive Affects among Cardiac Patients. Appl Psychol Health Well Being 2018; 9:370-386. [PMID: 29171195 DOI: 10.1111/aphw.12099] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Self-assessed health (SAH) predicts health outcomes above and beyond medical variables. One of the explanations for this robust finding is the sensitivity of SAH to changes in multiple aspects of health, including emotional factors. We assessed the dynamic nature of SAH by longitudinally examining the associations between initial and change levels of SAH and positive affect (PA) and negative affect (NA). METHODS Participants were 138 cardiac patients undergoing coronary angioplasty. Self-report questionnaires measured SAH, PA, and NA, one day and one month after catheterisation. RESULTS Means of SAH and NA did not change between measurement points, but PA decreased. Cross-lagged analysis indicated that the best model for representing the data included a path from affect at hospitalisation to SAH one month later; that is, lower NA (but not PA) at hospitalisation predicted higher SAH a month later. A latent change model analysis also revealed that NA (but not PA) at hospitalisation predicted changes in SAH (but SAH did not predict changes in negative or positive affect); and that increases in positive affect and decreases in negative affect were linked to increases in SAH. CONCLUSIONS These findings highlight the importance of NA as an indicator of SAH and SAH change, and provide further insights into the dynamics of SAH in cardiac patients.
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Affiliation(s)
| | | | - Shmuel Banai
- Tel Aviv University, Israel.,Tel Aviv Sourasky Medical Center, Israel
| | - Ariel Finkelstein
- Tel Aviv University, Israel.,Tel Aviv Sourasky Medical Center, Israel
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Courtin E, Dowd JB, Avendano M. The Mental Health Benefits of Acquiring a Home in Older Age: A Fixed-Effects Analysis of Older US Adults. Am J Epidemiol 2018; 187:465-473. [PMID: 29020190 DOI: 10.1093/aje/kwx278] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 07/13/2017] [Indexed: 11/12/2022] Open
Abstract
Homeownership is consistently associated with better mental health, but whether becoming a homeowner in later in life has positive psychological benefits has not, to our knowledge, been examined. We assessed whether acquiring a home after age 50 years was associated with depression in a representative sample of older US adults. We used individual fixed-effects models based on data from 20,524 respondents aged ≥50 years from the Health and Retirement Study, who were interviewed biennially during 1993-2010. Depressive symptoms were measured using the 8-item Center for Epidemiologic Studies Depression Scale. Controlling for confounders, becoming a homeowner in later life predicted a decline in depressive symptoms in the same year (β = -0.0768, 95% confidence interval (CI): -0.152, -0.007). The association remained significant after 2 years (β = -0.0556, 95% CI: -0.134, -0.001) but weakened afterward. Buying a home for reasons associated with positive characteristics of the new house or neighborhood drove this association (β = -0.426, 95% CI: -0.786, -0.066), while acquiring a home for reasons associated with characteristics of the previous home or neighborhood, the desire to be closer to relatives, downsizing, or upsizing did not predict mental health improvements. Findings suggest that there are small but significant benefits for mental health associated with acquiring a home in older age.
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Affiliation(s)
- Emilie Courtin
- Department of Global Health and Social Medicine, King’s College London, London, United Kingdom
- Department of Social Policy, London School of Economics and Political Science, London, United Kingdom
| | - Jennifer B Dowd
- Department of Global Health and Social Medicine, King’s College London, London, United Kingdom
- CUNY Graduate School of Public Health and Health Policy, New York, New York
| | - Mauricio Avendano
- Department of Global Health and Social Medicine, King’s College London, London, United Kingdom
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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Owen-Smith AA, Gerth J, Sineath RC, Barzilay J, Becerra-Culqui TA, Getahun D, Giammattei S, Hunkeler E, Lash TL, Millman A, Nash R, Quinn VP, Robinson B, Roblin D, Sanchez T, Silverberg MJ, Tangpricha V, Valentine C, Winter S, Woodyatt C, Song Y, Goodman M. Association Between Gender Confirmation Treatments and Perceived Gender Congruence, Body Image Satisfaction, and Mental Health in a Cohort of Transgender Individuals. J Sex Med 2018; 15:591-600. [PMID: 29463478 DOI: 10.1016/j.jsxm.2018.01.017] [Citation(s) in RCA: 91] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 01/19/2018] [Accepted: 01/29/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND Transgender individuals sometimes seek gender confirmation treatments (GCT), including hormone therapy (HT) and/or surgical change of the chest and genitalia ("top" and "bottom" gender confirmation surgeries). These treatments may ameliorate distress resulting from the incongruence between one's physical appearance and gender identity. AIM The aim was to examine the degree to which individuals' body-gender congruence, body image satisfaction, depression, and anxiety differed by GCT groups in cohorts of transmasculine (TM) and transfeminine (TF) individuals. METHODS The Study of Transition, Outcomes, and Gender is a cohort study of transgender individuals recruited from 3 health plans located in Georgia, Northern California, and Southern California; cohort members were recruited to complete a survey between 2015-2017. Participants were asked about: history of GCT; body-gender congruence; body image satisfaction; depression; and anxiety. Participants were categorized as having received: (1) no GCT to date; (2) HT only; (3) top surgery; (4) partial bottom surgery; and (5) definitive bottom surgery. OUTCOMES Outcomes of interest included body-gender congruence, body image satisfaction, depression, and anxiety. RESULTS Of the 2,136 individuals invited to participate, 697 subjects (33%) completed the survey, including 347 TM and 350 TF individuals. The proportion of participants with low body-gender congruence scores was significantly higher in the "no treatment" group (prevalence ratio [PR] = 3.96, 95% CI 2.72-5.75) compared to the definitive bottom surgery group. The PR for depression comparing participants who reported no treatment relative to those who had definitive surgery was 1.94 (95% CI 1.42-2.66); the corresponding PR for anxiety was 4.33 (95% CI 1.83-10.54). CLINICAL TRANSLATION Withholding or delaying GCT until depression or anxiety have been treated may not be the optimal treatment course given the benefits of reduced levels of distress after undergoing these interventions. CONCLUSIONS Strengths include the well-defined sampling frame, which allowed correcting for non-response, a sample with approximately equal numbers of TF and TM participants, and the ability to combine data on HT and gender confirmation surgeries. Limitations include the cross-sectional design and the fact that participants may not be representative of the transgender population in the United States. Body-gender congruence and body image satisfaction were higher, and depression and anxiety were lower among individuals who had more extensive GCT compared to those who received less treatment or no treatment at all. Owen-Smith AA, Gerth J, Sineath RC, et al. Association Between Gender Confirmation Treatments and Perceived Gender Congruence, Body Image Satisfaction and Mental Health in a Cohort Of Transgender Individuals. J Sex Med 2018;15:591-600.
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Affiliation(s)
- Ashli A Owen-Smith
- Department of Health Management and Policy, School of Public Health, Georgia State University, Atlanta, GA; Center for Clinical and Outcomes Research, Kaiser Permanente Georgia, Atlanta, GA.
| | - Joseph Gerth
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | | | - Joshua Barzilay
- Center for Clinical and Outcomes Research, Kaiser Permanente Georgia, Atlanta, GA
| | - Tracy A Becerra-Culqui
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA
| | - Darios Getahun
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA
| | - Shawn Giammattei
- Rockway Institute, Alliant International University, San Francisco, CA
| | - Enid Hunkeler
- Emeritus, Division of Research, Kaiser Permanente Northern California, Oakland, CA
| | - Timothy L Lash
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Andrea Millman
- Division of Research, Kaiser Permanente Northern California, Oakland, CA
| | - Rebecca Nash
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Virginia P Quinn
- Emeritus, Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA
| | - Brandi Robinson
- Center for Clinical and Outcomes Research, Kaiser Permanente Georgia, Atlanta, GA
| | - Douglas Roblin
- Mid-Atlantic Permanente Research Institute, Kaiser Permanente Mid-Atlantic States, Rockville, MD
| | - Travis Sanchez
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | | | - Vin Tangpricha
- School of Medicine, Emory University, Atlanta, GA; Atlanta US Department of Veterans Affairs Medical Center, Atlanta, GA
| | - Cadence Valentine
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA
| | - Savannah Winter
- Center for Clinical and Outcomes Research, Kaiser Permanente Georgia, Atlanta, GA
| | - Cory Woodyatt
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Yongjia Song
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Michael Goodman
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
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Tsai KW, Lin SC, Koo M. Correlates of depressive symptoms in late middle-aged Taiwanese women: findings from the 2009 Taiwan National Health Interview Survey. BMC WOMENS HEALTH 2017; 17:103. [PMID: 29121892 PMCID: PMC5679489 DOI: 10.1186/s12905-017-0461-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Accepted: 10/31/2017] [Indexed: 01/06/2023]
Abstract
Background Previous studies have shown that depressive symptoms in middle-aged women were associated with a number of factors such as climacteric symptoms. Nevertheless, studies based on population-based data with a wide range of potential correlates are still scarce. Therefore, the aim of this study was to investigate the correlates of depressive symptoms in late middle-aged Taiwanese women using data from a nationally-representative, population-based survey. Methods Women aged 50.0–65.0 years were identified from the dataset of the 2009 Taiwan National Health Interview Survey. The outcome measure was depressive symptoms in the past week, evaluated using the Center for Epidemiologic Studies Short Depression Scale (CES-D 10) with a cut-off score of 10 or greater. Univariate and multiple logistic regression analyses were used to evaluate the correlates of depressive symptoms. Results The mean age of the 533 respondents was 56.7 years. Depressive symptoms were present in 53 respondents (9.9%). Multiple logistic regression analysis revealed that an education level of elementary school or below (adjusted odds ratio [AOR] = 3.19, P = 0.003), nulliparity (AOR = 8.10, P = 0.001), living alone (AOR = 5.47, P = 0.003), never having worked (AOR = 4.14, P = 0.008), lack of regular exercise (AOR = 3.01, P = 0.003), a perceived health status of fair or bad (AOR = 4.34, P < 0.001), and somatic climacteric symptoms (AOR = 2.32, P = 0.012) were independent and significant factors of depressive symptoms in late middle-aged Taiwanese women. Conclusions Findings from this secondary analysis of a population-based survey suggested independent associations of somatic climacteric symptoms, and a number of socio-demographic and health-related factors with depressive symptoms in late middle-aged Taiwanese women.
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Affiliation(s)
- Kun-Wei Tsai
- Division of Geriatrics, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Dalin, Chiayi, Taiwan
| | - Shih-Chun Lin
- Division of Geriatrics, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Dalin, Chiayi, Taiwan
| | - Malcolm Koo
- Department of Medical Research, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Dalin, Chiayi, Taiwan. .,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
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Benson PR. The impact of child and family stressors on the self-rated health of mothers of children with autism spectrum disorder: Associations with depressed mood over a 12-year period. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2017. [DOI: 10.1177/1362361317697656] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Employing a cohort sequential design and multilevel modeling, the effects of child and family stressors and maternal depressed mood on the self-rated health of 110 mothers of children with autism spectrum disorder were assessed over a 12-year period when children in the study were 7–19 years old. Findings indicate a significant decline in self-rated health over time. In addition, child and family stressors, as well as maternal depressed mood, exerted significant between-persons effects on self-rated health such that mothers who reported more stressors and depressed mood across the study period were less likely to rate themselves in better health across that period. In addition, a significant within-person relationship between maternal depressed mood and self-rated health was found, indicating that at times when mothers reported higher levels of depressed mood than usual (their personal average across the study), they were significantly less likely to report better self-rated health. Finally, maternal depressed mood partially mediated the between-persons effects of child and family stressors on self-rated health such that increased stressors led to increased maternal depressed mood which, in turn, led to poorer maternal self-rated health. Findings suggest that chronic stressors erode maternal health over time and that depression may be an important mechanism linking stressors to decreased maternal health.
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Self-rated health, multimorbidity and depression in Mexican older adults: Proposal and evaluation of a simple conceptual model. BIOMEDICA 2017; 37:92-103. [PMID: 28527271 DOI: 10.7705/biomedica.v37i3.3070] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2015] [Revised: 08/09/2016] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Self-rated health is an individual and subjective conceptualization involving the intersection of biological, social and psychological factors. It provides an invaluable and unique evaluation of a person's general health status. OBJECTIVE To propose and evaluate a simple conceptual model to understand self-rated health and its relationship to multimorbidity, disability and depressive symptoms in Mexican older adults. MATERIALS AND METHODS We conducted a cross-sectional study based on a national representative sample of 8,874 adults of 60 years of age and older. Self-perception of a positive health status was determined according to a Likert-type scale based on the question: "What do you think is your current health status?" Intermediate variables included multimorbidity, disability and depressive symptoms, as well as dichotomous exogenous variables (sex, having a partner, participation in decision-making and poverty). The proposed conceptual model was validated using a general structural equation model with a logit link function for positive self-rated health. RESULTS A direct association was found between multimorbidity and positive self-rated health (OR=0.48; 95% CI: 0.42-0.55), disability and positive self-rated health (OR=0.35; 95% CI: 0.30-0.40), depressive symptoms and positive self-rated health (OR=0.38; 95% CI: 0.34-0.43). The model also validated indirect associations between disability and depressive symptoms (OR=2.25; 95% CI: 2.01- 2.52), multimorbidity and depressive symptoms (OR=1.79; 95% CI: 1.61-2.00) and multimorbidity and disability (OR=1.98; 95% CI: 1.78-2.20). CONCLUSIONS A parsimonious theoretical model was empirically evaluated, which enabled identifying direct and indirect associations with positive self-rated health.
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Cheng C. Anticipated support from children and later-life health in the United States and China. Soc Sci Med 2017; 179:201-209. [PMID: 28288316 PMCID: PMC5396393 DOI: 10.1016/j.socscimed.2017.03.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Revised: 02/28/2017] [Accepted: 03/03/2017] [Indexed: 11/25/2022]
Abstract
Past research has shown that anticipated support, the belief that someone will provide support if needed, benefits health. Few studies considered whether the relationship between anticipated support and health depends on the source of such support. This project addresses this gap and examines how anticipated support from children is related to older parents' health and whether such support can be replaced by anticipated support from other relatives and friends. Ordered logit and negative binomial regression models with lagged health outcomes were estimated using nationally representative data from the 2010 and 2012 Health and Retirement Study and the 2011 and 2013 China Health and Retirement Longitudinal Study. Results suggest that anticipated support from children is related to older parents' better self-rated health and fewer depressive symptoms in both countries. In the U.S. where filial norms are relatively weak, anticipated support from others is no less important for health than anticipated support from children. However, in China where filial norms are relatively strong, parents anticipating support only from others are no different in health from those anticipating support from no one.
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Affiliation(s)
- Cheng Cheng
- Department of Sociology, Office of Population Research, Princeton University, 219 Wallace Hall, Princeton, NJ 08544, USA.
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